Rural Health
Resources by Topic: Medicare
CMS Bundled Payments for Care Improvement Initiative Models 2-4: Year 7 Evaluation & Monitoring Annual Report
Seventh and final report describing findings from an evaluation of Models 2, 3, and 4 of the Bundled Payments for Care Improvement (BPCI) initiative, linking provider payments for an episode of care with the goal of decreasing cost of care while improving quality. Includes information specific to rural BPCI-participating hospitals, skilled nursing facilities, and home health agencies.
Additional links: Appendices, Findings at a Glance
Author(s): The Lewin Group, Abt Associates, GDIT, Telligen
Date: 03/2021
Sponsoring organization: Centers for Medicare and Medicaid Services
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Seventh and final report describing findings from an evaluation of Models 2, 3, and 4 of the Bundled Payments for Care Improvement (BPCI) initiative, linking provider payments for an episode of care with the goal of decreasing cost of care while improving quality. Includes information specific to rural BPCI-participating hospitals, skilled nursing facilities, and home health agencies.
Additional links: Appendices, Findings at a Glance
Author(s): The Lewin Group, Abt Associates, GDIT, Telligen
Date: 03/2021
Sponsoring organization: Centers for Medicare and Medicaid Services
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CMS Bundled Payments for Care Improvement Advanced Model: Year 2 Evaluation Report
Second annual report of the Bundled Payments for Care Improvement Advanced (BPCI Advanced) Model, which tests whether linking payments for a clinical episode of care can reduce Medicare expenditures while maintaining or improving quality of care. Covers the period from October 1, 2018, through January 1, 2020. Describes participants in the model; clinical episodes included; the reach of the model; and the impact of BPCI Advanced on episode payments, utilization, and quality of care. Includes information on rural hospital participation in the model.
Additional links: Appendices
Author(s): The Lewin Group, Abt Associates, GDIT, Telligen
Date: 03/2021
Sponsoring organization: Centers for Medicare and Medicaid Services
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Second annual report of the Bundled Payments for Care Improvement Advanced (BPCI Advanced) Model, which tests whether linking payments for a clinical episode of care can reduce Medicare expenditures while maintaining or improving quality of care. Covers the period from October 1, 2018, through January 1, 2020. Describes participants in the model; clinical episodes included; the reach of the model; and the impact of BPCI Advanced on episode payments, utilization, and quality of care. Includes information on rural hospital participation in the model.
Additional links: Appendices
Author(s): The Lewin Group, Abt Associates, GDIT, Telligen
Date: 03/2021
Sponsoring organization: Centers for Medicare and Medicaid Services
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Tackling America's Mental Health and Addiction Crisis Through Primary Care Integration
Explores how primary and behavioral healthcare integration can overcome the unmet needs for mental health and substance use services. Discusses barriers to integrated care delivery. Offers policy recommendations to improve the integration of primary and behavioral healthcare services through enhanced payments, training, and technical assistance, and improving access to behavioral health providers for consultation and referral.
Additional links: Infographic
Date: 03/2021
Sponsoring organization: Bipartisan Policy Center
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Explores how primary and behavioral healthcare integration can overcome the unmet needs for mental health and substance use services. Discusses barriers to integrated care delivery. Offers policy recommendations to improve the integration of primary and behavioral healthcare services through enhanced payments, training, and technical assistance, and improving access to behavioral health providers for consultation and referral.
Additional links: Infographic
Date: 03/2021
Sponsoring organization: Bipartisan Policy Center
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Update to Rural Health Clinic (RHC) Payment Limits
Provides an overview of the updates to Rural Health Clinic (RHC) payment limits per visit beginning April 1, 2021, through 2028.
Date: 03/2021
Sponsoring organization: Centers for Medicare and Medicaid Services
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Provides an overview of the updates to Rural Health Clinic (RHC) payment limits per visit beginning April 1, 2021, through 2028.
Date: 03/2021
Sponsoring organization: Centers for Medicare and Medicaid Services
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Post-Acute Care Trajectories for Rural Medicare Beneficiaries: Planned versus Actual Hospital Discharges to Skilled Nursing Facilities and Home Health Agencies
Examines care transitions among rural fee-for-service Medicare beneficiaries following discharge from an acute care hospital. Compares planned and actual discharges to home health agencies and skilled nursing facilities. Discusses implications of these findings on rural healthcare policy and practice.
Author(s): Tracy M. Mroz, Lisa A. Garberson, C. Holly A. Andrilla, et al.
Date: 03/2021
Sponsoring organization: WWAMI Rural Health Research Center
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Examines care transitions among rural fee-for-service Medicare beneficiaries following discharge from an acute care hospital. Compares planned and actual discharges to home health agencies and skilled nursing facilities. Discusses implications of these findings on rural healthcare policy and practice.
Author(s): Tracy M. Mroz, Lisa A. Garberson, C. Holly A. Andrilla, et al.
Date: 03/2021
Sponsoring organization: WWAMI Rural Health Research Center
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Telehealth Policy and Regulatory Considerations During a Pandemic
Toolkit examining policies related to telehealth regarding coverage and payment, licensing, patient privacy and security, remote prescribing, and others, noting temporary changes due to COVID-19. Offers policy recommendations and highlights other important policy areas for healthcare providers to be aware of.
Date: 03/2021
Sponsoring organization: National Telehealth Technology Assessment Resource Center
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Toolkit examining policies related to telehealth regarding coverage and payment, licensing, patient privacy and security, remote prescribing, and others, noting temporary changes due to COVID-19. Offers policy recommendations and highlights other important policy areas for healthcare providers to be aware of.
Date: 03/2021
Sponsoring organization: National Telehealth Technology Assessment Resource Center
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MedPAC Report to the Congress: Medicare Payment Policy, 2021
Annual review of Medicare payment policies, with recommendations to Congress. Includes discussion on Medicare payment policies directly affecting rural providers and beneficiaries. Addresses payment adequacy for healthcare facilities and services, improving Medicare payment for post-acute care, Medicare Advantage, Medicare Part D, and the impact of healthcare provider consolidation. Contains information on the effects of the COVID-19 pandemic on Medicare beneficiary healthcare access, mortality, and service use. Presents an option for Medicare's coverage of telehealth beyond the public health emergency.
Date: 03/2021
Sponsoring organization: Medicare Payment Advisory Commission
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Annual review of Medicare payment policies, with recommendations to Congress. Includes discussion on Medicare payment policies directly affecting rural providers and beneficiaries. Addresses payment adequacy for healthcare facilities and services, improving Medicare payment for post-acute care, Medicare Advantage, Medicare Part D, and the impact of healthcare provider consolidation. Contains information on the effects of the COVID-19 pandemic on Medicare beneficiary healthcare access, mortality, and service use. Presents an option for Medicare's coverage of telehealth beyond the public health emergency.
Date: 03/2021
Sponsoring organization: Medicare Payment Advisory Commission
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Report to Congress on Medicaid and CHIP, March 2021
Reports on five aspects of Medicaid: 1) improving Medicaid's responsiveness during economic downturns; 2) addressing concerns about high rates of maternal morbidity and mortality; 3) reexamining Medicaid's estate recovery policies; 4) integrating care for people who are dually eligible for Medicaid and Medicare; and 5) improving hospital payment policy for the nation's safety-net hospitals. Chapter 5 examines the relationship between disproportionate share hospital (DSH) allotments to states and the number of uninsured individuals, the amounts and sources of hospitals' uncompensated care costs, and the number of hospitals with high levels of uncompensated care that also provide essential community services. Table 5-1 details DSH spending for urban and rural hospitals and for Critical Access Hospitals.
Date: 03/2021
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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Reports on five aspects of Medicaid: 1) improving Medicaid's responsiveness during economic downturns; 2) addressing concerns about high rates of maternal morbidity and mortality; 3) reexamining Medicaid's estate recovery policies; 4) integrating care for people who are dually eligible for Medicaid and Medicare; and 5) improving hospital payment policy for the nation's safety-net hospitals. Chapter 5 examines the relationship between disproportionate share hospital (DSH) allotments to states and the number of uninsured individuals, the amounts and sources of hospitals' uncompensated care costs, and the number of hospitals with high levels of uncompensated care that also provide essential community services. Table 5-1 details DSH spending for urban and rural hospitals and for Critical Access Hospitals.
Date: 03/2021
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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2021 RHC Billing and Coding Update
Recording of a March 9, 2021, webinar providing an overview of coding and billing changes relevant to Rural Health Clinics (RHCs). Discusses guidelines for reporting COVID-19 immunizations and monoclonal antibody infusions, telehealth coding and billing during the COVID-19 public health emergency, ICD-10-CM diagnosis coding for COVID-19, and RHC lab billing and COVID test reporting. Part of the Rural Health Clinic Technical Assistance Series.
Additional links: AMA Code & Guideline Changes, COVID Vaccine Log, Presentation Slides, Transcript
Date: 03/2021
Sponsoring organization: National Association of Rural Health Clinics
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Recording of a March 9, 2021, webinar providing an overview of coding and billing changes relevant to Rural Health Clinics (RHCs). Discusses guidelines for reporting COVID-19 immunizations and monoclonal antibody infusions, telehealth coding and billing during the COVID-19 public health emergency, ICD-10-CM diagnosis coding for COVID-19, and RHC lab billing and COVID test reporting. Part of the Rural Health Clinic Technical Assistance Series.
Additional links: AMA Code & Guideline Changes, COVID Vaccine Log, Presentation Slides, Transcript
Date: 03/2021
Sponsoring organization: National Association of Rural Health Clinics
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Medicare Hospital Payments: Adjusting for Variation in Geographic Area Wages
Provides an overview of the use of the hospital wage index applied to the Medicare inpatient prospective payment system (IPPS) to account for geographic differences in hospitals' labor costs. Discusses the effect of the wage index on Medicare payments for inpatient hospital services, exceptions to wage index adjustments, and proposals for wage index reforms.
Date: 03/2021
Sponsoring organization: Congressional Research Service
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Provides an overview of the use of the hospital wage index applied to the Medicare inpatient prospective payment system (IPPS) to account for geographic differences in hospitals' labor costs. Discusses the effect of the wage index on Medicare payments for inpatient hospital services, exceptions to wage index adjustments, and proposals for wage index reforms.
Date: 03/2021
Sponsoring organization: Congressional Research Service
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