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Rural Health Information Hub

Rural Health
Resources by Topic: Reimbursement and payment models

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
Type: Document
Sponsoring organization: Rural Health Value
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A Federally Qualified Health Center and Certified Community Behavioral Health Clinic Partnership in Rural Missouri
Case study describing a medication for opioid use disorder (MOUD) program partnership between a Federally Qualified Health Center and a certified community behavioral health clinic in rural southwest Missouri. Covers the infrastructure of the MOUD program, staffing and services, financing, and more. Highlights challenges and successes, as well as recommendations for other health centers interested in a similar partnership.
Author(s): Ashley Jasko, Meryl Schulman
Date: 01/2024
Type: Document
Sponsoring organization: Center for Health Care Strategies
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The Effects of Medicare Advantage on Rural Hospitals With St. Bernards Healthcare
Podcast episode featuring a discussion with Chris Barber, president and CEO of St. Bernards Healthcare, which serves communities in Arkansas and Missouri. Describes how certain Medicare Advantage plan practices can create problems for rural hospitals, health systems, and patients.
Date: 01/2024
Type: Audio
Sponsoring organization: American Hospital Association
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Shared Savings Program Fast Facts
Provides summary statistics on the Medicare Shared Savings Program as of January 1, 2024. 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: 01/2024
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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What States Can Learn from Maryland's Experience with Hospital Global Budgeting
Podcast episode exploring lessons learned from Maryland's hospital global budgeting model. Includes a discussion on small and rural hospitals' financial sustainability and their involvement in the model, as well as comparisons to the Pennsylvania Rural Health Model and the Vermont All-Payer Accountable Care Organization (ACO) Model.
Date: 01/2024
Type: Audio
Sponsoring organization: Mathematica
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Billing Requirements for Intensive Outpatient Program Services for Federally Qualified Health Centers & Rural Health Clinics
Provides an overview of Medicare coverage for intensive outpatient program (IOP) services and billing requirements for Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs).
Date: 01/2024
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Produce Prescription Programs Offer 'A Holistic Approach' to Addressing Rural Food Insecurity and Diet-Related Disease
Features produce prescription programs serving rural Mississippi, New Mexico, and Vermont that are helping improve access to healthy foods for those with diet-related chronic conditions. Describes how produce Rx programs can support local food systems and discusses funding and sustainability considerations.
Author(s): Brendan Stermer
Citation: Rural Monitor
Date: 01/2024
Type: Document
Sponsoring organization: Rural Health Information Hub
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A Comparison of 2017-19 Uncompensated Care of Rural and Urban Hospitals by Net Patient Revenue, System Affiliation, and Ownership
Examines the association between uncompensated care and three factors - net patient revenue, system affiliation, and ownership - using Medicare Cost Report data from 2017-2019. Compares rates of uncompensated care as a percentage of operating expenses across Critical Access Hospitals (CAHs), rural prospective payment system (PPS) hospitals, and urban PPS hospitals.
Author(s): Emmaline Keesee, Susie Gurzenda, Kristie Thompson, George Pink
Date: 01/2024
Type: Document
Sponsoring organization: North Carolina Rural Health Research Program
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January 2024 MedPAC Meeting Transcript
Transcript from the Medicare Payment Advisory Commission's (MedPAC) January 2024 meeting. Covers payment adequacy and updates for physician and other health professional services, hospital inpatient and outpatient services, outpatient dialysis services, hospice services, skilled nursing facility services, home health agency services, and inpatient rehabilitation facility services. Discusses status reports on ambulatory surgical centers, Medicare Part D, and the Medicare Advantage program, as well as policy options for standardized benefits in Medicare Advantage plans. Includes rural references and considerations throughout.
Date: 01/2024
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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The Future of Remote Patient Monitoring
Provides an overview of remote monitoring, including evidence-based use cases, coverage and utilization across payers, U.S. Food and Drug Administration (FDA) regulation of remote monitoring devices, equity implications, and data security and privacy. Offers policy recommendations regarding ways to improve the use of remote monitoring services, ensure equitable access to these services across populations, and enhance data security and privacy standards. Includes rural references throughout.
Author(s): Julia Harris, Mikayla Curtis, Maya Sandalow, G. William Hoagland, Marilyn Werber Serafini
Date: 01/2024
Type: Document
Sponsoring organization: Bipartisan Policy Center
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