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Rural Health
Resources by Topic: Reimbursement and payment models

State Telehealth Laws and Reimbursement Policies
A summary of telehealth-related laws and reimbursement policies for all 50 states and the District of Columbia, using policy language available in each state as of April 2018. The primary focus of the report is Medicaid coverage for telehealth services but also includes references to state policies that require private insurer payment for the service. Interactive map allows results to be narrowed by state.
Additional links: 50 State Scan of Telehealth Reimbursement Laws and Medicaid Policies - Factsheet, Infographic, Interactive Map
Date: 05/2018
Type: Document
Sponsoring organization: Center for Connected Health Policy: The National Telehealth Policy Resource Center
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Medicaid Managed Care and the Rural Exception: A Review of Issues and Perspectives from the Field
Analyzes Medicaid waivers, current up to September 2017, to examine how state Medicaid procedures affect rural populations. Covers information gathered from State Offices of Rural Health (SORHs), state Medicaid offices, and other stakeholders to describe the process of waiver development.
Author(s): Janice C. Probst, Amy B. Martin, Victor Kirksey
Date: 05/2018
Type: Document
Sponsoring organization: South Carolina Rural Health Research Center
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Market Characteristics Associated with Rural Hospitals' Provision of Post-Acute Care
Findings brief summarizing hospital- and market-level factors related to post-acute care (PAC) provided in rural hospitals from 2012-2015. Features statistics including number of rural Medicare cost reports from 2012-2015, PAC provision by census region in 2015, and percent of hospitals in frontier and remote areas in 2015 with breakdowns by type and PAC provision.
Author(s): Abby F. Hoffman, Randy K. Randolph, Alex R. Schulte, George H. Pink
Date: 04/2018
Type: Document
Sponsoring organization: North Carolina Rural Health Research Program
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NACRHHS Policy Brief on Modernizing the Rural Health Clinic Act Provisions
Webinar recording discusses the National Advisory Committee on Rural Health and Human Services (NACRHHS) on proposed enhancements to the Rural Health Clinic Services Act. Features presentations from the NACRHHS Executive Secretary and representatives of the Federal Office of Rural Health Policy, the Maine Rural Health Research Center, and the Idaho Dept. of Health and Welfare.
Additional links: Audio Recording, PowerPoint Handout, Webinar Transcript
Date: 03/2018
Type: Video/Multimedia
Sponsoring organization: Rural Health Information Hub
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CMS Innovation Center: Model Implementation and Center Performance
Features a report on the Centers for Medicare and Medicaid Services' Innovation Center. Discusses the Center's goals of identifying, testing, and improving payment and delivery models, while cutting healthcare costs and sharing best practices. Includes models tested in rural areas.
Additional links: Full Report
Date: 03/2018
Type: Document
Sponsoring organization: Government Accountability Office
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MedPAC Report to the Congress: Medicare Payment Policy: Hospice Services: Chapter 12
Discusses payment adequacy for hospice and palliative support services. Includes statistics with breakdowns by urban and rural locations and demographics on Medicare decedents who used hospice during 2000 and 2013-2016.
Date: 03/2018
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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State Innovation Models (SIM) Initiative Evaluation: Model Test Year Four Annual Report
Fourth 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). Describes the experiences of providers, health systems, consumers, payers, and state officials during the final full implementation year for most Round 1 states. Presents interim impacts on healthcare utilization, cost, and quality for individuals reached by SIM-supported VPMs during the SIM Initiative period. Includes information specific to rural areas.
Date: 03/2018
Type: Document
Sponsoring organizations: Centers for Medicare and Medicaid Services, RTI International
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Catalog of Value-Based Initiatives for Rural Providers
Summarizes rural-relevant, value-based programs currently or recently implemented by the U.S. Department of Health and Human Services (HHS), including the Centers for Medicare and Medicaid Services (CMS) and the Center for Medicare and Medicaid Innovation (CMMI). Designed to help rural healthcare leaders identify HHS value-based programs that are suitable for rural participation. Catalog includes descriptions of each demonstration and provides direct links to the corresponding agency web page.
Date: 03/2018
Type: Document
Sponsoring organization: Rural Health Value
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MedPAC Report to the Congress: Medicare Payment Policy, 2018
Annual review of Medicare payment policies, with recommendations to Congress. Includes discussion on Medicare payment policies directly affecting rural providers and beneficiaries.
Date: 03/2018
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Behavioral Health Integration into Primary Care
Profile of a rural health system, Western Wisconsin Health (WWH), and its work to deliver behavioral health services. Provides an overview of how behavioral health providers and services were integrated with primary care, with a cultural change to focus on whole-person care. Includes information on Medicare and Medicaid reimbursement for the behavioral health services provided at WWH's Rural Health Clinic. Discusses how WWH behavioral health providers offer telehealth services to other rural areas of Wisconsin.
Date: 03/2018
Type: Document
Sponsoring organization: Rural Health Value
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