U.S. Department of Health and Human Services: Rural Health Network Development Program

The purpose of the Rural Health Network Development (RHND) Program is to support mature, integrated rural health care networks that have combined the functions of the entities participating in the network in order to address the health care needs of the targeted rural community. Awardees will combine the functions of the entities participating in the network to address the following statutory charges: (1) achieve efficiencies; (2) expand access, coordinate, and improve the quality of essential health care services; and (3) strengthen the rural health care system as a whole. Applicants will be required to select at least one activity from a prescribed topic from one statutory charge. The prescribed topic areas are described in detail below.

1. Achieve Efficiencies. The topic is: Integrated health networks will focus on integrating health care services and/or health care delivery of services to achieve efficiencies and improve rural health care services. Networks will focus on integrating their individual systems of care to achieve the following goals: 1) implement a financial strategy that will reduce costs; 2) improve quality and delivery of health care services; and 3) improve medical oversight. Awardees will choose at least one activity from the following areas:

• Integrating behavioral health in primary care settings
• Integrating primary care in behavioral health care settings
• Integrating oral health in primary care settings
• Integrating primary care in oral health settings
• Integrating emergency medical services (EMS) in hospital settings

2. Expand access to, coordinate, and improve the quality of essential health care services. The topic is: Integrated health networks will collaborate to expand access to and improve the quality of essential health care services by focusing on projects and/or network activities directly related to the evolving health care environment.

The new health care environment has a large emphasis on improving and transforming the quality of hospital care by realigning hospital financial incentives. Networks can achieve efficiencies and increase economic and provider financial viability through projects that focus on payment and care reform. Networks are also integral to providing effective coordination of services and expanded access to care through a range of care coordination activities, Health IT use (which meets meaningful use standards) and telehealth implementation. Awardees will choose at least one activity from the following areas:

• Improving performance on quality measures for clinicians such as through the Physician Quality Reporting System or the Medicare Quality Payment Program as well as for hospitals, skilled nursing facilities, home health agencies, and/or ambulatory surgical facilities
• Improving the quality and safety of health care by improving care transitions from the hospital to other settings and reducing hospital readmissions
• Improving coordination of services
• Implementing innovative solutions to alleviate the loss of local services and enhance access to care for communities that may have or are at risk of losing their local hospital
• Implementing telehealth services that may include: remote monitoring, interactive telehealth services, store and forward telehealth, imaging services, and specialist and primary care consultation
• Implementing Health IT and Meaningful Use (MU) activities that may include: E-prescribing and incorporating lab results into a Health Information Exchange (HIE), electronic transmission of patient care summaries, patient access to self-management tools, and patient centered HIE
• Facilitating enrollment in the health insurance marketplace, Medicaid, Children’s Health Insurance Program (CHIP), Medicare Advantage, and other forms of health insurance coverage through the use of Consumer Assistance Programs/Patient Navigation
• Leveraging competitive negotiations and contracts with Qualified Health Plans (QHPs) through Essential Community Provider (ECP) collaboration
• Implementing innovative alternative payment and delivery models
• Implementing programs to increase primary care workforce in rural areas
• Expanding access to outpatient cardiology and/or pulmonary rehabilitation, speech therapy, child psychology, or other critical shortages

3. Strengthen the rural health care system as whole. The topic is: Networks will improve population health by implementing promising practice, evidence-informed and/or evidence-based approaches to address health disparities and enhance population health in their communities. Population health can be defined as an approach that focuses on interrelated conditions and factors that influence the health of populations over the course of their lives. The health outcomes and distribution of health outcomes in a population are studied and appropriate policies and interventions are created to address the health concern of that population.

Programs implementing a promising practice, evidence-informed and/or evidence-based approaches to address population health may choose the intervention that best meets the needs of their community. Examples of interventions can be found online and may include the following:

• Medicare Diabetes Prevention Program
• Rural Training Track Technical Assistance Program
• Midcoast Maine Prescription Opioid Reduction Program
• Project ECHO® – Extension for Community Healthcare Outcomes
• SAMA HealthCare Services, a Patient-Centered Medical Home

Many rural communities have specific health outcomes particular to their community alone. Therefore, networks may serve as an appropriate organization to address population health needs and social determinants

Amount: A total of $9,000,000 is available to fund up to 30 grants, ranging up to $300,000 per year. The project period is three years.

Eligibility:

• Ownership and geographic requirements: Applicants must be a public or private non-profit entity located in a rural area or in a rural census tract of an urban county, and all services must be provided in a rural county or census tract. The applicant’s EIN number should verify that it is a rural entity. To ascertain rural eligibility, please refer to: http://datawarehouse.hrsa.gov/RuralAdvisor/. In addition to the states listed on the Rural Advisor, only the Commonwealth of Puerto Rico, the Northern Mariana Islands, American Samoa, Guam, the U.S. Virgin Islands, the Federated States of Micronesia, the Republic of the Marshall Islands, and the Republic of Palau may apply. If applicants are located outside the 50 states, they still have to meet the rural eligibility requirements. Faith-based and community-based organizations are eligible to apply. Tribes and tribal organizations are eligible to apply.
• Network requirements: The network must be formal and composed of at least three members that are separate, existing health care provider entities that have their own EIN number. The applicant must be a non-profit in a rural area. Network members may be for-profit or non-profit and may be in a rural or urban area. However, all services and activities conducted by the network and paid for through this funding must serve rural populations. A formally established and incorporated (501(c) (3) network may apply on behalf of all network members.

Link: http://www.grants.gov/web/grants/view-opportunity.html?oppId=284898

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