Rural Health
Resources by Topic: Reimbursement and payment models
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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Value-Based Care Assessment Tool
Online tool that assesses 80 different value-based care capacities in eight categories and creates a value-based care readiness report that can be used to support strategic planning. Tool is designed to be used by your healthcare organization's senior leadership team.
Date: 02/2024
Sponsoring organization: Rural Health Value
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Online tool that assesses 80 different value-based care capacities in eight categories and creates a value-based care readiness report that can be used to support strategic planning. Tool is designed to be used by your healthcare organization's senior leadership team.
Date: 02/2024
Sponsoring organization: Rural Health Value
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AHIP Value-Based Care Workgroup
Presentation slides from a January 23, 2024, presentation to the AHIP Value-Based Care Workgroup. Provides an overview of rural healthcare. Discusses rural-relevant engagement and rural value-based care and payment model design considerations. Highlights examples of rural providers successfully participating in value-based payment programs, including Medicare Shared Savings Programs and Accountable Care Organizations (ACOs).
Date: 01/2024
Sponsoring organization: Rural Health Value
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Presentation slides from a January 23, 2024, presentation to the AHIP Value-Based Care Workgroup. Provides an overview of rural healthcare. Discusses rural-relevant engagement and rural value-based care and payment model design considerations. Highlights examples of rural providers successfully participating in value-based payment programs, including Medicare Shared Savings Programs and Accountable Care Organizations (ACOs).
Date: 01/2024
Sponsoring organization: Rural Health Value
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The State of Rural Healthcare: Research Report and Outlook for 2024
Presents results of a survey of 106 rural healthcare organizations across 25 states regarding their financial health and strategic priorities. Identifies the top challenges identified by the surveyed organizations. Discusses how providers are addressing three strategic priorities in 2024, including people management, revenue capture, and digital capabilities.
Date: 01/2024
Sponsoring organization: Wipfli, LLP
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Presents results of a survey of 106 rural healthcare organizations across 25 states regarding their financial health and strategic priorities. Identifies the top challenges identified by the surveyed organizations. Discusses how providers are addressing three strategic priorities in 2024, including people management, revenue capture, and digital capabilities.
Date: 01/2024
Sponsoring organization: Wipfli, LLP
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Value-Based Care and North Dakota
Slides presented to the North Dakota legislature on January 30, 2024, providing an overview of an initiative assisting rural North Dakota Critical Access Hospitals (CAHs) in preparing for value-based care and payment. Discusses principles of the transition from volume-based to value-based payment. Outlines the technical assistance the initiative provides to five core CAHs in the state and a summary of a high-level financial analysis.
Author(s): Clint MacKinney
Date: 01/2024
Sponsoring organization: Rural Health Value
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Slides presented to the North Dakota legislature on January 30, 2024, providing an overview of an initiative assisting rural North Dakota Critical Access Hospitals (CAHs) in preparing for value-based care and payment. Discusses principles of the transition from volume-based to value-based payment. Outlines the technical assistance the initiative provides to five core CAHs in the state and a summary of a high-level financial analysis.
Author(s): Clint MacKinney
Date: 01/2024
Sponsoring organization: Rural Health Value
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