Rural Health
Resources by Topic: Reimbursement and payment models
Maternal Health in Rural America
White paper describing factors contributing to rural maternal health disparities, including financial barriers to providing obstetric services at rural hospitals, maternal health workforce shortages, access to care, and quality of care. Outlines policy considerations to increase access to maternal health services in rural areas.
Author(s): Hailey Waldman, Alexandra Zimmerman
Date: 02/2024
Sponsoring organization: National Rural Health Association
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White paper describing factors contributing to rural maternal health disparities, including financial barriers to providing obstetric services at rural hospitals, maternal health workforce shortages, access to care, and quality of care. Outlines policy considerations to increase access to maternal health services in rural areas.
Author(s): Hailey Waldman, Alexandra Zimmerman
Date: 02/2024
Sponsoring organization: National Rural Health Association
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Hearing on Examining Chronic Drug Shortages in the United States
Congressional hearing in the U.S. House of Representatives Ways & Means Committee discussing pharmaceutical drug shortages. Discusses cancer care, healthcare quality, the 340B program, supply and demand, reimbursement, and other policy measures. Witnesses include Dr. Stephen Schleicher discussing rural concerns. Captions available in video player.
Additional links: Dr. Stephen Schleicher Testimony
Date: 02/2024
Sponsoring organization: House Ways and Means Committee
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Congressional hearing in the U.S. House of Representatives Ways & Means Committee discussing pharmaceutical drug shortages. Discusses cancer care, healthcare quality, the 340B program, supply and demand, reimbursement, and other policy measures. Witnesses include Dr. Stephen Schleicher discussing rural concerns. Captions available in video player.
Additional links: Dr. Stephen Schleicher Testimony
Date: 02/2024
Sponsoring organization: House Ways and Means Committee
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Evaluation of the Primary Care First Model: Second Annual Report
Provides an overview of the Primary Care First (PCF) model, which aims to enhance primary care and move primary care practitioners toward value-based payment. Describes the PCF model implementation experiences for Cohort 1 and Cohort 2 practices. Explores the preliminary impact of the PCF Model on acute hospitalizations and Medicare Part A and B expenditures relative to a comparison group. Estimates the impacts of the model on a set of seven leading indicators to provide an early assessment of whether care delivery changes are resulting in meaningful early outcome changes. Highlights implications from this report for the Primary Care First model and future models.
Additional links: Findings at a Glance
Date: 02/2024
Sponsoring organizations: Centers for Medicare and Medicaid Services, Mathematica
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Provides an overview of the Primary Care First (PCF) model, which aims to enhance primary care and move primary care practitioners toward value-based payment. Describes the PCF model implementation experiences for Cohort 1 and Cohort 2 practices. Explores the preliminary impact of the PCF Model on acute hospitalizations and Medicare Part A and B expenditures relative to a comparison group. Estimates the impacts of the model on a set of seven leading indicators to provide an early assessment of whether care delivery changes are resulting in meaningful early outcome changes. Highlights implications from this report for the Primary Care First model and future models.
Additional links: Findings at a Glance
Date: 02/2024
Sponsoring organizations: Centers for Medicare and Medicaid Services, Mathematica
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2024 Stability of the Rural Health Safety Net: State and National Data Tables
Provides links to national and state data tables showing the financial impact of federal policies such as sequestration and bad debt reimbursement on rural hospital revenues, jobs, and gross domestic product. Presented at the February 2024 National Rural Health Association Policy Institute.
Date: 02/2024
Sponsoring organization: Chartis Center for Rural Health
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Provides links to national and state data tables showing the financial impact of federal policies such as sequestration and bad debt reimbursement on rural hospital revenues, jobs, and gross domestic product. Presented at the February 2024 National Rural Health Association Policy Institute.
Date: 02/2024
Sponsoring organization: Chartis Center for Rural Health
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Unrelenting Pressure Pushes Rural Safety Net Crisis Into Uncharted Territory
Examines financial and operational metrics for rural hospitals. Discusses the growth of Medicare Advantage (MA) enrollment in rural communities between 2019 and 2023, the impact of MA on rural hospital reimbursement, how the Rural Emergency Hospital (REH) designation can provide a path forward for some rural facilities, and the discontinuation of obstetrics and chemotherapy services at rural hospitals since 2011. Includes the percentage of rural hospitals in each state vulnerable to closure and nine factors significantly associated with rural hospital vulnerability.
Date: 02/2024
Sponsoring organization: Chartis Center for Rural Health
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Examines financial and operational metrics for rural hospitals. Discusses the growth of Medicare Advantage (MA) enrollment in rural communities between 2019 and 2023, the impact of MA on rural hospital reimbursement, how the Rural Emergency Hospital (REH) designation can provide a path forward for some rural facilities, and the discontinuation of obstetrics and chemotherapy services at rural hospitals since 2011. Includes the percentage of rural hospitals in each state vulnerable to closure and nine factors significantly associated with rural hospital vulnerability.
Date: 02/2024
Sponsoring organization: Chartis Center for Rural Health
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State Medicaid & CHIP Telehealth Toolkit
Toolkit to support state policymakers in expanding the use of telehealth to deliver Medicaid and Children's Health Insurance Program (CHIP) services. Provides information on telehealth flexibilities under Medicaid and CHIP; billing best practices; strategies for telehealth in value-based care; best practices from states during the COVID-19 public health emergency; strategies to promote the delivery of accessible and culturally competent care via telehealth; evaluation strategies to understand how telehealth affects quality, outcomes, and cost, and more. Offers state policy and operational considerations; information about common telehealth modalities; frequently asked questions for states to consider as they explore whether to expand the use of telehealth; Medicaid managed care and fee-for-service state checklists; and other planning tools. Includes information about using telehealth to deliver services to medically underserved and rural communities, older adults, and other specific populations.
Date: 02/2024
Sponsoring organization: Centers for Medicare and Medicaid Services
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Toolkit to support state policymakers in expanding the use of telehealth to deliver Medicaid and Children's Health Insurance Program (CHIP) services. Provides information on telehealth flexibilities under Medicaid and CHIP; billing best practices; strategies for telehealth in value-based care; best practices from states during the COVID-19 public health emergency; strategies to promote the delivery of accessible and culturally competent care via telehealth; evaluation strategies to understand how telehealth affects quality, outcomes, and cost, and more. Offers state policy and operational considerations; information about common telehealth modalities; frequently asked questions for states to consider as they explore whether to expand the use of telehealth; Medicaid managed care and fee-for-service state checklists; and other planning tools. Includes information about using telehealth to deliver services to medically underserved and rural communities, older adults, and other specific populations.
Date: 02/2024
Sponsoring organization: Centers for Medicare and Medicaid Services
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2024 Rural Advocacy Agenda
Outlines the American Hospital Association's federal policy priorities for rural hospitals in 2024. Offers recommendations in the areas of commercial insurer accountability, flexible payment options, reimbursement, workforce, and the 340B program.
Date: 02/2024
Sponsoring organization: American Hospital Association
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Outlines the American Hospital Association's federal policy priorities for rural hospitals in 2024. Offers recommendations in the areas of commercial insurer accountability, flexible payment options, reimbursement, workforce, and the 340B program.
Date: 02/2024
Sponsoring organization: American Hospital Association
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Bridging The Home-Based Primary Care Gap In Rural Areas
Discusses challenges with offering home-based primary care (HBPC) in rural communities for older adults and people with disabilities, notably workforce shortages, insufficient infrastructure, and funding. Offers HBPC redesign suggestions with these challenges in mind, discussing community health workers, technology and telehealth, leveraging community resources and partnerships, training, scope of practice laws, payment models, and infrastructure investments.
Author(s): Ginny Rogers, Montgomery Smith, Jonathan Gonzalez-Smith, Robert S. Saunders
Citation: Health Affairs Forefront
Date: 02/2024
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Discusses challenges with offering home-based primary care (HBPC) in rural communities for older adults and people with disabilities, notably workforce shortages, insufficient infrastructure, and funding. Offers HBPC redesign suggestions with these challenges in mind, discussing community health workers, technology and telehealth, leveraging community resources and partnerships, training, scope of practice laws, payment models, and infrastructure investments.
Author(s): Ginny Rogers, Montgomery Smith, Jonathan Gonzalez-Smith, Robert S. Saunders
Citation: Health Affairs Forefront
Date: 02/2024
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Early Impacts of the Pennsylvania Rural Health Model on Potentially Avoidable Utilization
Assesses the impact of the Pennsylvania Rural Health Model (PARHM) on potentially avoidable utilization rates between 2016 and 2022 by comparing participating and non-participating hospitals. Discusses the potential impact of COVID-19 on results.
Author(s): Donald S. Bourne, Eric T. Roberts, Lindsay M. Sabik
Citation: Health Affairs Scholar, 2(2)
Date: 02/2024
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Assesses the impact of the Pennsylvania Rural Health Model (PARHM) on potentially avoidable utilization rates between 2016 and 2022 by comparing participating and non-participating hospitals. Discusses the potential impact of COVID-19 on results.
Author(s): Donald S. Bourne, Eric T. Roberts, Lindsay M. Sabik
Citation: Health Affairs Scholar, 2(2)
Date: 02/2024
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Critical Access Hospital Telehealth Guide
Provides practical guidance on implementing and sustaining telehealth in Critical Access Hospitals, to optimize healthcare delivery, expand access, and enhance care coordination. Focuses on Medicare outpatient telehealth services, but also includes information on Medicaid coverage and remote services that may not strictly be considered telehealth.
Date: 02/2024
Sponsoring organizations: National Rural Health Resource Center, Northwest Regional Telehealth Resource Center
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Provides practical guidance on implementing and sustaining telehealth in Critical Access Hospitals, to optimize healthcare delivery, expand access, and enhance care coordination. Focuses on Medicare outpatient telehealth services, but also includes information on Medicaid coverage and remote services that may not strictly be considered telehealth.
Date: 02/2024
Sponsoring organizations: National Rural Health Resource Center, Northwest Regional Telehealth Resource Center
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