Rural Health
Resources by Topic: Reimbursement and payment models
Merit-based Incentive Payment System (MIPS) 2024 Small Practice Eligibility and Participation Frequently Asked Questions
Provides answers to frequently asked questions regarding small practice participation and eligibility for the Merit-based Incentive Payment System (MIPS) for the 2024 performance year. Covers individual and group eligibility, the low-volume threshold, changes to group composition during the performance year, and more.
Date: 03/2024
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Provides answers to frequently asked questions regarding small practice participation and eligibility for the Merit-based Incentive Payment System (MIPS) for the 2024 performance year. Covers individual and group eligibility, the low-volume threshold, changes to group composition during the performance year, and more.
Date: 03/2024
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Catalog of Value-Based Initiatives for Rural Providers
Summarizes rural-relevant, value-based programs currently or recently implemented by the U.S. Department of Health and Human Services (HHS), including the Centers for Medicare and Medicaid Services (CMS) and the CMS Innovation Center. Designed to help rural healthcare leaders identify HHS value-based programs that are suitable for rural participation. Contains descriptions of each demonstration and provides direct links to the corresponding agency web page.
Date: 03/2024
Type: Document
Sponsoring organization: Rural Health Value
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Summarizes rural-relevant, value-based programs currently or recently implemented by the U.S. Department of Health and Human Services (HHS), including the Centers for Medicare and Medicaid Services (CMS) and the CMS Innovation Center. Designed to help rural healthcare leaders identify HHS value-based programs that are suitable for rural participation. Contains descriptions of each demonstration and provides direct links to the corresponding agency web page.
Date: 03/2024
Type: Document
Sponsoring organization: Rural Health Value
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Rural Health Research Recap: Post-Acute Care in Rural Areas: The Role of Swing Beds and Nursing Homes
Offers statistics on availability of post-acute care in rural areas through skilled nursing facilities, home health agencies, hospice, inpatient rehabilitation facilities, and swing beds. Includes sections on prospective payment system and cost-based reimbursement, and provides statistics on the proportion of nursing home closures in metropolitan and nonmetropolitan areas from 2008-2018.
Author(s): Per Ostmo
Date: 03/2024
Type: Document
Sponsoring organization: Rural Health Research Gateway
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Offers statistics on availability of post-acute care in rural areas through skilled nursing facilities, home health agencies, hospice, inpatient rehabilitation facilities, and swing beds. Includes sections on prospective payment system and cost-based reimbursement, and provides statistics on the proportion of nursing home closures in metropolitan and nonmetropolitan areas from 2008-2018.
Author(s): Per Ostmo
Date: 03/2024
Type: Document
Sponsoring organization: Rural Health Research Gateway
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Merit-Based Incentive Payment System (MIPS): 2024 Improvement Activities Performance Category Quick Start Guide
Provides an overview of Merit-based Incentive Payment System (MIPS) requirements, data collection, and data submission for the improvement activities performance category for the 2024 performance year. Includes information about special status scoring for small practices and clinicians located in a rural or Health Professional Shortage Area.
Date: 03/2024
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Provides an overview of Merit-based Incentive Payment System (MIPS) requirements, data collection, and data submission for the improvement activities performance category for the 2024 performance year. Includes information about special status scoring for small practices and clinicians located in a rural or Health Professional Shortage Area.
Date: 03/2024
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Merit-Based Incentive Payment System (MIPS): 2023 Opt-in and Voluntary Reporting Election Process Guide
Discusses the eligibility of clinicians, groups, and Alternative Payment Model (APM) participants that exceed some low-volume threshold criteria to opt-in to the Merit-Based Incentive Payment System (MIPS) and the APM Performance Pathway (APP) for the 2023 performance period. Compares opting in and voluntarily reporting MIPS data and provides an overview of the election process.
Date: 03/2024
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Discusses the eligibility of clinicians, groups, and Alternative Payment Model (APM) participants that exceed some low-volume threshold criteria to opt-in to the Merit-Based Incentive Payment System (MIPS) and the APM Performance Pathway (APP) for the 2023 performance period. Compares opting in and voluntarily reporting MIPS data and provides an overview of the election process.
Date: 03/2024
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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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
Type: Video/Multimedia
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
Type: Video/Multimedia
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
Type: Document
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
Type: Document
Sponsoring organizations: Centers for Medicare and Medicaid Services, Mathematica
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Policy and Research Update: Financial Models for Rural Hospitals
Slides presented at the 2024 American Hospital Association's Rural Health Care Leadership conference that discuss healthcare payment policies, value-based care, alternative payment models, Medicare Advantage, and more. Provides discussion on how rural hospitals are are adapting to financial models, statistics on insurance adoption, and related resources.
Author(s): Christina Campos, Kristen Dillon, Keith Mueller, George Pink
Date: 02/2024
Type: Presentation Slides
Sponsoring organizations: Iowa College of Public Health, Rural Policy Research Institute
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Slides presented at the 2024 American Hospital Association's Rural Health Care Leadership conference that discuss healthcare payment policies, value-based care, alternative payment models, Medicare Advantage, and more. Provides discussion on how rural hospitals are are adapting to financial models, statistics on insurance adoption, and related resources.
Author(s): Christina Campos, Kristen Dillon, Keith Mueller, George Pink
Date: 02/2024
Type: Presentation Slides
Sponsoring organizations: Iowa College of Public Health, Rural Policy Research Institute
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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
Type: Website
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
Type: Website
Sponsoring organization: Chartis Center for Rural Health
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Lessons Learned from Efforts to Support Vulnerable Critical Access and Other Rural Hospitals
Provides an overview of state and federal programs, demonstrations, and models designed to support Critical Access Hospitals (CAHs) and other rural hospitals. Describes challenges facing CAHs and rural hospitals, including chronic workforce shortages, high operating and staffing costs, inadequate reimbursement, operational and regulatory issues, and the diverse demographics of rural communities. Discusses lessons learned, the new for a new rural hospital model, and next steps.
Author(s): John Gale, Celia Jewell, Karen Pearson
Date: 02/2024
Type: Document
Sponsoring organization: Flex Monitoring Team
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Provides an overview of state and federal programs, demonstrations, and models designed to support Critical Access Hospitals (CAHs) and other rural hospitals. Describes challenges facing CAHs and rural hospitals, including chronic workforce shortages, high operating and staffing costs, inadequate reimbursement, operational and regulatory issues, and the diverse demographics of rural communities. Discusses lessons learned, the new for a new rural hospital model, and next steps.
Author(s): John Gale, Celia Jewell, Karen Pearson
Date: 02/2024
Type: Document
Sponsoring organization: Flex Monitoring Team
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