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Rural Spotlight — A Health Care Resource for Missouri

Funding Opportunity

December 17, 2014

The Geriatrics Workforce Enhancement Program funding opportunity announcement (FOA) was recently announced!  Please pass along this message to anyone who may be interested in applying.  More information on the program purpose and eligibility can be found online at: and in the attached FOA.

HRSA will host four Technical Assistance Webinars this week and regional sessions the week of January 5th.

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MOHEC Stakeholder Preview

December 17, 2014

Podcast Series Focuses on Transgender and Gender-Expansive Youth Health

Today we will release a podcast series regarding transgender and gender-expansive youth health.  MOHEC has developed the podcast in partnership with TransParent with support from the Missouri Foundation for Health. There is a 17 minute summary piece that accompanies the complete podcast (4 segments totaling about 60 minutes). All can be found at:   I am reaching out to you as key stakeholders to help us spread the word. This series can be spread widely and is meant to be an educational tool and our hope is that it will raise awareness and promote health equity.

I would also like to and to extend a special invite to our feedback sessions. During these sessions we will look to our partners in health equity work to give insights as to how to make this tool even more effective. Register here:

Shannon Canfield

National Health Service Corps

December 17, 2014

Corps Connections – December 2014 E-Newsletter

Telehealth Guide

December 16, 2014

• During Iowa’s 2014 collaborative Rural Health Financing workshop, the health care organizations requested comprehensive and updated guidance to help them address pressing challenges with the implementation of telehealth service programs in their rural communities.
• Telligen and the Great Plains Telehealth Resource and Assistance Center (gpTRAC) developed this guide (attached) to specifically address the concerned and questions about telehealth raised by health care organizations and financing partners.
• This guidance will be useful to Critical Access Hospitals and rural communities nationwide, not only Iowa; it will also serve as a helpful resource for our partners who have financing assistance programs that may be used to support rural health.

Content of Guide: This guide aggregates information (most current as of October 2014) about policy considerations (e.g., licensing), best practices, toolkits, and the benefits of telehealth to health care organizations in terms of improving outcomes and generating revenue. For specific questions regarding the attached Telehealth Guide, please contact Susan Brown at

Announcements from the Federal Office of Rural Health Policy

December 12, 2014

Announcements from the Federal Office of Rural Health Policy

Hot Off the Presses

1.  On December 8, The Centers for Medicare & Medicaid Services (CMS) published the Medicare Shared Savings Program:  Accountable Care Organizations Proposed Rule in the Federal Register.  Comments are due by February 6th.  The rule includes the following proposals:

  • Changes to encourage ACO participation in risk-based models by:
    • Enabling existing ACOs under a one‑sided participation agreement (“Track 1” – shared savings, not losses) to continue for an additional 3-year period at a lower sharing rate
    • Adopting an alternative risk-based model (“Track 3”) that includes proposals for a higher shared savings rate and prospective attribution of beneficiaries.
    • Seeking comment on the waiver of Medicare payment rules and regulations related to telehealth, qualifying hospital stays for skilled nursing facility (SNF) admission, and qualifications for home health services and post-acute care referrals
  • Revisions to beneficiary assignment* that may be of interest to rural stakeholders include:
    • Including the claims from non-physician ACO professionals (NPs, PAs, and CNSs) in Step 1 of the beneficiary assignment rule.
    •  Clarifying how primary care services furnished in Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs) will be considered in the assignment process.  CMS proposes that all primary care services furnished by FQHCs and RHCs would be considered in Step 1 of the beneficiary assignment method.
  • Streamlining ACO access to beneficiary claims data while continuing to enable beneficiaries to opt out from having their claims shared with the ACO.
  • Seeking comments on alternative methods for establishing, updating, or resetting ACO financial benchmarks for determining shared savings/losses, including using regional expenditures rather than national expenditures to set the benchmark.

*{Note: The existing method assigns beneficiaries to ACOs in 2 steps based on having the plurality of primary care services furnished 1) by primary care physicians; or 2) by specialists, nurse practitioners (NPs), physician assistants (PAs), and clinical nurse specialists (CNSs).}

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Rural Assistance Center Health & Human Services Update

December 11, 2014

The Rural Assistance Center is a collaborative effort of the University of North Dakota Center for Rural Health, and the Rural Policy Research Institute (RUPRI); and is funded by a grant through HRSA’s Office of Rural Health Policy.  View the RAC Online newsletter.

Announcements from the Federal Office of Rural Health Policy

December 8, 2014

The Affordable Care Act

1. As the ACA’s second open enrollment period continues, a new tool from the Kaiser Family Foundation maps marketplace enrollment by state and at local level to compare the number of people eligible for a marketplace plan with the share who signed up.

The resource, Mapping Marketplace Enrollment, calculates by local area the percentage of potential ACA marketplace enrollees that signed up for a health plan in a federally-based exchange by mid-April 2014. It also displays the number of potential enrollees and the number of plan sign-ups in 100,000-resident statistical geographical areas associated with a zip code. Rural assistors and stakeholders may be interested in using this local data to target special enrollment efforts to areas where a relatively low percentage of possible enrollees were enrolled during the last open enrollment period. Stakeholders may also be interested in the most recent the Medicaid Enrollment Report for September 2014.

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