Rural Health
Resources by Topic: Reimbursement and payment models
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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How Regional Partnerships Bolster Rural Hospitals
Explores how Critical Access Hospitals (CAHs) and other rural providers partner to overcome challenges. Profiles six regional partnerships that address staffing, quality improvement, contracts with payers, value-based payment, and community development. Offers lessons learned that could inform policy changes to strengthen rural providers.
Author(s): Martha Hostetter, Sarah Klein
Date: 05/2023
Sponsoring organization: Commonwealth Fund
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Explores how Critical Access Hospitals (CAHs) and other rural providers partner to overcome challenges. Profiles six regional partnerships that address staffing, quality improvement, contracts with payers, value-based payment, and community development. Offers lessons learned that could inform policy changes to strengthen rural providers.
Author(s): Martha Hostetter, Sarah Klein
Date: 05/2023
Sponsoring organization: Commonwealth Fund
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340B Drug Discount Program: Information about Hospitals That Received an Eligibility Exception as a Result of COVID-19
Provides an overview of a provision of the Consolidated Appropriations Act, 2022, that allowed hospitals to request an exception to the disproportionate share hospital (DSH) percentage eligibility requirement if they were unable to meet it due to the COVID-19 pandemic. Explores the exception process and provides information on hospitals that received the exception. Discusses the amount of 340B drug purchases and discounts that excepted hospitals indicated they had in 2020 and 2021; the extent to which excepted hospitals indicated providing discounts on 340B drugs to low-income, uninsured patients; and results of the Health Resources and Services Administration's audits and oversight activities to assess program compliance.
Additional links: Full Report
Date: 05/2023
Sponsoring organization: Government Accountability Office
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Provides an overview of a provision of the Consolidated Appropriations Act, 2022, that allowed hospitals to request an exception to the disproportionate share hospital (DSH) percentage eligibility requirement if they were unable to meet it due to the COVID-19 pandemic. Explores the exception process and provides information on hospitals that received the exception. Discusses the amount of 340B drug purchases and discounts that excepted hospitals indicated they had in 2020 and 2021; the extent to which excepted hospitals indicated providing discounts on 340B drugs to low-income, uninsured patients; and results of the Health Resources and Services Administration's audits and oversight activities to assess program compliance.
Additional links: Full Report
Date: 05/2023
Sponsoring organization: Government Accountability Office
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Access to Maternity Providers: Midwives and Birth Centers
Provides an overview of the role of certified nurse-midwives and birth centers in Medicaid and how beneficiaries use these services. Describes policy issues and barriers to expanding access to midwives and birth centers, including payment policies; contracting with managed care organizations; licensure, certification, and accreditation; scope of practice; and limited supply. Includes rural considerations throughout.
Date: 05/2023
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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Provides an overview of the role of certified nurse-midwives and birth centers in Medicaid and how beneficiaries use these services. Describes policy issues and barriers to expanding access to midwives and birth centers, including payment policies; contracting with managed care organizations; licensure, certification, and accreditation; scope of practice; and limited supply. Includes rural considerations throughout.
Date: 05/2023
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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Closed, Converted, Merged, and New Hospitals with Medicare Rural Designations: January 2018-November 2022
Provides an overview of four Medicare rural hospital designations - Critical Access Hospital, Low-Volume Hospital, Medicare Dependent Hospital, and Sole Community Hospital - and factors related to financial distress that these designations are intended to address. Explores the number of rural-designated hospitals that have closed, merged, converted, or opened between January 2018-November 2022 and compares the number of rural-designated hospitals with the number of non-designated hospitals. Outlines considerations for Congress regarding policy options for rural hospitals and access to healthcare services in rural areas.
Date: 04/2023
Sponsoring organization: Congressional Research Service
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Provides an overview of four Medicare rural hospital designations - Critical Access Hospital, Low-Volume Hospital, Medicare Dependent Hospital, and Sole Community Hospital - and factors related to financial distress that these designations are intended to address. Explores the number of rural-designated hospitals that have closed, merged, converted, or opened between January 2018-November 2022 and compares the number of rural-designated hospitals with the number of non-designated hospitals. Outlines considerations for Congress regarding policy options for rural hospitals and access to healthcare services in rural areas.
Date: 04/2023
Sponsoring organization: Congressional Research Service
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April 2023 MACPAC Meeting Transcript
Transcript from the Medicaid and CHIP Payment and Access Commission's (MACPAC) April 2023 meeting. Covers automatic adjustments to Disproportionate Share Hospital (DSH) allotments, DSH third-party payer policy, integrating care for dually eligible beneficiaries, access to Medicaid coverage and care for adults leaving incarceration, adult access to covered dental benefits, access to home- and community-based services, and an update on the COVID-19 public health emergency (PHE) unwinding. Includes rural references and considerations throughout.
Date: 04/2023
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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Transcript from the Medicaid and CHIP Payment and Access Commission's (MACPAC) April 2023 meeting. Covers automatic adjustments to Disproportionate Share Hospital (DSH) allotments, DSH third-party payer policy, integrating care for dually eligible beneficiaries, access to Medicaid coverage and care for adults leaving incarceration, adult access to covered dental benefits, access to home- and community-based services, and an update on the COVID-19 public health emergency (PHE) unwinding. Includes rural references and considerations throughout.
Date: 04/2023
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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April 2023 MedPAC Meeting Transcript
Transcript from the Medicare Payment Advisory Commission's (MedPAC) April 2023 meeting. Covers high prices of drugs covered under Medicare Part B, draft recommendations for reforming Medicare's wage index systems, aligning fee-for-service payment rates across ambulatory settings, leveraging Medicare policies to address social determinants of health, assessing post-sale rebates for prescription drugs in Medicare Part D, and assessing the need for Medicare safety net payments for skilled nursing facilities and home health agencies. Features discussions on draft reports regarding a prototype design for a post-acute care prospective payment system, telehealth in Medicare, and behavioral health in Medicare. Includes rural references throughout.
Date: 04/2023
Sponsoring organization: Medicare Payment Advisory Commission
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Transcript from the Medicare Payment Advisory Commission's (MedPAC) April 2023 meeting. Covers high prices of drugs covered under Medicare Part B, draft recommendations for reforming Medicare's wage index systems, aligning fee-for-service payment rates across ambulatory settings, leveraging Medicare policies to address social determinants of health, assessing post-sale rebates for prescription drugs in Medicare Part D, and assessing the need for Medicare safety net payments for skilled nursing facilities and home health agencies. Features discussions on draft reports regarding a prototype design for a post-acute care prospective payment system, telehealth in Medicare, and behavioral health in Medicare. Includes rural references throughout.
Date: 04/2023
Sponsoring organization: Medicare Payment Advisory Commission
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Big Changes with the New Rural Emergency Hospital Model
Podcast episode providing an overview of the Rural Emergency Hospital designation. Discusses the role of the Rural Emergency Hospital Technical Assistance Center and the types of support it provides.
Date: 04/2023
Sponsoring organization: American Hospital Association
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Podcast episode providing an overview of the Rural Emergency Hospital designation. Discusses the role of the Rural Emergency Hospital Technical Assistance Center and the types of support it provides.
Date: 04/2023
Sponsoring organization: American Hospital Association
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Analysis of Hospital Operating Margins and Provision of Safety Net Services
Explores the association between five hospital safety net services - undercompensated care measured using the Disproportionate Share Hospital index, uncompensated care, essential community services, and Sole Community Hospital and Critical Access Hospital status - and hospital operating margins. Includes information on the relationship between bed count, Census region, urban/rural location, ownership status, and having a Graduate Medical Education residency program with operating margins.
Author(s): Lukas K. Gaffney, Kenneth A. Michelson
Citation: JAMA Network Open, 6(4), e238785
Date: 04/2023
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Explores the association between five hospital safety net services - undercompensated care measured using the Disproportionate Share Hospital index, uncompensated care, essential community services, and Sole Community Hospital and Critical Access Hospital status - and hospital operating margins. Includes information on the relationship between bed count, Census region, urban/rural location, ownership status, and having a Graduate Medical Education residency program with operating margins.
Author(s): Lukas K. Gaffney, Kenneth A. Michelson
Citation: JAMA Network Open, 6(4), e238785
Date: 04/2023
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Better Together: Rural Hospital High-Value Networks
Examines how rural hospital high-value networks can create economies of scale and value-based care capacity in order to enter into value-based payment contracts.
Author(s): Clint MacKinney, Nate White, Brett Norell
Citation: Rural Monitor
Date: 04/2023
Sponsoring organization: Rural Health Information Hub
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Examines how rural hospital high-value networks can create economies of scale and value-based care capacity in order to enter into value-based payment contracts.
Author(s): Clint MacKinney, Nate White, Brett Norell
Citation: Rural Monitor
Date: 04/2023
Sponsoring organization: Rural Health Information Hub
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