List of Revisions

REVISIONS - Rural Health Network Development Program (0906-0010).docx

Rural Health Network Development Program Performance Improvement and Measurement System (PIMS)

List of Revisions

OMB: 0906-0010

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Program Name: Rural Health Network Development Program

Clearance Number:0906-0010



Revisions:

In an effort to reduce burden on grantees, the Health Resources and Services Administration is removing the following measures from the previously approved information collection request:

  1. Indicate the total number of full-member (all members that signed MOU, MOA, or letters of commitment) network meetings conducted during the reported budget year by meeting type:

  2. Total number of meetings conducted in any manner (face-to-face, teleconference, etc.)?

  3. Number of meetings conduced in any manner (face-to-face, teleconference, etc.) that were attended by at least 75% of board members

  4. How many activities from the project work plan were initiated by at least two or more network members?

  5. How many activities from the project work plan were completed by at least two or more network members?

  6. How many of the network members have provided the following in-kind services during this budget period:

Goods

Services

Staff Support

Expertise

Other

  1. How many network policies or procedures were created during this budget period:

  2. How many network policies or procedures were amended during this budget period:

  3. How many network policies or procedures were implemented during this budget period:

  4. As a result of being part of the network, how many network member organizations were able to integrate joint policies/procedures within their respective organizations during this budget period?

  5. Does the network have a written long-range strategy (3-5 years) for obtaining future network revenue and economic self-sufficiency

  6. Did the network meet its program objectives?

  7. Does the network include a process or tool to assess effectiveness of network performance?

  8. If yes, how is network performance assessed?

  9. Are network performance measures and outcomes disseminated in writing to members at least annually?

  10. Does the network include a process or tool to assess effectiveness of network director?

  11. If yes, how is the network director assessed?

  12. Are discounted services currently available as a result of the activities conducted by your network?

  13. Number of people served by the program

  14. Number of people served by ethnicity

  15. Number of people served, by age group:

  16. Demographics Direct Clinical Services : Number of people served by ethnicity:

  17. Demographics Direct Clinical Services: Number of people served by race:

  18. Demographics Direct Clinical Services: Number of people served, by age group:

  19. Number of uninsured people

  20. Number of people covered through only Medicare

  21. Number of people covered through only Medicaid

  22. Number of people covered by both Medicare and Medicaid (Dual Eligible)

  23. Number of people covered through only the Children’s Health Insurance Program (CHIP)

  24. Number of people covered through only other state-sponsored insurance or public assistance program

  25. Number of people covered by only private insurance

  26. Unknown

  27. Number of positions funded by grant dollars

Clinical

Non-Clinical

  1. Type(s) of technology implemented, expanded or strengthened through this program: (Please check all that apply)

Computerized provider order entry (CPOE)

Electronic entry of prescriptions/e-prescribing

Electronic medical records/electronic health records

Health information exchange (HIE)

Patient/disease registry

Telehealth/telemedicine

None

Other

  1. Have your organization and/or any of your organization’s providers attested to Meaningful Use?

  2. If no, is your organization and/or providers planning to attest in the next 12 months?

  3. If yes, have your organization and/or providers received incentive payments?

  4. Is your organization participating in an ACO? (If yes, please check all that apply)

Medicare Shared Savings Program

Advanced Payment ACO Model

Pioneer ACO Model

Non-Medicare ACO

  1. Is your organization participating in a Medical Home or Patient Centered Medical Home (PCMH) initiative?

  2. If yes, have you achieved or are you pursuing certification or recognition? (If yes, please check all that apply)

National Committee for Quality Assurance (NCQA)

Accreditation Association for Ambulatory Health Care (AAAHC)

The Joint Commission

State/Medicaid Program

Other

  1. Care Coordination Activities?

Referral tracking system

Patient support and engagement

Integrated care delivery system (agreements with specialists, hospitals, community organizations, etc. to coordinate care)

Case management

Care Plans

Medication management

Other

  1. Participation in Partnership for Patients

  2. Participation in Million Hearts

  3. Critical Access Hospitals: Participation in Medicare Beneficiary Quality Improvement Project (MBQIP)

  4. Other – please specify

  5. Does your program focus on an initiative not covered by these measures?

  6. If yes, what is your program’s initiative?

The following measure are new to this information collection request:

  1. Will the programs created through this grant funding continue to sustain after this grant funding?

  2. Sustainability Indicator

Ability of the network to adapt to regional or national healthcare trends

Collaboration across traditional and non-traditional healthcare members within the network

Incorporation of the health needs of the community into the network’s decision making strategies

Creation of diverse products and services that meet the needs of the target population and network members

Creation of diverse revenue streams that include member dues, fee for services and product sales

Utilization of an evaluation plan to assess progress towards program goals and objectives

Absorption of the services provided from this grant funding into the routine operations of network members, without requiring additional funding support

Other

  1. Is your program using a certified EHR technology (CEHRT) to create a summary of care record?

  2. If yes, does your program submit this summary to a receiving provider for more than 10 percent of transitions of care referrals?

  3. What percentage of care transitions between organizations receive an electronic care summary (if available)?

  4. Telehealth: Patient Miles Saved





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