Rural Health
Resources by Topic: Reimbursement and payment models
2021 RHC Billing and Coding Update
Recording of a March 9, 2021, webinar providing an overview of coding and billing changes relevant to Rural Health Clinics (RHCs). Discusses guidelines for reporting COVID-19 immunizations and monoclonal antibody infusions, telehealth coding and billing during the COVID-19 public health emergency, ICD-10-CM diagnosis coding for COVID-19, and RHC lab billing and COVID test reporting. Part of the Rural Health Clinic Technical Assistance Series.
Additional links: AMA Code & Guideline Changes, COVID Vaccine Log, Presentation Slides, Transcript
Date: 03/2021
Type: Video/Multimedia
Sponsoring organization: National Association of Rural Health Clinics
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Recording of a March 9, 2021, webinar providing an overview of coding and billing changes relevant to Rural Health Clinics (RHCs). Discusses guidelines for reporting COVID-19 immunizations and monoclonal antibody infusions, telehealth coding and billing during the COVID-19 public health emergency, ICD-10-CM diagnosis coding for COVID-19, and RHC lab billing and COVID test reporting. Part of the Rural Health Clinic Technical Assistance Series.
Additional links: AMA Code & Guideline Changes, COVID Vaccine Log, Presentation Slides, Transcript
Date: 03/2021
Type: Video/Multimedia
Sponsoring organization: National Association of Rural Health Clinics
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Medicare Hospital Payments: Adjusting for Variation in Geographic Area Wages
Provides an overview of the use of the hospital wage index applied to the Medicare inpatient prospective payment system (IPPS) to account for geographic differences in hospitals' labor costs. Discusses the effect of the wage index on Medicare payments for inpatient hospital services, exceptions to wage index adjustments, and proposals for wage index reforms.
Date: 03/2021
Type: Document
Sponsoring organization: Congressional Research Service
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Provides an overview of the use of the hospital wage index applied to the Medicare inpatient prospective payment system (IPPS) to account for geographic differences in hospitals' labor costs. Discusses the effect of the wage index on Medicare payments for inpatient hospital services, exceptions to wage index adjustments, and proposals for wage index reforms.
Date: 03/2021
Type: Document
Sponsoring organization: Congressional Research Service
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The Effect of Medicare Payment Standardization Methods on the Perceived Cost of Post-Acute Swing Bed Care in Critical Access Hospitals
Discusses the different payment systems the Centers for Medicare and Medicaid Services (CMS) uses to reimburse for post-acute care in Critical Access Hospitals (CAHs), prospective payment system (IPPS) hospitals, and skilled nursing facilities (SNFs). Describes how the payment standardization methods may influence post-acute care discharge patterns and access to care for rural residents. Examines the effects of these payment methods on the perceived cost of CAH swing bed care as it relates to the Medicare Spending per Beneficiary performance measure.
Author(s): Tyler Malone, Denise Kirk, Kristin Reiter
Date: 03/2021
Type: Document
Sponsoring organization: North Carolina Rural Health Research Program
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Discusses the different payment systems the Centers for Medicare and Medicaid Services (CMS) uses to reimburse for post-acute care in Critical Access Hospitals (CAHs), prospective payment system (IPPS) hospitals, and skilled nursing facilities (SNFs). Describes how the payment standardization methods may influence post-acute care discharge patterns and access to care for rural residents. Examines the effects of these payment methods on the perceived cost of CAH swing bed care as it relates to the Medicare Spending per Beneficiary performance measure.
Author(s): Tyler Malone, Denise Kirk, Kristin Reiter
Date: 03/2021
Type: Document
Sponsoring organization: North Carolina Rural Health Research Program
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Sustainability Strategies for Community-based Palliative Care
Summarizes themes from two roundtable discussions conducted in late 2018 with 9 rural palliative care programs in Minnesota and surrounding states. Offers examples and resources for sustainability strategies to support community-based palliative care programs.
Date: 03/2021
Type: Document
Sponsoring organization: Stratis Health
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Summarizes themes from two roundtable discussions conducted in late 2018 with 9 rural palliative care programs in Minnesota and surrounding states. Offers examples and resources for sustainability strategies to support community-based palliative care programs.
Date: 03/2021
Type: Document
Sponsoring organization: Stratis Health
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Primary Care in the United States: A Chartbook of Facts and Statistics
Examines aspects of primary care in the United States, including facts and figures on patient contact with primary care, frequency and range of conditions seen in primary care, care coordination, scope of practice, payment models, and preventive care visit utilization. Features statistics on percentage of primary care physicians by geography, with breakdowns by urban, large rural, small rural, and isolated rural location.
Author(s): Brian Antono, Andrew Bazemore, Irene Dankwa-Mullan, et al.
Date: 02/2021
Type: Document
Sponsoring organization: Robert Graham Center
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Examines aspects of primary care in the United States, including facts and figures on patient contact with primary care, frequency and range of conditions seen in primary care, care coordination, scope of practice, payment models, and preventive care visit utilization. Features statistics on percentage of primary care physicians by geography, with breakdowns by urban, large rural, small rural, and isolated rural location.
Author(s): Brian Antono, Andrew Bazemore, Irene Dankwa-Mullan, et al.
Date: 02/2021
Type: Document
Sponsoring organization: Robert Graham Center
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Medicare Reimbursement in Rural America
Policy brief discussing Medicare reimbursement for services provided at rural hospitals and how it impacts hospital finances. Provides policy recommendations for rural health reimbursement, and identifies and other considerations for addressing rural healthcare sustainability.
Author(s): Eric Schlidt, Cody Wilkinson
Date: 02/2021
Type: Document
Sponsoring organization: National Rural Health Association
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Policy brief discussing Medicare reimbursement for services provided at rural hospitals and how it impacts hospital finances. Provides policy recommendations for rural health reimbursement, and identifies and other considerations for addressing rural healthcare sustainability.
Author(s): Eric Schlidt, Cody Wilkinson
Date: 02/2021
Type: Document
Sponsoring organization: National Rural Health Association
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Rural EMS Workforce: A Call to Action
Policy brief discussing rural emergency medical services (EMS) systems. Highlights challenges facing the rural EMS workforce, including the costs of training and reimbursement concerns. Outlines policy recommendations to strengthen rural EMS systems.
Author(s): Christopher McLaughlin, Olivia Riutta, Jonnathan Busko
Date: 02/2021
Type: Document
Sponsoring organization: National Rural Health Association
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Policy brief discussing rural emergency medical services (EMS) systems. Highlights challenges facing the rural EMS workforce, including the costs of training and reimbursement concerns. Outlines policy recommendations to strengthen rural EMS systems.
Author(s): Christopher McLaughlin, Olivia Riutta, Jonnathan Busko
Date: 02/2021
Type: Document
Sponsoring organization: National Rural Health Association
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Rural Obstetric Unit Closures and Maternal and Infant Health
Policy paper examining the discontinuation of obstetric services in rural communities. Discusses factors contributing to obstetric unit closures, including hospital financial constraints, Medicaid reimbursement rates, and maternal health workforce concerns. Offers policy recommendations to prevent additional obstetric unit closures in rural areas.
Author(s): Lindsay Corcoran, Catherine Clary, Sarah Brinkman
Date: 02/2021
Type: Document
Sponsoring organization: National Rural Health Association
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Policy paper examining the discontinuation of obstetric services in rural communities. Discusses factors contributing to obstetric unit closures, including hospital financial constraints, Medicaid reimbursement rates, and maternal health workforce concerns. Offers policy recommendations to prevent additional obstetric unit closures in rural areas.
Author(s): Lindsay Corcoran, Catherine Clary, Sarah Brinkman
Date: 02/2021
Type: Document
Sponsoring organization: National Rural Health Association
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Health System Challenges for Critical Access Hospitals: Findings from a National Survey of CAH Executives
Results of a 2019 survey of 174 respondents, examining challenges including uncompensated care, affordability of health insurance, patients seeking care beyond their local hospital, and prescription drug prices. Intended to help rural health policymakers in development of strategies to maintain Critical Access Hospital viability and access to healthcare in rural communities.
Author(s): Sharita Thomas, Kristie Thompson, Kathleen Knocke, George Pink
Date: 02/2021
Type: Document
Sponsoring organization: North Carolina Rural Health Research Program
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Results of a 2019 survey of 174 respondents, examining challenges including uncompensated care, affordability of health insurance, patients seeking care beyond their local hospital, and prescription drug prices. Intended to help rural health policymakers in development of strategies to maintain Critical Access Hospital viability and access to healthcare in rural communities.
Author(s): Sharita Thomas, Kristie Thompson, Kathleen Knocke, George Pink
Date: 02/2021
Type: Document
Sponsoring organization: North Carolina Rural Health Research Program
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January 2021 MACPAC Meeting Transcript
Transcript from the Medicaid and CHIP Payment and Access Commission's (MACPAC) January 2021 meeting. Covers the review of draft chapters and recommendations regarding postpartum coverage, estate recovery, automatic countercyclical financing adjustment, design considerations for creating a new unified program for dually eligible beneficiaries, and housing supports for individuals with substance use disorder, among other things. Also details a MACPAC study on non-emergency medical transportation (NEMT), which includes a discussion of NEMT in rural areas.
Date: 01/2021
Type: Document
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) January 2021 meeting. Covers the review of draft chapters and recommendations regarding postpartum coverage, estate recovery, automatic countercyclical financing adjustment, design considerations for creating a new unified program for dually eligible beneficiaries, and housing supports for individuals with substance use disorder, among other things. Also details a MACPAC study on non-emergency medical transportation (NEMT), which includes a discussion of NEMT in rural areas.
Date: 01/2021
Type: Document
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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