The National Association of Community Health Centers (NACHC), the Association of Asian Pacific Community Health Organizations (AAPCHO), the Oregon Primary Care Association (OPCA), and the Institute for Alternative Futures (IAF) have launched a Kresge Foundation-funded project to measure and capture health centers’ patient risks in terms of both clinical and non-clinical factors, such as the social determinants of health–the social, environmental, and economic factors that influence an individual’s health.

An $800,000 grant from The Kresge Foundation will support the three-year project to create, implement, and promote a standardized health risk assessment protocol that goes beyond medical acuity to account for the social determinants of health.

This project comes at a critical time, as payments become increasingly based on measures of health quality rather than the volume of services provided.  However, current quality measures do not account for the fact that much of the differences in health are related to the social determinants of health – poverty, jobs, education, housing, availability of healthy food, neighborhood safety, geographic isolation, and social exclusion.

As a result, quality measures and payment systems do not reflect the extra time and resources needed to help these patients become and stay healthy, putting health centers at a significant disadvantage.  Collecting data on patient risk, especially the social determinants of health that health center patients often confront in their environment and living situations, will be crucial to level the playing field for health centers when payment is based on performance rather than volume.

The protocol developed from this project will be critical to helping health centers better understand and manage their patient populations with needed services and community partnerships, identify which factors are driving higher health care costs and poorer health outcomes, and create more appropriate risk adjustments when operating under value- or performance-based payment systems.

In the first year, the partners will review and assess the nature and use of existing patient risk assessment tools and protocols to inform the development a national standardized health risk assessment protocol.  If your health center or health organization currently uses a patient risk assessment tool and you would be willing to share it with us, please contact Michelle Jester at or 202-331-4609.  If you would like to be kept informed about the progression of this project, please contact Michelle Jester.

Income,  education level, sex, race, ethnicity, employment status, and sexual  orientation are all related to health and health outcomes for a number of Americans,  according to a new Morbidity and Mortality Weekly Report Supplement released  today by the Centers for Disease Control and Prevention (CDC).

The  “CDC Health Disparities and Inequalities Report — United States,  2013,” is the second CDC report that highlights differences in mortality  and disease risk for multiple conditions related to behaviors, access to health  care, and social determinants of health – the conditions in which people are  born, grow, live, age, and work.

The  latest report looks at disparities in deaths and illness, use of health care, behavioral  risk factors for disease, environmental hazards, and social determinants of  health. This year’s report contains 10 new topics including access  to healthier foods, activity limitations due to chronic diseases, asthma  attacks, fatal and nonfatal work-related injuries and illnesses, health-related  quality of life, periodontitis in adults, residential proximity to major  highways, tuberculosis, and unemployment.

Some  of the report’s key findings include:

  • The overall birth rate for teens 15-19 years  old fell dramatically — by 18 percent — from 2007 to 2010.  Birth rate disparities also decreased because  the rates fell by more among racial and ethnic minority populations that had higher  rates.  However, across states, there was  wide variation, from no significant change to a 30 percent reduction in the  rate from 2007 to 2010.
  • Working in a high risk occupation — an  occupation in which workers are more likely than average to be injured or  become ill — is more likely among those who are Hispanic, are low wage  earners, were born outside of the United States, have no education beyond high  school, or are male.
  • Binge drinking is more common among persons  aged 18-34 years, men, non-Hispanic whites, and persons with higher household  incomes.

The full “CDC Health Disparities and  Inequalities Report — United States, 2013” and related information on the  individual chapters is available at .


Inspired Business By Design is showcasing leaders and their businesses who are transforming their business cultures for employee empowerment and creativity.  The showcase to be held February 12, 2014 will feature Michael Johnson, CEO of Boys and Girls Club of Dane County, Wisconsin.  Michael will speak on “How to Transform the Culture of your Organization and Empower an Engaged Workforce.”  Michael was instrumental in turning around Boys and Girls Club and shares his insights.

Location: Farm Credit Services, 5015 S 118th St, Omaha, NE 68137

Breakfast 7:30 a.m., Presentation 8:00 a.m. – 9:15 a.m.

Register here:

The $19.95 fee can be waived by using the code – BellevueU so the seminar is free.  Registration is required however for food planning.

For more information, go to

If you have questions, contact Gerald R. Wagner, PhD, President’s Office, Director, Employee Wellbeing Institute, Bellevue University, at 402 578 4057 or


The Energy and Commerce Health Subcommittee today convenes a legislative hearing on bipartisan legislation introduced by Representatives Tim Murphy (R-PA) and Gene Green (D-TX) to break down the barriers to health professional volunteerism at Community Health Centers (CHCs).  The Family Health Care Accessibility Act of 2013 (H.R. 2703) provides a legislative solution to a longstanding problem that health centers confront in attracting volunteer health care providers.  Testifying in support of the legislation will be Robert MtJoy, CEO of Cornerstone Care in Southwest, PA [link to testimony].

The legislation, which draws wide support from the national network of Community Health Centers, amends the Public Health Service Act to extend Federal Tort Claims Act (FTCA) medical malpractice coverage to all qualified health care professionals who volunteer at health centers. Health center employees, contractors, and board members receive medical malpractice coverage through FTCA, but doctors, dentists, and other health care professionals who wish to volunteer their services at health centers are required to provide their own medical malpractice coverage, which is extremely costly.

The Family Health Care Accessibility Act (H.R. 2703) could be paid for with funds available through the health centers’ annual appropriations.  Without these protections, medical malpractice insurance for physician-volunteers at CHCs could cost as much as $100,000, reducing the number of professional healthcare volunteers at a time when health centers are expanding services and access to meet the growing needs of their communities.  In the 111th Congress, the legislation overwhelmingly passed the House of Representatives by a vote of 417-1.

ONC released its second Web-based security training module, “CyberSecure: Your Medical Practice” for healthcare providers and staff. This latest game focuses on disaster planning, data backup and recovery and other elements of contingency planning.  Contingency planning helps providers and staff prepare for power outages, floods, fires or weather related events such as hurricanes or tornadoes. These events can damage patient health information or make it unavailable. Planning for these events can help ensure that patient health information is protected and that patient information can be accessed when the disaster is over.

October was National Cyber Security Awareness Month and is an ongoing opportunity for ONC to remind providers about the need to create contingency plans to assure a safe and secure cyber environment. Contingency Planning is also required by the HIPAA Security Rule.

“We know from recent experiences such as Hurricane Sandy, that these events can very adversely impact the delivery of health care,” said ONC Chief Privacy Officer Joy Pritts. “We hope that this video game will raise awareness of contingency planning and help practices begin to develop their own disaster plans, backup and recovery processes and other vital activities.”

This new online resource is available at:

About the Video Game

The security training module, which was developed with the assistance of the Regional Extension Center Program’s Privacy and Security Community of Practice, uses a game format that requires users to respond to privacy and security challenges often faced in a typical small medical practice. Users choosing the right response earn points and see their virtual medical practices flourish. But users making the wrong security decisions can hurt their virtual practices. In this version, the wrong decisions lead to floods, server outages, fire damage and other poor outcomes related to a lack of contingency planning.

The use of gamification by ONC is an innovative approach aimed at educating health care providers to make more informed decisions regarding privacy and security of health information.

A new study shows that more than 80 percent of Community Health Center patients rated their quality of care as high.  The study, published in the November/December issue of the Annals of Family Medicine, showed that 84 percent of patients reported excellent/very good overall quality of services, 81 percent reported excellent/very good quality of clinician care, and 84 percent were very likely to refer friends and relatives to the center.

“Clinicians seeking to improve their patients’ overall perceptions of health care experiences should focus on improving patients’ experiences in getting access to care before and during the visit and on promoting clinician and support staff communication skills,” writes Lydie A. Lebrun-Harris, PhD, MPH, from the Office of Research and Evaluation, Office of Planning, Analysis, and Evaluation, Health Resources and Services Administration, Department of Health and Human Services, Rockville, Maryland, and colleagues.

Researchers analyzed the association between patient satisfaction and Patient Centered Medical Home (PCMH) attributes, including access to care, preventive care, and support for chronic diseases.  This is the first national study to examine how patients viewed PCMH attributes in a safety net setting.

To view a NACHC blog post about the study visit this link.

HRSA-14-044  Rural Health Network Development (RHND) Grant Program

HRSA-14-043  Rural Health Network Development Planning

New Marketplace application aids posted in 14 languages

Spanish Language Version of CAC Training

Last week we released a report about the results of the first reporting period of open enrollment in the Health Insurance Marketplace. The report shows that 106,185 individuals have selected plans from the Marketplace, and another 975,407 have made it through the process by applying and receiving an eligibility determination, but have not yet selected a plan.  Below you will find a blog from Secretary Sebelius about the report, as well as the report itself.

Report on first month of enrollment

Blog by Secretary Sebelius on Marketplace enrollment

This year-long executive education program, developed and led by the DSC at the Massachusetts General Hospital and jointly sponsored by The National Committee for Quality Assurance (NCQA), is designed for leaders from hospitals, health plans and other health care organizations who wish to implement practical strategies to identify and address racial and ethnic disparities in health care, particularly through quality improvement.  Click here for a full description.  Contact with any questions.

Nebraska Medicaid will follow the same timeline adopted by the Centers for Medicare & Medicaid (CMS) for transition of the CMS 1500 Health Insurance Claims Form. The transition timeline for moving from the current 08/05 version to the 02/12 version is as follows: Effective January 6, 2014, Nebraska Medicaid will begin receiving and processing paper claims submitted on the revised CMS 1500 claim form (version 02/12).

Effective January 6 through March 31, 2014, Nebraska Medicaid will have a dual use and processing period during which we will continue to receive and process paper claims submitted on the old CMS 1500 claim form (version 08/05).  Effective April 1, 2014, Nebraska Medicaid will receive and process paper claims submitted only on the revised CMS 1500 claim form (version 02/12).

Please note that on or after April 1, 2014, any claims received utilizing the older versions of the CMS 1500 claim form will be returned to the provider.

To meet the April 1, 2014 requirement: Please refer to the NUCC website ( ) for information on the new version, review the 1500 instructions, obtain a 1500-837P crosswalk, etc.  Hardcopy billing providers currently using older versions of the CMS claim form should acquire the CMS 1500 claim form (02/12 version) as soon as possible.

Providers who are using practice management software with older versions of the hardcopy claim forms should contact their software vendor as soon as possible.   Providers who submit claims electronically should begin working with their clearinghouses on the 1500-837P crosswalk.

Billing instructions for completing the revised CMS 1500 claim form (version 02/12) under the various provider specialties utilizing this form are currently being updated and will be posted on our webpages prior to the transition period.

When finalized, updates will be posted within the various provider handbooks located at the following site: .

Providers can also subscribe to our Recent Web Updates page to be notified of changes as they take place, as well: .

For claims questions regarding this provider bulletin or concerns about this information, please contact Bob Kane at or 402-471-9382.