In this issue
greetings from MHA
Season’s greetings from the Minnesota Hospital Association! We
send our best wishes to you and hope you enjoy this holiday e-card:
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releases report on obstetric services in rural Minnesota
The Minnesota Department of Health’s (MDH) Rural Health Advisory
Committee (RHAC) recently released a report with 18 recommendations for
improving obstetric services in rural Minnesota.
An RHAC workgroup was formed to produce this report after identifying a need to
address declining obstetric services in rural areas. For example, data
contained in the report demonstrate that while there was very little net change
in the number of births in Minnesota from 2000-2010, the number of physicians
who performed the births decreased 15 percent.
The report illustrates that strong obstetric services benefit rural communities
by providing access to pregnancy planning and prenatal care; increased patient
satisfaction; and providing coverage for high-risk and emergency obstetric
However, the report notes the following barriers to providing these services
including the economic impact on rural hospitals; rural obstetric workforce
shortages; training and residency limitations; on-call and lifestyle
considerations; and infrastructure needs.
The 18 recommendations contained in the report are a call to action for rural
hospitals and health systems, medical schools, policy makers and other
stakeholders. They are as follows:
- Ensure the inclusion of
obstetrics as a required service in health payment and care delivery
models such as Accountable Care Organizations.
- Address smoking in
childbearing-age women in rural areas with a special focus on women who
are young, uninsured or publicly insured, and those most likely to have an
- Encourage collaboration between
rural obstetric providers and public health nurses to maximize the use of
local resources available to pregnant women and new parents.
- Educate rural providers and
hospital staff about ways to better serve American Indian women.
- Support a system for medical
school admission that considers rural provider perspectives and a
prospective student’s inclination toward a rural obstetrics practice.
- Provide more opportunities for
rural family physicians to receive training in natural births and Cesarean
- Analyze and address the impact
of 2011 federal work hour restrictions on medical residents.
- Support an appropriate number
of new medical graduates to meet future rural obstetric care needs.
- Address regulatory barriers to
practice at federal, state and hospital levels for certified
- Support rural obstetric teams’
involvement in educational offerings that supplement their labor and
- Support loan forgiveness
programs for obstetric providers in small and isolated rural areas.
- Address ongoing challenges
related to workforce shortages in rural obstetrics.
- Educate rural providers and
hospital staff about the role of doulas.
- Develop and promote a set of
best practices for rural hospitals that encounter obstetric emergencies
with limited obstetric staff or resources.
- Support improvements to
Medicaid reimbursement for rural obstetrics.
- Protect Minnesota’s low-cost
liability and malpractice insurance environment for obstetric providers.
- Support collaborative efforts
to maintain local obstetric services and share successful models.
- Develop and pilot a rural
obstetrics telehealth program in Minnesota.
The RHAC is a 15-member, governor-appointed committee charged
with advising the Commissioner of Health and other state agencies on rural
health issues. Click here to read the full report. return to top
announces training on two-midnight policy
The Centers for Medicare & Medicaid Services (CMS) will host
a telephone training session on the medical review criteria for the new
“two-midnight” policy for inpatient hospital admission and medical review on
Jan. 14, 2014 at 12:30 p.m. Central Standard Time. The call will provide an
overview of the policy and use case scenarios to describe its application to
sample medical records. CMS also will answer questions on the policy. Details
on the call will be posted at www.cms.gov. return to top
physician named Country Doctor of the Year
Dr. Robert Bösl, a physician at Stevens Community Medical Center
in Morris, was named Country Doctor of the Year by Staff Care, a company that
provides health care workforce solutions. The award is given annually to
physicians in communities with 30,000 or fewer residents. This is the first
time a Minnesotan has earned the award.
Bösl is the only doctor in the town of Starbuck, where he operates his clinic,
and makes the 40-mile round trip journey to Morris multiple times per day to
see patients at Stevens Community Medical Center and perform surgeries.
John Rau, president and CEO of Stevens Community Medical Center, told USA Today
that Bösl is “without question one of the finest physicians and individuals
I’ve ever had the opportunity to work with.”
Congratulations, Dr. Bösl, and thank you for helping ensure access to quality
care in Minnesota’s rural communities! return to top
Just a reminder that Newsline will take a
holiday break next week and will return to its normal publishing schedule on
Monday, Jan. 6. return to top