Rural Health
Resources by Topic: Reimbursement and payment models
April 2022 MedPAC Meeting Transcript
Transcript from the Medicare Payment Advisory Commission's (MedPAC) April 2022 meeting. Covers high prices of drugs covered under Medicare Part B, initial findings from MedPAC's analysis of Part D data on drug rebates and discounts, segmentation in the stand-alone Part D prescription drug plan market, leveraging Medicare policies to address social determinants of health, an approach to streamline and harmonize Medicare's portfolio of alternative payment models, and aligning fee-for-service payment rates across ambulatory settings. Includes rural references throughout.
Date: 04/2022
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Transcript from the Medicare Payment Advisory Commission's (MedPAC) April 2022 meeting. Covers high prices of drugs covered under Medicare Part B, initial findings from MedPAC's analysis of Part D data on drug rebates and discounts, segmentation in the stand-alone Part D prescription drug plan market, leveraging Medicare policies to address social determinants of health, an approach to streamline and harmonize Medicare's portfolio of alternative payment models, and aligning fee-for-service payment rates across ambulatory settings. Includes rural references throughout.
Date: 04/2022
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Medicare's Prospective Payment System for Inpatient Psychiatric Facilities at 15 Years
Examine how Medicare enrollees' use of inpatient psychiatric facility (IPF) services and the characteristics of IPFs have changed since the introduction of the IPF-PPS in 2005. Explores whether there have been changes in events that occur before or after IPF stays that may indicate potential changes in the quality of services. Includes information on per diem costs for rural IPFs compared to urban facilities.
Date: 04/2022
Type: Document
Sponsoring organizations: Medicare Payment Advisory Commission, Urban Institute
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Examine how Medicare enrollees' use of inpatient psychiatric facility (IPF) services and the characteristics of IPFs have changed since the introduction of the IPF-PPS in 2005. Explores whether there have been changes in events that occur before or after IPF stays that may indicate potential changes in the quality of services. Includes information on per diem costs for rural IPFs compared to urban facilities.
Date: 04/2022
Type: Document
Sponsoring organizations: Medicare Payment Advisory Commission, Urban Institute
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Evaluation of the Home Health Value-Based Purchasing (HHVBP) Model: Fifth Annual 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. Reports on the experiences of home health agencies and patients through 2020, the fifth performance year of the HHVBP Model, and the third year that agencies in the HHVBP states received a payment adjustment. Examines the impacts of the HHVBP Model on Medicare expenditures, healthcare utilization, quality of care and patient experience, and agency operations. Discusses rural access to high-quality home health agencies and the impact of HHVBP on rural home health patients.
Additional links: Findings at a Glance, Technical Appendices
Author(s): Alyssa Pozniak, Marc Turenne, Eric Lammers, et al.
Date: 04/2022
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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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. Reports on the experiences of home health agencies and patients through 2020, the fifth performance year of the HHVBP Model, and the third year that agencies in the HHVBP states received a payment adjustment. Examines the impacts of the HHVBP Model on Medicare expenditures, healthcare utilization, quality of care and patient experience, and agency operations. Discusses rural access to high-quality home health agencies and the impact of HHVBP on rural home health patients.
Additional links: Findings at a Glance, Technical Appendices
Author(s): Alyssa Pozniak, Marc Turenne, Eric Lammers, et al.
Date: 04/2022
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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MACPAC Response to CMS Request for Information on Access and Coverage in Medicaid and CHIP
Letter to the Centers for Medicare & Medicaid Services (CMS) responding to a request for information on access to coverage and care in Medicaid and the State Children's Health Insurance Program (CHIP). Discusses strategies related to enrolling in and maintaining coverage, accessing services, and ensuring adequate payment rates. Includes information on physical and behavioral health integration, substance use disorder treatment for pregnant and postpartum women, telehealth, and more.
Date: 04/2022
Type: Document
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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Letter to the Centers for Medicare & Medicaid Services (CMS) responding to a request for information on access to coverage and care in Medicaid and the State Children's Health Insurance Program (CHIP). Discusses strategies related to enrolling in and maintaining coverage, accessing services, and ensuring adequate payment rates. Includes information on physical and behavioral health integration, substance use disorder treatment for pregnant and postpartum women, telehealth, and more.
Date: 04/2022
Type: Document
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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Medicaid Coverage of Community Health Worker Services
Provides an overview of types of community health workers (CHWs) and the services they provide. Summarizes studies examining the effects of CHW programs on health outcomes and costs. Discusses state approaches to covering CHW services through Medicaid, including the services covered, regulatory authorities used to provide Medicaid payment, the populations served, and training and certification requirements.
Date: 04/2022
Type: Document
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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Provides an overview of types of community health workers (CHWs) and the services they provide. Summarizes studies examining the effects of CHW programs on health outcomes and costs. Discusses state approaches to covering CHW services through Medicaid, including the services covered, regulatory authorities used to provide Medicaid payment, the populations served, and training and certification requirements.
Date: 04/2022
Type: Document
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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Impact of Cost Report on CAH Decision Making
Webinar recording discussing cost-based reimbursement and the implications of the Medicare cost report for Critical Access Hospitals (CAHs). Describes opportunities for CAHs to maximize reimbursement using the cost report. Part of a series of webinars directed toward rural hospital CEOs and CFOs.
Date: 04/2022
Type: Document
Sponsoring organizations: Oklahoma Office of Rural Health, Stroudwater Associates
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Webinar recording discussing cost-based reimbursement and the implications of the Medicare cost report for Critical Access Hospitals (CAHs). Describes opportunities for CAHs to maximize reimbursement using the cost report. Part of a series of webinars directed toward rural hospital CEOs and CFOs.
Date: 04/2022
Type: Document
Sponsoring organizations: Oklahoma Office of Rural Health, Stroudwater Associates
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Sliding Fee Scale Discount Guide for CAHs and RHCs
Provides concepts and guidance to help Critical Access Hospital (CAH) and Rural Health Clinic (RHC) executives and management teams develop a sliding fee scale discount program. Addresses how these programs relate to Internal Revenue Code Section 501(r) compliance and participation in the National Health Service Corps (NHSC). Includes an example of a sliding fee schedule.
Date: 04/2022
Type: Website
Sponsoring organization: National Rural Health Resource Center
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Provides concepts and guidance to help Critical Access Hospital (CAH) and Rural Health Clinic (RHC) executives and management teams develop a sliding fee scale discount program. Addresses how these programs relate to Internal Revenue Code Section 501(r) compliance and participation in the National Health Service Corps (NHSC). Includes an example of a sliding fee schedule.
Date: 04/2022
Type: Website
Sponsoring organization: National Rural Health Resource Center
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Washington Rural Health Clinic Dental Services Toolkit
Resource guide to assist Rural Health Clinics (RHCs) in Washington implement dental services alongside primary care. Covers funding, facility, health information technology, and other considerations related to implementing dental care.
Date: 03/2022
Type: Document
Sponsoring organization: Washington State Department of Health
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Resource guide to assist Rural Health Clinics (RHCs) in Washington implement dental services alongside primary care. Covers funding, facility, health information technology, and other considerations related to implementing dental care.
Date: 03/2022
Type: Document
Sponsoring organization: Washington State Department of Health
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COVID-19 and the Rural Health Workforce: The Impact of Federal Pandemic Funding to Address Workforce Needs
Policy brief describing workforce challenges faced by rural healthcare delivery systems during the COVID-19 pandemic, and discussing how pre-pandemic financial instability in rural healthcare facilities may have contributed to these challenges. Discusses the availability of federal pandemic funding to address rural health workforce needs, the ability of rural facilities to access and utilize the funding, and the long-term needs of the rural health workforce and delivery system. Addresses telehealth solutions to workforce challenges, and funding sources for mental health needs of health professionals
Author(s): Natalia V. Oster, Davis G. Patterson, Susan M. Skillman, Bianca K. Frogner
Date: 03/2022
Type: Document
Sponsoring organization: UW Center for Health Workforce Studies
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Policy brief describing workforce challenges faced by rural healthcare delivery systems during the COVID-19 pandemic, and discussing how pre-pandemic financial instability in rural healthcare facilities may have contributed to these challenges. Discusses the availability of federal pandemic funding to address rural health workforce needs, the ability of rural facilities to access and utilize the funding, and the long-term needs of the rural health workforce and delivery system. Addresses telehealth solutions to workforce challenges, and funding sources for mental health needs of health professionals
Author(s): Natalia V. Oster, Davis G. Patterson, Susan M. Skillman, Bianca K. Frogner
Date: 03/2022
Type: Document
Sponsoring organization: UW Center for Health Workforce Studies
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Impact of New Rural Health Clinic (RHC) Reimbursement Methodology
Webinar discussing changes to the Rural Health Clinic (RHC) reimbursement methodology, covering upper payment limits and Oklahoma-specific implications of the changes, as well as RHC reimbursement impacts. Part a series of webinars directed toward rural hospital CEOs and CFOs.
Date: 03/2022
Type: Video/Multimedia
Sponsoring organizations: Oklahoma Office of Rural Health, Stroudwater Associates
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Webinar discussing changes to the Rural Health Clinic (RHC) reimbursement methodology, covering upper payment limits and Oklahoma-specific implications of the changes, as well as RHC reimbursement impacts. Part a series of webinars directed toward rural hospital CEOs and CFOs.
Date: 03/2022
Type: Video/Multimedia
Sponsoring organizations: Oklahoma Office of Rural Health, Stroudwater Associates
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