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FCHIP

Frontier Community Health Integration Project Demonstration

The Frontier Community Health Integration Project Demonstration aims to develop and test new models of integrated, coordinated health care in the most sparsely-populated rural counties. It utilizes Critical Access Hospitals (CAHs) to increase access to services like telehealth, nursing facility care, and ambulance services to avoid expensive transfers.

Active since 2016-08-01

Innovation

Testing new models of integrated, coordinated health care in the most sparsely-populated rural counties (frontier areas) using Critical Access Hospitals as hubs.

The Problem

Critical Access Hospitals (CAHs) serve as the hubs for healthcare activities in frontier areas, but they often serve few inpatients. Services are often unavailable in frontier communities, leading to expensive transfers to hospitals in larger communities.

The Solution

CAHs will increase access to services that are often unavailable in frontier communities, specifically in areas of telehealth, nursing facility care, and ambulance services, to better integrate the delivery of acute care, extended care and other healthcare services.

Expected Outcomes

Improved quality of care received by Medicare beneficiaries, increased patient satisfaction, and reduced Medicare expenditures.

Model Goals

  • Improve health outcomes
  • Reduce Medicare expenditures
  • Increase patient satisfaction
  • Avoid expensive transfers to hospitals in larger communities

Patient Eligibility

Medicare and Medicaid beneficiaries residing in very sparsely populated areas.

  • Medicare and Medicaid beneficiaries
  • Residing in very sparsely populated areas

Provider Eligibility

Critical Access Hospitals in specific sparsely populated states that meet Rural Hospital Flexibility Program requirements.

  • Adhering to the requirements of the Rural Hospital Flexibility Program under section 1830(g) of the Social Security Act
  • Describing intent in meeting community health needs in areas of telehealth, nursing facility care, and ambulance services
  • Located in a State where at least 65 percent of the counties have six or fewer residents per square mile
  • Limited to CAHs in Alaska, Wyoming, Montana, Nevada, and North Dakota

Care Categories

Integrated Care

TelehealthNursing facility careAmbulance servicesAcute careExtended care

CMS Benchmarks & Thresholds

eligibility

State County Population Density Threshold (Percent)0.65%
County Population Density Threshold (Residents)6
Number of Eligible States5
Eligible StatesAlaska,Wyoming,Montana,Nevada,North Dakota

operational

Initial Performance Period End Date2019-07-31
Extension Period Start Date2022-01-01
Extension Duration5
Initial Demonstration Duration3
Number of Participants5
Initial Performance Period Start Date2016-08-01

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