Critical access hospitals in five states are facing a spring deadline to apply for participation in a federal program aiming to develop and test new models of integrated, coordinated healthcare in rural communities.
CAHs in Alaska, Montana, Nevada, North Dakota and Wyoming have until May 5 to apply for participation in a three-year Medicare initiative called the Frontier Community Health Integration Project (FCHIP).
In collaboration with the Federal Office of Rural Health Policy in the Health Resources and Services Administration (HRSA), the Centers for Medicare & Medicaid Services (CMS) initiative has the of improving health outcomes and reducing Medicare expenditures in the rural counties of these states through integrated and coordinated care models.
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According to a CMS press release, CMS will support critical access hospitals in increasing access to services that are often unavailable in frontier communities with the goal of providing care in beneficiaries’ communities and avoiding expensive transfers to hospitals in larger communities. CMS will then evaluate whether providing these services in frontier communities can improve the quality of care received by Medicare beneficiaries, increase patient satisfaction and reduce Medicare expenditures.
Brock Slabach, senior vice president for member services at the National Rural Health Association (NHRA), explained that an initiative like FCHIP can be really beneficial to many CAHs because increasing access to healthcare services and integrating coordinated care are huge struggles for these hospitals.
“I think that rural hospitals are facing fiscal pressures that are causing them to look at their operations in different ways,” he said. “Fiscal pressures include declining volumes for traditional services and increased costs for providing those services. It’s also difficult for these hospitals to keep up with technology and improving the state-of-the-art care to populations in these remote places. So the combination of these factors creates a difficult environment for many rural hospitals.”
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According to a CMS webcast on Monday, applications for FCHIP is being accepted only from CAHs in Alaska, Montana, Nevada, North Dakota and Wyoming where at least 65 percent of the counties have six or fewer residents per square mile. Applicants must describe their intent in meeting community health needs in the specific areas of telemedicine, nursing facility care, home health services and ambulance services.
Another objective of the initiative is to decrease both the numbers of avoidable hospital admissions, readmissions and avoidable transfers to tertiary facilities so that there is no net increase in overall Medicare spending for the affected population, according to the CMS press release.
FCHIP is a potential “laboratory” in experimentation for potential models for rural health, noted Slabach.
“I think we need even more laboratories of experimentation like this,” he said. “My biggest concern for the next 10 years is that we, hopefully, don’t put large numbers of rural providers at risk for their survival as our healthcare system transitions out of pay-for-service models. We need to see changes in how we move forward and in a way that doesn’t decimate rural health in the meantime.”
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