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MVC Announces Summer Date for New Virtual Rural Health Meeting

MVC Announces Summer Date for New Virtual Rural Health Meeting

MVC will host a special virtual event this summer for its rural and northern Michigan members. The new MVC Rural Health Meeting is modeled after MVC’s collaborative-wide meetings that are offered in person in the spring and fall. This tailored member meeting differs in that its guest speakers and unblinded data presentations will focus on the unique challenges and opportunities in delivering value-based healthcare in rural or low-density communities. The event will take place over Zoom on Wednesday, August 9, 2023, from 10 a.m. - 12 p.m.

The Collaborative has diversified in recent years with the addition of more rural-based hospitals and physician organizations as well as more representation throughout Northern Michigan, including critical access hospitals. These sites play an integral role in the health system and have a unique care delivery experience.

According to the Centers for Medicare and Medicaid Services (CMS), rural providers have higher performance quality measures than their urban counterparts in areas such as safety, community engagement, efficiency, and cost reduction. At the same time, however, they also face unique challenges related to low patient volumes, higher rates of chronic disease, insufficient workforce recruitment and retention, and low reimbursement rates, among others.

It is these unique strengths and challenges that will be the focus of the August 9 agenda, along with unblinded MVC data that caters to priority conditions and areas of care for rural providers. If your hospital or physician organization is interested in presenting on a recent rural health initiative or would like to request data on a specific area of care, please contact the MVC Coordinating Center 

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New MVC Northern Summer Meeting Planned for August

New MVC Northern Summer Meeting Planned for August

MVC will launch a new in-person event this summer when it hosts members and speakers from Northern Michigan. This new MVC Northern Summer Meeting is modeled after the collaborative-wide semi-annual meetings, but it aims to focus on unique challenges and opportunities in delivering healthcare in this part of the state. The event will take place on August 18, 2022, from 12-5 p.m. at the Great Wolf Lodge in Traverse City, MI.

As MVC has gained new members, it has also diversified with the addition of more rural and critical access hospitals. These types of sites – many of which are located in the upper peninsula or northern half of the lower peninsula – play an integral role in the health system and have a unique care delivery experience. According to the Centers for Medicare and Medicaid Services (CMS), these types of hospitals have higher performance quality measures than their urban counterparts for areas such as safety, community engagement, efficiency, and cost reduction. At the same time, however, they also face unique challenges related to low patient volumes, higher rates of chronic disease, insufficient workforce recruitment and retention, and low reimbursement rates, among others.

It is these unique strengths and challenges that will be the focus of the day’s agenda, which will include speakers representing area hospitals, rural health organizations, community agencies, and the MVC Coordinating Center. The event’s keynote speaker will be Crystal Barter, MSA, Director of Programs and Services for the Michigan Center for Rural Health. Her presentation on “Michigan’s Rural Health Landscape: Challenges and Opportunities” will set the stage for the afternoon and be followed by speakers on specific topics, such as Hospital at Home care models and the aging population.

The other speakers include Stephanie Pins, MSA, Director of Quality Management, Risk, and Compliance, and Kristine Boyer, MSN, RN, Clinical Quality Manager, of MyMichigan Medical Center - Sault; Dr. Aditya Neravetla, MD, Chief Medical Officer at Munson Healthcare Grayling Hospital; and Jenna Lindholm, RN, CCM, Clinical Quality Supervisor at the Region 9 Area Agency on Aging.

The MVC Coordinating Center will also provide its latest updates as well as unblinded data to encourage member collaboration. The event includes dedicated networking sessions at the start and end of the day’s agenda when members can compare notes and glean ideas from peers.

MVC distributed invitations to northern members at the beginning of June and plans to share the full agenda with additional event specifics in the coming weeks. Those members who received invitations are encouraged to RSVP now.

If you have any questions about the upcoming event, contact the MVC Coordinating Center at michiganvaluecollaborative@gmail.com.

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Approach to quality improvement unique for rural hospitals

Approach to quality improvement unique for rural hospitals

Quality improvement is a key effort for healthcare systems and a driving force behind the work of the Michigan Value Collaborative. It is also an increasingly complex task with significant implications. Not surprisingly, quality improvement is not a one-size-fits-all approach, with the challenges impacting hospitals varying significantly by factors such as size and location. This variability showcases the importance of sharing tailored resources among Collaborative members.

Critical-access hospitals (CAHs) are the newest type of members to join the Collaborative. They play an important role in the healthcare system by caring for rural patients who might not otherwise have access to inpatient services. Defined as hospitals maintaining no more than 25 acute care beds and located more than 35 miles from the nearest hospital, they are unique in their populations, services, and structure. The majority of their patients would have to drive 30 minutes or more for an alternative hospital, and many communities have no alternative. Their offerings and size are reflective of the communities they serve, with services such as emergency care, inpatient care, laboratory testing, rehabilitation, long-term care, maternity care, home health care, and even primary care. As a result, their capacities, priorities, and challenges differ from those of their larger colleagues, as do their quality improvement efforts.

For example, a 2015 report from the National Quality Forum titled, “Performance Measurement for Rural Low-Volume Providers,” highlights several challenges to quality improvement in rural areas including fewer providers, lack of information technology, and fewer people to share the workload. Furthermore, rural hospitals often don't meet patient volume thresholds that are required for meaningful comparative analyses. It is critical, therefore, that CAH facilities are connected to resources tailored to their circumstances. One such resource is the 2021 Small Rural Hospital Blueprint for Performance Excellence and Value, produced by the National Rural Health Resource Center.

The purpose of this Blueprint is to aid rural hospital leaders in taking a comprehensive systems approach to quality improvement using factors and strategies relevant to small rural hospitals. Guided by the components of the Baldrige Framework that first took hold in healthcare over 20 years ago, the Blueprint outlines typical challenges, factors for success, and relevant resources for seven key inter-linked focus areas (see Figure 1): leadership; strategic planning; patients, partners, and communities; measurement, feedback, and knowledge management; workforce and culture; operations and processes; and impact and outcomes.

Figure 1.

The Blueprint also incorporates specific comments and feedback shared during the Small Rural Hospital Performance Excellence Summit that was held in the spring of 2021. For instance, within the section on leadership, the Blueprint suggests that educating and engaging the CAH’s board members on healthcare trends and issues is a critical factor of success, in large part because board members in rural areas often do not have a healthcare background. A quote from the Summit on this issue reads, “changes in healthcare are complicated, particularly for those that don’t spend all day every day focused on it.” The Blueprint then recommends resources listed in its appendix that are specifically designed for engaging CAH board members. In addition, a full companion resource focused on related strategies and resources for state flex programs is also available.

CAHs are an important piece of the healthcare puzzle and, like their larger colleagues, they stand to benefit significantly from quality improvement efforts. In fact, an October 2019 CMS fact sheet, “CMS Hospital Value-Based Purchasing Program Results for Fiscal Year 2020,” looked at adjustments made for Medicare payments to hospitals based on their performance on a set of quality measures. Compared to urban hospitals, rural and smaller hospitals generally performed better in both efficiency and cost reduction, among other areas.

The MVC Coordinating Center established regions within its membership in order to help hospitals network and share practices with their peers. Many of the CAH members within the Collaborative operate in region 1 in the northern parts of the state, and a regional networking event was held for region 1 earlier this week. The Coordinating Center is proud of its diverse membership and continues to encourage facilities and POs to leverage the knowledge of peers who operate in a similar capacity so that, together, members can improve the value of healthcare for Michigan patients. If your facility or PO is utilizing a resource that would benefit the work of a peer institution, please contact the Coordinating Center at michiganvaluecollaborative@gmail.com so it may be shared with the Collaborative.