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Events Calendar

NEWSLETTER
JULY - SEPTEMBER 2005

Clinic & Hospital Contracting: New Medicare products.

On a full page further back in this newsletter is a spreadsheet that we put together to help people understand these dramatic changes in Medicare originating from the Medicare Modernization Act (MMA) of 2004. Historically there was Medicare, Medicare with commercial supplement, and Medicare Medical Assistance dual eligible. The Feds seem to be outsourcing Medicare in the hopes of containing costs. The new Medicare Select and Cost plans are similar to Medicare with Commercial Supplement. The new Medicare Advantage plans REPLACE Medicare and need to be billed like Medicare. The new Medicare Senior Health Option plans are truly new as they increase benefits by combining Medicare and Medicaid revenue streams. Note that the spreadsheet is complete at the moment but it seems that this is a moving target and is definitely subject to change.

The MRHC Contracting Committee believes that these plans may be the way of the future particularly if the cost to the patient is attractive, as they currently seem to be. We are sending out a survey to determine everyone’s thought on these plans and how they plan to respond with blind results distributed to members.

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Due to the privacy of our contracting specifics we will not be posting that information on our website. Please contact Chuck Ness at the MRHC offices for those details.
 

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Minnesota Rural
Health Cooperative
Meeting Schedule

• July 4         Independence Day
• July 13      HIT Vendor Selection Meeting
• July 14      Contracting Committee Meeting
• July 18      Credentialing Teleconference
• July 19      HIT Site Selection Committee                   Meeting
• July 19      HIT Vendor Selection Meeting
• July 21      Board of Directors Meeting
• July 27      Quality Quarterly Meeting
• July 27      SWEPT Meeting
   
• August 3   Medi-Sota
• August 11  Contracting Committee Meeting
• August 17  SWEPT Meeting
• August 22  Credentialing Teleconference
• August 25  Clinic Managers Meeting
• August 25  Board of Directors Meeting
   
• Sept 5       Labor Day
• Sept 7       Medi-Sota
• Sept 8       Contracting Committee Meeting
• Sept 19      Credentialing Teleconference
• Sept 22      Board of Directors Meeting
• Sept 28      SWEPT Meeting
   
• October 5  Medi-Sota
• October 13 Contracting Committee Meeting
• October 19 Quality Quarterly Meeting
• October 20 Compliance Semi-Annual Meeting
• October 24 Credentialing Teleconference
• October 26 SWEPT Meeting
• October 27 Clinic Managers Meeting
• October 27 Board of Directors Meeting
• October 30 Daylight Savings Time ends     

Current Clinic & Hosp Membership

Clinics

Allergy & Asthma Specialty Clinic, Willmar
Appleton Medical Clinic
CCMH-Montevideo Clinic, P.A.
Counseling Associates of West Central MN, Benson
Divine Providence Clinic, Ivanhoe
ELEAH Medical Center, Elbow Lake
Family Practice Medical Center of Willmar
Glencoe Regional Health Services
Hendricks Medical Clinic, P.A.
Ivanhoe Clinic
Janning ENT Center, LLC, Willmar starting 08/01/05
JMHS Dawson Clinic
Lac Qui Parle Clinic, Madison
Lakeview Medical Clinic, Sauk Centre
Mark Satz, MD, Minneapolis
Marshall Eye Clinic
Minnesota Pathologists Chartered, Willmar
Murray County Clinic, Slayton
Northside Medical Center, Ortonville
Peter B. Meier, M.D., St. Paul
Prairie Family Practice Renville County, Olivia
Prairie Medical Associates, Morris
Rice Institute for Counseling & Education, Willmar
Sioux Valley Canby Campus Clinic
Sleepy Eye Medical Center, Sleepy Eye
Stanley C. Gallagher, D.O., P.A., Wheaton
Starbuck Clinic
The Rose Center for Women, Willmar
Tyler Medical Clinic
West Central Radiological Associates, Willmar
Wheaton Community Clinic
White Family Practice, White, SD
Williams IntegraCare Clinic, Sartell

Hospitals

Appleton Municipal Hospital & Home
Avera Marshall Regional Medical Center, Marshall
Chippewa County Montevideo Hospital 
Divine Providence Health Center, Ivanhoe
ELEAH Medical Center, Elbow Lake
Glencoe Regional Health Services Hospital
Granite Falls Municipal Hospital & Manor
Hendricks Community Hospital & Home
Johnson Memorial Health Services, Dawson
Madison Lutheran Home, Inc.
Meeker County Memorial Hospital, Litchfield
Murray County Memorial Hospital, Slayton
Ortonville Area Health Services 
Redwood Area Hospital
Renville County Hospital, Olivia
Rice Memorial Hospital, Willmar
Sioux Valley Canby Campus Hospital
Sleepy Eye Medical Center, Sleepy Eye
Swift County Benson Hospital
Tyler Healthcare Center 
Wheaton Community Hospital

Non-Voting Members (NV)

Cheryl Hanson, LICSW, Willmar - NV
Great Plains Eye Clinic, Ltd., Sioux Falls, SD-- NV
Hennepin Faculty Associates, Minneapolis – NV
Kenneth H. Rogotzke, Watertown, SD --NV
LCM Pathologists, Sioux Falls, SD – NV
Michael J. Fischer, LICSW, Willmar – NV
Michael J. Vener, MD, PC, Watertown, SD --NV
Patrick M. Malone, MD -- NV
Rick L. Nissen, MD, Bloomington – NV


Visit our website for meeting times and places at www.mrhc.net.

If you need a user ID and password,
please contact Paula Soine
at (320) 564-9118 (ext. 12) or psoine@mrhc.net.

 

2005 Board Members


Brendon Cullinan, M.D., Montevideo Clinic - Chair

Larry Grong, D.O., Lac qui Parle Clinic– Madison– Vice Chair

Leroy Meyering, CFO, Rice Memorial Hospital Willmar Secretary /Treasurer

Glenn Haugo, Administrator, Johnson Memorial Health Services - Dawson

Mark Huntington, M.D., Northside Medical Center – Ortonville

Romulo Kabatay, M.D., Appleton Clinic

David Koster, Pharmacist, Koster Pharmacy-Tyler

Dale Kruger, Administrator, Tyler Healthcare Center

Richard Mulder, M.D., Ivanhoe Clinic

Tom Richter, Administrator, Madison Hospital

Alan Roiseland M.D., Family Practice Medical Center-Willmar

James Schulte, Administrator, Redwood Area Hospital

Thomas Witt, Pharmacist, Witt’s Pharmacy --Springfield

AHRQ Health Information Technology (HIT) Project Update - Paula Soine, Project Coordinator

Five and a half busy months into our one-year Planning grant we had to submit our $1.5 million Implementation grant application April 14^th.  Our ambitious implementation plan calls for installing 15 electronic health record (EHR) systems, developing “real time” communication among providers in the region as well as other referral organizations, developing real time monitoring of compliance with Cooperative contracts with health plans, and developing and installing ten best practices protocols based on ICSI guidelines at each of the 15 selected sites.

While we wait on a funding decision on the Implementation application, we’ve remained diligent with our work on the HIT project. On June 1^st and 2^nd Stratis Health assisted us as we put on four EHR Readiness Workshops at the Prairie’s Edge Casino Convention Center for all facilities that indicated they were “highly interested” in being one of the selected Year 1, 2 or 3 implementers.  The 60 participants made up Project Teams from 13 clinics and 12 hospitals that attended the workshops to receive information on EHR planning, selection and successful implementation, tools to guide and plan organizational goals and strategies, and help determine if their facilities were ready to proceed with EHR.  Dr. Mike Morris from Family Practice Medical Center and Kathy Dillon, Sharon Ratliff-Crain, and Sharon Schmiesing from Rice Memorial Hospital gave well-received presentations providing excellent insights from their experiences implementing EHR systems in their facilities.  (Both clinic and hospital sessions were videotaped if anyone is interested in seeing them.)

Vendor and site selection committees have been formed, and we will soon begin those processes as the deadlines for selecting Year 1 sites is August 1^st and vendors is October 1^st, about the time we should hear if we received the grant or not, thus enabling us to move seamlessly forward from our Planning activities right into implementation.

Chuck and I remain confident that the MRHC will prevail in being one of the lucky 14 nationwide that will be awarded the $7 million/year 3-year Implementation grants: Of the $7 million that AHRQ is putting towards HIT funding, $5 million is reserved for efforts involving small and rural communities. At the recent MN-HiMSS annual conference where both grant award winners from the state gave presentations on their projects, the other grant award winner, professors from the U of M, were highly impressed with all that we had accomplished in such a short period of time with so many participants.  And finally, at the week long AHRQ 2005 Patient Safety and Health Information Technology Conference we attended in early June in Washington D.C., researchers, providers, and health care leaders in public and private sectors from across the nation, who spoke on best practices, lessons learned, and strategies for meeting common challenges, lent credence that we are on the right track.

We continue to learn as much as we can about emerging health information technology and EHR implementation processes so that we can inform and educate our members in their decisions to accelerate the use of the same and arm themselves with strategies, solutions and best practices to address and overcome any health information exchange implementation challenges they may encounter. June 23^rd has us at the Minnesota e-Health Summit, and July 25-28 has us both taking a health IT training session to gain HIT certification.   

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Quality Corner – Shirley Anderson

Another busy quarter just flew by, but as my grandmother always said, “Busy Is Best”. As our 1^st Annual Education Conference plans started rolling---it grew to a fast and furious pace.  It was very exciting and rewarding to be part of the planning and attending our first conference. I look forward to helping with our 2^nd --- plans are already in motion.

The first quarter results for Hospital Emergency Room Survey, Home Care (Current), and Acute Care have been processed and distributed.  Paula and Sandy gave me support with hands on help through the first quarter survey results.  I certainly appreciated it.  Our next Quality Council meeting is Wed., July 27, 2005, 9:30 AM – 11:00 AM in the Montevideo Room.

The first round of Clinic Patient Satisfaction Survey results and the first remeasures for the quality projects have been processed and distributed.  I am delighted to list the winners of the first quarter timely response award—it was a SEVEN-way tie: CCMH Montevideo, Appleton Clinic, Hendricks Clinic, Eleah Medical Center, Divine Providence Medical Clinic, Family Practice Medical Center and Prairie Medical Associates.  Thanks to all on your timely responses.  The next Clinic Quality Council meeting is Wed., July 27, 2005, 11:00 AM-12:30 PM in the Montevideo Room.

Attendance has been great for our Quality Council meetings (both Hospital and Clinic). YEA!  The Stratis Health presentations certainly have been an educational and rewarding part of those meetings.  Plus it gives us a chance to review survey results and discuss any additions, corrections or concerns with our present surveys.

Improvement in quality is always a goal and needs to be reviewed and discussed on a regular basis. As a group we are able to share ideas and track those improvements.    See you in July.

The many Medicare options available in 2005

Government Origins

Medicare Part A (Inpatient)

Medicare Part B (Outpatient)

"old style" Medicare Supplement products from many health plans

Basic Medicare Supplement with no riders

Extended Basic Medicare Supplements

Type

Blue Cross Blue Shield

HealthPartners

Medica

UCare

Sterling Life Insurance Company

Humana Insurance Company

UniCare Life and Health Insurance Company

Metropolian Health Plan (& Primewest)

Medicare Select Plans

Senior Gold

Senior Health Advantage

Select Solution

SeniorSelect:

None

None

None

None

Basic &

Extended Basic

Medicare Cost Plans

VantageBlue:

HealthPartners 65+:

Medica Prime Solution

None

None

None

None

None

Value, Std, or

Basic, Std or

Basic & Enhanced

Complete

w/prescrip coverage

Medicare Advantage

None

Partners for Seniors

None

UCare for Seniors:

None

None

None

None

HMO Plans

Value, Classic,

formerly

Grand & Superior

Medicare+Choice Plans

Medicare Advantage Private-Fee-For-Service Plans