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Rural Health Information Hub

Rural Health
Resources by Topic: Reimbursement and payment models

The Future Pediatric Subspecialty Physician Workforce: Meeting the Needs of Infants, Children, and Adolescents
Reports on barriers to increasing the pediatric subspecialist workforce and discusses the impact on research to improve health outcomes for children. Discusses access to care, education of the workforce, reimbursement rates, and more. Highlights rural specific challenges throughout.
Additional links: Read Online
Author(s): Board on Children, Youth, and Families
Date: 2023
Sponsoring organization: Health and Medicine Division (HMD), National Academies of Sciences, Engineering, and Medicine
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School-Based Telehealth Playbook
Guides health centers through the design, implementation, and operation of a telehealth program that meets the needs of children and adolescents. Covers assessing needs and readiness, program models, business models, technology and equipment, program evaluation, partnerships, and implementation. Highlights examples from rural areas throughout.
Date: 2023
Sponsoring organization: School-Based Health Alliance
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Rural Community Engagement Resource Guide
Describes the importance of community engagement in developing and implementing strategies to improve health, increase value, and drive equitable care delivery. Outlines a variety of toolkits, strategies, and resources to help initiate, improve, and inspire community engagement strategies that support value-based care.
Additional links: Community Engagement and Value Based Care Infographic
Date: 2023
Sponsoring organization: Rural Health Value
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Virginia Community Services Boards Behavioral Health Services: 2022
Report on activities of Virginia's Community Services Boards (CSBs), the state's primary mechanism for providing publicly funded behavioral health services in local communities. Includes a section on CSBs' role in providing services to rural areas. Features statistics on numbers of substance use disorder and mental health consumers, with breakdowns by urban and rural CSBs.
Date: 12/2022
Sponsoring organization: Joint Legislative Audit and Review Commission
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Evaluation of the Rural Community Hospital Demonstration: Interim Report Two (Covering 2016-2018)
Provides an overview of the Rural Community Hospital Demonstration (RCHD). Describes the characteristics of RCHD participants as of fiscal year 2018, the Medicare payments received under the program, and the impact of the RCHD on hospital financial measures. Examines whether hospitals that continued to participate in the RCHD under the 21st Century Cures Act (CCA) extension experienced additional changes to their financial condition, as well as the impact of the program on hospitals that joined the demonstration for the first time under the CCA extension.
Additional links: Findings at a Glance
Date: 12/2022
Sponsoring organizations: American Institutes for Research, Centers for Medicare and Medicaid Services
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Public Law 117–328: Consolidated Appropriations Act, 2023
Text of the Consolidated Appropriations Act, 2023, Public Law 117-328 (December 29, 2022). Section 4113 extends certain COVID-19 telehealth flexibilities, including the ability of Rural Health Clinics and Federally Qualified Health Centers to serve as distant site providers, through December 31, 2024. Section 4137 authorizes the extension of a 1% add-on payment for home health services provided in high-utilization rural counties through 2023.
Date: 12/2022
Sponsoring organization: U.S. Congress
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December 2022 MedPAC Meeting Transcript
Transcript from the Medicare Payment Advisory Commission's (MedPAC) December 2022 meeting. Covers payment adequacy and updates for hospital inpatient and outpatient services and supporting Medicare safety-net hospitals, ambulatory surgical center services, outpatient dialysis services, physician and other health professional services, hospice services, skilled nursing facilities, home health services, and inpatient rehabilitation facility services. Includes rural references throughout.
Date: 12/2022
Sponsoring organization: Medicare Payment Advisory Commission
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The Evolution of Hospital Designations and Payment in the U.S.: Implications for Rural Hospitals
Provides a history and overview of Medicare hospital payment polices as well as alternative payment models and their impact on rural facilities. Discusses the context in which rural hospitals serve patients, rural hospital payment provisions and designations, and current federal payment models that impact rural hospitals.
Author(s): Onyinye Oyeka, Clinton MacKinney, Keith J. Mueller
Date: 12/2022
Sponsoring organization: Rural Policy Research Institute Rural Health Panel
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Mandated Analysis of Home Health Service Utilization From January 2016 Through March 2022
Report evaluates the distribution of rural add-on payments for home health claims. Examines the results of the Centers for Medicare and Medicaid Services's new rural add-on methodology aimed at providing higher add-on percentages for "low population density" categories and explores the effect this methodology has had on "high utilization" categories. Makes comments and recommendations as to how this methodology can be adjusted.
Additional links: Report in Brief
Date: 12/2022
Sponsoring organization: Office of Inspector General (HHS)
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CMS Innovation Center: 2022 Report to Congress
Reports to Congress on payment and service delivery models and initiatives tested or announced by the Center for Medicare and Medicaid Innovation between October 2020 and September 2022. Includes summaries and updates on multiple rural-relevant models and initiatives, including Community Health Access and Rural Transformation (CHART) Model, the Pennsylvania Rural Health Model (PARHM), the Vermont All-Payer Accountable Care Organization Model, and more.
Date: 12/2022
Sponsoring organization: Centers for Medicare and Medicaid Services
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