Rural Health
Resources by Topic: Healthcare business and finance
Calendar Year (CY) 2015 Rural Health Clinic (RHC) and Federally Qualified Health Centers (FQHC) Updates: Payment Rate Increases for RHCs and FQHCs Billing Under the All-Inclusive Rate System (AIR), and Urban and Rural Designations for FQHCs Billing Under the AIR
Provides updates for RHCs and FQHCs that are submitting claims to Medicare Administrative Contractors (MACs) for services to Medicare beneficiaries.
Date: 12/2024
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Provides updates for RHCs and FQHCs that are submitting claims to Medicare Administrative Contractors (MACs) for services to Medicare beneficiaries.
Date: 12/2024
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Creating a Sustainable Future for Value-Based Care: A Playbook of Voluntary Best Practices for VBC Payment Arrangements
Describes themes that emerged from workgroup meetings regarding the implementation of value-based care (VBC) models, with a focus on total cost of care arrangements. Outlines voluntary best practices and domains within VBC payment arrangements for health plans, facilities, clinicians, and VBC entities to consider during the design, implementation, and evaluation of VBC participation. Includes rural information and considerations throughout.
Date: 04/2024
Type: Document
Sponsoring organizations: AHIP, American Medical Association, National Association of ACOs
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Describes themes that emerged from workgroup meetings regarding the implementation of value-based care (VBC) models, with a focus on total cost of care arrangements. Outlines voluntary best practices and domains within VBC payment arrangements for health plans, facilities, clinicians, and VBC entities to consider during the design, implementation, and evaluation of VBC participation. Includes rural information and considerations throughout.
Date: 04/2024
Type: Document
Sponsoring organizations: AHIP, American Medical Association, National Association of ACOs
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Medicare Accountable Care Organizations: Past Performance and Future Directions
Summarizes research findings about Medicare accountable care organizations (ACOs) from recent peer-reviewed journals, official evaluations of Medicare ACOs, and research organization reports. Describes characteristics of certain ACOs associated with greater savings and factors that limit ACOs' ability to achieve net budgetary savings for the Medicare program. Identifies policy approaches that could increase savings for Medicare through ACOs and the Medicare Shared Savings Program. Includes a brief discussion of challenges facing ACOs in rural and underserved areas.
Date: 04/2024
Type: Document
Sponsoring organization: Congressional Budget Office
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Summarizes research findings about Medicare accountable care organizations (ACOs) from recent peer-reviewed journals, official evaluations of Medicare ACOs, and research organization reports. Describes characteristics of certain ACOs associated with greater savings and factors that limit ACOs' ability to achieve net budgetary savings for the Medicare program. Identifies policy approaches that could increase savings for Medicare through ACOs and the Medicare Shared Savings Program. Includes a brief discussion of challenges facing ACOs in rural and underserved areas.
Date: 04/2024
Type: Document
Sponsoring organization: Congressional Budget Office
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What Would Shifting To A Single-Dose HPV Vaccine Mean For Health And Access?
Discusses the potential impact of single-dose human papilloma virus (HPV) vaccines on health disparities for rural residents, lower socioeconomic status patients, men, and sexual and gender minorities. Discusses relief of cost barriers for health systems and vaccine shortages.
Author(s): Matthew Najarian, Amanda F. Petrik
Citation: Health Affairs Forefront
Date: 04/2024
Type: Document
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Discusses the potential impact of single-dose human papilloma virus (HPV) vaccines on health disparities for rural residents, lower socioeconomic status patients, men, and sexual and gender minorities. Discusses relief of cost barriers for health systems and vaccine shortages.
Author(s): Matthew Najarian, Amanda F. Petrik
Citation: Health Affairs Forefront
Date: 04/2024
Type: Document
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Indian Health Service: Opportunities Exist to Improve Clinician Screening Adherence and Oversight
Examines the Indian Health Service's (IHS) oversight of the credentialing and privileging process that reviews and verifies the professional qualifications of IHS physicians. Describes administrative tasks performed by IHS clinicians at federally operated facilities and the amount of time spent on these tasks. Offers recommendations to IHS, including the development of a single, authoritative source outlining procedures to meet credentialing and privileging requirements.
Additional links: Full Report
Date: 04/2024
Type: Document
Sponsoring organization: Government Accountability Office
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Examines the Indian Health Service's (IHS) oversight of the credentialing and privileging process that reviews and verifies the professional qualifications of IHS physicians. Describes administrative tasks performed by IHS clinicians at federally operated facilities and the amount of time spent on these tasks. Offers recommendations to IHS, including the development of a single, authoritative source outlining procedures to meet credentialing and privileging requirements.
Additional links: Full Report
Date: 04/2024
Type: Document
Sponsoring organization: Government Accountability Office
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Evaluation of the Maryland Total Cost of Care Model: Progress Report
Provides an overview of the Maryland Total Cost of Care Model and evaluates the first four years of the program, 2019-2022. Explores the effects of the model on Medicare spending; service use, including preventable hospital use; and healthcare quality measures. Estimates the potential impact of switching Maryland to the Medicare prospective payment system (PPS) on Medicare spending and service use, including implications for rural and safety net hospitals.
Additional links: Appendices, Findings at a Glance, Transformation Spotlight
Date: 04/2024
Type: Document
Sponsoring organizations: Centers for Medicare and Medicaid Services, Mathematica
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Provides an overview of the Maryland Total Cost of Care Model and evaluates the first four years of the program, 2019-2022. Explores the effects of the model on Medicare spending; service use, including preventable hospital use; and healthcare quality measures. Estimates the potential impact of switching Maryland to the Medicare prospective payment system (PPS) on Medicare spending and service use, including implications for rural and safety net hospitals.
Additional links: Appendices, Findings at a Glance, Transformation Spotlight
Date: 04/2024
Type: Document
Sponsoring organizations: Centers for Medicare and Medicaid Services, Mathematica
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2023 National CAH Quality Inventory & Assessment National Report
Presents a high-level summary of key data points from the October-December 2023 National Critical Access Hospital (CAH) Quality Inventory and Assessment. Includes data on CAH system affiliation; median average daily census and emergency department volume; hospital inpatient, behavioral health and specialty care, and outpatient and other service lines; and CAH quality payment model participation.
Author(s): Megan Lahr, Robert Barclay, Madeleine Pick
Date: 04/2024
Type: Document
Sponsoring organization: Flex Monitoring Team
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Presents a high-level summary of key data points from the October-December 2023 National Critical Access Hospital (CAH) Quality Inventory and Assessment. Includes data on CAH system affiliation; median average daily census and emergency department volume; hospital inpatient, behavioral health and specialty care, and outpatient and other service lines; and CAH quality payment model participation.
Author(s): Megan Lahr, Robert Barclay, Madeleine Pick
Date: 04/2024
Type: Document
Sponsoring organization: Flex Monitoring Team
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Assessing the Impact of COVID-19 on Rural Hospitals
Explores the impact of the COVID-19 pandemic on rural hospital financial performance. Presents data on profitability and patient care margin trends from 2017 to 2022. Describes characteristics of rural hospitals in three categories of patient care margins: those that always had negative margins, always had positive margins, and those with mixed margins. Discusses the impact of COVID-19 relief funding on total hospital margins.
Author(s): Saleema A. Karim, Nathan W. Carroll, Paula H. Song, Adam Atherly
Date: 04/2024
Type: Document
Sponsoring organizations: American Hospital Association, Department of Health Administration at the Virginia Commonwealth University College of Health Professions
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Explores the impact of the COVID-19 pandemic on rural hospital financial performance. Presents data on profitability and patient care margin trends from 2017 to 2022. Describes characteristics of rural hospitals in three categories of patient care margins: those that always had negative margins, always had positive margins, and those with mixed margins. Discusses the impact of COVID-19 relief funding on total hospital margins.
Author(s): Saleema A. Karim, Nathan W. Carroll, Paula H. Song, Adam Atherly
Date: 04/2024
Type: Document
Sponsoring organizations: American Hospital Association, Department of Health Administration at the Virginia Commonwealth University College of Health Professions
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Medicare Payment for Rural or Geographically Isolated Hospitals
Displays data on Medicare payment adjustments for Sole Community Hospitals, Medicare-Dependent Hospitals, Low-Volume Hospitals, and Critical Access Hospitals. Includes information on the number of qualifying hospitals by state and eligibility criteria.
Date: 04/2024
Type: Document
Sponsoring organization: Congressional Research Service
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Displays data on Medicare payment adjustments for Sole Community Hospitals, Medicare-Dependent Hospitals, Low-Volume Hospitals, and Critical Access Hospitals. Includes information on the number of qualifying hospitals by state and eligibility criteria.
Date: 04/2024
Type: Document
Sponsoring organization: Congressional Research Service
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Protecting, Connecting and Thriving: Rural Public Health and Healthcare
Webinar recording of a panel discussing rural public health topics including rural health disparities, mortality, COVID-19, Medicaid coverage, primary care, graduate medical education, and services for veterans. Transcript is available in the video description.
Date: 04/2024
Type: Video/Multimedia
Sponsoring organizations: The RURAL Study, University of Texas Health Science Center at San Antonio
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Webinar recording of a panel discussing rural public health topics including rural health disparities, mortality, COVID-19, Medicaid coverage, primary care, graduate medical education, and services for veterans. Transcript is available in the video description.
Date: 04/2024
Type: Video/Multimedia
Sponsoring organizations: The RURAL Study, University of Texas Health Science Center at San Antonio
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