Rural Health
Resources by Topic: Reimbursement and payment models
Independent Evaluation of Comprehensive Primary Care Plus (CPC+): Final Annual Report
Reports on the Comprehensive Primary Care Plus (CPC+) model, a CMS primary care payment and delivery reform effort that ran from 2017-2021. Outlines key findings from the model, including CPC+ supports to practices, care delivery changes made by practices, impacts on outcomes for Medicare fee-for-service beneficiaries, and implications for primary care models. Describes the experiences of payers, practices, health IT vendors, and patients. Includes rural references throughout.
Additional links: Appendices to the Final Report, Volume 1, Appendices to the Final Report, Volume 2, Findings at a Glance
Date: 12/2023
Sponsoring organizations: Centers for Medicare and Medicaid Services, Mathematica
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Reports on the Comprehensive Primary Care Plus (CPC+) model, a CMS primary care payment and delivery reform effort that ran from 2017-2021. Outlines key findings from the model, including CPC+ supports to practices, care delivery changes made by practices, impacts on outcomes for Medicare fee-for-service beneficiaries, and implications for primary care models. Describes the experiences of payers, practices, health IT vendors, and patients. Includes rural references throughout.
Additional links: Appendices to the Final Report, Volume 1, Appendices to the Final Report, Volume 2, Findings at a Glance
Date: 12/2023
Sponsoring organizations: Centers for Medicare and Medicaid Services, Mathematica
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CMS Final Rules Overview - Impact for RHCs Beginning January 1, 2024
Recording of a December 11, 2023, webinar providing an overview of telehealth payment rates for Rural Health Clinics (RHCs) and other regulatory updates and potential changes for 2024. Covers new billable providers for RHCs, changes to care management services and billing, telehealth regulations, intensive outpatient program (IOP) services, and more. Part of the Rural Health Clinic Technical Assistance Series.
Additional links: Presentation Slides
Date: 12/2023
Sponsoring organization: National Association of Rural Health Clinics
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Recording of a December 11, 2023, webinar providing an overview of telehealth payment rates for Rural Health Clinics (RHCs) and other regulatory updates and potential changes for 2024. Covers new billable providers for RHCs, changes to care management services and billing, telehealth regulations, intensive outpatient program (IOP) services, and more. Part of the Rural Health Clinic Technical Assistance Series.
Additional links: Presentation Slides
Date: 12/2023
Sponsoring organization: National Association of Rural Health Clinics
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Participation in a Medicare Advanced Primary Care Model and the Delivery of High-Value Services
Examines if participation in the Comprehensive Primary Care Plus Initiative (CPC+) impacted the high-value services delivered by primary care providers. Utilizes multiple national data sets to estimate the association of CPC+ and services such as annual wellness visits (AWVs), advance care planning (ACP), flu shots, tobacco prevention counseling, and depression screening. Provides data on intervention groups and comparison groups by patient demographics as well as provider demographics, specialty, and location, including urban, large rural, small rural, and isolated rural.
Author(s): Fang He, Angela Gasdaska, Lindsay White, Yan Tang, Chris Beadles
Citation: Health Services Research, 58(6), 1266-1291
Date: 12/2023
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Examines if participation in the Comprehensive Primary Care Plus Initiative (CPC+) impacted the high-value services delivered by primary care providers. Utilizes multiple national data sets to estimate the association of CPC+ and services such as annual wellness visits (AWVs), advance care planning (ACP), flu shots, tobacco prevention counseling, and depression screening. Provides data on intervention groups and comparison groups by patient demographics as well as provider demographics, specialty, and location, including urban, large rural, small rural, and isolated rural.
Author(s): Fang He, Angela Gasdaska, Lindsay White, Yan Tang, Chris Beadles
Citation: Health Services Research, 58(6), 1266-1291
Date: 12/2023
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Medicare Advantage in Rural Areas: Implications for Hospital Sustainability
Explores the relationship between Medicare Advantage (MA) penetration levels in rural areas and acute care hospital financial distress and closure between 2008 and 2019. Analyzes data from Healthcare Cost and Utilization Project (HCUP) State Inpatient Databases from 14 states to describe rural acute care hospitals with low and high MA penetration.
Author(s): Rachel Mosher Henke, Kathryn R. Fingar, Lan Liang, H. Joanna Jiang
Citation: American Journal of Managed Care, 29(11), 594–600
Date: 11/2023
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Explores the relationship between Medicare Advantage (MA) penetration levels in rural areas and acute care hospital financial distress and closure between 2008 and 2019. Analyzes data from Healthcare Cost and Utilization Project (HCUP) State Inpatient Databases from 14 states to describe rural acute care hospitals with low and high MA penetration.
Author(s): Rachel Mosher Henke, Kathryn R. Fingar, Lan Liang, H. Joanna Jiang
Citation: American Journal of Managed Care, 29(11), 594–600
Date: 11/2023
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Beyond the Waiting Room: The State of Dental Care Access in West Virginia
Discusses dental care access in West Virginia, highlighting workforce shortages and underserved populations including rural residents. Offers policy recommendations to decrease disparities including interprofessional care, reimbursement structures, and more.
Date: 11/2023
Sponsoring organizations: Harmony Health Foundation, West Virginia Oral Health Coalition
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Discusses dental care access in West Virginia, highlighting workforce shortages and underserved populations including rural residents. Offers policy recommendations to decrease disparities including interprofessional care, reimbursement structures, and more.
Date: 11/2023
Sponsoring organizations: Harmony Health Foundation, West Virginia Oral Health Coalition
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Uncompensated Care is Highest for Rural Hospitals, Particularly in Non-Expansion States
Analyzes uncompensated care and hospital operating expense data to explore trends over time, the role of Medicaid expansion, and the impact on rural hospitals. Includes state-by-state comparisons as well as rural and urban comparisons.
Author(s): Emmaline Keesee, Susie Gurzenda, Kristie Thompson, George H. Pink
Citation: Medical Care Research and Review, 81(2), 164-170
Date: 11/2023
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Analyzes uncompensated care and hospital operating expense data to explore trends over time, the role of Medicaid expansion, and the impact on rural hospitals. Includes state-by-state comparisons as well as rural and urban comparisons.
Author(s): Emmaline Keesee, Susie Gurzenda, Kristie Thompson, George H. Pink
Citation: Medical Care Research and Review, 81(2), 164-170
Date: 11/2023
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Final Rule for CY 2024 Physician Fee Schedule: Fact Sheet
Fact sheet covering Centers for Medicare & Medicaid Services (CMS) telehealth policy changes for 2024 as outlined in the final calendar year (CY) 2024 Physician Fee Schedule. Covers eligible services that can be delivered by telehealth, remote monitoring services, physician supervision, diabetes self-management training (DSMT), and more.
Date: 11/2023
Sponsoring organization: Center for Connected Health Policy: The National Telehealth Policy Resource Center
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Fact sheet covering Centers for Medicare & Medicaid Services (CMS) telehealth policy changes for 2024 as outlined in the final calendar year (CY) 2024 Physician Fee Schedule. Covers eligible services that can be delivered by telehealth, remote monitoring services, physician supervision, diabetes self-management training (DSMT), and more.
Date: 11/2023
Sponsoring organization: Center for Connected Health Policy: The National Telehealth Policy Resource Center
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The Evolution of Rural Emergency Hospitals as a New Model of Care
Podcast episode with Laura Appel, executive vice president of the Michigan Health and Hospital Association, and Christina Campos, CEO at Guadalupe County Hospital. Discusses the Rural Emergency Hospital (REH) designation, the conversion process, meeting eligibility requirements, and the benefit of REHs to rural patients and communities.
Date: 11/2023
Sponsoring organization: American Hospital Association
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Podcast episode with Laura Appel, executive vice president of the Michigan Health and Hospital Association, and Christina Campos, CEO at Guadalupe County Hospital. Discusses the Rural Emergency Hospital (REH) designation, the conversion process, meeting eligibility requirements, and the benefit of REHs to rural patients and communities.
Date: 11/2023
Sponsoring organization: American Hospital Association
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Ensuring Medicare Beneficiary Access: A Path to Telehealth Permanency
Recording of a November 14, 2023, U.S. Senate Committee on Finance Subcommittee on Health Care hearing on the role of telehealth in improving access to care and the potential to make COVID-19 Medicare flexibilities permanent. Features testimony from Nicki Perisho, Principal Investigator and Program Director for the Northwest Regional Telehealth Resource Center, and Eric Wallace, Medical Director for the University of Alabama at Birmingham (UAB) Health System Telehealth Program.
Additional links: Eric Wallace, UAB Health System Telehealth Program - Testimony, Nicki Perisho, Northwest Regional Telehealth Resource Center - Testimony
Date: 11/2023
Sponsoring organization: Senate Committee on Finance, Subcommittee on Health Care
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Recording of a November 14, 2023, U.S. Senate Committee on Finance Subcommittee on Health Care hearing on the role of telehealth in improving access to care and the potential to make COVID-19 Medicare flexibilities permanent. Features testimony from Nicki Perisho, Principal Investigator and Program Director for the Northwest Regional Telehealth Resource Center, and Eric Wallace, Medical Director for the University of Alabama at Birmingham (UAB) Health System Telehealth Program.
Additional links: Eric Wallace, UAB Health System Telehealth Program - Testimony, Nicki Perisho, Northwest Regional Telehealth Resource Center - Testimony
Date: 11/2023
Sponsoring organization: Senate Committee on Finance, Subcommittee on Health Care
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Improving Access to Primary Care for Underserved Populations: A Review of Findings from Five Case Studies and Recommendations
Summarizes and synthesizes the findings from a series of five case studies that explored the impact of policy initiatives that aim to improve access to primary care. Covers increasing the availability of primary care providers, improving underserved communities' access to outpatient clinics, removing structural barriers to care, making primary care affordable, and improving comfort and communication between providers and patients. Presents recommendations for federal and state policymakers, primary care practices, medical schools, and other relevant stakeholders. Includes rural examples and considerations throughout.
Additional links: Executive Summary
Author(s): Maanasa Kona, Jalisa Clark, Emma Walsh-Alker
Date: 11/2023
Sponsoring organizations: Center on Health Insurance Reforms, Milbank Memorial Fund, National Institute for Health Care Reform
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Summarizes and synthesizes the findings from a series of five case studies that explored the impact of policy initiatives that aim to improve access to primary care. Covers increasing the availability of primary care providers, improving underserved communities' access to outpatient clinics, removing structural barriers to care, making primary care affordable, and improving comfort and communication between providers and patients. Presents recommendations for federal and state policymakers, primary care practices, medical schools, and other relevant stakeholders. Includes rural examples and considerations throughout.
Additional links: Executive Summary
Author(s): Maanasa Kona, Jalisa Clark, Emma Walsh-Alker
Date: 11/2023
Sponsoring organizations: Center on Health Insurance Reforms, Milbank Memorial Fund, National Institute for Health Care Reform
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