by
Loren Bonner, DOTmed News Online Editor | September 25, 2012
From the September 2012 issue of HealthCare Business News magazine
CMS recently said they would accept applications until Sept. 19 for critical access hospitals and small rural hospitals who want to participate in the Advance Payment Model ACO program starting Jan. 1, 2013. This first wave of applicants will more or less be the test group to determine whether advance payments to small ACOs will help them coordinate care more effectively and generate Medicare savings.
Strength in numbers
Rural communities constantly battle with recruiting and retaining health care providers. Only 10 percent of physicians practice in rural health facilities, although 20 percent of the population lives there. One of the major ways health care reform supports providers in rural America is through several payment incentives.
“This really represents the largest expansion and investment into the workforce that we’ve seen in a number of years and it’s across the board,” says Morgan. “It is investments in training, grants, government support, distribution of residency slots, and on and on.”
Of all the provisions under health care reform, Morgan says workforce expansion is the one most favored by the rural health care community.
Reliance on telemedicine
Part of Carilion Giles’ revamp meant going all-digital. Now, images can be stored through PACS and incorporated into the patient’s medical record.
“If we do a CT on a stroke victim, and then put them in a helicopter to transport them to the mothership, they don’t have to do another CT of the head,” says Tyler. “So it’s better utilization of resources.”
Although Carilion Giles is fortunate enough to have one radiologist on staff, many rural facilities aren’t so lucky and instead have to depend on teleradiology to transmit imaging results for review. But that requires broadband access. Without sufficient broadband speed, transmissions are either delayed until after business hours, or other Internet-based operations in the hospital are impacted.
The White House Rural Council, created last year, recognized this issue and many others facing rural hospitals. It included rulemaking to help expand deployment of broadband capacity and health IT infrastructure. The Office of Rural Health Policy within the U.S. Department of Health and Human Services and other federal agencies have consulted with the Federal Communications Commission on the redesign of its programs to encourage greater participation by rural health care providers.
In Carilion Giles case, the hospital was even able to make large capital equipment purchases when they rebuilt— something that likely helped tie them for first place in patient satisfaction among Virginia hospitals.
