Idaho Flex State Profile

The Technical Assistance and Services Center (TASC), a program of the National Rural Health Resource Center, provides technical assistance for the Rural Hospital Medicare Flexibility (Flex) Program in the form of information, tools and resources. State Flex Programs benefit from sharing information with one another and the Flex State Profiles are meant to be a method to encourage that sharing.
 
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State Contacts

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State Office Director, Idaho
Flex Coordinator, Idaho

Survey Results

Core Area 1: Support for Quality Improvement

Recruit critical access hospital (CAH) quality improvement (QI) staff to participate in the Medicare Beneficiary Quality Improvement Project (MBQIP) peer learning collaborative focused on improving core measures and Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) data.

Projected Outcomes:

  • November 2013 full-day educational MBQIP peer learning event focused on improving HCAHPS scores and outpatient core measures 
  • February 2014 MBQIP peer learning webinar focused on benchmarking highest MBQIP measures from two Idaho CAHs and presenting their best practices; sharing effective strategies to improve core measures
  • April 2014 full-day educational MBQIP peer learning event focused on outpatient core measures and pharmacy Phase 3 measures
  • June 2014 MBQIP peer learning webinar focused on benchmarking highest MBQIP measures from two Idaho CAHs and presenting their best practices; sharing effective strategies to improve core measures
  • Idaho CAH core measure and HCAHPS data compared to baseline data to capture improvement
  • Learning assessments implemented immediately post full-day workshop and four months post-event to capture immediate and sustained knowledge change
Core Area 2: Support for Operational and Financial Improvement

Use Flex Monitoring Team (FMT) reports to identify struggling CAHs within state to determine where to provide targeted technical assistance (TA) to assist in improved operational performance. 

Projected Outcomes:

  • Improvement in financial indicators related to revenue cycle analysis: average days in net account receivable, average days in gross accounts receivable, average days cash on hand, and operating margin
  • Project will also be evaluated regarding staff participation in activities and the percent of recommendations made during the assessment which are implemented at 90 days and sustained at 12 months post assessment period
  • Identifying two CAHs at risk based on FMT data is an on-going activity
Core Area 3: Support for Health System Development and Community Engagement

Develop a plan to establish a community health emergency medical services (EMS) pilot program in partnership with a CAH. The plan will be similarly structured to rural community paramedicine initiatives but align with the scope of practice for advanced emergency medical technicians (EMTs).

Projected Outcomes:

  • CAH, community EMS, and stakeholders will identify resources and develop a plan to implement a community health EMS project that meets community needs. Idaho currently has two community paramedicine projects, however, most CAHs do not have paramedic level services. This effort will identify resources, strategies, and educational needs aligned with the Advanced EMT scope of practice that will decrease readmission rates, reduce unnecessary emergency department visits, and improve community health. 
  • Develop a plan to implement a project that meets the needs of Idaho CAHs that lack paramedic services.
Please provide information regarding any networks you have within your state – quality, financial, etc., and specify if they overlap core areas; also discuss the composition of your network.

There are three regional, independent, non-profit networks in Idaho that the State Office of Rural Health & Primary Care partners with. These networks are made up of CAH and prospective payment system (PPS) hospitals and receive some Flex funds to implement projects related to Core Area 2: Support for Operational and Financial Improvement. In the current Flex year, these networks will provide board education and leadership development for the CAH member hospitals. The education will improve the knowledge and skills for CAH boards of directors.

MBQIP peer learning collaborative was created in FY 2012 by the State Office of Rural Health. This collaborative is made up of CAH quality improvement staff to support their efforts to report core measure and HCAHPS data for MBQIP. Please refer to the initiative described in Core Area 1: Support for Quality Improvement.

How are you measuring activities for this/these network(s)?

Board Education and Leadership Development measures:

  • The number and percent of CAHs actively participating in CAH governance events
  • The number of CAHs developing financial components in their board education programs
  • Difference in CAH board members' and leaders’ pre- and post-education knowledge levels
  • The number of CAH leaders and managers participating in financial education workshops and collaboratives

MBQIP peer learning collaborative measures:

  • See projected outcomes from Core Area 1 activities
How are activities within these collaboratives being measured and what are the intended outcomes?

Qualis Health (QIO), Idaho Hospital Association (IHA) and the State Office of Rural Health meet in-person for monthly meetings to determine how best to collaborate on quality improvement initiatives for Idaho.

Please provide information regarding any collaborative(s) that your Flex program is involved in (QIO, hospital association, foundation, telehealth/other ORHP grants).

Measures from the Qualis Health, IHA, and the State Office of Rural Health collaborative include the number of CAHs reporting to Hospital Compare and MBQIP and outcomes focus on improvement to quality core measure data in the state aggregate as reported on MBQIP.

From the last Flex program year, describe a best practice you want to share with other states.

Creating the Idaho MBQIP peer learning collaborative series to “Move the Needle” for Idaho CAHs with regard to core measure data. These events took place via webinar, one-day regional workshops, and a one-day interactive presentation at the State Office of Rural Health annual conference. The State Office of Rural Health contracted with a consultant to provide best practices for CAHs with regard to inpatient, outpatient and HCAHPS data.

How did you measure this best practice?
  • The number of Idaho CAHs participating in each event
  • The number of CAHs participating in MBQIP
  • Inpatient core measure data (MBQIP state aggregate data)
  • Outpatient core measure data (MBQIP state aggregate data)
  • Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) reports (MBQIP)
  • Difference in CAH quality improvement (QI) staff pre- and post-education knowledge levels
  • The number of CAHs who report implementing a quality improvement project based on MBQIP data

Program Statistics

Do you have any hospitals interested in converting to CAH status?
no
What is the smallest number of hospital beds among the CAHs in your state?
10
Percent of CAHs submitting MBQIP data:
78.00%
What is the largest number of hospital beds among the CAHs in your state?
25
How many CAHs are in your state?
27
What type of organization is your Flex office housed in?
State Government

Mary Sheridan

State Office Director, Idaho
Phone: (208) 332-7212

Specialty Areas / Background

Mary is a registered nurse. Her specialty areas include rural emergency medical services, nursing, health care quality, and patient safety.

State Office Director and Flex Coordinator since October 2003 

Stephanie Sayegh

Flex Coordinator, Idaho
Phone: (208) 332-7363

Specialty Areas / Background

Stephanie has a M.A. in International Affairs with a focus on socio-economic development. She has supported a variety of health programs in Honduras, Sierra Leone, and Mozambique.

Health Program Specialist Since November 2013