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Rural Health
Resources by Topic: Medicare

Communication Technology Based Services and Payment for Rural Health Clinic (RHCs) and Federally Qualified Health Centers (FQHCs)
Guidance for Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs) billing related to communication technology-based services effective January 1, 2019.
Citation: MLN Matters, MM10843
Date: 01/2019
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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The SUPPORT for Patients and Communities Act (P.L.115-271): Medicare Provisions
Provides a section-by-section description of Medicare provisions in the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act (SUPPORT Act). Addresses rural in two sections: Section 6083 seeks to expand access to addiction treatment in Federally Qualified Health Centers and Rural Health Clinics by paying for training costs to obtain a DATA waiver to furnish OUD treatment; Section 6042 authorizes a demonstration project testing expanded access to MAT drugs through teams with a primary care provider.
Date: 01/2019
Type: Document
Sponsoring organization: Congressional Research Service
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Quality Improvement Implementation Guide and Toolkit for Critical Access Hospitals
A guide for Critical Access Hospitals to help them navigate the Medicare Beneficiary Quality Improvement Project (MBQIP) and find ways to support quality improvement in their facilities. Includes ways to organize quality improvement programs, what to focus on, federal program examples, and info-graphics.
Date: 01/2019
Type: Document
Sponsoring organization: Stratis Health
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Technical Assistance for Hospitals Applying to the Pennsylvania Rural Health Model — A CMMI-Sponsored Rural Hospital Global Budget Model
Describes the experiences of the Rural Health Value program in coaching hospitals in Pennsylvania that were interested in participating in a global budget model. Explains a process to quickly develop a plan focused on community health rather than exclusively on clinical services, to facilitate the transition from volume to value.
Date: 2019
Type: Document
Sponsoring organization: Rural Health Value
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State Innovation Models (SIM) Round 2: Model Test Annual Report Three
Third annual report on the Round 2 State Innovation Models (SIM) program across eleven participating states - Colorado, Connecticut, Delaware, Idaho, Iowa, Michigan, New York, Ohio, Rhode Island, Tennessee, and Washington. Addresses the adoption of delivery models and payment reforms related to value-based payment (VBP) and alternative payment models (APMs). Offers an update and lessons learned on strategies to support healthcare delivery transformation related to behavioral health integration, data for improving health care quality and performance, health information technology, care coordination, and workforce development. Describes states' population health activities. Includes discussion of rural issues throughout the report.
Additional links: Findings at a Glance
Date: 2019
Type: Document
Sponsoring organizations: Centers for Medicare and Medicaid Services, RTI International
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Skilled Nursing Data Initiative
Provides statistics on occupancy, patient day mix, revenue per patient day, and revenue mix including Medicare and Medicaid reimbursement, with breakdowns by rural location, urban cluster, urban area, and national total. Uses data beginning from January 2012. Requires free registration for download.
Date: 2019
Type: Document
Sponsoring organization: National Investment Center for Seniors Housing & Care
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Perspectives of Physicians in Small Rural Practices on the Medicare Quality Payment Program
Provides feedback from small, rural practices on the implementation of Medicare's Quality Payment Program (QPP), which includes the Merit-Based Incentive Payment System (MIPS) and Advanced Alternative Payment Models (APMs). Identifies challenges rural physicians face and offers recommendations to help more small practices participate in the program.
Author(s): Peter Mendel, Christine Buttorff, Peggy G. Chen, et al.
Date: 2019
Type: Document
Sponsoring organizations: HHS Office of the Assistant Secretary for Planning and Evaluation, RAND Corporation
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State Innovation Models (SIM) Initiative Evaluation: Model Test Year Five Annual Report
Fifth annual report on Round 1 of the CMS State Innovation Models (SIM) Initiative, which tests the ability of the governments in six states - Arkansas, Maine, Massachusetts, Minnesota, Oregon, and Vermont - to move providers to value-based payment models (VPMs). Presents the final summary findings for SIM Round 1. Includes information specific to rural areas.
Additional links: Appendices, Findings at a Glance
Date: 12/2018
Type: Document
Sponsoring organizations: Centers for Medicare and Medicaid Services, RTI International
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Medicare: Voluntary and Mandatory Episode-Based Payment Models and Their Participants
Reviews tests of 6 episode-based Medicare payment models. Describes the characteristics of providers that participated in these models, including rural or urban location, addresses factors affecting their decision to participate, and compares the advantages of mandatory versus voluntary participation.
Additional links: Full Report
Date: 12/2018
Type: Document
Sponsoring organization: Government Accountability Office
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Assessing the Unintended Consequences of Health Policy on Rural Populations and Places
Explores health policies that have affected, or could potentially have affected, rural people, places, and providers, in ways that ran counter to policy intent. Examines 6 historical health policies and their effect on rural health systems. Includes a framework for analyzing policy impact on rural populations and places.
Author(s): Keith J. Mueller, Charlie Alfero, Andrew F. Coburn, et al.
Date: 12/2018
Type: Document
Sponsoring organization: Rural Policy Research Institute Rural Health Panel
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