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Rural Health Information Hub

Rural Health
Resources by Topic: Reimbursement and payment models

Health Panel Comment Letter – Medicare Advantage Program
Offers comments in response to the Centers for Medicare & Medicaid Services (CMS) Request for Information on various aspects of the Medicare Advantage (MA) program. Presents a rural perspective on the MA program and discusses health equity in the MA program, expanding access to care, and value-based contracting. Includes data on the proportion of MA plans offering supplemental benefits in noncore, micropolitan, and metropolitan counties in 2020.
Date: 08/2022
Type: Document
Sponsoring organization: Rural Policy Research Institute Rural Health Panel
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What Happens When a Hospital Closes?
Podcast episode discussing the impact of rural hospital closures and obstetrics units on their communities. Explores why facilities and units close and the impact of closures on mortality, prenatal care, maternal and infant health outcomes, and access to quality care.
Date: 08/2022
Type: Audio
Sponsoring organization: Freakonomics
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2023 Merit-Based Incentive Payment System (MIPS) Payment Year Payment Adjustment User Guide
Provides information on Merit-Based Incentive Payment System (MIPS) payment adjustments for calendar year 2023. Covers how COVID-19 relief efforts affect 2023 MIPS payment adjustments. Offers answers to frequently asked questions.
Date: 08/2022
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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MedPAC Comment on CMS's Proposed Rule on the ESRD PPS Update for CY 2023
Comments on a June 28, 2022, Federal Register proposed rule related to Medicare payment policies for end-stage renal disease (ESRD). Includes comments addressing the low-volume payment adjustment (LVPA) and the rural adjustment.
Date: 08/2022
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Changes in the Provision of Health Care Services by Rural Critical Access Hospitals and Prospective Payment System Hospitals in 2009 compared to 2017
Findings brief exploring changes in the availability and provision of different health care services among rural Critical Access Hospitals and Prospective Payment System hospitals from 2009 to 2017, using data from the American Hospital Association Annual Survey Database. Features statistics with breakdowns by types of services offered, type of hospital, and percentage-point change from 2009 to 2017.
Author(s): Randall John, Kathleen Knocke, Sharita Thomas, et al.
Date: 08/2022
Type: Document
Sponsoring organization: North Carolina Rural Health Research Program
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Merit-Based Incentive Payment System (MIPS): Small Practice Countdown to Performance Year 2022 Data Submission Checklist
Checklist outlining the steps small practices must follow to submit Merit-based Incentive Payment System (MIPS) 2022 performance year data. Highlights key dates and links to key resources for small practices.
Date: 08/2022
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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MedPAC Comment on CMS's Proposed Rule on the Home Health Prospective Payment System for CY 2023
Comments on a June 23, 2022, Federal Register proposed rule related to Medicare payment policies for home health agencies. Includes comments regarding the collection of data on the use of telecommunications technology under the Medicare home health benefit and quality measure stratification as a tool to address healthcare disparities and advance health equity.
Date: 08/2022
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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2020 Quality Payment Program Experience Report
Reports on the clinician experience for those participating in the Quality Payment Program in 2020. Presents data on Merit-based Incentive Payment System (MIPS) eligibility and participation rates for clinicians in small practices and rural areas, as well as their mean payment adjustment scores.
Date: 08/2022
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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COVID-19 Frequently Asked Questions (FAQs) on Medicare Fee-for-Service (FFS) Billing
Addresses issues related to Medicare fee-for-service (FFS) billing during the COVID-19 public health emergency. Covers COVID-19 test specimen collection, diagnostic laboratory services, hospital services, ambulance services, Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs), telehealth, skilled nursing facility services, home health, vaccination, and other services.
Date: 08/2022
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Rural Emergency Hospitals Proposed Rulemaking
Provides an overview of Rural Emergency Hospitals, a Medicare provider type established by the Consolidated Appropriations Act, 2021. Details key policies outlined in two proposed rules, including payment policies, conditions or participation, REH provider enrollment, and exceptions to the physician self-referral law.
Date: 07/2022
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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