NRMC applies for program to help rural hospitals

Nevada Daily Mail

During their monthly meeting Tuesday, the Nevada Regional Medical Center board of directors voted to pay the $1,000, refundable fee in order to apply to be part of the new, National Rural Accountable Care Organizations program, whose goal is to partner with rural hospitals without the size or finances of other providers participating in Medicare.

Chief Executive Officer Kevin Leeper said the ACO model of providing care, developed only in the last decade, groups hospitals and physicians into one network and then assigns them a number of Medicare patients, likely as many as 5,000 to 10,000.

Previously, those ACOs only included larger hospitals in urban areas, but the NRACO is being organized specifically for rural hospitals such as NRMC through a grant that will fund the program for three years for participating hospitals.

"This new program enables NRMC to enroll in this new paradigm, risk free for three years," Leeper said. "To learn and develop policies on how this mode of care can work in small communities."

The way the ACO works, is that it asks its care providers to be proactive in taking care of the patients assigned to it, using hired care coordinators, funded by the grant, to establish contact with patients and evaluate their health and their medical history, hopefully leading to an early diagnosis of ailments. Those coordinators would then follow up with patients to make sure they understand and follow directions of their physicians.

By following this method, the Centers for Medicare Services and the ACOs hope to prevent later, more serious and costly illnesses from developing, thus giving the patients better quality of life while also improving Medicare's financial state.

"It's a carrot with no stick," Mike Stenger, of Quorum Health Resources, said of the program, which should not cost NRMC anything since fees are refunded to them, although if they go beyond the grant they may have to absorb some costs. "You're basically joining a private club."

Leeper said hiring the care coordinators will result in two to four new jobs for that three year time, and even longer if the program is successful, adding that NRMC's goal in the program is to learn about their population, build inroads with those patients and potentially retain them locally instead of sending them to other providers.

"It's scary," Leeper said of entering the pilot program. "But it's kind of exciting, too."

During the three year trial, Leeper said they will continue to bill for services as they have been. If they find success in the method, however, they will consider switching to the new method of managing population health.

Leeper said NRMC appears to be the type of hospital being sought for the program and this community may have an advantage in the program because of Cerner's Healthy Nevada initiatives, which have already began educating the public concerning healthy living.

Stenger said about 20 hospitals have already shown interest. The program requires a non-binding, letter of intent by the end of April and the application by July 1. Hospitals will be selected and assigned to a community of providers by Sept.1, with the program starting in 2016.

"This is a learning experience," Chief Quality Officer Holly Bush said.

The board voted unanimously to start the application process for joining the NRACO program.