Post on 05-Jan-2016
transcript
ISSUES IN RURAL HEALTH PLANNING
WEBINAR 2 THURSDAY, JULY 21, 2011
1:00 – 2:00 PM
UNDERSTAND THE PROS AND CONS OF RURAL HEALTH
CLINICS
Learning Objectives
Understand the role and function of a Rural Health Clinic
Identify the primary benefits of opening a Rural Health Clinic
Learn the process of being certified as a Rural Health Clinic
Explore the downside of opening a Rural Health Clinic
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Definition of a RHC
Established through Public Law 95-210, the Rural Health Clinic Services Act, 1977, to increase the provision of primary care services for Medicare and Medicaid patients residing in rural communities.
RHC can be provider-based or independent (freestanding).
Provider-Based: integral part of a hospital, nursing home, home health agency
Independent: stand alone clinics
Status can be public, private, or not-for-profit
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Requirements for a RHC
Staffed with a mid-level practitioner practicing at least 50% of the time
Provide basic laboratory services
Develop written clinical protocols and operational policies and procedures
Conduct an annual evaluation
Gain certification by Medicare
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RHC Location Requirements
Must be in a Health Professional Shortage Area (HPSA) or Geographic Primary Care or
Must be in a Medically Underserved Area/Population (MUA/P)
Designation must be less than 3 years old
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Benefits of Opening a Rural Health Clinic
Potential of significant higher reimbursement (looking at all payors in the aggregate)
Increased coordination between hospital and physicians
Increased clinical integration with hospital
Greater flexibility in financing and efficiencies with administration and shared staff
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Potential Downsides of Operating a RHC
Increased costs related to hospital wage and benefits
More facility costs
Less effective cost management
Decreased physician control of practice staff
Less control of financial accountability and productivity
Steps Necessary for RHC Certification
Confirm site eligibility Evaluate financial feasibility Assess cost of hiring needed staff Complete a RHC application and a CMS provider
enrollment form Receive RHC certification inspection by ADHS File a CMS cost report to have the Medicare rate
determined
Current RHC Reimbursement Rate ??
Current RHC maximum encounter rate - $78.07
Important Resources
Center for Medicare and Medicaid Web Site: https://www.cms.gov/center/rural.asp
National Association of Rural Health Clinics Web Site: www.narhc.org Listserve:
http://www.narhc.org/members/members_listserve.php
Rural Assistance Center Web Site: www.raconline.org Toll Free #: 1.800.270.1898
Revised Arizona Rural Health Clinic Manual, 2011 (available soon)
Questions + Contacts
Connie Belden, Team Leader, ADHS Licensing Connie.Belden@azdhs.gov
Joyce Hospodar, Rural Health Office hospodar@u.arizona.edu; 520.626.2432
Ron Smith, CFO, Wickenburg Community Hospital Ron.Smith@wickhosp.com; 928.684.5421
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