Continuing Projects
1. Maintaining and Updating the National CAH Database
Lead Center: University of North Carolina Rural Health Research & Policy Analysis
Center
Principal Investigator: Mark Holmes, Ph.D., 919-966-9694 or holmes@schsr.unc.edu
Contact Person: Indira Richardson, M.P.A. 919-966-5541 or richardson@schsr.unc.edu
This project will continue the tracking of Critical Access Hospital (CAH) conversions. A CAH management information dataset, housed at the University of North Carolina, will be updated with information on conversions supplied by the Centers for Medicare and Medicaid Services (CMS). These data are also used to update products on the Monitoring Team website, including a spreadsheet that lists all certified CAHs, a map of current CAHs, and a new table that contains state-level totals of the number of CAHs, and the number with rehabilitation distinct part units (DPU) and the number with psychiatric DPUs. Because the data from CMS do not capture changes in bed size, by agreement with Flex coordinators, an email will be sent to all coordinators once a year requesting updated information on the bed size of CAHs in their state.
2. Measuring Financial Performance in Critical Access Hospitals
Lead Center: University of North Carolina Rural Health Research & Policy Analysis
Center
Principal Investigator: Mark Holmes, Ph.D., 919-966-9694 or
holmes@schsr.unc.edu
Contact Person: George Pink, Ph.D., 919-966-5541 or gpink@schsr.unc.edu
The purpose of the CAH Financial Indicators Report is to provide CAH administrators and boards with comprehensive information about the financial performance and condition of their hospitals. The report includes 20 key financial indicators that are compared to benchmarks established specifically for CAHs and relative performance of other similar types of CAHs. This continuing project is based on work that has been ongoing under the current cooperative agreement. We also propose to extend this work by adding a survey of state Flex Coordinators to describe activities being conducted to improve the financial performance of CAHs in their states.
Using data from CMS Medicare Cost Reports, the primary purpose of the CAH Financial Indicators Report is to provide CAH administrators with comparative financial indicators. The data in this report can be used to assess financial performance across time and in relation to other similar institutions.
3. Measuring Quality Performance: National and State CAH Hospital Compare Analyses
Lead Center: University of Minnesota Rural Health Research Center
Principal Investigator: Ira Moscovice, Ph.D., 612-624-8618 or mosco001@umn.edu
Contact Person: Michelle Casey, M.S., 612-623-8316 or mcasey@umn.edu
The purpose of this project is to measure the quality performance of CAHs nationally and by state on an ongoing basis using quality measure data from the CMS Hospital Compare database. This project is based on continuing work that has been ongoing under the previous cooperative agreement. The project will be led by staff at the University of Minnesota. It will be an ongoing project for all five years of the cooperative agreement, with national and state-level reports prepared annually.
This project builds upon previous Flex Monitoring Team and UMN activities related to the development and field-testing of quality performance measures for small rural hospitals, three previous national studies of CAH quality performance using Hospital Compare quality measure data in 2006, 2007, and 2008 and state-level CAH Hospital Compare reports produced in 2008. In each year of the cooperative agreement, we will use annual quality measure data from the CMS Hospital Compare website to prepare a national report and state-level reports on CAH participation and performance in Hospital Compare for each Flex state.
4. Measuring the Community Impact of CAHs
Lead Center: University of Southern Maine
Expected completion date: August 2008
Principal Investigator: Andrew F. Coburn, Ph.D., 207-780-4435 or
andyc@usm.maine.edu
Contact Person: John A. Gale, M.S., 207-228-8246 or jgale@usm.maine.edu
This project builds on the Flex Monitoring Team's past work in understanding how CAHs impact their communities by developing a series of community impact performance indicators and a related performance monitoring system that to prepare national and state-level annual community impact performance reports. Using the American Hospital Association’s Annual Hospital Survey, we will track and report on the community impact activities of CAHs nationally and at the state level for all 45 states participating in the Flex Program. As part of this project focused on measuring the community impact of CAHs, we are developing a multi-state community impact collaborative made up of representatives from states, CAHs, and community benefit/impact experts. The goal of the multi-state collaborative is to raise the visibility of the CAH community impact and benefit activities and highlight the importance of approaching these activities in a strategic and coordinated fashion. The collaborative will focus on the strategic aspects of community impact initiatives and examine the ways in which hospitals are implementing, evaluating, and reporting on their community impact initiatives. Areas of focus will include the needs assessment processes used by CAHs to identify and support the development of hospital activities; CAH community impact and benefit strategic planning efforts; best/promising practices detailing the community impact/benefit activities of CAHs to address specific community needs; measurement and evaluation of the outcomes of community impact/benefit activities; and the ways in which CAHs report their community impact and benefit activities to internal management, their boards, and external audiences. As part of this project, we are developing educational resources for CAHs and communities interested in community impact and benefits activities and programming.