Other Case Studies and Collections of Program Examples: Reimbursement and payment models
In addition to RHIhub's Rural Health Models and Innovations rural program examples, you may also want to browse other case studies, databases, and websites with collections of health programs.
Each resource listed below uses its own criteria for selecting program examples, which may range from programs known to be effective based on research to anecdotal accounts. In each resource, you may want to review information on the level of evidence required for a program's inclusion.
May include non-rural programs that could be applicable to rural health delivery.
A Federally Qualified Health Center and Certified Community Behavioral Health Clinic Partnership in Rural Missouri
Case study describing a medication for opioid use disorder (MOUD) program partnership between a Federally Qualified Health Center and a certified community behavioral health clinic in rural southwest Missouri. Covers the infrastructure of the MOUD program, staffing and services, financing, and more. Highlights challenges and successes, as well as recommendations for other health centers interested in a similar partnership.
Author(s): Ashley Jasko, Meryl Schulman
Date: 01/2024
Type: Document
Sponsoring organization: Center for Health Care Strategies
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Case study describing a medication for opioid use disorder (MOUD) program partnership between a Federally Qualified Health Center and a certified community behavioral health clinic in rural southwest Missouri. Covers the infrastructure of the MOUD program, staffing and services, financing, and more. Highlights challenges and successes, as well as recommendations for other health centers interested in a similar partnership.
Author(s): Ashley Jasko, Meryl Schulman
Date: 01/2024
Type: Document
Sponsoring organization: Center for Health Care Strategies
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Serving Rural America: Health Insurance Providers at Work
Offers 5 case studies to showcase the ways in which health insurance providers are working to ensure access to high quality healthcare in rural areas. Examples feature 8 insurance providers in Maryland, Pennsylvania, California, and Oregon sharing different approaches to healthcare delivery, financing, and community engagement.
Date: 09/2019
Type: Document
Sponsoring organization: AHIP
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Offers 5 case studies to showcase the ways in which health insurance providers are working to ensure access to high quality healthcare in rural areas. Examples feature 8 insurance providers in Maryland, Pennsylvania, California, and Oregon sharing different approaches to healthcare delivery, financing, and community engagement.
Date: 09/2019
Type: Document
Sponsoring organization: AHIP
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Behavioral Health Integration into Primary Care
Profile of a rural health system, Western Wisconsin Health (WWH), and its work to deliver behavioral health services. Provides an overview of how behavioral health providers and services were integrated with primary care, with a cultural change to focus on whole-person care. Includes information on Medicare and Medicaid reimbursement for the behavioral health services provided at WWH's Rural Health Clinic. Discusses how WWH behavioral health providers offer telehealth services to other rural areas of Wisconsin.
Date: 03/2018
Type: Document
Sponsoring organization: Rural Health Value
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Profile of a rural health system, Western Wisconsin Health (WWH), and its work to deliver behavioral health services. Provides an overview of how behavioral health providers and services were integrated with primary care, with a cultural change to focus on whole-person care. Includes information on Medicare and Medicaid reimbursement for the behavioral health services provided at WWH's Rural Health Clinic. Discusses how WWH behavioral health providers offer telehealth services to other rural areas of Wisconsin.
Date: 03/2018
Type: Document
Sponsoring organization: Rural Health Value
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Affiliation Partners Sought to Prepare Small Hospital for Value-Based Care
Details how Grinnell Regional Medical Center (GRMC) in Grinnell, Iowa, followed a robust due diligence process to identify affiliation partners and prepare for participation in risk-based reimbursement models. GRMC is a 49-bed private, nonprofit medical center that serves 6 rural counties in Iowa.
Date: 01/2018
Type: Document
Sponsoring organization: Rural Health Value
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Details how Grinnell Regional Medical Center (GRMC) in Grinnell, Iowa, followed a robust due diligence process to identify affiliation partners and prepare for participation in risk-based reimbursement models. GRMC is a 49-bed private, nonprofit medical center that serves 6 rural counties in Iowa.
Date: 01/2018
Type: Document
Sponsoring organization: Rural Health Value
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Global Budget Process as an Alternative Payment Model
Analyzes the all-payer hospital rate-setting system of McCready Health in rural Maryland. Discusses the Total Patient Revenue (TPR) system and corresponding essential functions such as rate setting, strategic planning, and care coordination.
Date: 03/2017
Type: Document
Sponsoring organization: Rural Health Value
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Analyzes the all-payer hospital rate-setting system of McCready Health in rural Maryland. Discusses the Total Patient Revenue (TPR) system and corresponding essential functions such as rate setting, strategic planning, and care coordination.
Date: 03/2017
Type: Document
Sponsoring organization: Rural Health Value
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Innovations in Rural Health System Development: Moving Rural Health Systems to Value-Based Payment
Offers examples of rural health system transformation models and strategies from Maine and other regions of the U.S. to assist rural communities in moving forward with value-based payment systems.
Author(s): Sara Kahn-Troster, Andrew Coburn
Date: 10/2016
Type: Document
Sponsoring organizations: Maine Health Access Foundation, Maine Rural Health Research Center
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Offers examples of rural health system transformation models and strategies from Maine and other regions of the U.S. to assist rural communities in moving forward with value-based payment systems.
Author(s): Sara Kahn-Troster, Andrew Coburn
Date: 10/2016
Type: Document
Sponsoring organizations: Maine Health Access Foundation, Maine Rural Health Research Center
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Proactively Pursuing Value-Based Payment
Profiles a program developed at a Critical Access Hospital (CAH) located in rural Washington that is transitioning from volume- to value-based care. The CEO of the hospital is working with payers to design a value-based payment contract to help the facility fund the continued transition to value-based care and hopefully create a payment model other CAHs in the state can adopt.
Date: 05/2016
Type: Document
Sponsoring organization: Rural Health Value
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Profiles a program developed at a Critical Access Hospital (CAH) located in rural Washington that is transitioning from volume- to value-based care. The CEO of the hospital is working with payers to design a value-based payment contract to help the facility fund the continued transition to value-based care and hopefully create a payment model other CAHs in the state can adopt.
Date: 05/2016
Type: Document
Sponsoring organization: Rural Health Value
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Investing in Population Health
Profile of a pilot project in rural New Mexico focused on population health for Medicaid recipients. Offers communities 3 levels of patient services and payment. Uses community health workers to address the social determinants of health.
Date: 08/2015
Type: Document
Sponsoring organization: Rural Health Value
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Profile of a pilot project in rural New Mexico focused on population health for Medicaid recipients. Offers communities 3 levels of patient services and payment. Uses community health workers to address the social determinants of health.
Date: 08/2015
Type: Document
Sponsoring organization: Rural Health Value
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Young Entrepreneurs Help Remold Rural Healthcare in Oregon Through Membership Payment Model
Highlights the Orchid Clinic, which has found success by providing primary care to low-income rural residents via a paid membership model.
Author(s): Candi Helseth
Citation: Rural Monitor
Date: 11/2014
Type: Document
Sponsoring organization: Rural Health Information Hub
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Highlights the Orchid Clinic, which has found success by providing primary care to low-income rural residents via a paid membership model.
Author(s): Candi Helseth
Citation: Rural Monitor
Date: 11/2014
Type: Document
Sponsoring organization: Rural Health Information Hub
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Rural Health Value: Innovations & Demonstrations
Profiles of rural health delivery and finance innovations and summaries of selected rural health demonstration programs.
Type: Website
Sponsoring organization: Rural Health Value
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Profiles of rural health delivery and finance innovations and summaries of selected rural health demonstration programs.
Type: Website
Sponsoring organization: Rural Health Value
view details