CRH Project Presented to CDC Headquarters

Nov 14, 2024

The Center for Rural Health (CRH) was asked to present a program update to the U.S. Centers for Disease Control and Prevention (CDC) regarding the COVID-19 Health Disparities Grant, with special focus on the Rural Health Value Project.

Ten states were invited to the CDC headquarters in Atlanta, for a one-day meeting in October, featuring three panels.

Nicole Threadgold, director of the State Office of Rural Health, presented with Katarina Domitrovich, community engagement specialist, with North Dakota Health and Human Services. They were part of the panel focusing on Healthcare Delivery Care Collaboration.

Rural Health Value Project

The Rural Health Value Project has been a collaboration with five Critical Access Hospital (CAH) CEOs and the University of Iowa to study value-based care scenarios in North Dakota CAHs. The project looked at different value-based payment structures which will help providers move from a volume-based system to one that focuses more on population health. With population health, providers are paid based on outcomes and performance-based metrics.

Centers for Medicare & Medicaid Services (CMS) has been pushing health systems to convert to value-based care for years. Now, according to CMS, the organization has set a goal of having 100% of Traditional Medicare beneficiaries and the vast majority of Medicaid beneficiaries in accountable care relationships by 2030.

"We have been talking value-based care for long time," said Threadgold, "and for North Dakota to be able to take a deep dive in what value-based care could look like for our CAHs really helped identify the opportunity that could come from value-based care and payment."

She continued, "We ran the five CAHs through three difference scenarios, the status quo (nothing changes), one-sided risk, and two-sided risk. If we stay status quo, it is not good financially for the CAHs. This project has allowed us to take a lens to North Dakota's hospital structure, what the financials could look like and to figure out what will work best for North Dakota."

At the time this project started, there was a clinically integrated network in the early stages of development in North Dakota. The two projects, while separate, but working concurrently, helped affirm the need to move forward. Today, two thirds of the CAHs in the state have joined an Accountable Care Organization.

About the COVID-19 Health Disparities Grant

The COVID-19 Health Disparities Grant is comprised of five different projects that will provide additional resources to hospitals, health workforce, Indigenous caregivers, and behavioral health professionals to increase health equity throughout the state. The CDC funded state health departments which worked with the SORHs to develop projects geared toward helping state populations who faced disparities, including rural communities.