Category Archives: Health
Average Beneficiary CMS Hierarchical Condition Category (HCC) Risk Scores for Rural and Urban Providers
Risk adjustment mechanisms predict whether a given patient, or group of patients, is likely to be more or less costly to treat than the average population and provides a way to adjust payment accordingly. The Centers for Medicare & Medicaid Services (CMS) risk adjustment model is a hierarchical condition category (HCC) score. Use of the HCC model is expanding, and there is concern over whether it functions as intended. If CMS-HCC risk scores do not accurately reflect patient health status because of factors such as coding practices or capacity, then payments may not be associated with the true cost of treatment.
Existing evidence suggests that there may be cause for concern. Rural populations experience worse health outcomes than their urban counterparts. By contrast, rural Medicare beneficiaries have lower average CMS-HCC risk scores than urban beneficiaries, suggesting that rural beneficiaries are healthier and less costly. Additionally, preliminary analyses suggest that smaller physician practices, which are disproportionately located in rural areas, have the lowest average CMS-HCC risk scores. On the other hand, rural Medicare beneficiaries are younger than urban beneficiaries, and it may be the case that patients with more complexity systematically seek care in urban areas.
This brief investigates potential differences in urban and rural CMS-HCC risk scores at the provider’s patient panel level. We used the 2015 Medicare Physician and Other Supplier Public Use File to compare patient panel CMS-HCC risk scores between urban and rural providers across provider specialties, census divisions, and Merit-Based Incentive Payment System (MIPS) participation requirements. (more…)
July 5, 2018
CDC Funding for Public Health Crisis Response – July 30. The Centers for Disease Control and Prevention (CDC) will make 69 cooperative agreements with awards ranging from $100,000 up to $5 million to increase capacity for responding to the opioid crisis, declared a public health emergency last year. Eligible applicants are state, local and territorial health departments and include federally-recognized Native American tribal governments. Applicants must have functional public health emergency management already in place and aligned with CDC’s Public Health Emergency Preparedness Program (PHEP) or the agency’s Epidemiology and Laboratory Capacity for Infectious Diseases (ELC).
Technical Assistance Agreement for Rural Opioid Response Program – August 10. The Health Resources and Services Administration will award $3 million in a cooperative agreement with one entity to provide technical assistance (TA) support for rural communities engaging in activities to combat opioid use disorder (OUD) through the Rural Communities Opioid Response Program – Technical Assistance (RCORP-TA) . Eligible applicants include domestic public or private, non-profit entities. Domestic faith-based and community-based organizations, tribes, and tribal organizations are also eligible to apply. The award recipient will provide resources and expertise in support of prevention, treatment and recovery efforts for OUD in rural areas. See Events section below for assistance for applicants of RCORP-TA.
June 29, 2018
Technical Assistance Cooperative Agreement to Support the Rural Opioid Response Program
The Federal Office of Rural Health Policy will provide up to $3,000,000 per year over a four-year project period to support one technical assistance (TA) center to assist rural communities engaging in activities to combat opioid use disorder (OUD) through the Rural Communities Opioid Response Program (RCORP).
The Rural Communities Opioid Response Program-Technical Assistance (RCORP-TA) is part of a multi-year, $130 million opioid-focused effort by the Health Resources and Services Administration (HRSA). The awardee of this cooperative agreement will be an entity with the ability to provide TA on a national scale and with extensive knowledge of OUD, and OUD prevention, treatment, and recovery efforts, in rural communities.
The RCORP-TA award recipient will provide in-depth technical assistance to HRSA’s RCORP award recipients, who will be multi-sector consortiums engaged in the planning and implementation of OUD prevention, treatment, and recovery initiatives. The TA provider’s support will promote strategies for capacity-building and sustainability, and will cultivate methodologies to assist RCORP award recipients as they address prevention, treatment, and recovery services in rural communities.
Eligible applicants include domestic public, private, and non-profit entities. Domestic faith-based and community-based organizations, tribes, and tribal organizations are also eligible to apply.
Note: The purpose of this funding opportunity is not for the receipt of TA, but to solicit an entity(s) to provide resources and expertise in support of the execution RCORP activities.
June 29, 2018
Call for Grant Reviewers. The Health Resources and Services Administration (HRSA) relies on grant reviewers to select the best programs from competitive groups of applicants. Over the coming months, the Federal Office of Rural Health Policy (FORHP) will be competing a number of programs, including the Rural Communities Opioid Response Program-Planning, and will need more reviewers than usual, particularly those with expertise in rural and mental/behavioral health. Reviews are typically held remotely over a period of a few days and reviewers who participate and complete their assigned duties will receive an honorarium. Learn more and register to become a potential reviewer at the link above. Registration is easy and does not commit you to serving as a reviewer. Please consider lending your expertise to these important initiatives.
Locate HIV/AIDS Medical Providers. HRSA’s Ryan White HIV/AIDS Bureau recently launched a re-design of their HIV Testing Sites & Care Locator. Users of the website or cell phone app will be able to search by their current location and find results for nearby testing services, housing providers, health centers and other service providers displayed on a dynamic map. The tool uses open data from agencies such as the Centers for Disease Control and Prevention (CDC), the Substance Abuse and Mental Health Services Administration (SAMHSA), and the Department of Housing and Urban Development (HUD) to identify nearby service providers, their contact information and directions to their location. The CDC has shown that suburban and rural areas in certain parts of the country have seen an increase in new cases. Preventive treatment for those who are high-risk, and proven viral suppression for HIV-infected individuals can reduce the number of new infections.
Call for Posters: Rural HIV Research and Training Conference – July 15. Planners for the Sixth Annual Rural HIV Research and Training Conference have closed the call for abstracts and presentations, but still seek proposals for posters that will be displayed at the event. Preference will be given to proposals that include objectives and learning outcomes that present new information and evidence-based tools to address the challenges of the HIV/AIDS epidemic. They must also provide a clear explanation of how the proposal is relevant to rural populations in one of four conference tracks: 1) clinical research, 2) prevention and intervention, 3) family and community, 4) advocacy.
Funding for Full-Service Rural Schools Program – July 13. The U.S. Department of Education (ED) Full-Service Community Schools program supports the planning, implementation, and operation of comprehensive academic, social, and health services in high-poverty schools. Applicants must propose to provide at least three eligible services, including “social, health, nutrition, and mental health services and supports.” ED will prioritize proposals serving high-poverty school districts in rural areas. Whole School, Whole Community, Whole Child (CDC) and school-based services integration are two models by which schools can play a vital role in improving the health of rural residents.
DOT Grants for Buses and Bus Facilities – August 6. The U.S. Department of Transportation (DOT) will make 150 awards of up to $36.6 million “to assist in the financing of buses and bus facilities capital projects, including replacing, rehabilitating, purchasing or leasing buses or related equipment, and rehabilitating, purchasing, constructing or leasing bus-related facilities.” Eligible applicants are city, state, and county governments, including federally-recognized tribal governments. Transportation is an important social determinant of health in rural communities, allowing access to jobs, nutritious food and health care.
SAMHSA State Opioid Response Grants – August 13. The Substance Abuse and Mental Health Services Administration (SAMHSA) will make 59 awards to state governments for prevention, treatment and recovery efforts for opioid use disorder (OUD). Grantees of the program will use data to identify gaps in availability of treatment by geographic, demographic and service-level terms, and use evidence-based implementation strategies “to identify which system design models will most rapidly and adequately address the gaps in their systems of care.”
SAMSHA Tribal Opioid Response Grants – August 20. In addition to the State Opioid Response Grants, SAMHSA will make 263 awards to supplement current activities for federally-recognized American Indian/Alaska Native tribes or tribal organizations to increase access to culturally appropriate and evidence-based treatment of OUDs.