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Report: Hospital Performance Measurement In Rural New England

March 19, 2010: The purpose of this report is to serve as the foundation for developing a consensus-based set of “rural-relevant and useful” quality indicators and measures that CAHs can use. Because most reporting requirements are generated by particular legislative or regulatory interests, the information which CAHs report is generally not helpful to them for comparative or operational uses. This report, therefore, recommends creating a set of common measures that CAHs could use for their performance improvement work, and to serve as benchmarks for comparison with other similar CAHs.

Specific deliverables focus on the creation of an inventory of all measures currently collected and reported by CAHs in Maine, Massachusetts, New Hampshire, and Vermont, identification of the similarities and differences, and the recommendation of a list of “core” rural relevant measures. Tables of the reporting requirements by state are laid out in appendices to this report, using a Balanced Scorecard framework.

To learn more, download the full report (PDF/809KB)


Vermont's Springfield Medical Care Systems Sets National Precedent

March 6, 2009: With the award of $1.3 million in grant funding through the American Recovery and Reinvestment Act (the "stimulus package"), Springfield Medical Care Systems (SMCS), Springfield, VT, parent system of Springfield Hospital, will convert the Hospital's network of primary medical care practices to a network of federally qualified health centers (FQHCs).

As Andrew Majka, chief financial officer, commented, "We are believed to be the first FQHC ever established by an entity that also operates a Critical Access Hospital under the same corporate umbrella, allowing us unique opportunities for efficiency and coordination of care."

Years of hard work and community involvement led to the decision to seek Community Health Center (CHC) funding that would enable the primary care network operated by Springfield Hospital to be transferred to SMCS. The hospital retains its status as a Critical Access Hospital and has its own board of directors. SMCS has undergone a corporate reorganization in order to become Federal section 330(3) CHC grant eligible, with a board of directors made up of patient and community members. The effort to bring about this change began in 2003, culminating in a December 2007 Community Health Center New Access Point application. Although that application received high marks in the competitive process, it was not funded until March 1, 2009, with monies available through the stimulus bill. Senator Bernie Sanders (I-VT), a powerful advocate for community health centers, was instrumental in securing the grant.

Thomas Crawford, Chief Executive Officer of SMCS, comments, "Receipt of this grant is very exciting. Its purpose is closely aligned with our initiatives to make primary and preventive medical care accessible to the most vulnerable members of our community." He continues, "The services are not unlike those we've always provided. This grant will provide financial resources that help us meet the growing needs for health care services across all segments of our communities, improve health education and preventive care initiatives and, in general, enhance the health status of our residents. Very timely in this period of uncertainty, the FQHC program will provide resources to allow us to pay particular attention to the low income, elderly, and underserved among us. It will help us provide access to dental care, mental health counseling, and low-cost prescription drugs."

With the addition of the SMCS network there are now eight FQHCs in Vermont - seven, plus one FQHC look-alike. SMCS defines its service area as 14 towns in the VT counties of Windsor (eight towns) and Windham (three towns) and the NH counties of Sullivan (two towns) and Cheshire (one town). SMCS provides and coordinates care for the service area population from nine clinic sites located in Springfield, Rockingham, Ludlow, and Chester, VT, and Charlestown, NH.

From these clinic sites SMCS provides comprehensive primary medical care, behavioral health counseling and supportive and ancillary services to nearly 25,000 individual users and treats all patients without regard to insurance status or ability to pay. SMCS patients will have access to dental services, either through direct provision or via arrangement. SMCS will also participate in the 340B discount pharmacy program, to expand access to affordable prescription drugs.

The FQHC operated by SMCS will serve a population living in a remote, non-urbanized and economically depressed area. Both per capita income and median household income compare unfavorably with VT and NH: 27.5% of the residents are considered low-income, 8.1% live in poverty, and 32% of the low-income are uninsured. These barriers lead to a variety of health disparities for area residents including high mortality rates for cancer heart disease, diabetes, asthma, and suicide.

The community-based services of SMCS are the primary source of health care for low-income residents and essentially the only source for the uninsured and those with Medicaid.

For more information... Download Article (PDF/15KB); Visit Springfield Hospital Web site
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