August 2023 Newsletter

Message from the IARHC Board President

IARHC members, 

It is an exciting time for rural health organizations, as we continue to grow and adapt, remaining always motivated and responsive to the needs and betterment of rural health organizations and our members. Rural medicine is confronting a time of many changes and we are meeting these needs during a time of larger shifts across the nation. The world of rural health medicine is an exciting area in which to work, learn and meet inspired people together in forums to ensure we remain at the forefront.


I would like to personally invite all of you to attend our conference and come together to network with your fellow colleagues in rural health. You, as organization leaders, have the vision, the knowledge, and the experience to help us pave our way into the future. You are truly our greatest asset today and tomorrow, and we could not accomplish what we do without your support and leadership. We hope you are able to take advantage of the many sessions related to your work and bring your ideas to share.


In this newsletter you will find more information about the conference and the sessions that will be available to you.

Thank you for being members of IARHC and your continued commitment to providing quality access to healthcare to rural communities across Iowa.  


Ann Wise

Board President

Clinic Director

UnityPoint Clinic Buena Vista, Sac City, and Lake View

IMGMA/IARHC Fall Conference | Register Today!

We are excited for the annual IARHC Fall Conference on September 21-22, 2023. IARHC is pleased to partner with the Iowa Medical Group Management Association and bring two organizations together in collaboration where several general and breakout sessions will be offered. Join us for an event bringing together healthcare colleagues across the state to explore latest trends, share knowledge, and network. 

What to expect at the IMGMA/IARHC Fall Conference:

  1. Inspiring Keynote Speakers, Engaging Workshops and Sessions: View the conference agenda here.
  2. Networking Opportunities: Connect with fellow healthcare professionals, colleagues, and industry leaders during our dedicated networking sessions.
  3. Sponsor and Exhibitor Displays: Explore the latest products, technologies, and services from our sponsors and exhibitors.
  4. Member Specials: We will be offering exclusive discounts on conference registration fees, ensuring that you can take full advantage of this remarkable learning and networking experience.
  5. IARHC Breakout Sessions: RHC breakout sessions will include topics such as legislative updates, compliance, quality improvement, and survey readiness. More information about IARHC sessions is available here.

*The member rate of $375 includes all sessions, meals, and the Thursday evening networking event. Registration will increase to $425 on August 28th.

IARHC Annual Needs Assessment

We want to hear from YOU! It's time for the annual Rural Health Needs Assessment! Your responses will be used to guide the IARHC Board of Directors and staff in providing valuable training, technical assistance and resources for our members as well as inform and shape efforts to support RHCs by our state partners. The survey will close on Friday, September 22, 2023.

Click here to fill out the IARHC Needs Assessment

Resources For Rural Health Clinics

IARHC Resources

IARHC's new website contains updated resources for all RHCs as well as exclusive resources for IARHC members. Resources for IARHC members only will be announced in our weekly listserv communications and newsletters. Two resources available to members only are Transitions of Care Process Flow Checklist and a RHC Evidence Binder which includes an evidence binder description and content that should be included in your clinics evidence binder.

Other resources developed by IARHC include: a check list of items requested during a surveyRHC chart reviews28 day multi-dose medication calendar, and more. The resource page also includes information from HRSA, CMS, Iowa Medicaid, NARHC, and Iowa HHS.

IARHC Resources Webpage

Catalog of Value-Based Initiatives for Rural Providers

This Catalog of Value-Based Initiatives for Rural Providers summarizes rural-relevant, value-based programs currently or recently implemented by the U.S. Department of Health and Human Services (HHS), including the Centers for Medicare and Medicaid Services (CMS) and the CMS Innovation Center. Designed to help rural healthcare leaders identify HHS value-based programs that are suitable for rural participation. Contains descriptions of each demonstration and provides direct links to the corresponding agency web page.

3RNET Recruitment and Retention Assistance

The organization originally formed as the National Rural Recruitment and Retention Network helps rural practices expand their reach for posting job vacancies. See how your rural health clinic can utilize this resource here.  

CY 2024 Medicare Physician Fee Schedule Proposed Rule

Fact sheet providing an overview of the Centers for Medicare & Medicaid Services (CMS) proposed rule for updates and changes to the Medicare payments under the Physician Fee Schedule (PFS) and other Medicare Part B issues for calendar year 2024. Covers proposals related to paying separately for Community Health Integration, Social Determinants of Health (SDOH) Risk Assessment, and Principal Illness Navigation services; telehealth services; mental health visits furnished by Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs); including marriage and family therapists and mental health counselors as eligible for payment at RHCs and FQHCs; and more.

Lilypad Quality Improvement Programs

Over the last year, Lilypad has worked to develop and implement a formal quality improvement project for provider-based rural health clinics (PB-RHC) in Iowa. The goal of the project is to help PB-RHCs improve the quality of care for their patients, simplify and streamline transitions of care between primary care and inpatient services, and strengthen chronic disease management processes. Lilypad has worked to identify a cohort of provider-based RHCs that are motivated to implement a set of clinical and operational best practices to improve performance in one of the focus areas listed below:

  • Controlling Blood Pressure
  • Preventive Care and Screening: Tobacco Use
  • Childhood Immunization Status
  • Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%)
  • Documentation of Current Medications

These metrics are the most relevant quality improvement metrics for rural health clinics and are built into Lilypad’s Practice Operations National Database (POND) web application and are available for reporting on a quarterly basis. Participating PB-RHCs selected a metric/focus area and translated those activities into a formal Plan-Do-Study-Act (PDSA) initiative to be implemented during the project year. Lilypad’s PDSA initiative tool is a component part of its Learning and Knowledge Exchange (LAKE), a web-based portal containing quality improvement tools, best practice models and a library of compliance, regulatory, strategy and performance improvement resources for RHCs. While not a prerequisite, the proposed project can serve as a basis for RHCs to earn and/or maintain Patient Centered Medical Home (PCMH) accreditation.

Incase you missed the Linking Finance and Quality in Iowa RHCs webinar on August 10th, the session slides can be found here. Greg Wolf will present more details on how clinics can participate in a statewide RHC quality improvement project at the IARHC Fall Conference.

Upcoming Webinars & Events

What is in the Medicare Physician Fee Schedule for RHCs? | NARHC Webinar

Every July, the Centers for Medicare & Medicaid Services (CMS) releases the Medicare Physician Fee Schedule (MPFS) and the Medicare Hospital Outpatient Prospective Payment System (HOPPS) proposed rules. This year, the proposed rules included details about implementation of the two additional provider types billable as RHC providers beginning January 1, 2024, as well as information on the Intensive Outpatient Services Treatment category. Further, it contained a proposal to expand the billable services under G0511 to include RPM/RTM, Community Health Integration, and Principal Illness Navigation Services.

NARHC will craft and submit comments over the next few months on the various sections applicable to RHCs. CMS will review all comments and publish a final MPFS and HOPPS rule in November 2023. In this upcoming webinar on Wednesday, August 30th at 2:00pm, the NARHC DC staff will discuss the relevant RHC provisions and seek feedback from you on what additional topics CMS should be considering in their rulemaking. Speakers include Nathan Baugh, Executive Director and Sarah Hohman, Director of Government Affairs. There will also be a Q&A session during the webinar.

Click here to register

Iowa Healthcare Collaborative Patient Safety Conference

The Iowa Healthcare Collaborative (IHC) Patient Safety Conference will be taking place September 12 - 13, 2023 at The Meadows Events and Conference Center in Altoona, IA. This event highlights best practices and innovations for healthcare quality improvement and patient safety. At this event, conference presenters share their best practices that have directly impacted outcomes in patient safety and equity for patients in Iowa and across the nation. The goal of the conference is to educate and inspire the healthcare community to engage in quality activities that improve patient safety and quality across the healthcare continuum. 

Funding Opportunities

MultiPlan Rural Health Grant

MultiPlan Rural Health Outreach Grant Program awards funding to help healthcare providers in rural areas introduced or expand services, education, screenings, and other programs aimed at improving the health of people in their communities.

NARHC News, Policy, & Resources

New Details on Medicare Coverage of Marriage and Family Therapists and Mental Health Counselors in RHCs

The CY 2024 Medicare Physician Fee Schedule (MPFS) Proposed Rule implements provisions from the Consolidated Appropriations Act of 2023 passed by Congress in December, including allowing RHCs to bill for Marriage and Family Therapists (MFTs) and Mental Health Counselors (MHCs) beginning January 1, 2024.

Consistent with the statute, CMS is proposing to add MFTs and MHCs as qualified RHC providers meaning that they can generate a Medicare encounter, reimbursable at the RHC’s All-Inclusive Rate (AIR). Further, MFTs and MHCs will be subject to the same policies and supervision requirements as a PA, NP, CNM, CP, and CSW. The definitions of MFTs and MHCs, as well as what will be considered MFT/MHC services can be found here.

CY24 CMS Proposed Rules Summary for RHCs

On July 13th, the Centers for Medicare and Medicaid Services (CMS) issued the CY 2024 Medicare Physician Fee Schedule (MPFS) Proposed Rule, as well as the 2024 Medicare Hospital Outpatient Prospective System (HOPPS) Proposed Rule. This year’s 2,033 page and 963 page rules, respectively, contain several Rural Health Clinic (RHC) specific policy proposals, as well as other provisions with implications for the RHC community. If these policies are finalized by CMS this November, they would go into effect January 1, 2024, unless otherwise specified. In order to provide the complete details on RHC-relevant provisions and NARHC’s perspectives on this year’s proposals, the larger topics have been broken down into separate articles, on NARHC's website.

Intensive Outpatient Program (IOP) Details Proposed

The CY 2024 Medicare Hospital Outpatient Prospective Payment System (HOPPS) Proposed Rule implements provisions from the Consolidated Appropriations Act of 2023 passed by Congress in December regarding the new treatment category “Intensive Outpatient Program (IOP)” services.

RHCs, as well as hospital outpatient departments, community mental health centers, and FQHCs, can begin billing for these services on January 1, 2024, and RHCs will be reimbursed under a special payment rule.

CMS is currently accepting comments on this proposed rule. Over the coming weeks, NARHC is interested in hearing from RHCs who are heavily engaged in behavioral health services as to if the proposed details of Intensive Outpatient Program services are feasible for implementation in your RHCs as well as any questions you may have that we can relay to CMS for clarification. More information can be found here.

2024 MPFS Proposes Expansion of Services Billable as G0511

The CY 2024 Medicare Physician Fee Schedule (MPFS) Proposed Rule vastly expanded the care management related services billable in RHCs under the general care management code of G0511, beginning January 1, 2024.

Since 2016, RHCs have been able to bill for Chronic Care Management (CCM) services through this consolidated care management code. G0511 pays a consolidated fee schedule amount, $77.24 in 2023, which is the average of the Physician Fee Schedule (PFS) rates for CCM and principal care management (PCM) services, as well as codes newly added in 2023: Chronic Pain Management and General Behavioral Health Integration.

In this proposed rule, CMS is granting RHCs the opportunity to bill for Remote Patient Monitoring (RPM) and Remote Therapeutic Monitoring (RTM) services, as well as establishing new care management codes for Community Health Integration (CHI) and Principal Illness Navigation (PIN), all through the G0511 code. More information can be found here.

Proposed Change to the RHC Nurse Practitioner Definition and Implementation of Various Telehealth Provisions

Additional provisions included in the Centers for Medicare and Medicaid Services (CMS) CY 2024 Medicare Physician Fee Schedule (MPFS) Proposed Rule relevant to RHCs includes a proposed change to the definition of a Nurse Practitioner certified for practice in a RHC, as well the implementation of various telehealth policies passed by Congress. More information can be found here.

NARHC Technical Assistance Webinars

Did you miss the NARHC RHC Cost Reporting 101? Watch the recordings or view the slide presentations below.

NARHC provides technical assistance webinars covering the most current and up-to-date information for RHCs. View more TA webinars here.

Contact Us


Questions? Ideas you want to share? Concerns or barriers you’re facing? Feel free to reach out to staff at [email protected] - we’ll try to help or get you connected.

IARHC Staff Members

Hannah Toresdahl

[email protected]


Iowa Association of Rural Health Clinics | | [email protected]