{"id":3363,"date":"2020-10-14T08:00:37","date_gmt":"2020-10-14T13:00:37","guid":{"rendered":"http:\/\/blogs.luc.edu\/compliance\/?p=3363"},"modified":"2020-10-14T08:00:37","modified_gmt":"2020-10-14T13:00:37","slug":"rural-hospitals-in-crisis-receive-a-boost-to-value-based-care-model-from-new-cms-chart-model","status":"publish","type":"post","link":"https:\/\/blogs.luc.edu\/compliance\/?p=3363","title":{"rendered":"Rural Hospitals in Crisis Receive a Boost to Value-Based Care Model from New CMS CHART Model"},"content":{"rendered":"<p><span style=\"font-family: 'times new roman', times, serif;color: #000000\"><em>Kennedy<\/em><em> Chiglo<br \/>\nAssociate Editor<br \/>\n<\/em><em>Loyola University Chicago School of Law, JD <\/em><em>2022<\/em><\/span><\/p>\n<p><span style=\"font-family: 'times new roman', times, serif;color: #000000\">The Centers for Medicare &amp; Medicaid Services (\u201cCMS\u201d) Innovation Center (\u201cCMMI\u201d) recently announced a <a style=\"color: #000000\" href=\"https:\/\/innovation.cms.gov\/innovation-models\/chart-model\">new model for health care providers in rural areas<\/a> to receive payment from the federal government. The Community Health Access and Rural Transformation (\u201cCHART\u201d) initiative aims to improve rural health care while promoting the Trump Administration\u2019s push to shift health care providers into a more expansive value-based payment model.<!--more--><\/span><\/p>\n<p><span style=\"font-family: 'times new roman', times, serif;color: #000000\"><strong>Why would CMS introduce the CHART model now?<\/strong><\/span><\/p>\n<p><span style=\"font-family: 'times new roman', times, serif;color: #000000\">Rural communities in the United States comprise of nearly <a style=\"color: #000000\" href=\"https:\/\/gis-portal.data.census.gov\/arcgis\/apps\/MapSeries\/index.html?appid=7a41374f6b03456e9d138cb014711e01#:~:text=Define%20%22Rural%3F%22-,How%20Does%20the%20U.S.%20Census%20Bureau%20Define%20%22Rural%3F%22,areas%20of%20the%20United%20States.\">60 million people<\/a> who face unique barriers in their access to quality health care services. A vast majority of Americans residing in rural areas are Medicare and Medicaid beneficiaries, yet many are unable to utilize their health care benefits for lack of transportation, shortages in health care services, and dated technology that hinders care-delivery innovations. <a style=\"color: #000000\" href=\"https:\/\/www.cms.gov\/newsroom\/fact-sheets\/community-health-access-and-rural-transformation-chart-model-fact-sheet\">CMS has stated<\/a> that the current fee-for-service and volume-based payment models permeate the health care inequities in rural communities but remains focused on the transformation of rural health care delivery through the new CHART model.<\/span><\/p>\n<p><span style=\"font-family: 'times new roman', times, serif;color: #000000\">Since 2010, over <a style=\"color: #000000\" href=\"https:\/\/www.shepscenter.unc.edu\/programs-projects\/rural-health\/rural-hospital-closures\/\">130 rural hospitals have closed their doors<\/a>, and this trend has led to a <a style=\"color: #000000\" href=\"https:\/\/www.gao.gov\/products\/GAO-17-411\">shortage of 20,000<\/a> rural health care workers, including primary care physicians. These circumstances have led to rural Americans with higher rates of preventable diseases, unintentional injuries, and <a style=\"color: #000000\" href=\"https:\/\/www.americanhealthlaw.org\/content-library\/publications\/briefings\/aba4b388-1c5c-4b6a-8cfb-1ac6ce3c6ea9\/Understanding-the-New-Community-Health-Access-and?Token=b12a0b2d-d685-45ed-a330-0407b6fe36b5\">worse health outcomes<\/a> than Americans residing in urban and suburban communities. The CMS introduction of the CHART model attempts to remedy these inherent rural health care obstacles by empowering local communities to create solutions that are tailored to their specific needs.<\/span><\/p>\n<p><span style=\"font-family: 'times new roman', times, serif;color: #000000\"><strong>How will the CHART model operate?<\/strong><\/span><\/p>\n<p><span style=\"font-family: 'times new roman', times, serif;color: #000000\">CMMI will be providing <a style=\"color: #000000\" href=\"https:\/\/innovation.cms.gov\/innovation-models\/chart-model\">$75 million<\/a> of seed funding from CMS to fifteen rural communities to submit their plans to transform their health care facilities ranging from rural health centers, ambulatory surgery clinics, rural inpatient facilities, freestanding clinics, and more. \u00a0The selected rural communities will serve as Lead Organizations who are paid for their quality and outcomes of care rather than the volume of their care. The Lead Organizations must be contained within rural counties as classified by the <a style=\"color: #000000\" href=\"https:\/\/data.hrsa.gov\/tools\/rural-health\">Federal Office of Rural Health Policy<\/a> and will be responsible for working closely with CHART model participants in the communities.<\/span><\/p>\n<p><span style=\"font-family: 'times new roman', times, serif;color: #000000\">In return, <a style=\"color: #000000\" href=\"https:\/\/www.advisory.com\/daily-briefing\/2020\/08\/13\/chart\">CMS will offer flexibility<\/a> in both regulatory and operational requirements in an effort to embolden rural hospitals to transform their care delivery system. CMS will also provide regular monthly payments to these hospitals in an effort to stabilize the CHART model throughout the trial period.<\/span><\/p>\n<p><span style=\"font-family: 'times new roman', times, serif;color: #000000\">Additionally, <a style=\"color: #000000\" href=\"https:\/\/www.cms.gov\/newsroom\/fact-sheets\/community-health-access-and-rural-transformation-chart-model-fact-sheet#_ftn3\">twenty rural Accountable Care Organizations<\/a> (\u201cACOs\u201d) will have the ability to join in the CHART model. ACOs will be paid their shared savings upfront to encourage stable infrastructure and long-term expansion of the ACO in a given rural community.\u00a0<\/span><\/p>\n<p><span style=\"font-family: 'times new roman', times, serif;color: #000000\"><strong>What is the timeline for rural communities to apply for CHART funding?<\/strong><\/span><\/p>\n<p><span style=\"font-family: 'times new roman', times, serif;color: #000000\">Interested rural health care providers and hospital systems can find the notice of funding opportunity on the CMMI CHART website now or on the <a style=\"color: #000000\" href=\"https:\/\/www.grants.gov\/web\/grants\/search-grants.html?keywords=93.624\">federal government grant website<\/a>. Communities that <a style=\"color: #000000\" href=\"https:\/\/www.medicaid.gov\/about-us\/messages\/101126\">wish to participate<\/a> in the Transformation Track of the CHART Model must submit their Letters of Intent by January 28, 2022, and applications for the program will be due shortly thereafter on February 16, 2022.<\/span><\/p>\n<p><span style=\"font-family: 'times new roman', times, serif;color: #000000\">The current public health emergency from COVID-19 has exacerbated health disparities in rural communities. Not only have rural health systems suffered for years under the volume-based payment model, but access to quality care during a pandemic has highlighted the need for swift and meaningful intervention from CMS. The complicated and outdated payment model has not benefited rural health care providers, but the introduction of the CHART model will be the necessary push into a value-based payment system that will enhance rural health care access and lessen disparate outcomes. Although the CHART model is not operational yet, compliance with program rules will be essential to the pilot program. Rural hospitals that receive the CMS funding will need to reinforce their internal monitoring and auditing functions to guarantee funding and CHART program functionality.\u00a0<\/span><\/p>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>The Centers for Medicare &amp; Medicaid Services (\u201cCMS\u201d) Innovation Center (\u201cCMMI\u201d) recently announced a new model for health care providers in rural areas to receive payment from the federal government. The Community Health Access and Rural Transformation (\u201cCHART\u201d) initiative aims to improve rural health care while promoting the Trump Administration\u2019s push to shift health care providers into a more expansive value-based payment model.<\/p>\n","protected":false},"author":71,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[377,432,826,921,1010,1014,1030,1205,1304,1310,1690,1747,1749,1750,2017],"class_list":["post-3363","post","type-post","status-publish","format-standard","hentry","category-uncategorized","tag-chart-model","tag-cms","tag-federal-grants","tag-funds","tag-health-insurance","tag-healthcare","tag-hhs","tag-journal-of-regulatory-compliance","tag-medicaid","tag-medicare","tag-regulation","tag-rulemaking","tag-rural","tag-rural-healthcare","tag-trump-administration"],"_links":{"self":[{"href":"https:\/\/blogs.luc.edu\/compliance\/index.php?rest_route=\/wp\/v2\/posts\/3363","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/blogs.luc.edu\/compliance\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blogs.luc.edu\/compliance\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blogs.luc.edu\/compliance\/index.php?rest_route=\/wp\/v2\/users\/71"}],"replies":[{"embeddable":true,"href":"https:\/\/blogs.luc.edu\/compliance\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=3363"}],"version-history":[{"count":0,"href":"https:\/\/blogs.luc.edu\/compliance\/index.php?rest_route=\/wp\/v2\/posts\/3363\/revisions"}],"wp:attachment":[{"href":"https:\/\/blogs.luc.edu\/compliance\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=3363"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blogs.luc.edu\/compliance\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=3363"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blogs.luc.edu\/compliance\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=3363"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}