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Rural Health
Resources by Topic: Reimbursement and payment models

Medicare Advantage Versus the Traditional Medicare Program: Costs of Inpatient Stays, 2009–2017
Examines the costs of hospital inpatient stays among patients 65 years of age and older with a primary expected payer of Medicare Advantage compared to traditional Medicare, based on data from 18 states. Includes data by location of patient residence for rural, micropolitan, small metropolitan, and large metropolitan areas.
Author(s): Brian J. Moore, Lan Liang
Date: 08/2020
Type: Document
Sponsoring organization: Agency for Healthcare Research and Quality
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Experiences of Community Health Centers in Expanding Telemedicine
Presents an overview of the experiences of nine health centers in California that received funding to increase their telemedicine services. Describes barriers to implementing and sustaining expanded services, including reimbursement policies and other regulatory restrictions. Includes recommendations for health centers and policymakers to promote the use of telehealth services.
Author(s): Lori Uscher-Pines, Jessica Sousa, Alina I. Palimaru, et al.
Date: 07/2020
Type: Document
Sponsoring organization: RAND Corporation
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Medicare Beneficiary Use of Telehealth Visits: Early Data from the Start of the COVID-19 Pandemic
Examines changes in Medicare in-person primary care visits and the use of telehealth services at the start of the COVID-19 public health emergency. Discusses how Medicare telehealth flexibilities implemented in response to COVID-19 impacted access to these services. Compares the percentage of primary care telehealth visits between rural and urban providers. Includes a county-level map displaying the percentage of primary care visits conducted via telehealth services in April 2020.
Date: 07/2020
Type: Document
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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Independent Evaluation of Comprehensive Primary Care Plus (CPC+): Second Annual Report
Reports on the first two program years of the CPC+, a CMS primary care payment and delivery reform effort. Discusses CPC+ participating practices, payer partners, and health information technology (HIT) vendors supporting the program. Describes practices changes and outcomes for Medicare fee-for-service beneficiaries. Includes statistics with breakdowns by rural, suburban, or urban practice location.
Additional links: Appendices to the Supplemental Volume, CMS Perspective Report, Findings at a Glance, Supplemental Volume
Date: 07/2020
Type: Document
Sponsoring organizations: Centers for Medicare and Medicaid Services, Mathematica
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MedPAC Data Book: Health Care Spending and the Medicare Program, 2020
Provides an overview of Medicare spending and highlights data on Medicare beneficiary demographics, dual-eligible beneficiaries, quality of care provided through the Medicare program, and other payer liability. Examines settings of care, including rural specific provider sites, as they relate to spending, access to care, and profit margins. Compares rural and urban beneficiaries and providers throughout. Chart 6-2 addresses rural hospital closures.
Date: 07/2020
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Advance Care Planning: New Realities in Times of COVID-19
Examines the challenges of advance care planning, planning for decision-making in times of medical crisis, due to COVID-19. Shares insights from clinicians and others involved in helping rural patients.
Author(s): Kay Miller Temple
Citation: Rural Monitor
Date: 07/2020
Type: Document
Sponsoring organization: Rural Health Information Hub
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Insights for What Enhances or Undermines Trust in Hospital Settings
Reviews research on the trust rural and underserved populations have in hospitals. Highlights dimensions of patient trust identified by researchers. Profiles a study by the Colorado Hospital Association examining the relationship between patient and family engagement activities and patient trust in rural hospitals. Includes a discussion on the impact of the COVID-19 pandemic on rural hospitals and Critical Access Hospitals.
Author(s): Bonnie Austin Cluxton
Date: 07/2020
Type: Document
Sponsoring organization: AcademyHealth
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Rural-Relevant Quality Measures for Testing of Statistical Approaches to Address Low Case-Volume
Draft report that summarizes recommendations of the Measure Applications Partnership (MAP) Rural Health Workgroup. Recommends that 15 rural-relevant quality measures susceptible to low case-volume challenges could be used to test statistical approaches designed to address this problem. Discusses reporting challenges and gaps in rural health care quality measurement.
Date: 07/2020
Type: Document
Sponsoring organization: National Quality Forum
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MedPAC Comment on CMS's Proposed Rule on the Hospital Inpatient PPS and the Long-term Care Hospital PPS for FY 2021
Comments on a May 29, 2020, Federal Register proposed rule revising the hospital inpatient and long-term care hospital (LTCH) prospective payment systems. Discusses proposals to use commercial insurer data to set Medicare severity–diagnosis related group (MS–DRG) relative weights and adopt changes to geographic area delineations to establish hospital wage indexes for the IPPS and LTCH PPS.
Date: 07/2020
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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New and Expanded Flexibilities for Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs) During the COVID-19 Public Health Emergency (PHE)
Provides an overview of changes to Rural Health Clinic (RHC) and Federally Qualified Health Centers (FQHCs) requirements and payment policies in response to the COVID-19 pandemic. Includes information on exceptions to the productivity standards for RHCs during the public health emergency. Discusses new payments for telehealth services, the expansion of virtual communication services, the revision of the home health agency shortage requirements for visiting nursing services, and accelerated or advance payments.
Date: 07/2020
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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