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Rural Health
Resources by Topic: Reimbursement and payment models

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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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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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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January 2021 MedPAC Meeting Transcript
Transcript from the Medicare Payment Advisory Commission's (MedPAC) January 2021 meeting. Features a discussion on the expansion of telehealth in Medicare. Also covers payment adequacy and updates for hospital inpatient and outpatient services and the mandated report expanding the post-acute care transfer policy to hospice, physician and other health professional services, ambulatory surgical center services, outpatient dialysis services, hospice services, skilled nursing facility services, home health agency services, inpatient rehabilitation facility services, long-term care hospital services, and CMMI's development and implementation of alternative payment models.
Date: 01/2021
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Congress Establishes New Medicare Provider Category and Reimbursement for Rural Emergency Hospitals
Provides an overview of the Rural Emergency Hospital (REH) provider designation established in the Consolidated Appropriations Act, 2021. Discusses provider eligibility criteria, REH requirements and permitted services, and Medicare reimbursement. Highlights key questions that need to be addressed by the Centers for Medicare and Medicaid Services.
Author(s): Emily J. Cook, Sandra M. DiVarco, Caroline Reigart
Citation: National Law Review, XI(5)
Date: 01/2021
Type: Document
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Continuing on the Road to Value
Slides presented at the Indiana Rural Health Association's Annual Public Policy Forum in 2021. Discusses management methods and policy initiatives for transitioning hospitals to value-based care. Includes information on the Community Health Access and Rural Transformation (CHART) Model, Accountable Care Organization (ACO) Pathways to Success, and global budgeting.
Author(s): Keith J. Mueller
Date: 01/2021
Type: Presentation Slides
Sponsoring organization: Rural Policy Research Institute
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Telehealth After COVID-19: Clarifying Policy Goals for a Way Forward
Examines how telehealth may be used to improve healthcare quality, reduce costs, improve access to care, and meet other policy objections. Presents recommendations for telehealth policy after the COVID-19 pandemic.
Author(s): Lori Uscher-Pines, Monique Martineau
Date: 01/2021
Type: Document
Sponsoring organization: RAND Corporation
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Independent Evaluation of Comprehensive Primary Care Plus (CPC+): Third Annual Report
Reports on the first three program years of the Comprehensive Primary Care Plus (CPC+) model, a CMS primary care payment and delivery reform effort. Discusses CPC+ participating practices, payer partners, and health information technology (HIT) vendors supporting the program. Describes practice changes and outcomes for Medicare fee-for-service beneficiaries.
Additional links: Appendices, Findings at a Glance
Date: 01/2021
Type: Document
Sponsoring organizations: Centers for Medicare and Medicaid Services, Mathematica
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Mental Health Systems Solutions Explorer
Interactive tool offering evidence-based solutions to increase mental healthcare utilization, increase access to care, and establish a continuum of care. Contains examples of each solution in practice. Solutions can be filtered to view those specifically of interest to rural communities.
Date: 01/2021
Type: Tool
Sponsoring organization: RAND Corporation
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How to Transform the U.S. Mental Health System: Evidence-based Recommendations
Discusses evidence-based strategies to promote mental healthcare utilization, improve access to care, and establish a continuum of care. Offers 15 recommendations to improve mental healthcare, including policies regarding reimbursement, workforce growth, and digital and telehealth services, among other topics. Includes rural references throughout.
Additional links: Full Report, Research Brief: Transforming Mental Health Care in the United States
Author(s): Ryan K. McBain, Nicole K. Eberhart, Joshua Breslau, et al.
Date: 01/2021
Type: Document
Sponsoring organization: RAND Corporation
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