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SMALL Rural Hospital Improvement Program (SHIP)

October 6, 2010

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SHIP OVERVIEW

1. Program Purpose / Use of Funds 2. Hospital Eligibility3. Funding Availability4. Application Process 5. Contracting6. VENDOR REQUEST FOR PAYMENT 7. progress Reporting 8. New categories

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2010 PROGRAM PURPOSE CHANGES

• The purpose of ship is to help small rural hospitals do any or all of the following:1. SHIP continues to make funds available for costs

related to implementation of prospective payment systems (PPS)

2. In 2010 and forward, ship funds will be used to pay for the costs related to delivery system changes as outlined in the patient protection and affordable care act (such as value-based purchasing (VBP), accountable care organization (ACO) and payment bundling.

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Hospital Eligibility

• All designated critical access hospitals

• Small rural non federal short-term general acute care facilities with 49 staffed beds or less

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Funding Availability

• Grant award for September 1, 2010 – August 31, 2011 is approximately $ - 8,281

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The Ship ProcessAPPLICATION – CONTRACT – INVOICING - PROGRESS REPORT

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SMALL RURAL HOSPITAL IMPROVEMENT GRANT PROGRAM (SHIP)HOSPITAL GRANT APPLICATION FOR FY 2010

  Due back to State Office of Rural Health by:

A. Grantee Information (Check) Continuing or New / CAH: Yes or No  Hospital Name: _____________________________________________________________Address: __________________________________________________________________ City: ________________ ____State: ______ Zip: ________ County: ___________________Phone: ___________________ Fax: ____________________  Administrator / CEO: __________________________ E-mail: _________________________  Number of beds per line #12 of last Medicare Cost Report: ________

B. Grant Program Activities The information provided below will help your State Office of Rural Health (SORH) understand the goodsand services required to best meet your hospital’s needs under SHIP.

1) List the percent of funds and the dollar amount of your hospital’s proposed budget for the SHIP grant that will be used in the following area(s); you can use it all in one category or split the funds up. Use $9,000 as approximate / tentative amount of the base award. 

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Several months later…

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contracting

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MISSOURI DEPARTMENT OF HEALTH AND SENIOR SERVICES PROGRAM SERVICES CONTRACT

TRACKING NO AM DOC NO

CONTRACT NO.     

VENDOR NO.     

CONTRACTOR     

CONTRACTOR TYPEGOVERNMENT AGENCY PRIVATE OR NON-PROFIT ENTITYMISSOURI MBE / WBE CERTIFICATION NO.      

CONTRACT TITLESmall Rural Health Improvement Program

FUNDING SOURCESTATE     %

FEDERAL100%

CFDA TITLESmall Rural Hospital Improvement Grant Program

CFDA NO. AND FEDERAL AGENCY NAME93.301Dept of Health & Human ServHealth Resources & Serv Adm

RESEARCH AND DEVELOPMENT YES NO

SUBJECT TO A-133 REQUIREMENTS YES NO

FEDERAL AWARD NUMBER AND NAMEH3HRH00010-09-00Small Rural Hospital Improvement Grant Program

FEDERAL AWARD YEAR2010

1. This contract is entered into by and between the State of Missouri, Department of Health and Senior Services, (Department) and the above-named Contractor, and shall consist of this form DH-70, and the following attached documents which are incorporated herein:

Scope of Work – 13 page (s) Attachments / Exhibits –       page (s) Terms and Conditions – 3 page (s)

2. The contract period shall be from September 1, 2010 through August 31, 2011 .

3. The contract amount shall not exceed $ 8,281.30.

4. This contract expresses the complete agreement of the parties and shall supersede all previous communication, representations or agreements, either verbal or written, between the parties. Performance shall be governed solely by the terms and conditions contained in this contract. By signing below, the Contractor and Department agree to all terms and conditions set forth in this contract. 5. Type of contract: X Cost-Reimbursement Fixed-Price

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INVOICINGUSE STATE PROVIDED VENDOR REQUEST FOR PAYMENT FORM TO REQUEST REIMBURSEMENT

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September 1, 2010 – August 31, 2011

June 30, 2011

ERROR

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September 1, 2010 – August 31, 2011

Sept. 1, 2011

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September 1, 2010 – June 30, 2011

June 30, 2011

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June 15, 2011

June 30, 2011

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SMALL RURAL HOSPITAL IMPROVEMENT GRANT PROGRAM (SHIP) Revised Hospital Grant Application for FY 2010Due back to State Office of Rural Health by:      

A. Grantee Information (Check) Returning New CAH: Yes or No

If returning, is there a change in hospital address? Yes No If returning, is there a change in Administrator/CEO information?

Yes No

Hospital Name:      ________________________________________

Address:      ______________________________________________City:   _______________________________State:  _________ Zip:   ________ County:    ______________  Phone:  ___________________ Fax:   _________________Administrator / CEO:  _____________________________ E-mail:   _________________________________   Number of staffed beds:  ___________

B. Grant Program ActivitiesThe information provided below will help your State Office of Rural Health (SORH) understand the goods and services required to best meet your hospital’s needs under SHIP. 1) List the percent of funds and the dollar amount of your hospital’s proposed budget for the SHIP grant that will be used in

the following area(s). You can use it all in one category or split the funds across categories. Use $9,000 as approximate of the base award.

Percent / Amount expended on implementation of Perspective Payment Systems (PPS)        % $      Percent / Amount expended on Value-based Purchasing (VBP)        % $      Percent / Amount expended on Accountable Care Organizations (ACOs)       % $      Percent / Amount expended Bundled Payments       % $      

TOTALS: 100 %

$ 9,000

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Progress report

FY 2009 Report - Due October 29, 2010

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B. Grant Program Expenditures1) List the percent of funds and the dollar amount of your hospital’s SHIP grant expenditures that were used for the following area(s):Percent / Amount expended on purchase of computer software and hardware (such as applications that focus on quality improvement, performance improvement and patient safety):

______ % $_________ Percent / Amount expended on education and training of hospital staff on computer information systems (such as using technology to improve patient outcomes):

______ % $ _________

Percent / Amount expended on implementation of PPS (such as updating chargemasters or providing training in billing and coding) ______ % $ _________

Totals: 100 % $ _________

2) Describe any significant differences between the percentages budgeted for purchase of computer hardware / software, education and training of hospital staff on computer information systems, and implementation of PPS in your FY 09 Hospital Application Form and the actual percentages noted above. Please enter “none” if there were no significant differences.

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Changes to ship 2010

Aco, vbp, bundled payment

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Pps implementation

SHIP continues to make funds available forcosts related to implementation of prospective payment systems (PPS) -

(such asupdating chargemasters or providingtraining in billing and coding).

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Value -based purchasing - VBP

• One of the key challenges for hospitals in the area of VBP is improving data collection activities in order to facilitate reporting to Hospital Compare.

• Examples of activities that satisfy PPACA:– Activities that support data collection/reporting to

Hospital Compare.– Purchase of computer hw/sw, training /education,

equipment, consultants or assessments in this category is appropriate use of SHIP funds.

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Accountable care organization – aco

• The ACO concept is heavily focused on improving quality outcomes. Focus SHIP activities on supporting quality improvement such as reduction of medical errors, education and training in data collection and reporting and benchmarking.

• Example of activities that satisfy PPACA:– Any activities that support quality improvement

• Education and training in data collection and reporting, benchmarking

• Reduction of medical errors– Purchase of computer hw/sw, training /education,

equipment, consultants or assessments in this category is appropriate use of SHIP funds.

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Payment bundling• One of the concepts behind bundled payment is building

accountability across the continuum of care so SHIP funding could be used to improve care transitions.

• Examples of activities that satisfy PPACA:– Improving care transitions between ambulatory and

acute, acute to upstream acute and acute to step-down facility

– Training– Clinical care transition protocol development– Data collection that documents these processes.

• Purchase of computer hw/sw, training /education, equipment, consultants or assessments in this category is appropriate use of SHIP funds.

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??? Questions ???