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Rural Health
Resources by Topic: Reimbursement and payment models

Rural Emergency Hospital Conversion: Critical Factors for EMS Support
Policy position paper focused on emergency medical services (EMS) in communities with hospitals converting to Rural Emergency Hospital (REH) status. Outlines barriers to EMS delivery in rural areas including funding, workforce, and community engagement and support. Includes policy recommendations.
Author(s): Julie Bosak, Jed Hansen
Date: 02/2022
Type: Document
Sponsoring organization: National Rural Health Association
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Palliative Care for Rural Growth and Wellbeing: Identifying Perceived Barriers and Facilitators in Access to Palliative Care in Rural Indiana, USA
Presents findings from interviews with 15 palliative care providers regarding access to palliative care in rural Indiana. Identifies barriers to and facilitators of palliative care access in rural Indiana.
Author(s): Nasreen Lalani, Yun Cai
Citation: BMC Palliative Care, 21(1), 25
Date: 02/2022
Type: Document
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Medicaid and Counties: Understanding the Program and Why It Matters to Counties
Discusses the importance of Medicaid in county-level healthcare. Describes the role Medicaid plays in financing and delivering healthcare for children, the elderly, the disabled, and rural residents. Highlights the impact of COVID-19 on the Medicaid program and challenges for county governments.
Date: 02/2022
Type: Document
Sponsoring organization: National Association of Counties
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Meeting the Behavioral Health Needs of Farm Families in Times of Economic Distress
Offers strategies to support development and integration of behavioral health services across healthcare and community-based organizations, including leveraging payment systems to support coordinated care for farm families and aligning federal grant programs to address mental health and substance use disorders. Features recommendations including integrating primary and behavioral care for initial treatment of mental health and substance abuse concerns, expanding the workforce to improve rural behavioral health services capacity, increasing telehealth services, and expanding private and public insurance coverage.
Author(s): Andrew F. Coburn, Alva O. Ferdinand, Alana Knudson, et al.
Date: 02/2022
Type: Document
Sponsoring organization: Rural Policy Research Institute Rural Health Panel
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CMS Bundled Payments for Care Improvement Advanced Model: Third Evaluation Report
Third annual report of the Bundled Payments for Care Improvement Advanced (BPCI Advanced) Model, which tests whether linking payments for a clinical episode of care can reduce Medicare expenditures while maintaining or improving quality of care. Explores the impact of BPCI Advanced on episode payments, utilization, and quality of care through Model Years 1 and 2, Medicare savings in Model Years 1 and 2, and how the COVID-19 pandemic affected BPCI Advanced participants through June 30, 2020.
Additional links: Appendices, Findings at a Glance
Author(s): The Lewin Group, Abt Associates, GDIT, Telligen
Date: 02/2022
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Quality Payment Program Participation in 2020: Results At-a-Glance
Provides an overview of the results of the Quality Payment Program for the 2020 performance year. Highlights mean and median final scores in the Merit-based Incentive Payment System (MIPS) for small practices.
Date: 02/2022
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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January 2022 MedPAC Meeting Transcript
Transcript from the Medicare Payment Advisory Commission's (MedPAC) January 2022 meeting. Covers payment adequacy and updates for hospital inpatient and outpatient services, physician and other health professional services, outpatient dialysis services and improving the ESRD payment system, skilled nursing facility services, home health agency services, long-term care hospital services, inpatient rehabilitation facility services, hospice services, and ambulatory surgical center services. Includes rural references throughout.
Date: 01/2022
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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The Effectiveness of Policies to Improve Primary Care Access for Underserved Populations: An Assessment of the Literature
Review of research literature to assess whether policy initiatives targeting primary care access for rural and underserved populations has been effective in reducing healthcare disparities. Initiatives considered include availability, accessibility, accommodation, affordability, and acceptability.
Additional links: Fact Sheet: Alleviating Structural Barriers to Obtaining Primary Care Services, Fact Sheet: Bringing Outpatient Clinics into Communities, Fact Sheet: Ensuring Comfort and Communication in the Delivery of Primary Care Services, Fact Sheet: Increasing the Availability of Primary Care Clinicians, Fact Sheet: Removing Financial Barriers to Primary Care
Author(s): Maanasa Kona, Megan Houston, Nia Gooding
Date: 01/2022
Type: Document
Sponsoring organization: Milbank Memorial Fund
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CARES Act Telehealth Expansion: Trends in Post-Discharge Follow-Up and Association with 30-Day Readmissions for Hospital Readmissions Reduction Program Health Conditions
Provides an overview of the Hospital Readmissions Reduction Program (HRRP) and examines the impact of expanded Medicare payment for telehealth services on post-discharge follow-up and hospital readmissions for HRRP conditions. Describes trends in post-discharge follow-up before and after the telehealth expansion and compares trends by health condition, sociodemographic characteristics, rurality, and follow-up method.
Date: 01/2022
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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U.S. Health Care Expenditures: Costs, Lessons, and Opportunities
Summarizes a March 15-16, 2021, workshop exploring issues related to increasing healthcare spending in the United States. Provides an overview of the scope of healthcare spending in the United States, innovations implemented to address spending, and the role of research in policy change. Includes information on rural payment models.
Additional links: Read Online
Date: 2022
Type: Document
Sponsoring organization: Health and Medicine Division (HMD), National Academies of Sciences, Engineering, and Medicine
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