Program
Purpose
The purpose of the Frontier Extended Stay Clinic
(FESC) Cooperative Agreement Program is to examine the effectiveness
and appropriateness of a new type of provider, the FESC, in providing
health care services in certain remote locations.
Program Overview
In remote, frontier areas of the country, weather
and distance can prevent patients who experience severe injury or
illness from obtaining immediate transport to an acute care hospital.
For residents in some of those communities, providers offer observation
services traditionally associated with acute care inpatient hospitals
until the patient can be transferred or is no longer in need of
transport. Provision of these services requires the staffing, equipment
and quality assurance programs of an acute care hospital. However,
extended stay services are not currently reimbursed by Medicare,
Medicaid or other third-party payers. For several years, officials
in the State of Alaska and several State Offices of Rural Health,
Primary Care Offices and Primary Care Associations have explored
the development of a new provider type, or other mechanism, that
would enable reimbursement of these services through the FESC model.
The Medicare Prescription Drug Improvement and
Modernization Act of 2003 (MMA) acknowledged the work of FESC supporters
by authorizing the Centers for Medicare and Medicaid Services (CMS)
to conduct a demonstration program in which FESCs would be treated
as Medicare providers. Under MMA, FESCs are defined as clinics that
are: 1) located in communities which are at least 75 miles away
from the closest hospital or are inaccessible by public road and
2) designed to address the needs of patients who are unable to be
transferred to an acute care facility because of adverse weather
conditions or who need monitoring and observation for a limited
period of time.
In a separate recognition of the extended care
services provided by some frontier clinics, an additional demonstration
program to be administered by the Health Resources and Services
Administration (HRSA) was established by the Consolidated Appropriations
Act of 2004.
Program
Contact
For additional information contact:
Carrie Cochran
Office of Rural Health Policy
5600 Fishers Lane, Rm 9A-55
Rockville, MD 20857
(301) 443-0502
ccochran@hrsa.gov
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FESC CA Activities FY04- FY06
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FESC Modeling Project Report
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State of Alaska Department of Health and
Social Services FESC Regulations
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State of Alaska Department of Health and
Social Services FESC Self Survey Tool
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