Flex State Profiles
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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In each core area, what are the top Flex activities in your state?
Core Area 2: Support for Operational and Financial Improvement
ICD-10 Training: Providing billing and coding training, to include ICD-10 training, for the purpose of improving coding accuracy and compliance, to capture missed revenue, and to increase productivity.
- Provide or arrange for direct technical assistance to individual critical access hospitals (CAHs) on charge master updates or other financial management tools.
- Provide the infrastructure for a multi-hospital financial collaborative that supports CAHs in sharing best practices, benchmarks, resources and expertise.
- Provide training on improving revenue cycles to hospital leaders to increase their ability to better manage their revenue cycles.
- Provide educational programs and technical services to develop AZ CAH capacity to improve financial and operational performance.
- Develop a grant development infrastructure that enables AZ CAHs and emergency medical service (EMS) providers to identify and pursue local, state, federal, and private foundation funding.
- Entered into an agreement with an outside vendor to provide access to market, quality, safety, patient satisfaction and financial performance data to the 29 critical access hospitals (CAHs). The vendor has provided three webinars to review the methodology and results of the reports.
- Provide a 2-day workshop on revenue cycle management.
- Provide updated maps of local market share and service area migration.
The California Flex Program: monitors the performance of critical access hospitals (CAHs); identifies potential areas of financial and operational distress; and, plans and implements evidence-based strategies for improving financial performance. The following services are available to CAHs:
- Targeted consulting and technical assistance such as operational assessments, charge master review, strategic planning, contractual reviews, revenue cycle and charge capture reviews.
- Ongoing financial support and technical assistance.
- Evidence-based strategic planning, performance improvement workshops and financial trainings.
- Statewide financial workshops through the California Rural Health Symposium, state and regional meetings and conferences including the Western Regional CAH Conference, and the Northern Regional Conference.
- Planning and implementing interventions for improving operational processes.
- On-site and web-based Lean educational and trainings sessions.
- Providing assistance to critical access hospitals (CAHs) in operating provider-based clinics through the State Office of Rural Health's (SORH) Rural Health Clinic Technical Assistance Program.
- Continuing to provide Quality Health Indicators (QHI) benchmarking tool for reporting financial measures to assits hospitals in identifying areas of need in financial and operation performance.
- Providing assitance and inforamtino to assist CAHs with compliance with federal and state regulations.
The Florida Flex Program sponsors a Financial Improvement Collaborative with HomeTown Health, Georgia. The collaborative provides onsite visits, webinars and workshops with financial experts to all of Florida's critical access hospitals (CAHs) and tracks improvement in specific financial benchmarks.
The 2011-2012 Flex Operational and Financial Improvement Program will continue to provide education to Georgia’s 34 CAHs. The education subject areas are a result of the Flex funded CAH fiscal analyses of 32 of Georgia’s 34 CAHs as well as feedback obtained from CAH leadership critical needs assessments. A series of eight, two-day education and training workshops will be conducted across the state. At a minimum the curriculum will include leadership development, accountable care organizations (ACOs), cost reporting, revenue cycle management, diversification, and understanding benchmarking. Six companion webinars will concentrate on community health needs assessments, the charge master description, International Classification of Diseases version 10 (ICD-10), compliance, readmissions and present-on-admission topics as well as to reinforce retention of workshop education and training. Expected outcomes of this program are to improve CAHs’ ability to internally monitor and obtain proper program payments throughout the year avoiding costly financial settlements at year end; provide CAH leadership with the foundational tools, knowledge and skills necessary to effectively manage their CAHs and to meet the ever-expanding state and federal laws, rules, and regulations.
- Conduct revenue cycle assessments in designated CAHs
- Maintain quarterly meeting of CAH CEOs and CFOs to review financial and operational indicators and to share best practices
- Assist critical access hospitals (CAHs) in identifying potential areas of financial and operational performance improvement by conducting financial and operational assessments.
- Increase Idaho CAH staff ability to better manage their revenue cycles.
- Support Idaho CAHs to create an efficient and compliant charging mechanism through chargemaster review.
- Provide billing and coding education to help prepare CAHs for ICD-10 conversion.
- Support the spread of “Lean Transformation” techniques to Idaho CAHs.