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Rural Health
Resources by Topic: Reimbursement and payment models

State Telehealth Medicaid Fee-For-Service Policy: A Historical Analysis of Telehealth: 2013-2019
Examines national and state-by-state trends in Medicaid fee-for-service policies regarding telehealth between 2013-2019. Highlights changes in expanded telehealth and telemedicine definitions, modalities that are reimbursed, and geographic limitations. Provides graphs and national maps throughout to supplement reported trends.
Date: 01/2020
Type: Document
Sponsoring organization: Center for Connected Health Policy: The National Telehealth Policy Resource Center
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Burnout: Measurement Tool(s), Cause(s) and Impact(s)
Reports on what is known about burnout among rural healthcare providers, highlighting several research studies. Discusses the impact of burnout on turnover, productivity, healthcare quality, and safety.
Author(s): Kay Miller Temple
Citation: Rural Monitor
Date: 01/2020
Type: Document
Sponsoring organization: Rural Health Information Hub
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2018 Quality Payment Program Performance Year Data
Provides an overview of the results of the Quality Payment Program for the 2018 performance year. Highlights mean and median final scores and payment adjustments for rural and small practices.
Date: 12/2019
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Impact of the Medicare Disproportionate Share Hospital Payment Cap on Rural and Urban Hospitals
Describes the number and location of hospitals that qualify for Medicare Disproportionate Share Hospital (DSH) payments and meet the criteria for a 12% payment cap. Examines how the payment cap and lost revenue impacts urban and rural hospitals. Presents options to modify DSH payments to ease the financial strain on rural hospitals.
Author(s): Paula Weigel, Fred Ullrich, Keith J. Mueller
Date: 12/2019
Type: Document
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Evaluation of the Home Health Value-Based Purchasing (HHVBP) Model: Second Annual Report
Evaluates the Home Health Value-Based Purchasing (HHVBP) Model, designed by the Center for Medicare & Medicaid Innovation (CMMI), implemented in nine states: Arizona, Florida, Iowa, Massachusetts, Maryland, Nebraska, North Carolina, Tennessee, and Washington. The HHVBP Model was created to establish the impact of providing financial incentives to home health agencies (HHAs) for improvements in quality of care. The analysis, based on data from the implementation stages (2013-2015) and performance years (2016-2017), reports on the effects of financial incentives on quality of care, Medicare expenditures, patient outcomes, and identifies regional differences in beneficiary demographics, and rural and urban status.
Author(s): Alyssa Pozniak, Marc Turenne, Purna Mukhopadhyay, et al.
Date: 12/2019
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Evaluation of the Maryland All-Payer Model: Volume I - Final Report
Evaluation of the All-Payer Model operating under an agreement with the Centers for Medicare & Medicaid Services (CMS) for hospitals in rural and urban settings implemented in Maryland in 2014. This model shifted the state's hospital payment structure to an annual, global hospital budget that includes both inpatient and outpatient hospital services. Report covers 4.5 years of implementation, and compares outcomes by rural and urban residency.
Author(s): Susan Haber, Heather Beil, Marisa Morrison, et al.
Date: 11/2019
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Intergovernmental Advisory Committee to the Federal Communications Commission Advisory Recommendation No: 2019-2 in the Matter of State, Local Tribal, and Territorial Regulatory and Other Barriers and Incentives to Telemedicine
Examines the technical infrastructure necessary for effective telemedicine delivery in state, territorial, tribal, and local (rural and urban) areas. Discusses the regulatory barriers including legislation, licensing, reimbursement, malpractice insurance, and privacy that obstruct its development and utilization, and offers recommendations addressing these barriers. Appendix A presents case studies of broadband and telehealth development in several states and territories.
Date: 11/2019
Type: Document
Sponsoring organizations: Federal Communications Commission, Intergovernmental Advisory Committee to the Federal Communications Commission
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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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The Development of Telehealth Laws in the U.S. from 2008 to 2015: A Legal Landscape
Policy brief examining the scope and evolving nature of telehealth statutes and regulations in the 50 states and the District of Columbia. Explores the extent to which state laws regulate primary care delivery through use of telehealth. Features U.S. maps showing changes from 2008 to 2015 in terms of various types of telehealth-related laws, including those governing insurance coverage, and statistics with breakdowns by the top 25 and bottom 25 rural states.
Author(s): Cason D. Schmit, Alva O. Ferdinand, Timothy Callaghan, et al.
Date: 11/2019
Type: Document
Sponsoring organization: Southwest 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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