Rural Health
Resources by Topic: Reimbursement and payment models
Rural Health Equity and Quality Summit Report
Summarizes a June 2022 summit with experts in rural healthcare policy, health equity, value-based care, and clinical quality to explore the roles of small rural hospitals and Rural Health Clinics in achieving health equity. Discusses barriers and challenges to achieving rural health equity. Presents best practices and innovative models in promoting health equity in rural areas.
Date: 09/2022
Type: Document
Sponsoring organization: National Rural Health Resource Center
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Summarizes a June 2022 summit with experts in rural healthcare policy, health equity, value-based care, and clinical quality to explore the roles of small rural hospitals and Rural Health Clinics in achieving health equity. Discusses barriers and challenges to achieving rural health equity. Presents best practices and innovative models in promoting health equity in rural areas.
Date: 09/2022
Type: Document
Sponsoring organization: National Rural Health Resource Center
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Landscape of Area-Level Deprivation Measures and Other Approaches to Account for Social Risk and Social Determinants of Health in Health Care Payments
Examines social determinants of health (SDOH) at the community level and their impact on health-related social needs (HRSNs) of the individual. Discusses how policies related to federal payment systems can incentivize screening for HRSNs as well as referrals to appropriate social and behavioral services. Provides an environmental scan of what measures can be used to provide accountability for funding and policy efforts targeted at SDOH. Includes an appendix that defines and describes indices of social risk, such as the social vulnerability index (SVI) and area deprivation index (ADI), as well as payment models that include measures of social risk.
Author(s): Joshua Breslau, Laurie Martin, Justin Timbie, Nabeel Qureshi, Deborah Zajdman
Date: 09/2022
Type: Document
Sponsoring organizations: HHS Office of the Assistant Secretary for Planning and Evaluation, RAND Corporation
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Examines social determinants of health (SDOH) at the community level and their impact on health-related social needs (HRSNs) of the individual. Discusses how policies related to federal payment systems can incentivize screening for HRSNs as well as referrals to appropriate social and behavioral services. Provides an environmental scan of what measures can be used to provide accountability for funding and policy efforts targeted at SDOH. Includes an appendix that defines and describes indices of social risk, such as the social vulnerability index (SVI) and area deprivation index (ADI), as well as payment models that include measures of social risk.
Author(s): Joshua Breslau, Laurie Martin, Justin Timbie, Nabeel Qureshi, Deborah Zajdman
Date: 09/2022
Type: Document
Sponsoring organizations: HHS Office of the Assistant Secretary for Planning and Evaluation, RAND Corporation
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Next Steps for the Rural Emergency Hospital Model
Blog post discussing rural hospital closures and how the Rural Emergency Hospital (REH) model can help financially vulnerable hospitals align their services to the needs of the community. Highlights recommendations to the U.S. Department of Health and Human Services regarding REH Conditions of Participation and payment.
Date: 09/2022
Type: Document
Sponsoring organization: Bipartisan Policy Center
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Blog post discussing rural hospital closures and how the Rural Emergency Hospital (REH) model can help financially vulnerable hospitals align their services to the needs of the community. Highlights recommendations to the U.S. Department of Health and Human Services regarding REH Conditions of Participation and payment.
Date: 09/2022
Type: Document
Sponsoring organization: Bipartisan Policy Center
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September 2022 MACPAC Meeting Transcript
Transcript from the Medicaid and CHIP Payment and Access Commission's (MACPAC) September 2022 meeting. Covers Medicaid race and ethnicity data collection and reporting, state processes and stakeholder engagement for unwinding continuous coverage requirement, countercyclical disproportionate share hospital policies, and integrating care for dually eligible beneficiaries in Medicaid fee-for-services, among other things. Includes rural references throughout.
Date: 09/2022
Type: Document
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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Transcript from the Medicaid and CHIP Payment and Access Commission's (MACPAC) September 2022 meeting. Covers Medicaid race and ethnicity data collection and reporting, state processes and stakeholder engagement for unwinding continuous coverage requirement, countercyclical disproportionate share hospital policies, and integrating care for dually eligible beneficiaries in Medicaid fee-for-services, among other things. Includes rural references throughout.
Date: 09/2022
Type: Document
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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Health Panel Comment Letter – Hospital Outpatient Prospective Payment System and Rural Emergency Hospitals
Comments offered in response to a July 26, 2022, Federal Register proposed rule revising the Medicare Hospital Outpatient Prospective Payment System (OPPS) and Medicare Ambulatory Surgical Center (ACS) payment system for calendar year 2023 and establishing Rural Emergency Hospital (REH) payment policy, quality measures, and enrollment policy. Discusses telehealth services for mental healthcare; REH quality measures, telehealth, and Conditions of Participation; and the use of Centers for Medicare & Medicaid Services (CMS) data on hospital and skilled nursing facilities changes in ownership.
Date: 09/2022
Type: Document
Sponsoring organization: Rural Policy Research Institute Rural Health Panel
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Comments offered in response to a July 26, 2022, Federal Register proposed rule revising the Medicare Hospital Outpatient Prospective Payment System (OPPS) and Medicare Ambulatory Surgical Center (ACS) payment system for calendar year 2023 and establishing Rural Emergency Hospital (REH) payment policy, quality measures, and enrollment policy. Discusses telehealth services for mental healthcare; REH quality measures, telehealth, and Conditions of Participation; and the use of Centers for Medicare & Medicaid Services (CMS) data on hospital and skilled nursing facilities changes in ownership.
Date: 09/2022
Type: Document
Sponsoring organization: Rural Policy Research Institute Rural Health Panel
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MedPAC Comment on CMS's Proposed Rule on the Payment Systems for Hospital Outpatient Departments and Ambulatory Surgical Centers for 2023
Comments on a July 26, 2022, Federal Register proposed rule revising the Medicare Hospital Outpatient Prospective Payment System (OPPS) and Medicare Ambulatory Surgical Center (ACS) payment system for calendar year 2023. Includes considerations for payment for 340B drugs, additional facility payments for Rural Emergency Hospitals, telehealth rehabilitation services beyond the COVID-19 public health emergency, and efforts for measuring equity and healthcare quality disparities.
Date: 09/2022
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Comments on a July 26, 2022, Federal Register proposed rule revising the Medicare Hospital Outpatient Prospective Payment System (OPPS) and Medicare Ambulatory Surgical Center (ACS) payment system for calendar year 2023. Includes considerations for payment for 340B drugs, additional facility payments for Rural Emergency Hospitals, telehealth rehabilitation services beyond the COVID-19 public health emergency, and efforts for measuring equity and healthcare quality disparities.
Date: 09/2022
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Rural Hospital Closures Threaten Access: Solutions to Preserve Care in Local Communities
Provides an overview of rural hospital closures between 2010-2021. Discusses rural demographics and outlines trends affecting rural hospital financial sustainability, including patient volume and health, reimbursement, staffing shortages, COVID-19, new models of care, and more.
Date: 09/2022
Type: Document
Sponsoring organization: American Hospital Association
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Provides an overview of rural hospital closures between 2010-2021. Discusses rural demographics and outlines trends affecting rural hospital financial sustainability, including patient volume and health, reimbursement, staffing shortages, COVID-19, new models of care, and more.
Date: 09/2022
Type: Document
Sponsoring organization: American Hospital Association
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MedPAC Comment on CMS's Proposed Rule on the Physician Fee Schedule and Other Revisions to Part B for CY 2023
Comment on a July 29, 2022, Federal Register proposed rule revising the physician fee schedule to improve payment systems for physicians and other Medicare Part B revisions. Includes a discussion of the coverage of certain telehealth services after the COVID-19 public health emergency, as well as rebasing and revising the Medicare Economic Index (MEI).
Date: 09/2022
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Comment on a July 29, 2022, Federal Register proposed rule revising the physician fee schedule to improve payment systems for physicians and other Medicare Part B revisions. Includes a discussion of the coverage of certain telehealth services after the COVID-19 public health emergency, as well as rebasing and revising the Medicare Economic Index (MEI).
Date: 09/2022
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Telehealth Reimbursement Guide for California, 2022 Edition
Provides an overview of telehealth and explains telehealth reimbursement criteria for Medicare, Medi-Cal, and other insurance programs in California. Includes specific information for Critical Access Hospitals, Rural Health Clinics, and Federally Qualified Health Centers.
Date: 09/2022
Type: Document
Sponsoring organization: California Telehealth Resource Center
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Provides an overview of telehealth and explains telehealth reimbursement criteria for Medicare, Medi-Cal, and other insurance programs in California. Includes specific information for Critical Access Hospitals, Rural Health Clinics, and Federally Qualified Health Centers.
Date: 09/2022
Type: Document
Sponsoring organization: California Telehealth Resource Center
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Experience in the Pennsylvania Rural Health Model: Barnes-Kasson County Hospital
Profiles Barnes-Kasson County Hospital, a Critical Access Hospital with three hospital-based Rural Health Clinics and a skilled nursing facility in Pennsylvania. Discusses the CAH's experience participating in the Pennsylvania Rural Health Model (PARHM). Describes the Barnes-Kasson transformation plan, challenges of the global budget model, peer learning and networking opportunities, and next steps.
Date: 08/2022
Type: Document
Sponsoring organization: Rural Health Value
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Profiles Barnes-Kasson County Hospital, a Critical Access Hospital with three hospital-based Rural Health Clinics and a skilled nursing facility in Pennsylvania. Discusses the CAH's experience participating in the Pennsylvania Rural Health Model (PARHM). Describes the Barnes-Kasson transformation plan, challenges of the global budget model, peer learning and networking opportunities, and next steps.
Date: 08/2022
Type: Document
Sponsoring organization: Rural Health Value
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