Rural Health
Resources by Topic: Reimbursement and payment models
Medicare Accountable Care Organizations: Presence in Rural America
Presentation slides from a June 6, 2023, webinar for the Rural Northern Border Healthcare Support Technical Assistance Center. Provides an overview of the Medicare Shared Savings Program, including the composition of program participants in 2023, the spread of Accountable Care Organizations (ACOs) in rural counties, and the federal and state policy landscape. Details changes to the Shared Savings Program for 2024.
Author(s): Keith J. Mueller
Date: 06/2023
Sponsoring organization: Rural Policy Research Institute
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Presentation slides from a June 6, 2023, webinar for the Rural Northern Border Healthcare Support Technical Assistance Center. Provides an overview of the Medicare Shared Savings Program, including the composition of program participants in 2023, the spread of Accountable Care Organizations (ACOs) in rural counties, and the federal and state policy landscape. Details changes to the Shared Savings Program for 2024.
Author(s): Keith J. Mueller
Date: 06/2023
Sponsoring organization: Rural Policy Research Institute
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MedPAC Comment on CMS's Proposed Rule on the Payment System for Inpatient Psychiatric Facilities for FY 2024
Comment on an April 4, 2023, Federal Register proposed rule revising the Inpatient Psychiatric Facility Prospective Payment System (IPF PPS) for fiscal year 2024. Includes a discussion of rural IPF PPS payment adjustments.
Date: 06/2023
Sponsoring organization: Medicare Payment Advisory Commission
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Comment on an April 4, 2023, Federal Register proposed rule revising the Inpatient Psychiatric Facility Prospective Payment System (IPF PPS) for fiscal year 2024. Includes a discussion of rural IPF PPS payment adjustments.
Date: 06/2023
Sponsoring organization: Medicare Payment Advisory Commission
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Policy Recommendations for Improving Rural Cancer Services in the United States
Discusses cancer healthcare access for rural residents and factors in access challenges. Discusses rural physician recruitment, facility closures, reimbursement, data gathering, and graduate medical education. Offers policy recommendations for incentivizing and increasing the rural cancer care workforce as well as gathering cancer-related data.
Author(s): Adrienne B. Lent, Daniel Derksen, Elizabeth T. Jacobs, Leila Barraza, Elizabeth A. Calhoun
Citation: JCO Oncology Practice, 19(5), 288-294
Date: 05/2023
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Discusses cancer healthcare access for rural residents and factors in access challenges. Discusses rural physician recruitment, facility closures, reimbursement, data gathering, and graduate medical education. Offers policy recommendations for incentivizing and increasing the rural cancer care workforce as well as gathering cancer-related data.
Author(s): Adrienne B. Lent, Daniel Derksen, Elizabeth T. Jacobs, Leila Barraza, Elizabeth A. Calhoun
Citation: JCO Oncology Practice, 19(5), 288-294
Date: 05/2023
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Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs): CMS Flexibilities to Fight COVID-19
Outlines specific regulatory waivers and Medicare flexibilities for Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs) issued in response to the COVID-19 pandemic. Includes information on payments for telehealth services, COVID-19 vaccines, therapeutics, and more. Identifies whether each waiver or flexibility was terminated, ended at the conclusion of the public health emergency, was extended, or became permanent.
Date: 05/2023
Sponsoring organization: Centers for Medicare and Medicaid Services
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Outlines specific regulatory waivers and Medicare flexibilities for Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs) issued in response to the COVID-19 pandemic. Includes information on payments for telehealth services, COVID-19 vaccines, therapeutics, and more. Identifies whether each waiver or flexibility was terminated, ended at the conclusion of the public health emergency, was extended, or became permanent.
Date: 05/2023
Sponsoring organization: Centers for Medicare and Medicaid Services
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Study of Telehealth Expansion and Payment Parity: Preliminary Report to the Minnesota Legislature 2023
Provides an overview of telehealth usage in Minnesota, with a focus on the impacts of the COVID-19 pandemic on telehealth; issues of access, quality, satisfaction, and equity; payment parity; audio-only telehealth; and more. Includes 2021 Minnesota Health Access (MNHA) Survey data about telehealth satisfaction for various populations, including rural, as well as telehealth implications for rural areas.
Date: 05/2023
Sponsoring organization: Minnesota Department of Health
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Provides an overview of telehealth usage in Minnesota, with a focus on the impacts of the COVID-19 pandemic on telehealth; issues of access, quality, satisfaction, and equity; payment parity; audio-only telehealth; and more. Includes 2021 Minnesota Health Access (MNHA) Survey data about telehealth satisfaction for various populations, including rural, as well as telehealth implications for rural areas.
Date: 05/2023
Sponsoring organization: Minnesota Department of Health
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Achieving Behavioral Health Care Integration in Rural America
Provides an overview of behavioral health and primary care integration and how integration may be different in rural areas than in urban and suburban areas. Examines the barriers to integration in rural areas and opportunities for policies that can improve access to care. Offers policy recommendations to better coordinate and integrate primary care and behavioral health services for high-risk groups and expand the ability of primary care providers to handle the lower-acuity behavioral health needs of patients through enhanced payments, training, and improved access to behavioral health providers for consultation and referral. Builds on the March 2021 report, Tackling America's Mental Health and Addiction Crisis Through Primary Care Integration.
Author(s): Kendall Strong, Michele Gilbert, Julia Harris, et al.
Date: 05/2023
Sponsoring organization: Bipartisan Policy Center
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Provides an overview of behavioral health and primary care integration and how integration may be different in rural areas than in urban and suburban areas. Examines the barriers to integration in rural areas and opportunities for policies that can improve access to care. Offers policy recommendations to better coordinate and integrate primary care and behavioral health services for high-risk groups and expand the ability of primary care providers to handle the lower-acuity behavioral health needs of patients through enhanced payments, training, and improved access to behavioral health providers for consultation and referral. Builds on the March 2021 report, Tackling America's Mental Health and Addiction Crisis Through Primary Care Integration.
Author(s): Kendall Strong, Michele Gilbert, Julia Harris, et al.
Date: 05/2023
Sponsoring organization: Bipartisan Policy Center
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New England Health System CEOs Address Rural Healthcare Crisis In A Live Conversation
Recording of a May 22, 2023, roundtable discussion with the chief executive officers (CEOs) of Dartmouth Health, MaineHealth, and the University of Vermont Health Network regarding the challenges rural healthcare providers face. Covers workforce challenges, regulatory and inflation challenges, and innovations to preserve access to care. Transcript is available in the video description.
Date: 05/2023
Sponsoring organization: Dartmouth Health
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Recording of a May 22, 2023, roundtable discussion with the chief executive officers (CEOs) of Dartmouth Health, MaineHealth, and the University of Vermont Health Network regarding the challenges rural healthcare providers face. Covers workforce challenges, regulatory and inflation challenges, and innovations to preserve access to care. Transcript is available in the video description.
Date: 05/2023
Sponsoring organization: Dartmouth Health
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Ambulance Deserts: Geographic Disparities in the Provision of Ambulance Services
Chartbook presenting data on ambulance deserts from 41 states in 2021-2022, and identifying places and people that are more than 25 minutes from an ambulance station. Include maps of ambulance desert locations and health care facility locations for every state with available data, and documents coverage gaps in the provision of ambulance services across geographic areas across the United States.
Author(s): Yvonne Jonk, Carly Milkowski, Zachariah Croll, Karen Pearson
Date: 05/2023
Sponsoring organization: Maine Rural Health Research Center
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Chartbook presenting data on ambulance deserts from 41 states in 2021-2022, and identifying places and people that are more than 25 minutes from an ambulance station. Include maps of ambulance desert locations and health care facility locations for every state with available data, and documents coverage gaps in the provision of ambulance services across geographic areas across the United States.
Author(s): Yvonne Jonk, Carly Milkowski, Zachariah Croll, Karen Pearson
Date: 05/2023
Sponsoring organization: Maine Rural Health Research Center
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Barriers to Rural Health Care From the Provider Perspective
Results of a study using data from interviews with 20 healthcare providers in rural areas of western Pennsylvania. Explores barriers to care, including cost and insurance, geographic dispersion, and provider shortage and burnout. Offers strategies for improvement, including use of telehealth, mobile clinics, and increased use of advanced practice providers.
Author(s): Avinash Maganty, Mary E. Byrnes, Megan Hamm, et al.
Citation: Rural and Remote Health, 23(2), 7769
Date: 05/2023
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Results of a study using data from interviews with 20 healthcare providers in rural areas of western Pennsylvania. Explores barriers to care, including cost and insurance, geographic dispersion, and provider shortage and burnout. Offers strategies for improvement, including use of telehealth, mobile clinics, and increased use of advanced practice providers.
Author(s): Avinash Maganty, Mary E. Byrnes, Megan Hamm, et al.
Citation: Rural and Remote Health, 23(2), 7769
Date: 05/2023
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Improving Health Care Access in Rural Communities: Obstacles and Opportunities
Presents the U.S. Senate Committee on Finance, Subcommittee on Health Care hearing on improving access to high-quality, affordable healthcare in rural communities. Discusses workforce issues, education pipeline, transportation, broadband, school-based health centers, payment models and value-based care, and rural-friendly policies. Features testimonies from representatives of Frances Mahon Deaconess Hospital, Choptank Community Health System, Essentia Health, and the Sheps Center For Health Services Research.
Additional links: Testimony by David Herman, Testimony by Erin Aune, Testimony by Mark Holmes, Testimony by Sara Rich
Date: 05/2023
Sponsoring organization: Senate Committee on Finance, Subcommittee on Health Care
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Presents the U.S. Senate Committee on Finance, Subcommittee on Health Care hearing on improving access to high-quality, affordable healthcare in rural communities. Discusses workforce issues, education pipeline, transportation, broadband, school-based health centers, payment models and value-based care, and rural-friendly policies. Features testimonies from representatives of Frances Mahon Deaconess Hospital, Choptank Community Health System, Essentia Health, and the Sheps Center For Health Services Research.
Additional links: Testimony by David Herman, Testimony by Erin Aune, Testimony by Mark Holmes, Testimony by Sara Rich
Date: 05/2023
Sponsoring organization: Senate Committee on Finance, Subcommittee on Health Care
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