Medicare launches effort to improve access, quality of care in rural areas of North Dakota

Today, the U.S. Department of Health and Human Services announced an effort to increase access to care for Medicare beneficiaries in North Dakota….

Today, the U.S. Department of Health and Human Services announced an effort to increase access to care for Medicare beneficiaries in North Dakota through three critical access hospital (CAH) project sites: Jacobson Memorial Hospital Care Center, Southwest Healthcare Services, and McKenzie County Healthcare Systems. The program, called the Frontier Community Health Integration Project (FCHIP) Demonstration, will launch in frontier areas of the country where access to health services can be limited because of distance from health care providers. CMS defines frontier areas as rural, sparsely populated and isolated from population centers and services. In many rural areas, patients often depend on their local hospitals as hubs for essential health care services in their communities.

“Every American deserves access to high-quality health care regardless of whether they live in a remote rural area or a big city,” said Acting Deputy Secretary Mary Wakefield. “The Frontier Community Health project incentivizes rural Medicare providers to deliver more efficient care by providing a wide range of services that are closer to home.”

The FCHIP Demonstration, launched by the CMS Innovation Center, will test new models of integrated, coordinated health care in the most sparsely populated rural counties in the nation over three years. Created in collaboration with the Health Resources and Services Administration’s Federal Office of Rural Health Policy, this demonstration program will encourage ten critical access hospitals in Montana, Nevada and North Dakota to provide essential services that are often not financially viable in rural communities with the goal of improving quality of care and increase patient satisfaction in rural communities while spending health care dollars more wisely. The demonstration will provide financial incentives for care coordination activities for local critical access hospitals (CAHs) to reduce unnecessary admissions and readmissions across their networks of care.

“Medicare beneficiaries who live in frontier areas of the country often travel hundreds of miles just to see a doctor. This increases the cost of care and often discourages beneficiaries from seeking the treatment they need,” said Patrick Conway, M.D., principal deputy administrator and chief medical officer at CMS. “The effort announced today will look at ways to shrink the distance between the Medicare beneficiary and the care they need.”

Specifically, the demonstration aims to:

•Support the CAH and local delivery system in keeping patients within the community who might otherwise be transferred to distant providers;

•Test whether reasonable payments for certain services will enhance access to care for patients, increase the integration and coordination of care among providers, and reduce avoidable hospitalizations, admissions and transfers; and

•Test new CAH activities in three service categories: skilled nursing care, telehealth, and ambulance services.

The FCHIP Demonstration is mandated by Section 123 of the Medicare Improvements for Patients and Providers Act of 2008, as amended by Section 3126 of the Affordable Care Act of 2010. The law requires a demonstration project on community health integration models in certain rural counties to develop and test new models for the delivery of health care to better integrate the delivery of acute care, extended care, and other health care services. The Federal Office of Rural Health Policy will monitor the work of the technical assistance provider, Montana Health and Research Education Foundation, collect information on key policy challenges facing frontier providers, while CMS will test alternative payment and administrative strategies.

The FCHIP is another example of how the Administration is working to ensure that Americans receive better care, we spend our health care dollars more wisely, and we have healthier people. Applications were received from CAHs in Montana, Nevada, and North Dakota (although eligible, CAHs in Alaska or Wyoming did not apply).

For more information on the Frontier Community Health Integration Project Demonstration, please visit: