Rural Health
Resources by Topic: Reimbursement and payment models
Evaluation of the Home Health Value-Based Purchasing (HHVBP) Model: Final Report
Evaluates the Home Health Value-Based Purchasing (HHVBP) Model, which tests the impact of providing financial incentives to home health agencies in nine states: Arizona, Florida, Iowa, Massachusetts, Maryland, Nebraska, North Carolina, Tennessee, and Washington. Examines how the financial incentives under the model influenced agency behavior. Describes impacts across key outcomes, including service utilization, quality of care, and patient experience, and examines the model's effects on various access to care and Medicare spending issues. Explores whether the model had unique impacts on access to home health care in rural areas.
Additional links: Appendices, Findings at a Glance
Date: 09/2023
Sponsoring organizations: Arbor Research Collaborative for Health, Centers for Medicare and Medicaid Services, L&M Policy Research
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Evaluates the Home Health Value-Based Purchasing (HHVBP) Model, which tests the impact of providing financial incentives to home health agencies in nine states: Arizona, Florida, Iowa, Massachusetts, Maryland, Nebraska, North Carolina, Tennessee, and Washington. Examines how the financial incentives under the model influenced agency behavior. Describes impacts across key outcomes, including service utilization, quality of care, and patient experience, and examines the model's effects on various access to care and Medicare spending issues. Explores whether the model had unique impacts on access to home health care in rural areas.
Additional links: Appendices, Findings at a Glance
Date: 09/2023
Sponsoring organizations: Arbor Research Collaborative for Health, Centers for Medicare and Medicaid Services, L&M Policy Research
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Health Panel Comment Letter - 2024 Physician Fee Schedule and Medicare Part B Proposed Rule
Comments offered in response to a July 13, 2023, Federal Register proposed rule revising the Medicare Physician Fee Schedule. Includes discussions on telehealth services, services addressing health-related social needs, advancing access to behavioral health services, Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs), and the Medicare Shared Savings Program.
Date: 09/2023
Sponsoring organization: Rural Policy Research Institute Rural Health Panel
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Comments offered in response to a July 13, 2023, Federal Register proposed rule revising the Medicare Physician Fee Schedule. Includes discussions on telehealth services, services addressing health-related social needs, advancing access to behavioral health services, Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs), and the Medicare Shared Savings Program.
Date: 09/2023
Sponsoring organization: Rural Policy Research Institute Rural Health Panel
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MedPAC Comment on CMS's Proposed Rule on the Outpatient Prospective Payment System for FY 2024
Comment on the July 31, 2023, Federal Register proposed rule revising the physician fee schedule to improve Medicare Hospital Outpatient Prospective Payment System (OPPS) and Medicare Ambulatory Surgical Center (ACS) payments for calendar year 2024. Includes discussions on extending the use of the hospital market basket to update ASC payment rates, a proposed quality measure for emergency department visits in Rural Emergency Hospitals (REHs), and more.
Date: 09/2023
Sponsoring organization: Medicare Payment Advisory Commission
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Comment on the July 31, 2023, Federal Register proposed rule revising the physician fee schedule to improve Medicare Hospital Outpatient Prospective Payment System (OPPS) and Medicare Ambulatory Surgical Center (ACS) payments for calendar year 2024. Includes discussions on extending the use of the hospital market basket to update ASC payment rates, a proposed quality measure for emergency department visits in Rural Emergency Hospitals (REHs), and more.
Date: 09/2023
Sponsoring organization: Medicare Payment Advisory Commission
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MedPAC Comment on CMS's Proposed Rule on the Physician Prospective Payment System for FY 2024
Comment on the August 7, 2023, Federal Register proposed rule revising the physician fee schedule to improve payment systems for physicians and other Medicare Part B revisions. Includes discussions on payment rates for Medicare telehealth services; the Medicare Shared Savings Program, including regional adjustments; incorporating Medicare Advantage data into public reporting; and more.
Date: 09/2023
Sponsoring organization: Medicare Payment Advisory Commission
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Comment on the August 7, 2023, Federal Register proposed rule revising the physician fee schedule to improve payment systems for physicians and other Medicare Part B revisions. Includes discussions on payment rates for Medicare telehealth services; the Medicare Shared Savings Program, including regional adjustments; incorporating Medicare Advantage data into public reporting; and more.
Date: 09/2023
Sponsoring organization: Medicare Payment Advisory Commission
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Rural Health Value Summit: Driving Value Through Community-Based Partnerships
Provides an overview of a June 2023 summit regarding the intersection of rural providers and communities, value-based care and payment models, and social determinants of health (SDOH). Describes the efforts of Arkansas, Michigan, Oregon, and South Carolina communities that had representatives at the summit. Discusses opportunities for policymakers, payers, and health system leaders to build and support infrastructure to address social determinants of health in rural communities and offers possible next steps.
Date: 09/2023
Sponsoring organization: Rural Health Value
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Provides an overview of a June 2023 summit regarding the intersection of rural providers and communities, value-based care and payment models, and social determinants of health (SDOH). Describes the efforts of Arkansas, Michigan, Oregon, and South Carolina communities that had representatives at the summit. Discusses opportunities for policymakers, payers, and health system leaders to build and support infrastructure to address social determinants of health in rural communities and offers possible next steps.
Date: 09/2023
Sponsoring organization: Rural Health Value
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Further Extension of Grace Period Related to the "Four Walls" Requirement under 42 C.F.R. ยง 440.90 for Indian Health Service and Tribal Facilities to February 11, 2025
Guidance announcing the extension of a grace period permitting Indian Health Service (IHS) and tribal facilities to claim Medicaid reimbursement under the clinic services benefit for services provided outside of the "four walls" of the facility through February 11, 2025. Provides an overview of the history of this flexibility during the COVID-19 public health emergency (PHE) and previous guidance.
Date: 09/2023
Sponsoring organization: Centers for Medicare and Medicaid Services
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Guidance announcing the extension of a grace period permitting Indian Health Service (IHS) and tribal facilities to claim Medicaid reimbursement under the clinic services benefit for services provided outside of the "four walls" of the facility through February 11, 2025. Provides an overview of the history of this flexibility during the COVID-19 public health emergency (PHE) and previous guidance.
Date: 09/2023
Sponsoring organization: Centers for Medicare and Medicaid Services
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Emergency Department Interventions for Opioid Use Disorder: Overview of the Landscape, Key Components, and Analysis of Five Case Studies
Provides an overview of the evidence base for emergency department (ED)-based programs to address and treat opioid use disorders (OUD). Describes factors that motivated the development of these programs, how they are structured and financed, and barriers and facilitators to ED-based OUD treatment. Features case studies of five ED-based programs, including Marshall Medical Center in rural California.
Date: 08/2023
Sponsoring organizations: Brandeis University, HHS Office of the Assistant Secretary for Planning and Evaluation
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Provides an overview of the evidence base for emergency department (ED)-based programs to address and treat opioid use disorders (OUD). Describes factors that motivated the development of these programs, how they are structured and financed, and barriers and facilitators to ED-based OUD treatment. Features case studies of five ED-based programs, including Marshall Medical Center in rural California.
Date: 08/2023
Sponsoring organizations: Brandeis University, HHS Office of the Assistant Secretary for Planning and Evaluation
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MedPAC Comment on CMS's Proposed Rule on the Home Health Prospective Payment System for FY 2024
Comments on a July 10, 2023, Federal Register proposed rule related to Medicare payment policies for home health agencies. Includes comments on expanding the Home Health Value-Based Purchasing Model nationwide, wage index adjustments, the Hospice Special Focus Program (SFP), and more.
Date: 08/2023
Sponsoring organization: Medicare Payment Advisory Commission
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Comments on a July 10, 2023, Federal Register proposed rule related to Medicare payment policies for home health agencies. Includes comments on expanding the Home Health Value-Based Purchasing Model nationwide, wage index adjustments, the Hospice Special Focus Program (SFP), and more.
Date: 08/2023
Sponsoring organization: Medicare Payment Advisory Commission
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MedPAC Comment on CMS's Proposed Rule on the End-Stage Renal Disease Payment System Update for FY 2024
Comments on a June 30, 2023, Federal Register proposed rule related to Medicare payment policies for end-stage renal disease (ESRD). Includes comments addressing the low-volume payment adjustment (LVPA) and recommending the development of a new payment adjustment based on geographic isolation.
Date: 08/2023
Sponsoring organization: Medicare Payment Advisory Commission
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Comments on a June 30, 2023, Federal Register proposed rule related to Medicare payment policies for end-stage renal disease (ESRD). Includes comments addressing the low-volume payment adjustment (LVPA) and recommending the development of a new payment adjustment based on geographic isolation.
Date: 08/2023
Sponsoring organization: Medicare Payment Advisory Commission
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An Examination of Practices and Barriers of Procedures Performed by Physicians in Rural Hawai'i
Surveys 47 rural Hawaiian physicians to evaluate their scope of practice for procedures and learn the barriers to performing procedures. Discusses specialty care, reimbursement, training, time management, resource access, and more.
Author(s): Joseph W. Turban, Eun Ah Cho, Weston McCue, Kelley Withy
Citation: Hawai'i Journal of Health & Social Welfare, 82(8), 183-187
Date: 08/2023
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Surveys 47 rural Hawaiian physicians to evaluate their scope of practice for procedures and learn the barriers to performing procedures. Discusses specialty care, reimbursement, training, time management, resource access, and more.
Author(s): Joseph W. Turban, Eun Ah Cho, Weston McCue, Kelley Withy
Citation: Hawai'i Journal of Health & Social Welfare, 82(8), 183-187
Date: 08/2023
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