May 11th, 2012
Please review the following updated Anchor List and Regional Healthcare Partnership (RHP) map dated May 11, 2012 (both of which are based on RHP confirmation forms submitted to HHSC in April). HHSC attempted to incorporate all submitted requests into the new map, but could not in all cases due to geographic proximity and conflicting submissions. In updating the map, HHSC considered the RHP principles (dated April 2, 2012). HHSC was only able to incorporate requests submitted in an RHP Confirmation Form via the waiver email address or fax by April 24, 2012. Any additional requests for changes to the map or to the anchor list should be provided via in-person testimony at the May 17, 2012 public hearing.
MAY 17, 2012 RHP PUBLIC HEARING:
Please download the notice and agenda for the May 17, 2012 RHP Public Hearing as published in the May 11, 2012 Texas Register. The public hearing will discuss the May 11, 2012 map, not the March 30, 2012 map.
**A few important items not included in the attached notices that HHSC would like to share with stakeholders include:
• The public hearing will start promptly at 1:30 p.m. HHSC will hear public testimony until each person who wishes to speak has an opportunity to present. If testimony ends before 4:30 p.m., the hearing will end early. Those interested in speaking at the public hearing should plan to arrive by 1:30.
• The purpose of the hearing is for Executive Commissioner Tom Suehs to hear from entities in RHPs that are still in contention (either counties disagreeing with RHP placement on the May 11, 2012 map or an RHP anchor still in question) in order to finalize RHP region development. HHSC requests those counties and anchors in question to please attend the public hearing to voice concerns to the Executive Commissioner. The Executive Commissioner will take these public hearing comments into consideration when developing the final RHP geography and anchors. HHSC will issue the final RHP map shortly following the public hearing based on the Executive Commissioner’s final recommendations and submit to CMS for federal approval.
• HHSC encourages RHP participants to work together prior to the public hearing to determine RHP geography and anchors.
• During the public hearing, HHSC intends to accept comments in response to the May 11, 2012 RHP map, not the March 30, 2012 RHP map.
• Depending on the amount of public comment during the hearing, the three-minute presentation rule may be invoked.
• HHSC continues to work with CMS to determine how an IGT entity can fund a performing provider in a different RHP based on certain principles. For instance, total computable payment must stay with the recipient. HHSC recognizes that IGT crossing regions is particularly important for specialty providers—such as children’s hospitals or burn care—that may serve more than one RHP.
• A conference call line is available for out-of-town stakeholders interested in listening to the hearing. Please note: stakeholders wishing to testify need to attend the hearing in person. Testimony will not be allowed over the conference call line. Conference Call Number: 1-877-226-9790. Access Code: 8317345
Thank you for your continued interest in the 1115 Transformation Waiver. Please contact HHSC should you have any questions on RHP development.
Tags: 1115 Waiver
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May 9th, 2012
On Monday, Senators Charles Schumer and Chuck Grassley introduced a bill that would extend the Medicare Dependent Hospital (MDH) and Low-Volume Hospital (LVH) programs. Senate Bill 2620 would help avoid the pending expiration of both programs. Important new data indicates that the Federal investment in rural health has significant benefits both for the rural patient and the tax payer. In fact, small rural hospitals nationally have equal or better quality outcomes, and cost 3.7 percent less per Medicare beneficiary than their urban counterparts. These vital rural hospital programs are examples of the benefits of targeted, effective government action but will expire on October 1 if action is not taken. Their continuation is critical both to providers and the patients they serve. TORCH is requesting its members to call on their legislators in both chambers of Congress to act to protect rural hospitals.
Congress established the Medicare-dependent hospital (MDH) program in 1987. There are approximately 200 MDHs in the United States. These hospitals are paid by Medicare with a special rate to address the fact that most of their patients are Medicare patients. These payments allow MDHs greater financial stability and leave them better able to serve their communities. A hospital qualifies for the MDH program if it is located in a rural area, has no more than 100 beds, is not classified as a Sole Community Hospital, and has at least 60 percent of inpatient days or discharges covered by Medicare. This program expires September 30, 2012. Schumer’s bill will extend the program for one year.
Low volume hospitals are those that are critical to the community but may not serve a high volume of patients. Since 1988, the Medicare program has recognized that these hospitals need additional support so that they can continue to provide high quality care to rural communities. A low-volume hospital is defined as one that is more than 15 road miles from another comparable hospital and has less than 1,600 Medicare discharges are year. Medicare seeks to pay efficient providers their costs of furnishing services. However, certain factors beyond providers’ control can affect the costs of furnishing services. Patient volume is one such factor and is particularly relevant in small and isolated communities where providers frequently cannot achieve the economies of scale possible for their larger counterparts. The bill would extend the additional payments for low volume hospitals for one year. Download the bill here.
Tags: Low-Volume Hospital (LVH), Medicare Dependent Hospital (MDH), Senate Bill 2620
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May 3rd, 2012
We are very pleased to present the new TORCH Foundation Report and the TORCH Leadership & Management Institute (TLMI) Special Publication. Here’s a copy for you and we hope that you will share with your staff. In these publications you will find highlights of our recent accomplishments, current programs and services, as well as a preview of exciting activities in store for the near future. We have much to be proud of and celebrate. As we build upon our success, we recognize the important opportunities and challenges that lie ahead. Our members are our first priority and we are committed to delivering quality programs and services to meet your needs.
Tags: TORCH Foundation, TORCH Leadership & Management Institute
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May 2nd, 2012
The notice and agenda for the May 17, 2012 RHP public hearing will be published in the May 11, 2012 Texas Register. Based on stakeholder feedback, HHSC will soon issue a revised map to be dated May 11, 2012. The public hearing is being held to discuss the May 11, 2012 map, not the one dated March 30, 2012. The public hearing will start promptly at 1:30 p.m. HHSC will hear public testimony until each person who wishes to speak has an opportunity to present. Depending on the amount of public comment during the hearing, the 3-minute presentation rule may be invoked. If testimony ends before 4:30 p.m., the hearing will end early. Those interested in speaking at the public hearing should plan to arrive by 1:30. A conference call line is available for out-of-town stakeholders interested in listening to the hearing. Please note that any stakeholder wishing to testify, needs to attend the hearing in person. Testimony will not be allowed over the conference call line, but to listen in please dial 1-877-226-9790 and use access code 8317345.
The purpose of this hearing is for Executive Commissioner Tom Suehs to hear from entities in RHPs that are still in contention. If there are still counties disagreeing with their RHP placement on the May 11, 2012 map or the RHP anchor is still in question, HHSC wants public input in order to finalize the RHP region development. HHSC requests those counties and anchors in question to please attend the public hearing to voice concerns to the Executive Commissioner. The Executive Commissioner will take these public hearing comments into consideration when developing the final RHP geography and anchors. HHSC will issue the final RHP map shortly following the public hearing based on the Executive Commissioner’s final recommendations and submit to CMS for federal approval. HHSC encourages RHP participants to work together prior to the public hearing to determine RHP geography and anchors. Should participants have questions on RHP development, please contact HHSC.
RHP Hearing Notice [182KB PDF]
RHP Public Hearing_Agenda_5_17_12 [55KB PDF]
Tags: CMS, Executive Commissioner Tom Suehs, HHSC, RHP public hearing
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May 1st, 2012
TORCH, the TORCH Foundation and the State Office of Rural Health are pleased to host the Texas Critical Access Hospital Conference & Tradeshow on June 6-7 at the Doubletree Hotel San Antonio (near the airport). This is the only educational and networking event of its kind developed solely for Texas CAHs. With all the changes occurring both at the state and federal level that impact CAHs, we encourage you to stay informed and prepared by attending this year’s event. This program agenda covers a wide range of topic areas of significant interest to CAHs both financially and operationally. These topics include:
· Medicare Rural Hospital Flexibility (Flex) Program: State and Federal Update
· Improving the Financial Performance of Critical Access Hospitals
· Care in a Culture of Quality: Moving from Volume to Value
· Sound Off! Let’s Talk
· The Medicaid 1115 Waiver
· Flex 101: Program Orientation and Refresher
· EHR Adoption Stages and Lessons Learned: Panel Discussion
· 340B Drug Pricing Program for Critical Access Hospitals
· Performance Improvement in Rural Emergency Departments: Strategies, Benchmarks and Trends
· Operational Strategies for Managing Critical Access Hospitals Swing Bed Program
In addition to the educational sessions, this event presents a great networking opportunity with industry experts, health care professionals, policy makers and your peers. In addition, this conference provides the following approved continuing education credits: nine total CE hours for CPAs and nine total hours for pre-approved ACHE Qualified Education credits. Finally, this program qualifies for the CAH Board of Trustee Training Reimbursement through the Texas State Office of Rural Health.
For more detail on the conference program agenda and registration, please visit our web site or email Quang Ngo or Dawn Haberkorn.
Register here or scan this QR Code to your smartphone.
Please don’t miss out on this great educational and networking opportunity for CAH administrators, staff and trustees. We hope to see many of you there!
Tags: Critical Access Hospitals, State Office of Rural Health, Texas Critical Access Hospital Conference & Tradeshow, TORCH, TORCH Foundation
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May 1st, 2012
Executive Commissioner Vows to have final maps for Regional Health Partnerships Finalized Soon
Tom Suehs, Executive Commissioner of the Texas Health and Human Services Commission, testified today before a special meeting of the Texas House Committee on County Affairs in Austin that the 1115 to replace the Texas Upper Payment Limit (UPL) system for Texas hospitals is on track for full implementation on October 1, and he further told the committee monitoring the process that the maps outlining Regional Health Partnerships (RHP) in the new system will be finalized with a hearing on May 17.
Suehs and some of his top staff appeared before Committee Chairman Garnet Coleman and some of the County Affairs Committee members who are meeting in the off legislative year to oversee the major change in the hospital supplemental payment system. Suehs shared with the committee that despite the fast track monumental task of revamping how the UPL system works and the far reaching implications, he fully expects the new system to be in place on time and by October 1. That is the deadline imposed by the Centers for Medicare and Medicaid Services (CSM) who must approve the change. Suehs also reminded the committee that massive task of revising the UPL system was the result of Texas converting its Medicaid system to a fully managed care network where all Medicaid recipients are furnished private HMO insurance by the state. The problem is that CMS does not recognize Medicaid payments made through an HMO in its UPL calculations. Keeping the old UPL system in place with the new Medicaid managed care would have all but wiped out UPL payments for Texas. The new system is based on an agreement reached with CMS to continue UPL payments to Texas.
The Executive Commissioner went on to admit to the committee that the new system has brought about frustration among hospitals that will transition to a “two pots of money” payment system. One will be similar to their traditional UPL payment and is called the Uncompensated Care fund while the second funding source, known as the Delivery System Reform Incentive Payment (DSRIP), will fund new and innovative projects that the Health and Human Services Commission believes will lead to a better, more efficient Medicaid health care system. In commenting on the DSRIP part of the plan, Suehs told the committee that this is where the greatest change occurs and where the most frustration is being centered from. He admitted that many details are still being worked out and that there was vague and limited guidance in the beginning, but added that he was pleased how hospitals across the state have come together on a regional basis to form the Regional Health Partnerships (RHP) which are required in the plan.
Suehs also shared that 17 of the 19 RHPs have a fairly high level of agreement as to what their geographic partnership region will look like and who will serve as the “anchor” entity processing money and paperwork between hospitals in the regions and the Texas Health and Human Services Commission. The Executive Commissioner also revealed in today’s hearing that a public hearing will be conducted on May 17th in Austin where any remaining disagreements on the maps and anchors should be aired out. After that date, he plans to quickly use his authority to make final the maps and anchor list.
One of the concerns expressed by TORCH during the process has been the timing of funding for the new DSRIP projects. As originally presented, hospitals would implement approved projects at their own expense and receive some level of reimbursement well after the fact. At today’s special hearing, Lisa Kirch, Deputy Director for the 1115 waiver project, told the committee that CMS committed last week to promptly and immediately send funding to Texas as soon as they receive the list of DSRIP projects in September. While few more details were shared, it would appear that hospitals could receive much of their approved DSRIP payments only weeks into their projects.
Comments in the later part of today’s hearing turned to questions remaining at to where the state can find additional local level Intergovernmental Transfer (IGT) funds to draw down more federal Medicaid dollars to expand the new projects beyond the current hospital only system. Commissioner Suehs again made comments to the committee that he believes he can expand the program by as much as $6 billion a year, subject to finding additional IGT. He did not share many details as to where that effort is, but did confirm in the hearing that CMS has already ruled out the use of local and state health care expenses for inmates in county jails and prisons. Expenses such as county expenditures for indigent health care, mental related expenses and some other categories are still under discussion with CMS.
Click here for more information on the 1115 waiver implementation and timelines.
Tags: 1115 Waiver, Centers for Medicare and Medicaid Services (CSM), Delivery System Reform Incentive Payment (DSRIP), Regional Health Partnerships (RHP), Texas Health and Human Services Commission, Texas Hospitals, Texas Upper Payment Limit (UPL), TORCH
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April 24th, 2012
Texas Commissioner of Agriculture, Todd Staples recently invited all rural stakeholders to take part in the first Texas Rural Summit: Rural Texas – Growing Texas. This event is open to the public and will be hosted by Commissioner Staples and the Texas Rural Health and Economic Development Advisory Council. The council was created to identify challenges to the development of rural areas and recommend efficiencies in existing programs to best meet the needs of Texans across the state. This summit is intended to meet that goal. The interactive panel presentations and discussions will address the needs and opportunities in rural Texas that are related to economic development, health care, workforce development and skills training and community infrastructure.
The feedback that is received during the event will likely inform the policy direction for the agency and the council as we head towards the upcoming state legislative session. We would encourage interested TORCH members to attend the event and to take part in the discussion about health care and other areas of interest to your rural community. The event will be taking place on May 8, 2012 from 9:00 a.m. – 4:00 p.m. at the Texas Medical Association on 401 West 15th Street, Austin, Texas 78701. The registration fee is $20, which includes lunch. To make your reservations, please contact Rick Rhodes in the Office of Rural Affairs.
Tags: Office of Rural Affairs, rural community, Texas Rural Health and Economic Development Advisory Council, Texas Rural Summit, TORCH
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April 24th, 2012
The recent 2012 TORCH Foundation Silent Auction was a huge success and we would like to thank everyone who donated and participated in the bidding. There were a number of great items up for auction and together we were able to raise over $6,500 this year. This money will be used to fund a variety of scholarships and stipends to support rural health care staff and students. Already this year, scholarships have been awarded to five deserving individuals.
The award recipients so far in 2012 are:
·Kyle Toomey from Texas A&M received the 2012 Texas MHA Scholarship.
·Monte Bailey received the 2012 Texas Rural Healthcare Internship Stipend. Monte is interning at Parmer Medical Center.
·Sarah Clure from North Texas Medical Center received the 2012 Continuing Education Stipend.
· Veronica Harris from Family Medical Center with Limestone Medical Center received the 2012 Continuing Education Stipend.
· Jeff Prukop from Jackson County Hospital District received the 2012 Continuing Education Stipend.
Congratulations to all the award recipients and be sure to look for future announcements regarding scholarship opportunities available through the TORCH Foundation.
Also, applications are currently being accepted for the TORCH Healthcare Fellowship Program. This special training initiative for working health care professionals will provide the opportunity for a core-group of emerging leaders to participate in a year-long program of educational and networking events. A small stipend will be provided to attend three-to-four key conferences, both state and national, work with the staff and leadership at TORCH and participate in a capstone project to be presented at the TORCH Leadership and Management Institute. If you are interested, please contact Quang Ngo or Dawn Haberkorn at the TORCH office for an application.
Tags: TORCH Foundation, TORCH Healthcare Fellowship Program, TORCH Leadership and Management Institute
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April 24th, 2012
Time is running out to join your colleagues from across the state in this education conference for hospital-based home care programs offering vital topics and up-to-date information specifically for hospital home health care directors, nurses and hospital administrators. This annual THHHA education conference is for rural and urban hospital-based home care programs only. Topics typically focus on home health administration, operations, patient care, finances, staffing and management. The short format allows hospital and home health executives to get enough education to satisfy the annual requirements through DADS and to ensure organizational viability as a department or affiliate of the hospitals and communities they serve.
The 2012 THHHA Education Conference will take place on May 10-11, 2012 in Downtown San Antonio. The cost for the event is $150 for THHHA-member hospitals and home health agencies and $180 for non-members. The registration fee covers all conference sessions, CNE Certificate, course materials, refreshments and luncheon. Hotel rooms are still available at the Holiday Inn San Antonio Riverwalk, 217 N. St. Mary’s Street, San Antonio, TX 78205. The special conference guest room rate is $107 (single/double). Please call the hotel directly to reserve your room at 210-224-2500. Be sure to mention THHHA Education Conference to confirm that you are receiving the group rate, since the deadline has now passed. Click here for detailed program information and registration information.
Tags: CNE Certificate, Education Conference, hospital-based home care, Rural Hospitals, THHHA
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April 17th, 2012
The inaugural edition of Rural Matters, the new quarterly magazine for and about TORCH members, was distributed for the very first time at the 2012 TORCH Annual Conference & Trade Show. The first edition included a feature story about the Medicaid 1115 Waiver, which provided background information and analysis on the state’s delivery system reform initiative and its effect on rural providers. Another focus of Rural Matters will be to include articles and stories about our member hospitals and administrators. This edition shines the spotlight on Childress Regional Medical Center, Jack Endres and Lance Keilers to name a few. There are also numerous other hospital-related topics and programs that will be discussed every quarter in areas such as advocacy, quality, technology, compliance, finance and more. The full-color publication drew a lot of attention from the attendees at the conference and it will soon arrive in the mailbox at your facility. If you have thoughts about the format or a suggestion for a future story or feature, please contact David Pearson or Judey Dozeto. If you cannot wait to receive your copy of Rural Matters, you can access the magazine here.
Advertising in Rural Matters Puts You in Front of Your Market
Texas has the largest and most geographically diverse rural population of 3.6 million in the United States. If Texas rural and community hospitals were a single health system, TORCH would represent the largest health system, along with its affiliated clinics and home health agencies, in Texas. TORCH hospital membership alone is more than 150 members that manage over 6,480 beds. TORCH hospitals range in size from 12 to 216 beds. Affiliate associations include the Texas Association of Rural Health Clinics (TARHC) with more than 115 clinics and the Texas Hospital Home Health Association (THHHA) with over 85 hospital based home health agencies.
In addition, our readership and circulation extends to:
• Key purchasers including executives, clinical leaders and board members of more than 350 TORCH hospitals, TARHC and THHHA members;
• More than 185 TORCH Corporate and endorsed members;
• Key influencers of rural health policy, regulations, education and governance within the state of Texas exceeds 400; and
• Numerous out-of-state and national associations, government agencies and rural health leaders.
Don’t miss out on this unique opportunity!
Download Our Media Kit
Download the 2012 TORCH Media Kit [4.1MB PDF] here.
Place Your Ad Today
Contact David Streilein, Rural Matters advertising representative, or (512) 873-0045 for information.
Tags: Annual Conference, Rural Matters, TORCH
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