Texas State Office of Rural Health: Supporting CAHs and RHCs to Create Tangible Change in Rural Texas Communities

Rural Healthcare Provider  Transition Project (RHPTP) staff spoke with Albert Ruiz, with the Texas State Office of Rural Health (SORH) in June 2022 concerning his role in supporting small rural hospitals and rural health clinics, including Texas organizations participating in RHPTP. 

The TX SORH participated in the end-of-project action planning meetings between Sudan Medical Clinic (SMC) and RHPTP project consultants.  SMC is a family-owned certified RHC in Sudan and Muleshoe, Texas, and a 2020-2021 participant of RHPTP. During these meetings, the TX SORH learned about all of the value-based care (VBC) work that SMC had done during their time with the project, as well as explored ways in which they might be able to help support their efforts moving forward.

Ruiz recently visited SMC to get a firsthand look at the important strides they have taken on their VBC journey. He shared that transitioning to VBC as a whole, even as a larger health care organization with greater resources can be daunting, and that the financial risk assessment and quality improvement TA provided through the project allowed a great foundation for the clinic. Albert commented that all of the things that SMC had learned from their time with RHPTP were really showing in their great culture of outstanding patient care. “RHPTP looks at everything from the ground up, and from a different angle, with a room full of folks who are experts in the areas that will bring a small rural hospital or rural health clinic to VBC”, stated Ruiz. Albert also shared that SMC staff revisit RHPTP resources on a regular basis and that he appreciates that they are so easy for small rural hospitals and rural health clinics to access.

“SMC was a fantastic clinic from the get-go, and their participation in RHPTP has been key to the success they are seeing towards their VBC journey. SMC is truly making a tangible difference in their community.”

As much as we reach out to our RHCs, they are reaching out to us.  

Ruiz shared that SMC inviting them to participate in their RHPTP action planning meetings has been a huge step forward. Prior to 2020, there wasn’t much for RHCs within the TX SORH, and they now have a lot of bilateral communication. “We didn’t have a prior connection with SMC, and now we can be a part of the VBC work they’re doing.  This is a tremendous success!”

Ruiz will next be sitting in on EMH’s August 2022 RHPTP quality improvement action planning meeting where he will learn about the notable work they have been doing in their preparation for VBC, as well as explore ways in which the TX SORH can help support their continued work in this area.

The TX SORH has long been providing support and quality technical assistance (TA) to the rural health care organizations in their state. Texas is home to 88 CAHs, and 326 RHCs, and is broken into six regions, with a SORH coordinator assigned to each region. In 2020 they kicked off a specific focus on their rural health clinics (RHC).

This focus mimics the same support and TA provided to TX CAHs, which is provided via a combination of their participation in the Medicare Rural Hospital Flexibility (Flex) Program. In addition, they’ve partnered with the Texas Organization of Rural and Community Hospitals (TORCH) in providing additional support to RHCs. Together, they identified all of the RHCs in Texas and conducted a thorough needs assessment. 

Partners and stakeholders are key in being able to extend all the assistance that we offer to our Texas RHCs.

The findings were then put into a report, as well as included in the TX SORH’s strategic plan. A complex TA program was created and includes activities such as regular webinars, an RHC toolkit, a website, geocoded RHC maps, quarterly listening sessions, and site visits to name a few. Webinars cover topics such as care coordination for RHCs, RHC readiness and compliance, hospice billing, and the importance of the revenue cycle process.  The quarterly learning sessions are face-to-face connections from the TX SORH, regional HRSA representatives, regional CMS representatives, and the Texas Primary Care Office. Ruiz stated, “now RHCs not only know who their federal contacts are, but they also have direct contact with them in these sessions.” The listening sessions cover everything from standard rural health updates to very complex federal changes, mandates, rules, and regulations. 

We believe that you can't just provide a little support and then go away, it needs to be constant and sustainable. 

The TX SORH encourages all of their small rural hospitals and certified rural health clinics to apply to participate in the Rural Healthcare Provider Transition Project. Ruiz affirmed that RHPTP is a spectacular program that provides a great foundation. He stated, “you can always do things better, which is exactly what this program does, it helps health care organizations become better”.