Each state was asked to respond to the following question:
In each of the following program areas, please list up to three top Flex activities in your state for FY2016, and include information on how you measure this/these activities. Also, if applicable, please include information on past work for this/these activities if your current work is building upon it.
The following responses relate to Program Area: Support for Integration of Innovative Health Care Models.
New federal and state initiatives focused on health care delivery system reform are increasing with an effort to move the health care system toward paying providers for value of care rather than volume of care. The activities in this area will focus on assessing CAH readiness and supporting one or more multi-stakeholder processes to explore new models of care for rural communities. The activities in year one will focus on technical assistance subcontractor support to explore options and best practices suited to CAHs through a multi-stakeholder effort involving patients, providers, payers, Medicaid and other key entities.
Measures: The number of CAHs who complete a survey during year one and indicate their readiness to transition to new modelsView Alaska's State Flex Profile >
CRHC expanded on the work occurring through its iCARE program to fulfill its vision to create a community-based, rural-relevant program. iCARE began with Colorado’s CAHs in 2010 through Flex. In 2012, CRHC received additional state funding allowing the program to expand to include CAH provider-based clinics. Through this new innovations opportunity with Flex, CRHC moves forward with opportunities to raise awareness amongst other care providers in rural communities. Through the existing monthly iCARE webinar series, CRHC offers an avenue to explore the care coordination processes between hospitals, clinics, and other care providers including EMS, long-term care, home health and others. Discussion topics within these areas include information transfer protocols between care settings, data transfer, patient communication and follow-up processes.View Colorado's State Flex Profile >
Hawaii has started a Project ECHO with clinics around endocrinology, geriatrics and behavioral health. The ORHPC is developing and will release a clinic on incorporation behavioral health in the primary care setting. The Hawaii Flex Program uses part of its funds to help develop clinics that are taught to the rural areas through video-telecommunications software. Hawaii is in its early stages of doing Project ECHO and has had a good turnout from the clinics it offers Project ECHO, and those clinics have scored very well on participant feedback.View Hawaii's State Flex Profile >
The Flex Coordinator released an annual competitive opportunity for all Idaho CAHs exploring health care transformation models. This opportunity allows applicants to develop and implement an innovative health care model that can impact rural health. This competitive application encourages interested CAHs to develop baseline data and targets for improvement related to a specific effort targeting care coordination. This year, Caribou Memorial Hospital in Soda Springs will partner with Bear Lake Memorial Hospital in Montpelier to create a clinically integrated network with a regional tertiary hospital.View Idaho's State Flex Profile >
The Illinois Flex Program plans to support financial and operational transition to value-based models and healthcare transformation models in the health care system. ICAHN is working with the CAHs to assess innovative health care models designed to have a positive transformational impact on rural health. Through IRCCO and ICAHN, efforts are being made to develop and pilot an emergency department patient satisfaction survey program, to address educational programming for self-management for patients with chronic diseases, to develop health and wellness programs for employees and the community, and to assist in the development of a rural community health worker or health coach.View Illinois's State Flex Profile >
Michigan provides support for the Rural Health Clinic Quality Network.View Michigan's State Flex Profile >
The Montana Flex Program is partnering with the Montana Medical Association to develop a rural healthcare team leadership program, integrating hospital leadership staff, trustees, medical staff, clinic staff and public health. This project is in the early phases and is currently conducting CAH CEO self-assessments, based on the CAH Blueprint for Performance Excellence framework, to determine readiness for value-based care. A gap analysis from the survey results will be conducted and program content will be developed to address identified needs. The goal is to develop multidisciplinary, integrated leadership teams which can lead to change and shape a future that ensures enduring, high quality, accessible health care for their community.View Montana's State Flex Profile >
The Nevada Flex Program supports Nevada CAH clinical and non-clinical staff participation in Project Extension for Community Health Outcomes (ECHO) Nevada activities, provider education and technical assistance. ECHO is a telehealth linkage connecting university-based faculty specialists to primary care providers in rural and under-served areas of Nevada to extend specialty care to patients with chronic, costly and complex medical illnesses.View Nevada's State Flex Profile >
OPCRH is in negotiations with New Mexico Black Lung Program. This will provide New Mexico a resource to see a correlation between black lung patients with diabetes and give the number of patients in areas where this correlation is higher. Since the Black Lung Program travels to very remote areas of New Mexico, they have the ability to test patients that are not getting treatment because they have difficulty traveling or their diabetes may not be treated because they were never tested prior to this program. This information will provide the CAHs in those areas information to do more outreach for this population.View New Mexico's State Flex Profile >
PORH is participating with the College of Engineering at Penn State University in their work with the National Science Foundation-sponsored Center for Health Organization Transformation (CHOT) consortium of national universities. PORH has been identified to participate in the CHOT focus areas for 2016-2017 that include population health, payment models, workforce training, home care, operations and care coordination. The Fall 2016 CHOT National Meeting was hosted by Penn State where a representative of the Healthy Communities Institute participated.View Pennsylvania's State Flex Profile >
South Carolina supports the integration of innovative health care models to develop/implement and assess innovative health care models designed to have a positive transformational impact of rural health in the state. Activities include:
- Technical assistance in improving outcomes and partner engagement, identifying and distributing lessons learned and best practices during semi-annual network meetings, using statewide data to identify CAHs who need extra assistance through site visits and partner engagement, providing targeting strategic planning, providing a statewide annual Population Health Summit with state partners for CAHs, Rural Health Networks (RHN), community partners and stakeholders
- Analysis presentation on the root cause analyses completed in FY15 on the factors that differentiate rural population health outcomes from urban ones and the South Carolina state rural health plan development
- Support the development of new provider types including community paramedics, community health workers, health coaches and care coordinators
Success for support is measured by number of technical assistance calls, emails and site visits; the number of RHN meetings held; the number of best practices shared; the number of CAH, RHN, community partners and stakeholders attending the Summit; presentations completed; and the number of stakeholder meetings hosted and attended.View South Carolina's State Flex Profile >
Washington Flex has partnered with the US Department of Agriculture (USDA) and Health Resources and Services Administration (HRSA) Federal Office of Rural Health Policy to provide a funding workshop that was performed on each side of the state, bringing together state and federal resources that provided an opportunity to support the CAHs in innovation planning.View Washington's State Flex Profile >