Rural Health
Resources by Topic: Reimbursement and payment models
Medicare Billing for Telehealth Encounters: An Introductory Guide on Fee-for-Service
Presents an overview of how to bill fee-for-service Medicare and Medicaid for telehealth encounters. Includes information on originating and distant sites, virtual healthcare, and coding telehealth services. Lists types of practice sites, including Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs), and implications for billing telehealth services. Provides contact information for Regional Telehealth Research Centers (RTRC).
Date: 09/2024
Type: Document
Sponsoring organization: Center for Connected Health Policy: The National Telehealth Policy Resource Center
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Presents an overview of how to bill fee-for-service Medicare and Medicaid for telehealth encounters. Includes information on originating and distant sites, virtual healthcare, and coding telehealth services. Lists types of practice sites, including Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs), and implications for billing telehealth services. Provides contact information for Regional Telehealth Research Centers (RTRC).
Date: 09/2024
Type: Document
Sponsoring organization: Center for Connected Health Policy: The National Telehealth Policy Resource Center
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MedPAC Comment on CMS's Proposed Rule on the Payment System for End-Stage Renal Disease for CY 2025
Comments on a July 5, 2024, Federal Register proposed rule related to Medicare payment policies for end-stage renal disease (ESRD). Includes comments addressing modifications to the outlier policy, updates to the low-volume payment adjustment (LVPA), and updates to the wage index methodology.
Date: 08/2024
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Comments on a July 5, 2024, Federal Register proposed rule related to Medicare payment policies for end-stage renal disease (ESRD). Includes comments addressing modifications to the outlier policy, updates to the low-volume payment adjustment (LVPA), and updates to the wage index methodology.
Date: 08/2024
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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MedPAC Comment on CMS's Proposed Rule on the Home Health Prospective Payment System for CY 2025
Comments on a July 3, 2024, Federal Register proposed rule related to Medicare payment policies for home health agencies. Includes comments regarding permanent and temporary budget-neutrality adjustments, the plan of care development and scope of services home health patients receive, and the proposed adoption of the core-based statistical area (CBSA) delineations for the home health wage index.
Date: 08/2024
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Comments on a July 3, 2024, Federal Register proposed rule related to Medicare payment policies for home health agencies. Includes comments regarding permanent and temporary budget-neutrality adjustments, the plan of care development and scope of services home health patients receive, and the proposed adoption of the core-based statistical area (CBSA) delineations for the home health wage index.
Date: 08/2024
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Advancing Health Equity through Primary Care Policy: Priorities and Recommendations for California
Provides policy recommendations to improve access to primary care and improve health equity in California, summarizing perspectives and conclusions from policy, primary care, and health equity experts who participated in the 2023 Summit on Primary Care Policy to Advance Health Equity. Covers topics including engagement with community organizations, workforce development, access to care, data sharing, payment, and accountability. Discusses people who live in rural areas and other underserved populations throughout.
Author(s): Diane Rittenhouse, Rebeckah Muratore, Alexandra Ament, Deliya Wesley, Katie Morrison Lee
Date: 08/2024
Type: Document
Sponsoring organization: California Health Care Foundation
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Provides policy recommendations to improve access to primary care and improve health equity in California, summarizing perspectives and conclusions from policy, primary care, and health equity experts who participated in the 2023 Summit on Primary Care Policy to Advance Health Equity. Covers topics including engagement with community organizations, workforce development, access to care, data sharing, payment, and accountability. Discusses people who live in rural areas and other underserved populations throughout.
Author(s): Diane Rittenhouse, Rebeckah Muratore, Alexandra Ament, Deliya Wesley, Katie Morrison Lee
Date: 08/2024
Type: Document
Sponsoring organization: California Health Care Foundation
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Small Practice After-Action Review: 2022 Performance Year Final Score
Tool for small practices interested in examining their 2022 Merit-based Incentive Payment System (MIPS) final score to identify opportunities to improve performance in 2024.
Additional links: Video: Small Practice Action Planning Tool for MIPS
Date: 08/2024
Type: Tool
Sponsoring organization: Centers for Medicare and Medicaid Services
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Tool for small practices interested in examining their 2022 Merit-based Incentive Payment System (MIPS) final score to identify opportunities to improve performance in 2024.
Additional links: Video: Small Practice Action Planning Tool for MIPS
Date: 08/2024
Type: Tool
Sponsoring organization: Centers for Medicare and Medicaid Services
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FY 2025 Hospital Inpatient Prospective Payment System (IPPS) and Long-Term Care Hospital Prospective Payment System (LTCH PPS) Final Rule – CMS-1808-F
Fact sheet providing an overview of the Centers for Medicare & Medicaid Services (CMS) fiscal year 2025 hospital inpatient prospective payment system (IPPS) and long-term care hospital prospective payment system (LTCH PPS) final rule. Includes information about the extension of the low-wage index hospital policy, a separate IPPS payment for small and independent hospitals to establish and maintain a buffer stock of essential medicines, the distribution of graduate medical education (GME) residency slots, updates to quality reporting programs, and more.
Date: 08/2024
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Fact sheet providing an overview of the Centers for Medicare & Medicaid Services (CMS) fiscal year 2025 hospital inpatient prospective payment system (IPPS) and long-term care hospital prospective payment system (LTCH PPS) final rule. Includes information about the extension of the low-wage index hospital policy, a separate IPPS payment for small and independent hospitals to establish and maintain a buffer stock of essential medicines, the distribution of graduate medical education (GME) residency slots, updates to quality reporting programs, and more.
Date: 08/2024
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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An REH Conversion Story: Harper County Hospital
Profiles Oklahoma's Harper County Hospital and its transition from a Critical Access Hospital (CAH) to a Rural Emergency Hospital (REH). Summarizes an interview with Kevin O'Brien, Chief Executive Officer (CEO) of Harper County Hospital, regarding the experience of converting to REH status. Covers the hospital's financial position before conversion, including limitations to being a county-owned hospital; the exploration of the REH designation; and the financial and operational impacts of the REH designation, including services added by the hospital after the conversion.
Date: 07/2024
Type: Document
Sponsoring organization: Rural Health Redesign Center
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Profiles Oklahoma's Harper County Hospital and its transition from a Critical Access Hospital (CAH) to a Rural Emergency Hospital (REH). Summarizes an interview with Kevin O'Brien, Chief Executive Officer (CEO) of Harper County Hospital, regarding the experience of converting to REH status. Covers the hospital's financial position before conversion, including limitations to being a county-owned hospital; the exploration of the REH designation; and the financial and operational impacts of the REH designation, including services added by the hospital after the conversion.
Date: 07/2024
Type: Document
Sponsoring organization: Rural Health Redesign Center
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An REH Conversion Story: Mercy Hospital
Profiles Mercy Hospital, in Moundridge, Kansas, and its transition from a prospective payment system (PPS) hospital to a Rural Emergency Hospital (REH). Summarizes an interview with Aaron Herbel, Chief Executive Officer (CEO) of Mercy Hospital, regarding the experience of converting to REH status. Covers the conversion timeline, the involvement of hospital and community stakeholders, and the opening of a walk-in clinic that coincided with the REH conversion.
Author(s): Hope Burch, Tracey Dorff, Anna Anna, Janice Walters
Date: 07/2024
Type: Document
Sponsoring organization: Rural Health Redesign Center
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Profiles Mercy Hospital, in Moundridge, Kansas, and its transition from a prospective payment system (PPS) hospital to a Rural Emergency Hospital (REH). Summarizes an interview with Aaron Herbel, Chief Executive Officer (CEO) of Mercy Hospital, regarding the experience of converting to REH status. Covers the conversion timeline, the involvement of hospital and community stakeholders, and the opening of a walk-in clinic that coincided with the REH conversion.
Author(s): Hope Burch, Tracey Dorff, Anna Anna, Janice Walters
Date: 07/2024
Type: Document
Sponsoring organization: Rural Health Redesign Center
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Certified Community Behavioral Health Clinics Demonstration Program: Report to Congress, 2023
Provides an overview of the Certified Community Behavioral Health Clinic (CCBHC) demonstration. Describes changes in the quality of care during the first four years of the demonstration for states with available quality measures, as well as quality bonus payments states made to CCBHCs based on quality measure performance. Builds on findings on demonstration implementation, quality improvement, and costs outlined in previous evaluation reports, focusing on data collected since spring 2022.
Date: 07/2024
Type: Document
Sponsoring organizations: HHS Office of the Assistant Secretary for Planning and Evaluation, Mathematica, RAND Corporation
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Provides an overview of the Certified Community Behavioral Health Clinic (CCBHC) demonstration. Describes changes in the quality of care during the first four years of the demonstration for states with available quality measures, as well as quality bonus payments states made to CCBHCs based on quality measure performance. Builds on findings on demonstration implementation, quality improvement, and costs outlined in previous evaluation reports, focusing on data collected since spring 2022.
Date: 07/2024
Type: Document
Sponsoring organizations: HHS Office of the Assistant Secretary for Planning and Evaluation, Mathematica, RAND Corporation
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Rural Community Health Worker Programs: Proving Value and Finding Sustainability
Features four rural healthcare organizations describing the impact of their community health worker (CHW) programs and strategies for sustaining them. Discusses CHW roles, activities, reimbursement options, and more.
Author(s): Kay Miller Temple
Citation: Rural Monitor
Date: 07/2024
Type: Document
Sponsoring organization: Rural Health Information Hub
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Features four rural healthcare organizations describing the impact of their community health worker (CHW) programs and strategies for sustaining them. Discusses CHW roles, activities, reimbursement options, and more.
Author(s): Kay Miller Temple
Citation: Rural Monitor
Date: 07/2024
Type: Document
Sponsoring organization: Rural Health Information Hub
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