Another annual conference has come and gone, and those who attended said it was the best mix of information and networking they had experienced thus far. The meeting got off to a soggy start as high winds and heavy rain shut down the local airports and made travel to Dallas difficult, and in some cases impossible. However, that didn’t dampen our spirits and those who braved the high seas were treated to some great speakers and an exuberant opening night reception.
      All three of our keynote speakers left a deep impression on the audience as they delved into performance improvement, customer service and change management. Handling these three areas well is what moves organizations from average to ‘Super’, which was the theme of this year’s conference. Another goal of this year’s meeting was to encourage hospitals to carry a message back to their community members that rural healthcare is every bit as good, if not better than the care that is being delivered in urban settings. Hospital CEOs, executives, trustees and other staff left the meeting with more tools in their toolbox than ever before.
       Our trade show was the biggest it has ever been, in spite of the weather it included a full complement of exhibits from 112 vendors, 12 non-profit organizations and an additional 27 sponsoring companies that came to participate in the largest trade show specifically for rural hospitals in the Southwest. We pride ourselves on creating a place where hospital leaders and corporate representatives can exchange ideas and information in a relaxed manner. This is by far the number one reason to attend every year. Where else can you find the new opportunities you are seeking and visit with 140 dedicated companies who want to assist you with strengthening your business?
      As with all of TORCH’s meetings and conferences, our success depends ultimately on your participation. However, recordings of the general and concurrent sessions will be available soon on DVD and at Health.edu. A big thanks to Texas Tech University HealthNet for taping our education sessions again this year.
       The staff, volunteers, sponsors and exhibitors thank you for attending the 2008 Texas Conference of Rural and Community Hospitals. Be on the lookout for an announcement coming soon so that you can plan your attendance next year well in advance. We sure hope that you all had a ‘Super’ time at the TORCH Annual Conference in 2008.
      A list of the 2008 Exhibitors and Sponsors is included below.

 The TORCH Media Success Award was presented to both Lavaca Medical Center and the Hallettsville Tribune Herald at the TORCH Annual Awards Luncheon held in Dallas on March 19th. On hand to receive the awards was James Vanek, CEO, Lavaca Medical Center. Each entity received a matching plaque to symbolize the ongoing partnership that these organizations have developed within their local community.
      Hospitals depend on the local media to share news and information about changes taking place within the healthcare industry. Local newspapers as well as radio and television stations are also an important part of any successful public relations campaign. The Texas Organization of Rural & Community Hospitals developed the TORCH Media Success Awards to recognize local media for its role in advocating for rural and community hospitals. This year’s winners did an outstanding job of informing the citizens of Hallettsville and Lavaca County about the good things taking place at their local hospital.
      David Pearson, President/CEO of TORCH, said “It is a pleasure to present this year’s Media Success Awards to such deserving institutions. Newspapers and hospitals are the bedrock of the community and when they cooperate effectively, great things can happen.” Jim Buckner, Chair of the TORCH Board of Directors and CEO of the Uvalde Memorial Hospital, said “Congratulations to Lavaca Medical Center and the Hallettsville Tribune Herald for working to improve communications and the understanding of rural hospitals. We hope to encourage more rural hospitals to reach out to the local media and tell their story.”
       The TORCH Board of Directors and staff congratulate both organizations for their efforts to inform and enlighten the citizens of Hallettsville about the great work that Lavaca Medical Center is doing.

Apparently driven by the rising price of silver, several attempted thefts of old x-ray film have been reported by TORCH member hospitals. Hamilton in Olney, Frio Regional in Pearsall, and Nocona General Hospital all report very similar incidents in March where persons arrived at the hospital claiming to be with the x-ray salvage company.
      In all three cases, the theft was thwarted by hospital employees questioning the persons. There are also reports of similar attempts at other hospitals. The theft of processed x-ray film from hospitals is not new. In the last few decades this problem has occurred when the price of silver reaches a high point. Thefts have been reported in the past involving both scam x-ray pickup couriers and hospital employees.
      Hospital administrators should alert appropriate hospital employees to this potential theft issue and verify that used x-ray film is secured. Any hospital that becomes the victim of such a theft or attempted theft should immediately notify local law enforcement. As this is most likely a larger organized theft ring, hospitals should also request that local law enforcement notify the Texas Rangers.

The Texas A&M Health Science Center School of Rural Public Health recently celebrated National Public Health Week and their 10-year anniversary on Saturday, April 5, 2008. On Saturday evening, the HSC-SRPH held its 10-year anniversary celebration at the George Bush Presidential Library and Conference Center. A wine-and-cheese hour began at 5:30 p.m., accompanied by library tours. The formal dinner and recognition program started at 7:00 pm.
      After dinner, the School presented awards to several people and organizations in recognition of their commitment to public health. Public Health Champion awards were presented to the Texas Organization of Rural & Community Hospitals; the late John F. Boff, founder and first President/CEO of TORCH; Harrison C. Spencer, M.D., M.P.H., president and CEO of the Association of Schools of Public Health; Phillip D. Robinson, chairman of the Charter Development Council; Don Strickland, first chair of the Brazos Valley Health Partnership; Chevron.
      David Pearson and Susan Reed were on hand to receive the award for TORCH. Paul and Devon Boff and their son Brayden received the award for John. Each recipient was presented a medallion emblazoned with the Texas A&M University seal and an inscription that recognized TORCH and John for their contributions to public health improvement in the State of Texas. Both Dr. Mike McKinney, Chancellor of the Texas A&M University System, and Dr. Nancy Dickey, Dean of the Texas A&M Health Science Center, were present to recognize Dr. Ciro Sumaya for his leadership role at the School of Rural Public Health. Many state and local dignitaries were on hand to recognize the SRPH for its work.
      The Texas A&M Health Science Center provides the state with health education, outreach and research. Its seven colleges located in communities throughout Texas are Baylor College of Dentistry, the College of Medicine, the College of Nursing, the Graduate School of Biomedical Sciences, the Institute of Biosciences and Technology, the Irma Lerma Rangel College of Pharmacy, and the School of Rural Public Health.

This meeting is being co-sponsored by Rees Associates, Inc., and TORCH and will be taking place June 5, 2008, at the Marriott Dallas Las Colinas. We are pleased to make available this workshop designed specifically for rural hospitals. Through the cooperative efforts of Rees Associates in bringing the concept to us and working jointly to develop the program, and their sponsorship generosity, we are able to offer this affordable workshop to provide a wide scope of information to help hospital administrators and trustees make informed decisions about their hospital’s facility needs.

Content: This all-day workshop has knowledgeable speakers presenting a comprehensive agenda including:

• Strategic / Master Planning - Market Study/Needs Analysis; Debt Capacity Study; Pre-Design Process; Staff/Physician Recruitment Plan
• Public Relations / Outreach Plan - Community Support Plan; Fund Raising Plan; Furniture/Fixtures and Equipment Donation Plan; Land Donation Plan
• Financing - Financing Plan; Options; Financing Implementation
• Design and Construction Process - Architecture, Engineering, Interiors; Furniture, Fixtures and Medical Equipment; Construction and Delivery Options; Commissioning of the Facility
• Occupancy and Post Construction - Celebration Planning; Staff Training; Move-In Planning; Occupancy; Post Occupancy Evaluation

Schedule: 8:15 am to 4:00 pm; breakfast, lunch, refreshments and syllabus provided.
Location: The hotel is located at 223 West Las Colinas Blvd., Irving, Texas 75039. To make reservations for the evening of June 4 at the special $135 TORCH rate call the hotel directly at 972-831-0000, call before May 19th.
       Make plans NOW to participate in this workshop tailor-made for the scores of Texas rural hospitals in need of significant facility improvements. Watch your mail for the program brochure with complete speaker and program information and registration form.

Super Hospitals have Super (Healthy, Happy and Productive) Employees. By proactively addressing wellness, Super Hospitals can save money, improve morale, reduce turnover, promote their brand and reinforce their role as the leading wellness resource in their service area.
      TORCH has partnered with the LoneStart Wellness Initiative so your hospital can realize the many benefits of a proven employee wellness challenge. We have a unique opportunity to show Texas and the nation that by word and deed, we are committed to improving the health of our employees, their families and our communities. We will demonstrate that we have the vision and the ability to address the urgent issues of overweight, obesity and inactivity in our nation.

Participating hospitals will:

• Receive a 66 percent discount on the LoneStart Team Esteem Wellness Challenge
• Be eligible to compete for the first annual TORCH Super Hospital Wellness Challenge Trophy
• Be recognized at next year’s Annual Conference
• Be mentioned in a “spotlight” article in the TORCH “Frontline” newsletter
• Benefit from local, state and national press releases promoting this challenge

To take part, call LoneStart at: 512-894-3440, or go to http://www.lonestartnow.com/contact.html, click information@LoneStartNow.com and type “Torch Challenge” into the subject line.
       In order to receive the 66% TORCH member discount, you must commit to a 50 employee minimum at $50 per employee. (All additional employees will be billed at $40 per employee). A full proposal outlining the program and Contract for Services will be emailed to you. The Contract for Services should be signed and returned with the initial payment.
      On-site Challenge Start Meetings will be conducted in May, June and July. Results will be announced on September 15, 2008. For additional information about LoneStart, visit www.lonestartnow.com, or call Jay Seifert with the LoneStart Wellness Initiative at 512-894-3440.
      Together we’ll prove that TORCH Super Hospitals are the wellness leaders in Texas and in the nation!

Sometimes it seems as though we’re being bombarded on all sides. Such has been the case for most of the early part of this year. The state is seeking a Medicaid waiver to be able to restructure Medicaid in order to create a funding pool that would provide premium subsidies for those Texans who can’t afford health insurance. Unfortunately, the mechanism that the state planned to use as seed money for this new program would have erased any benefit hospitals would have received from the Medicaid rate rebasing that was passed during the last regular session.
      Eventually, questions about the value of the proposed insurance benefit, provider payment rates that were equal to the Medicaid program and the potential destabilizing effect that the new payment mechanism might have on hospitals led the Health and Human Services Commission to scrap their plans to roll out Phase I of the program to the parents of CHIP-eligible children by September.
      HHSC has instead promised to wrap up their work with CMS regarding the 1115 waiver and proceed with implementing the funding of the pool and then schedule a rollout to the entire eligible population in 2009 or 2010. The Commission has also committed to trying to ensure that providers would be held truly harmless (dollar for dollar) during the startup period.
      Once the new approach becomes clearer, our challenge again will be to try and assess any negative impact on member hospitals before the program goes public. However, HHSC staff has promised to meet more regularly with the various stakeholder groups, including TORCH, to continue gathering feedback and ensure their understanding and support for the overall reform process.

Congress has been considering several pieces of legislation designed to halt the effects of several rules that CMS designed to cut payments to hospitals and reduce costs associated with IGT programs, most notably the Upper Payment Limit program or UPL, which is designed to help providers to cover the cost of caring for the uninsured by filling the gap between state Medicaid payments and the rates paid by Medicare.
      The idea of extending the moratorium on the rules has been brewing since the last one-year moratorium was passed along with a supplemental funding bill for the wars in Iraq and Afghanistan. This year, Congressional Democrats, who overwhelmingly support the extension, plan to employ the same tactics. Legislation was recently filed in both the House and the Senate that includes all the necessary language that hospitals and other healthcare providers support.
      On April 9th, the House Energy and Commerce Health Subcommittee passed H.R. 5613 that would delay until April 1, 2009, implementation of all seven Medicaid regulations expected to cut funding to safety-net providers by an estimated $50 billion over five years. The bill is expected to be considered by the full committee next week, was revised by an amendment offered by committee chair John Dingell (D-MI) to require a study of the impact of the regulations on the states.
      The amended bill also would provide $25 million a year for the Department of Health and Human Service to investigate fraud and abuse in the Medicaid program, and contains an offset of the cost of the moratoria to be funded by expanding Medicaid’s asset verification program to all 50 states and by borrowing from the physician quality reporting fund. Without congressional action, a moratorium on two of the Medicaid rules that directly impact hospitals will expire May 25.
      Don McBeath and David Pearson will be headed to Washington, DC, for visits with the members of our rural Texas delegation at the end of April to ask for their support and secure passage of some vehicle that will protect our member hospitals for the negative effects of these toxic and detrimental regulations. This is the 3rd round of face-to-face visits that TORCH representatives have had with members of Congress and their staff in 2008.
      Please reach out to your own elected representative and urge them to support H.R. 5613 today.

Kerry Weems, Acting Administrator of the federal Centers for Medicare & Medicaid Services, was in Austin recently to encourage the local health care community to apply to be one of a dozen sites around the country for a Medicare test project to help pay part of the cost for electronic health records.
      The five-year project would give doctors incentive payments to use electronic health records in their practices. “This is a way of improving physicians’ practices and speeding adoption” of electronic health records, Weems said.
      If a doctor adopts electronic health records, all patients — not just Medicare patients — would benefit, Weems said. Using them has been shown to reduce the cost of — and improve the quality of — health care, he said. Electronic health records help reduce duplicative tests, cut down on doctors’ administrative burden, improve management of chronic diseases and reduce hospitalization, he said.
      Individual doctors could earn up to $58,000 in incentive payments — and group practices up to $290,000 — during the five-year demonstration project. The money would come from what Medicare expects to save through the use of the electronic records. Weems said he expects about 30 communities to apply for the competition by the May deadline. In his words, “This is real money.”
       The Centers for Medicare & Medicaid Services said it wants 1,200 physician practices to participate. It will begin recruitment next summer, giving priority to small- and medium-sized practices. The agency has not determined how it will choose the practices. It also has not calculated how large the incentive payments will be. CMS will determine how much savings the program will generate and then calibrate payouts so the project ends up being budget-neutral.
      The mood was cautiously optimistic and many of those in attendance, including David Pearson, President/CEO of TORCH, were glad to receive the information from Mr. Weems first hand. TORCH pledged to work with the Governor’s office to ensure that any pilot submitted by the State of Texas includes rural physicians and some rural health clinic involvement as well.

The Medicare Modernization Act of 2003 established the Medicare Recovery Audit Contractor (RAC) program as a demonstration program to identify improper Medicare payments – both overpayments and underpayments. RACs are paid on a contingency fee basis, receiving a percentage of the improper overpayments and underpayments they collect from providers.
      Under the demonstration program operating in California, Florida and New York, RACs can review the last four years of provider claims for the following types of services: hospital inpatient and outpatient, skilled nursing facility, physician, ambulance and laboratory, as well as durable medical equipment. The RACs use automated software programs to identify potential payment errors in such areas as duplicate payments, fiscal intermediaries’ mistakes, medical necessity and coding.
      Data released by the Centers for Medicare & Medicaid Services (CMS) at the end of February showed that $371.5 million in improper Medicare payments has been collected from or repaid to health care providers and suppliers as part of a demonstration program using recovery audit contractors (RACs) in California, Florida and New York in 2007. Nearly $440 million has been collected since the program began in 2005.
      The Tax Relief and Health Care Act of 2006 made the RAC program permanent and authorized the CMS to expand the program to all 50 states by 2010. The agency has already expanded RAC review to Massachusetts and South Carolina, with plans to expand RAC review to Texas in October of this year.
       TORCH and THA have agreed to work cooperatively with the eventual RAC vendor for Texas and to communicate their scope of work and audit philosophy with their respective membership.

We appreciate the participation, support, and financial contributions of the companies and organizations who were present at the 2008 TORCH Annual Conference. A list of sponsors follows. We encourage our hospital members to take advantage of the interest that these sponsors have shown by contacting them for products and services you need. The Conference Syllabus contains a complete listing with description and contact information on each—keep it handy all year as a great resource for you and your department heads.

2008 List of Exhibitors and Sponsors for TORCH Annual Conference
Advanced Health Education Ctr/MedRelief Staffing
Advanced Ultrasound Electronics
Affinity Diagnostic Imaging
AHFD
American HealthNet
American Heart Association
Amerinet
Anderson Consultation Services, LLC
Arthur, Marshall Inc
Assetdynamx Healthcare, Inc.
Barrington Medical Imaging, LLC
BKD, LLP
Blackhawk Healthcare
Boyken International, Inc.
BR Healthcare Services
C2P Group
CareMedic Systems Inc.
Centers for Medicare/Medicaid Services
CIMS-Clinical Imaging Management Systems, LLC
Citi
CNA HealthPro
Collection Conductor
Column Financial
Concord Medical Group, Inc.
Consolidated Financial
Cooper Medical Buildings
Craneware, Inc.
Crews & Associates
CRG Medical, Inc.
CTA Architects Engineers
Custom Software Systems, Inc.
Dairyland Healthcare Solutions
Davis & Wilkerson, PC
Diagnostic Management Group
Diamond Healthcare
DMS Imaging
Durbin & Company, LLP
E-Hospital Consulting, LP
Emergency Staffing Solutions
Envision Telepharmacy
ETMC Regional Healthcare System
FD&S Insurance Agency, Inc.
Financial Review Services, Inc.
FirstChoice Cooperative
FJW Group, Inc.
FormFast
Frost
FujiFilm Medical Systems, USA
Gemino Healthcare Finance
Government Capital Corporation
GroupOne Services
Health InfoTechnics, Inc.
Health.edu-TTUHSC
Healthcare Coding/Consulting Services
Healthcare Funding Solutions
Healthcare Management Systems, Inc.
Healthcare/S. Plains Biomedical Services, Inc.
HealthShare/THA
HealthSure Insurance Services, Inc.
HealthTrust Purchasing Group
Hunter Pharmacy Services, Inc.
ICE Technologies
Imaging E, LLC
Intellamed
JL Morgan & Associates, Inc.
KGA Architecture
Lancaster Pollard
Magnetic Ink, Inc.
Management Koncepts, Inc.
Martin, Fletcher
Medical Inventory Control
MEDITECH
MEMdata, LLC
Merritt, Hawkins & Associates
Milliman
MTS of Texas
National Healthcare Capital
National Network/Libraries of Medicine
Net.Orange
Northwest Texas Hospital Assoc
NRS Healthcare Services
O'Connell Robertson
Office of Rural Community Affairs
Optio Healthcare
Opus Healthcare Solutions, Inc.
Orion Health
Panasonic-NeoPaper
Paramount Recovery Systems
Parrish, Moody & Fikes, P.C.
Patient Line Products
PharmaCare Services
PHNS
Phoenix Health Systems
Pinnacle Partners In Medicine
PMAB, LLC
PNC/Xpack Network Services
Polkinghorn Group Architects, Inc.
Press Ganey Associates
Principle Pharmacy Group, Inc.
Prochaska & Associates
Prognosis Health Information Sys
ProjX, LLC
QHR
Ramtech Building Systems, Inc.
Receivable Recovery Services
Red Capital Group
Rees Associates, Inc.
Reimbursement Counselors, Inc.
Reliance Medical Systems
Resolution
Rogers-O'Brien Construction
Rowland Companies
Shared Imaging
Smith Seckman Reid, Inc.
SNB Bank
Southeast Texas Health Systems
Southwest Medical Associates, Inc.
Spectron Corp
SRJ Marketing Communications
Stroudwater Associates
Systemware, Inc.
TAHFA
TEAM Medical
Texas A&M HSC-RCHI
Texas A&M School/Rural Public Hlth
Texas Assc. of Local Health Officials
Texas Assoc of Nurse Anesthetists
Texas Hosp Insurance Exchange
Texas Hospital Association
Texas Hospital Home Hlth Assoc
Texas Hospital Trustees
Texas Mutual Ins. Co.
Texas Recruiters
The CFP Group, LLC
The Delta Companies
The MASH Program
The Merrimac Group, Inc.
TimeLine Physician Recruiting
TORCH Management Services, Inc.
Trilogy Healthcare Group, Inc.
Turner Construction Company
Universal Hospital Services
University of Phoenix
Visions in Architecture
Voice Products
Welch Allyn, Inc.
Wellness Environment