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Rural Health
Resources by Topic: Medicare

Rural Health Clinic Costs and Medicare Reimbursement
Policy brief exploring whether updates to the Medicare per-visit reimbursement cap have allowed Rural Health Clinics (RHCs) of various types and sizes to keep pace with increases in staffing and other costs. Features statistics including RHC mean Medicare adjusted cost per visit and RHC mean Medicare healthcare staff costs as of 2014, with breakdowns by 4 sizes of RHCs and private or publicly-owned status.
Author(s): John Gale, Zachariah T. Croll, Andrew F. Coburn
Date: 11/2019
Type: Document
Sponsoring organization: Maine Rural Health Research Center
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Finalized CY 2020 Physician Fee Schedule
Fact sheet describing calendar year 2020 changes to Medicare's telehealth reimbursement policy as a part of the Physician Fee Schedule (PFS) final rule. Includes sections on opioid use disorder treatment services, care management services, chronic care remote physiologic monitoring services, and online digital evaluation service (E-visit).
Date: 11/2019
Type: Document
Sponsoring organization: Center for Connected Health Policy: The National Telehealth Policy Resource Center
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Delta Region Community Health Systems Development (DRCHSD) Program: 340B Drug Pricing Program Guide
Provides rural hospital administrators with information regarding the 340B Drug Pricing Program. Offers State Offices of Rural Health (SORHs) directors and Flex Program coordinators a better understanding of the process hospitals must abide by to participate in the 340B Program.
Author(s): BKD CPAs & Advisors
Date: 10/2019
Type: Document
Sponsoring organization: National Rural Health Resource Center
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Delta Region Community Health Systems Development (DRCHSD) Program: Best Practice Concepts in Revenue Cycle Management Guide
Offers rural hospital executives and management teams best practice concepts in revenue cycle management by assisting them in identifying performance improvement within their hospitals and departments. Provides State Offices of Rural Health (SORH) directors and Flex Program coordinators a better understanding of the revenue cycle best practices to help them design educational training programs to support rural hospital administrators with performance improvement.
Author(s): BKD CPAs & Advisors
Date: 10/2019
Type: Document
Sponsoring organization: National Rural Health Resource Center
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Qualifying Alternative Payment Model Participants (QPs) Methodology Fact Sheet: Medicare Option 2019 Performance Period
Explains the methods used by the Centers for Medicare & Medicaid Services (CMS) to determine if clinicians participating in the Medicare Advanced Alternative Payment Models (APMs), a track of the Quality Payment Program, are eligible as Qualifying Alternative Payment Model Participants (QPs), or partial QPs for the 2019 performance period. This includes eligible clinicians who receive payments for Medicare Part B services furnished at Method II Critical Access Hospitals (CAHs), Rural Health Clinics (RHCs), or Federally Qualified Health Centers (FQHCs).
Date: 10/2019
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Estimate of Federal Payment Reductions to Hospitals Following the ACA: 2010-2029: Estimates and Methodology
Estimates the reduction in Medicare hospital payments due to sequestration from 2010 to 2019, not including reductions enacted under the Affordable Care Act (ACA). Demonstrates how other legislative acts and regulatory changes by the Centers for Medicare and Medicaid Services (CMS) reduced federal payments to hospitals over the same period. Highlights how reductions in Medicare payments for bad debt impacted Critical Access Hospitals (CAHs).
Date: 10/2019
Type: Document
Sponsoring organizations: American Hospital Association, Federation of American Hospitals
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Medicare Payment Basics: Skilled Nursing Facility Services Payment System
Overview of Medicare payments for skilled nursing and rehabilitation services and discusses changes to the payment rates as of October, 2019 based on components of care. Describes what constitutes a skilled nursing facility and how with CMS approval small, rural hospitals and critical access hospitals may be used to provide these services. Compares Medicare daily base rates for urban and rural skilled nursing facilities.
Date: 10/2019
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Medicare Payment Basics: Physician and Other Health Professional Payment System
Overview of Medicare payments for physician services conducted in a variety of settings including physicians' offices, hospitals, ambulatory surgical centers, skilled nursing facilities and other post-acute care settings, hospices, outpatient dialysis facilities, clinical laboratories, and beneficiaries' homes.
Date: 10/2019
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Medicare Payment Basics: Part D Payment System
Overview of the Medicare Part D prescription drug benefit including subsidy amounts, payments to plans, and how enrollee premiums are calculated.
Date: 10/2019
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Medicare Payment Basics: Outpatient Hospital Services Payment System
Outlines Medicare's payments for outpatient hospital services. Features considerations for rural sole community hospitals.
Date: 10/2019
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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