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Rural Public Health Policy Forum

Rural Public Health Policy Forum. Medically Underserved Areas/Populations and Health Professional Shortages. Indiana State Department of Health Office of Primary Care. Health Underserved Areas and Health Workforce Shortages. Identified by States

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Rural Public Health Policy Forum

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  1. Rural Public Health Policy Forum Medically Underserved Areas/Populations and Health Professional Shortages Indiana State Department of Health Office of Primary Care

  2. Health Underserved Areas and Health Workforce Shortages • Identified by States • Approved by the federal Office of Designation • Federal health workforce assistance programs require work in designated areas

  3. Health Underserved Areas and Health Workforce Shortages • Geographic definitions of areas of greatest need • Prioritize limited resources and direct them to people in those areas • Medically Underserved Area/Population (MUA/P) • Health Professional Shortage Area (HPSA)

  4. Medically Underserved Area/Population (MUA/P) • MUA/P designation is required for eligibility for grant awards to plan, develop, and operate a community health center • Criteria include: • primary medical care physicians per 1,000 population, • infant mortality rate, • percentage of the population with incomes below the poverty level, and • percentage of the population age 65 or over

  5. Health Professional Shortage Area (HPSA) • HPSA - a prerequisite • National Health Service Corps (NHSC) • Conrad 30 • Exchange Visitor Program • Medicare bonus payments • 3 types of designations each with different criteria • Geographic Area • Population Groups • Facilities

  6. Health Professional Shortage Area (HPSA) • Criteria in general • Population count • Practitioner count • Barriers to access • Nearby resources • High needs of a certain kind of care (primary, dental, mental) • Low income

  7. Designation Requirements for Selected Federal Programs 9

  8. National Health Service Corps Recipients

  9. Designations and Negotiated Rule Making • Committee created to review criteria for the designation of Medically Underserved Areas and Health Professional Shortage Areas • 28 members = key stakeholders of programs most affected • health centers, • rural health clinics • other rural providers • special populations w/unique health care needs • technical experts

  10. Designations and Negotiated Rule Making • mandated by Section 5602 of Public Law 111-148, the Patient Protection and Affordable Care Act of 2010 (ACA) • If the committee reaches a consensuson a proposed rule, at the conclusion of negotiations the committee shall transmit a proposed rule to HHS • Committee to submit to HHS July 2011

  11. Affordable Care Act Impact • Eligibility Requirements for Professionals • Incentive payments for eligible professionals are based on individual practitioners. • As part of a practice, each eligible professional may qualify for an incentive payment if each successfully demonstrates meaningful use of certified EHR technology. • Each eligible professional is only eligible for one incentive payment per year, regardless of how many practices or locations at which he or she provide services. • Hospital-based eligible professionals are not eligible for incentive payments. An eligible professional is considered hospital-based if 90% or more of his or her services are performed in a hospital inpatient or emergency room setting.

  12. Affordable Care Act Impact • Who is an Eligible Professional under the Medicare EHR Incentive Program? • Doctor of medicine or osteopathy • Doctor of dental surgery or dental medicine • Doctor of podiatry • Doctor of optometry • Chiropractor

  13. Affordable Care Act Impact • Who is an Eligible Professional under the Medicaid EHR Incentive Program? • Physicians (primarily doctors of medicine and doctors of osteopathy) • Nurse practitioner • Certified nurse-midwife • Dentist • Physician assistant who furnishes services in a Federally Qualified Health Center or Rural Health Clinic that is led by a physician assistant.

  14. Affordable Care Act Impact • To qualify for an incentive payment under the Medicaid EHR Incentive Program, an eligible professional must meet oneof the following criteria: • Have a minimum 30% Medicaid patient volume • Have a minimum 20% Medicaid patient volume, and is a pediatrician • Practice predominantly in a Federally Qualified Health Center or Rural Health Center and have a minimum 30% patient volume attributable to needy individuals

  15. Affordable Care Act Impact • The extra 10% for HPSA professionals is just for Medicare • Professionals must choose to participate in either the Medicare or Medicaid program • EHR Incentives:  https://www.cms.gov/EHRIncentivePrograms/35_Basics.asp#TopOfPage

  16. Contacts • Ray Guest, Primary Care Office Manager, rguest@isdh.in.gov • Ann Alley, Office of Primary Care and Rural Health, Director aalley@isdh.in.gov

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