Rural Health
Resources by Topic: Reimbursement and payment models
Enhancing Rural Access to Medications for Opioid Use Disorder: Policy Brief and Recommendations to the Secretary
Provides an overview of issues related to opioid use disorder (OUD) in rural areas. Discusses access to medication for opioid use disorder (MOUD), MOUD workforce, telehealth to support access to MOUD, and Medicaid 1115 demonstrations that address OUD. Offers policy recommendations related to regulatory barriers, reimbursement flexibility, workforce, and service site expansion to increase access to MOUD in rural areas.
Date: 01/2025
Sponsoring organization: National Advisory Committee on Rural Health and Human Services
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Provides an overview of issues related to opioid use disorder (OUD) in rural areas. Discusses access to medication for opioid use disorder (MOUD), MOUD workforce, telehealth to support access to MOUD, and Medicaid 1115 demonstrations that address OUD. Offers policy recommendations related to regulatory barriers, reimbursement flexibility, workforce, and service site expansion to increase access to MOUD in rural areas.
Date: 01/2025
Sponsoring organization: National Advisory Committee on Rural Health and Human Services
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AHRQ Summit to Address Emergency Department Boarding: Technical Report
Report from an October 2024 Agency for Healthcare Research and Quality (AHRQ) summit to discuss emergency department boarding. Examines some of emergency physicians' biggest concerns and highlights possible solutions to address boarding head-on, including enhancing measurement and standards, re-aligning hospital incentives, and increasing support to empower emergency physicians to do their jobs effectively. Includes sections on rural patients and rural areas.
Author(s): Robin M. Weinick, Sean Bruna, Rachael M. Boicourt, Sean S. Michael, Laura L. Sessums
Date: 01/2025
Sponsoring organization: Agency for Healthcare Research and Quality
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Report from an October 2024 Agency for Healthcare Research and Quality (AHRQ) summit to discuss emergency department boarding. Examines some of emergency physicians' biggest concerns and highlights possible solutions to address boarding head-on, including enhancing measurement and standards, re-aligning hospital incentives, and increasing support to empower emergency physicians to do their jobs effectively. Includes sections on rural patients and rural areas.
Author(s): Robin M. Weinick, Sean Bruna, Rachael M. Boicourt, Sean S. Michael, Laura L. Sessums
Date: 01/2025
Sponsoring organization: Agency for Healthcare Research and Quality
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Merit-Based Incentive Payment System (MIPS): 2025 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 2025 performance year. Includes information about special status scoring for small practices and clinicians located in a rural or Health Professional Shortage Area.
Date: 01/2025
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 2025 performance year. Includes information about special status scoring for small practices and clinicians located in a rural or Health Professional Shortage Area.
Date: 01/2025
Sponsoring organization: Centers for Medicare and Medicaid Services
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January 2025 MedPAC Meeting Transcript
Transcript from the Medicare Payment Advisory Commission's (MedPAC) January 2025 meeting. Covers payment adequacy and updates for physician and other health professional services, hospital inpatient and outpatient services, skilled nursing facility services, home health agency services, inpatient rehabilitation facility services, outpatient dialysis services, and hospice services. Discusses status reports on Medicare Part D, ambulatory surgical centers, and the Medicare Advantage program, as well as policy options for modifying the cost-sharing liability for beneficiaries who receive care at Critical Access Hospitals. Includes rural references and considerations throughout.
Additional links: Reducing Beneficiary Cost-sharing for Outpatient Services at Critical Access Hospitals
Date: 01/2025
Sponsoring organization: Medicare Payment Advisory Commission
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Transcript from the Medicare Payment Advisory Commission's (MedPAC) January 2025 meeting. Covers payment adequacy and updates for physician and other health professional services, hospital inpatient and outpatient services, skilled nursing facility services, home health agency services, inpatient rehabilitation facility services, outpatient dialysis services, and hospice services. Discusses status reports on Medicare Part D, ambulatory surgical centers, and the Medicare Advantage program, as well as policy options for modifying the cost-sharing liability for beneficiaries who receive care at Critical Access Hospitals. Includes rural references and considerations throughout.
Additional links: Reducing Beneficiary Cost-sharing for Outpatient Services at Critical Access Hospitals
Date: 01/2025
Sponsoring organization: Medicare Payment Advisory Commission
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Emergency Triage, Treat, and Transport (ET3) Model: Final Evaluation Report
Presents quantitative and qualitative results from the evaluation of the Emergency Triage, Treat, and Transport (ET3) Model, a voluntary model that allowed ambulance care teams to use alternate models of emergency healthcare to improve quality and lower care costs. Describes the characteristics of ET3 participants, the extent to which ET3 interventions successfully prevented emergency department (ED) visits, and how average Medicare Parts A and B spending for patients that received ET3 interventions compared to patients who had low acuity ED visits. Discusses challenges and barriers to delivering ET3 interventions. Includes rural references throughout.
Additional links: Findings at a Glance, Technical Appendix
Date: 01/2025
Sponsoring organization: Centers for Medicare and Medicaid Services
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Presents quantitative and qualitative results from the evaluation of the Emergency Triage, Treat, and Transport (ET3) Model, a voluntary model that allowed ambulance care teams to use alternate models of emergency healthcare to improve quality and lower care costs. Describes the characteristics of ET3 participants, the extent to which ET3 interventions successfully prevented emergency department (ED) visits, and how average Medicare Parts A and B spending for patients that received ET3 interventions compared to patients who had low acuity ED visits. Discusses challenges and barriers to delivering ET3 interventions. Includes rural references throughout.
Additional links: Findings at a Glance, Technical Appendix
Date: 01/2025
Sponsoring organization: Centers for Medicare and Medicaid Services
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A Summary of State Innovation Models (SIM) Evaluation Results Across 17 States (2013-2020)
Summarizes evaluation results of the State Innovation Models (SIM), which examined the ability of 17 state governments to implement and test innovative value-based payment (VBP) healthcare models across multiple payers between 2013 and 2020. Presents findings regarding the implementation and impact of 29 delivery and payment models, including patient-centered medical homes, accountable care organizations, behavioral health integration, and more. Covers state contracting and consensus building, practice transformation, pediatric care, behavioral healthcare, beneficiary and provider perspectives, and more. Includes a section on payment model designs tailored to unique state needs, including rural populations, as well as rural references throughout.
Additional links: A Summary of State Innovation Models (SIM): Focus on State-Led Transformation - Findings at a Glance, Executive Summary, Findings at a Glance
Date: 01/2025
Sponsoring organization: Centers for Medicare and Medicaid Services
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Summarizes evaluation results of the State Innovation Models (SIM), which examined the ability of 17 state governments to implement and test innovative value-based payment (VBP) healthcare models across multiple payers between 2013 and 2020. Presents findings regarding the implementation and impact of 29 delivery and payment models, including patient-centered medical homes, accountable care organizations, behavioral health integration, and more. Covers state contracting and consensus building, practice transformation, pediatric care, behavioral healthcare, beneficiary and provider perspectives, and more. Includes a section on payment model designs tailored to unique state needs, including rural populations, as well as rural references throughout.
Additional links: A Summary of State Innovation Models (SIM): Focus on State-Led Transformation - Findings at a Glance, Executive Summary, Findings at a Glance
Date: 01/2025
Sponsoring organization: Centers for Medicare and Medicaid Services
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Shared Savings Program Fast Facts
Provides summary statistics on the Medicare Shared Savings Program as of January 1, 2025. Offers data on the number of Accountable Care Organizations (ACOs), assigned beneficiaries, total earned shared savings, and quality scores each year since 2012; the number and percent of ACOs in each track; and more. Includes information on ACO participants, including the number of Rural Health Clinics (RHCs) and Critical Access Hospitals (CAHs) participating in the program.
Date: 01/2025
Sponsoring organization: Centers for Medicare and Medicaid Services
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Provides summary statistics on the Medicare Shared Savings Program as of January 1, 2025. Offers data on the number of Accountable Care Organizations (ACOs), assigned beneficiaries, total earned shared savings, and quality scores each year since 2012; the number and percent of ACOs in each track; and more. Includes information on ACO participants, including the number of Rural Health Clinics (RHCs) and Critical Access Hospitals (CAHs) participating in the program.
Date: 01/2025
Sponsoring organization: Centers for Medicare and Medicaid Services
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Maximizing the Value of Remote Patient Monitoring
Provides a brief description of the remote patient monitoring landscape. Discusses four areas policymakers could focus on to improve the effectiveness and accessibility of remote patient monitoring.
Author(s): Maya Sandalow, Julia Harris
Date: 01/2025
Sponsoring organization: Bipartisan Policy Center
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Provides a brief description of the remote patient monitoring landscape. Discusses four areas policymakers could focus on to improve the effectiveness and accessibility of remote patient monitoring.
Author(s): Maya Sandalow, Julia Harris
Date: 01/2025
Sponsoring organization: Bipartisan Policy Center
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Community Health Center Patients, Financing, and Services
Describes health center patient characteristics, services, patient experiences, and financing changes between 2019 and 2023. Presents data on health centers in rural communities throughout.
Author(s): Akash Pillai, Bradley Corallo, Jennifer Tolbert
Date: 01/2025
Sponsoring organization: KFF
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Describes health center patient characteristics, services, patient experiences, and financing changes between 2019 and 2023. Presents data on health centers in rural communities throughout.
Author(s): Akash Pillai, Bradley Corallo, Jennifer Tolbert
Date: 01/2025
Sponsoring organization: KFF
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Medical Debt and Its Impact on Rural Patients and Providers, with Carrie Henning-Smith
An episode of the Exploring Rural Health podcast featuring Carrie Henning-Smith, Co-Director of the University of Minnesota Rural Health Research Center. Focuses on the prevalence of and difficulties caused by medical debt for both rural patients and providers.
Date: 01/2025
Sponsoring organization: Rural Health Information Hub
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An episode of the Exploring Rural Health podcast featuring Carrie Henning-Smith, Co-Director of the University of Minnesota Rural Health Research Center. Focuses on the prevalence of and difficulties caused by medical debt for both rural patients and providers.
Date: 01/2025
Sponsoring organization: Rural Health Information Hub
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