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Rural coalition wants its share of quality-improvement money

When Congress returns next week from its August recess, a coalition of healthcare providers will be poised to lobby them hard on an issue they'd like to resolve by year's end: the inclusion of rural health clinics in federal quality-improvement efforts—and the funds tied to those programs.

Spearheaded largely by the Quincy (Ill.) Medical Group, an alliance of nearly 30 organizations large and small—including the National Rural Health Association, the Illinois Critical Access Hospital Network, the Billings (Mont.) Clinic, Catholic Healthcare Partners and the American Medical Group Management Association—have banded together to push for physicians at rural health clinics to be included in the federal government's quality programs.

“Whether it's PQRS (Physician Quality Reporting System), e-prescribing or meaningful use, we view those as important and vital quality programs,” says Aric Sharp, CEO of the Quincy Medical Group in central Illinois . “And how those rules have been drafted—rural health physicians are being left out of all of those quality programs.”

That's due to an administrative problem that needs only a “technical correction,” according to Dan Boston, executive vice president at Health Policy Source, the Washington-based consulting firm that is helping to guide the coalition's efforts. As Boston and Sharp both explained, the meaningful use rules were written in such a way that requires CMS to cull data from physicians who submit an HCFA 1500 form. This method excludes physicians at rural health clinics, who instead submit data for reimbursement on a UB-04 form. The technical correction would make it possible for physicians at rural health clinics to include their data and be eligible for the incentives that come with those quality programs.

Sharp says Congressional Budget Office already figured the cost of these rural physicians to the quality programs, so there is no extra expense. He added that the coalition just wants doctors at these clinics to have an equal opportunity for the funds that have been already allocated.

Rep. Aaron Schock's (R-Ill.) office has “taken the lead on it,” Boston says of the legislation in the House. Other supporters include Reps. Greg Walden (R-Ore.) and Bill Huizenga (R-Mich.)—all of whom represent districts that have these rural clinics. And the vehicle for it? Possibilities include a year-end “patch” to the physician sustainable growth rate formula, or SGR; a year-end appropriations bill; or the legislative proposal from the deficit-reduction “supercommittee” (which just yesterday named Mark Prater, former deputy staff director and chief tax counsel on the Senate Finance Committee as the panel's staff director).

“We still have to talk this through,” Boston says. “This is not about saying: we have X co-sponsors,” he adds. “It's more about just getting the job done.”

You can follow Jessica Zigmond on Twitter @MHJZigmond.



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