Program Name: Rural Health Network Development Program
Clearance Number:0906-0010
Revisions:
In an effort to reduce burden on grantees, the Health Resources and Services Administration is removing the following measures from the previously approved information collection request:
Indicate the total number of full-member (all members that signed MOU, MOA, or letters of commitment) network meetings conducted during the reported budget year by meeting type:
Total number of meetings conducted in any manner (face-to-face, teleconference, etc.)?
Number of meetings conduced in any manner (face-to-face, teleconference, etc.) that were attended by at least 75% of board members
How many activities from the project work plan were initiated by at least two or more network members?
How many activities from the project work plan were completed by at least two or more network members?
How many of the network members have provided the following in-kind services during this budget period:
Goods
Services
Staff Support
Expertise
Other
How many network policies or procedures were created during this budget period:
How many network policies or procedures were amended during this budget period:
How many network policies or procedures were implemented during this budget period:
As a result of being part of the network, how many network member organizations were able to integrate joint policies/procedures within their respective organizations during this budget period?
Does the network have a written long-range strategy (3-5 years) for obtaining future network revenue and economic self-sufficiency
Did the network meet its program objectives?
Does the network include a process or tool to assess effectiveness of network performance?
If yes, how is network performance assessed?
Are network performance measures and outcomes disseminated in writing to members at least annually?
Does the network include a process or tool to assess effectiveness of network director?
If yes, how is the network director assessed?
Are discounted services currently available as a result of the activities conducted by your network?
Number of people served by the program
Number of people served by ethnicity
Number of people served, by age group:
Demographics Direct Clinical Services : Number of people served by ethnicity:
Demographics Direct Clinical Services: Number of people served by race:
Demographics Direct Clinical Services: Number of people served, by age group:
Number of uninsured people
Number of people covered through only Medicare
Number of people covered through only Medicaid
Number of people covered by both Medicare and Medicaid (Dual Eligible)
Number of people covered through only the Children’s Health Insurance Program (CHIP)
Number of people covered through only other state-sponsored insurance or public assistance program
Number of people covered by only private insurance
Unknown
Number of positions funded by grant dollars
Clinical
Non-Clinical
Type(s) of technology implemented, expanded or strengthened through this program: (Please check all that apply)
Computerized provider order entry (CPOE)
Electronic entry of prescriptions/e-prescribing
Electronic medical records/electronic health records
Health information exchange (HIE)
Patient/disease registry
Telehealth/telemedicine
None
Other
Have your organization and/or any of your organization’s providers attested to Meaningful Use?
If no, is your organization and/or providers planning to attest in the next 12 months?
If yes, have your organization and/or providers received incentive payments?
Is your organization participating in an ACO? (If yes, please check all that apply)
Medicare Shared Savings Program
Advanced Payment ACO Model
Pioneer ACO Model
Non-Medicare ACO
Is your organization participating in a Medical Home or Patient Centered Medical Home (PCMH) initiative?
If yes, have you achieved or are you pursuing certification or recognition? (If yes, please check all that apply)
National Committee for Quality Assurance (NCQA)
Accreditation Association for Ambulatory Health Care (AAAHC)
The Joint Commission
State/Medicaid Program
Other
Care Coordination Activities?
Referral tracking system
Patient support and engagement
Integrated care delivery system (agreements with specialists, hospitals, community organizations, etc. to coordinate care)
Case management
Care Plans
Medication management
Other
Participation in Partnership for Patients
Participation in Million Hearts
Critical Access Hospitals: Participation in Medicare Beneficiary Quality Improvement Project (MBQIP)
Other – please specify
Does your program focus on an initiative not covered by these measures?
If yes, what is your program’s initiative?
The following measure are new to this information collection request:
Will the programs created through this grant funding continue to sustain after this grant funding?
Sustainability Indicator
Ability of the network to adapt to regional or national healthcare trends
Collaboration across traditional and non-traditional healthcare members within the network
Incorporation of the health needs of the community into the network’s decision making strategies
Creation of diverse products and services that meet the needs of the target population and network members
Creation of diverse revenue streams that include member dues, fee for services and product sales
Utilization of an evaluation plan to assess progress towards program goals and objectives
Absorption of the services provided from this grant funding into the routine operations of network members, without requiring additional funding support
Other
Is your program using a certified EHR technology (CEHRT) to create a summary of care record?
If yes, does your program submit this summary to a receiving provider for more than 10 percent of transitions of care referrals?
What percentage of care transitions between organizations receive an electronic care summary (if available)?
Telehealth: Patient Miles Saved
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| Author | Fallahkhair, Michael (HRSA) |
| File Modified | 0000-00-00 |
| File Created | 2021-01-20 |