North American Healthcare Management Services

A colleague told me last week that I don't beat my chest enough on our accomplishments at North American. (I responded that I can come up with twenty people who swear the exact opposite!). So - here's my work humble brag: Just got off of the phone with a hospital CEO. He said, "Charles - you guys took us from a $600,000 annual loss to about a $200,000 annual gain. That's quite a swing. Thank you for what you do!" And THAT makes it all worthwhile - that is also healthcare security for under-served patients in deep Arkansas. With blood, sweat, and tears...

Meet Maude Callen (1898-1990) who was a nurse-midwife in the South Carolina Lowcountry for over 60 years. She operated a clinic out of her home in Pineville, Be...rkeley County, and delivered 600-800 babies in her 62-year practice. She frequently had to park her car and walk through mud, woods, and creeks to reach her patients. No roads were paved. Her practice covered 400 square miles. Her work was brought to national attention in W. Eugene Smith's photo essay, "Nurse Midwife," published in Life in December 3, 1951. Smith spent weeks observing her and going on her rounds with her. Smith is quoted as saying the photographs he took of Nurse Maude were the "most rewarding of all [his] work" and that Callen was "the most completely fulfilled person I have ever known." After her retirement in 1971, Callen petitioned county officials to start a Senior Citizens Nutrition Site, which operated, starting in 1980, out of the clinic. As a volunteer, Callen managed the center, which cooked and delivered meals five days a week and provided car service to seniors needing transportation. She is quoted as having said, on turning down an invitation from President Reagan to visit the White House, "You can't just call me up and ask me to be somewhere. I've got to do my job." She continued her volunteer work until her death in 1990. Nurse Midwife Maude Callen, tenderly caring for an old chair-bound patient who is touched by her kindness. Photo by: W. Eugene Smith.

New research shows that more than half of all COVID-19 cases are spread by infected people without any symptoms. Wear a mask, wash your hands, and stay 6 feet from otherseven if you’re feeling well. Learn more in JAMA Network Open: https://bit.ly/3oKknBF.

If you missed today's webinar, here is the link. Thanks to Charles James, Patty Goff Harper, and Dani Gilbert for helping out.

CMS COVID-19 Office Hours Calls (twice a month on Tuesday at 5:00 6:00 PM Eastern)

There are some great Telehealth links and resources here:

We owe a big shout out to all the dedicated NPs who take care of rural America as safety net providers in our RHCs and CAHs! Thank you!

Trump Administration Drives Telehealth Services in Medicaid and Medicare On October 14, CMS expanded the list of telehealth services that Medicare Fee-for-Service will pay for during the COVID-19 Public Health Emergency (PHE). CMS is also providing additional support to state Medicaid and Children’s Health Insurance Program (CHIP) agencies in their efforts to expand access to telehealth. The actions reinforce President Trump’s Executive Order on Improving Rural Health and Tel...ehealth Access to improve the health of all Americans by increasing access to better care. Expanding Medicare Telehealth Services: https://www.cms.gov//Medicare-/Telehealth/Telehealth-Codes For the first time using a new expedited process, CMS added 11 new services to the Medicare telehealth services list since the publication of the May 1 COVID-19 Interim Final Rule with comment period (IFC). Medicare will begin paying eligible practitioners who furnish these newly added telehealth services effective immediately and for the duration of the PHE. These new telehealth services include certain neurostimulator analysis and programming services, and cardiac and pulmonary rehabilitation services. The list of these newly added services is available on the List of Telehealth Services webpage. In the May 1 COVID-19 IFC, CMS modified the process for adding or deleting services from the Medicare telehealth services list to allow for expedited consideration of additional telehealth services during the PHE outside of rulemaking. This update to the Medicare telehealth services list builds on the efforts CMS has already taken to increase Medicare beneficiaries’ access to telehealth services during the COVID-19 PHE. Since the beginning of the PHE, CMS added over 135 services to the Medicare telehealth services list such as emergency department visits, initial inpatient and nursing facility visits, and discharge day management services. With this action, Medicare will pay for 144 services performed via telehealth. Between mid-March and mid-August, over 12.1 million Medicare beneficiaries over 36% of people with Medicare Fee-for-Service received a telemedicine service. Preliminary Medicaid and CHIP Data Snapshot on Telehealth Utilization and Medicaid & CHIP Telehealth Toolkit Supplement: In an effort to provide greater transparency on telehealth access in Medicaid and CHIP, CMS released, for the first time, a preliminary Medicaid and CHIP data snapshot on telehealth utilization during the PHE. This snapshot shows, among other things, that there have been more than 34.5 million services delivered via telehealth to Medicaid and CHIP beneficiaries between March and June of this year, representing an increase of more than 2,600% when compared to the same period from the prior year. The data also shows that adults ages 19-64 received the most services delivered via telehealth, although there was substantial variance across both age groups and states.

CMS is taking every action to ensure U.S. laboratories are fit to deliver reliable, accurate, and timely patient test results for COVID-19 by confirming Clinical Laboratory Improvement Amendments of 1988 (CLIA) certifications are up-to-date. A recent record check by CMS resulted in the issuance of 171 cease and desist letters to facilities that did not have proper CLIA certifications in place. CLIA certification is important because it verifies that laboratories meet federal ...performance, quality, and safety standards to properly diagnose, prevent, and treat diseases. Testing capacity has rightly been at the top of President Trump’s priority list since the early stages of this pandemic, said CMS Administrator Seema Verma. But we also understood that for testing to fulfill its potential, tests must be reliable. Today’s announcement will help ensure that Americans can rest secure that they will receive test results that are both fast, accurate, and trustworthy. Every facility that conducts COVID-19 testing is considered a laboratory and must be certified under CLIA. To make certification easy, CMS implemented an expedited review process at the beginning of the public health emergency and recently released a quick-start guide that helps laboratories with the application process. It is imperative to public safety that facilities apply for CLIA certification and only operate within the scope of that certification to prevent false results that could adversely alter diagnosis, treatments, and contribute to the further spread of COVID-19. Since August 12, 2020, CMS issued 171 cease and desist letters to entities across the U.S. that were testing for COVID-19 without an appropriate CLIA certificate. Of those 171 letters, 34% went to facilities conducting laboratory testing without a CLIA certificate and 66% were issued to laboratories performing COVID-19 testing outside the scope of the existing CLIA certification. The letters ordered these laboratories to stop immediately to safeguard the integrity of COVID-19 testing and protect patients from potential endangerment if they provided inaccurate or unreliable test results. Following receipt of the letter, laboratories are required to provide CMS an attestation certifying they have ceased testing. In the letters, CMS provided non-certified laboratories with information on how to become CLIA certified and encouraged certified laboratories to obtain the proper CLIA certification to resume testing. CMS has taken this action to promote compliance with CLIA and keep patients safe. https://www.cms.gov/outreach-and-education/2020-10-15-mlnc

"Place-based stories about the often painful cracks in the American health system that leave people frustrated and without the care they need. Hosted by investigative journalist Sarah Jane Tribble, the podcast is a production of Kaiser Health News and St. Louis Public Radio." This is an excellent podcast published by Kaiser Health News and NPR. Kaiser Health News is the gold-standard for information. https://www.npr.org/podcasts/915395193/where-it-hurts

North American clients!

Announcing the winners of the 2020 NOSORH Awards!! Congratulations to all! #PowerofRural Emerging Leader Award: Stephanie Moore, WV SORH Director, WV Depart...ment of Health & Human Resources Mentoring Award: Angie Allen, TN SORH Director Award of Excellence: Pennsylvania Office of Rural Health Rural Health Advocate Award: Bill Finerfrock, National Association of Rural Health Clinics

We had such wonderful timing on our table-top display upgrade. It shipped February 28, 2020. At least they look nice in the office?