Rural Health
Resources by Topic: Reimbursement and payment models
Evaluation of the Home Health Value-Based Purchasing (HHVBP) Model: Fifth Annual Report
Evaluates the Home Health Value-Based Purchasing (HHVBP) Model, which tests the impact of providing financial incentives to home health agencies in nine states: Arizona, Florida, Iowa, Massachusetts, Maryland, Nebraska, North Carolina, Tennessee, and Washington. Reports on the experiences of home health agencies and patients through 2020, the fifth performance year of the HHVBP Model, and the third year that agencies in the HHVBP states received a payment adjustment. Examines the impacts of the HHVBP Model on Medicare expenditures, healthcare utilization, quality of care and patient experience, and agency operations. Discusses rural access to high-quality home health agencies and the impact of HHVBP on rural home health patients.
Additional links: Findings at a Glance, Technical Appendices
Author(s): Alyssa Pozniak, Marc Turenne, Eric Lammers, et al.
Date: 04/2022
Sponsoring organization: Centers for Medicare and Medicaid Services
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Evaluates the Home Health Value-Based Purchasing (HHVBP) Model, which tests the impact of providing financial incentives to home health agencies in nine states: Arizona, Florida, Iowa, Massachusetts, Maryland, Nebraska, North Carolina, Tennessee, and Washington. Reports on the experiences of home health agencies and patients through 2020, the fifth performance year of the HHVBP Model, and the third year that agencies in the HHVBP states received a payment adjustment. Examines the impacts of the HHVBP Model on Medicare expenditures, healthcare utilization, quality of care and patient experience, and agency operations. Discusses rural access to high-quality home health agencies and the impact of HHVBP on rural home health patients.
Additional links: Findings at a Glance, Technical Appendices
Author(s): Alyssa Pozniak, Marc Turenne, Eric Lammers, et al.
Date: 04/2022
Sponsoring organization: Centers for Medicare and Medicaid Services
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MACPAC Response to CMS Request for Information on Access and Coverage in Medicaid and CHIP
Letter to the Centers for Medicare & Medicaid Services (CMS) responding to a request for information on access to coverage and care in Medicaid and the State Children's Health Insurance Program (CHIP). Discusses strategies related to enrolling in and maintaining coverage, accessing services, and ensuring adequate payment rates. Includes information on physical and behavioral health integration, substance use disorder treatment for pregnant and postpartum women, telehealth, and more.
Date: 04/2022
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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Letter to the Centers for Medicare & Medicaid Services (CMS) responding to a request for information on access to coverage and care in Medicaid and the State Children's Health Insurance Program (CHIP). Discusses strategies related to enrolling in and maintaining coverage, accessing services, and ensuring adequate payment rates. Includes information on physical and behavioral health integration, substance use disorder treatment for pregnant and postpartum women, telehealth, and more.
Date: 04/2022
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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Medicaid Coverage of Community Health Worker Services
Provides an overview of types of community health workers (CHWs) and the services they provide. Summarizes studies examining the effects of CHW programs on health outcomes and costs. Discusses state approaches to covering CHW services through Medicaid, including the services covered, regulatory authorities used to provide Medicaid payment, the populations served, and training and certification requirements.
Date: 04/2022
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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Provides an overview of types of community health workers (CHWs) and the services they provide. Summarizes studies examining the effects of CHW programs on health outcomes and costs. Discusses state approaches to covering CHW services through Medicaid, including the services covered, regulatory authorities used to provide Medicaid payment, the populations served, and training and certification requirements.
Date: 04/2022
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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Impact of Cost Report on CAH Decision Making
Webinar recording discussing cost-based reimbursement and the implications of the Medicare cost report for Critical Access Hospitals (CAHs). Describes opportunities for CAHs to maximize reimbursement using the cost report. Part of a series of webinars directed toward rural hospital CEOs and CFOs. Transcript available in video description.
Date: 04/2022
Sponsoring organizations: Oklahoma Office of Rural Health, Stroudwater Associates
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Webinar recording discussing cost-based reimbursement and the implications of the Medicare cost report for Critical Access Hospitals (CAHs). Describes opportunities for CAHs to maximize reimbursement using the cost report. Part of a series of webinars directed toward rural hospital CEOs and CFOs. Transcript available in video description.
Date: 04/2022
Sponsoring organizations: Oklahoma Office of Rural Health, Stroudwater Associates
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Sliding Fee Scale Discount Guide for CAHs and RHCs
Provides concepts and guidance to help Critical Access Hospital (CAH) and Rural Health Clinic (RHC) executives and management teams develop a sliding fee scale discount program. Addresses how these programs relate to Internal Revenue Code Section 501(r) compliance and participation in the National Health Service Corps (NHSC). Includes an example of a sliding fee schedule.
Date: 04/2022
Sponsoring organization: National Rural Health Resource Center
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Provides concepts and guidance to help Critical Access Hospital (CAH) and Rural Health Clinic (RHC) executives and management teams develop a sliding fee scale discount program. Addresses how these programs relate to Internal Revenue Code Section 501(r) compliance and participation in the National Health Service Corps (NHSC). Includes an example of a sliding fee schedule.
Date: 04/2022
Sponsoring organization: National Rural Health Resource Center
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Washington Rural Health Clinic Dental Services Toolkit: A Guide to Implementing Dental Services in Washington's Rural Health Clinics
Resource guide to assist Rural Health Clinics (RHCs) in Washington implement dental services alongside primary care. Covers funding, facility, health information technology, and other considerations related to implementing dental care.
Date: 03/2022
Sponsoring organization: Washington State Department of Health
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Resource guide to assist Rural Health Clinics (RHCs) in Washington implement dental services alongside primary care. Covers funding, facility, health information technology, and other considerations related to implementing dental care.
Date: 03/2022
Sponsoring organization: Washington State Department of Health
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COVID-19 and the Rural Health Workforce: The Impact of Federal Pandemic Funding to Address Workforce Needs
Policy brief describing workforce challenges faced by rural healthcare delivery systems during the COVID-19 pandemic, and discussing how pre-pandemic financial instability in rural healthcare facilities may have contributed to these challenges. Discusses the availability of federal pandemic funding to address rural health workforce needs, the ability of rural facilities to access and utilize the funding, and the long-term needs of the rural health workforce and delivery system. Addresses telehealth solutions to workforce challenges, and funding sources for mental health needs of health professionals
Author(s): Natalia V. Oster, Davis G. Patterson, Susan M. Skillman, Bianca K. Frogner
Date: 03/2022
Sponsoring organization: UW Center for Health Workforce Studies
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Policy brief describing workforce challenges faced by rural healthcare delivery systems during the COVID-19 pandemic, and discussing how pre-pandemic financial instability in rural healthcare facilities may have contributed to these challenges. Discusses the availability of federal pandemic funding to address rural health workforce needs, the ability of rural facilities to access and utilize the funding, and the long-term needs of the rural health workforce and delivery system. Addresses telehealth solutions to workforce challenges, and funding sources for mental health needs of health professionals
Author(s): Natalia V. Oster, Davis G. Patterson, Susan M. Skillman, Bianca K. Frogner
Date: 03/2022
Sponsoring organization: UW Center for Health Workforce Studies
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Impact of New Rural Health Clinic (RHC) Reimbursement Methodology
Webinar discussing changes to the Rural Health Clinic (RHC) reimbursement methodology, covering upper payment limits and Oklahoma-specific implications of the changes, as well as RHC reimbursement impacts. Part a series of webinars directed toward rural hospital CEOs and CFOs.
Date: 03/2022
Sponsoring organizations: Oklahoma Office of Rural Health, Stroudwater Associates
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Webinar discussing changes to the Rural Health Clinic (RHC) reimbursement methodology, covering upper payment limits and Oklahoma-specific implications of the changes, as well as RHC reimbursement impacts. Part a series of webinars directed toward rural hospital CEOs and CFOs.
Date: 03/2022
Sponsoring organizations: Oklahoma Office of Rural Health, Stroudwater Associates
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Environmental Scan on Issues Related to the Development of Population-Based Total Cost of Care (TCOC) Models in the Broader Context of Alternative Payment Models (APMs) and Physician-Focused Payment Models (PFPMs)
Presents results of an environmental scan regarding population-based total cost of care (TCOC) payment models and the role these models can play in optimizing health care delivery and value-based transformation in the context of alternative payment models (APMs) and physician-focused payment models (PFPMs). Provides an overview of TCOC payment models, relevant performance and outcome measures used in reporting and evaluation, findings from research related to population-based models and programs that seek to reduce TCOC, barriers and challenges related to implementing population-based TCOC models, and opportunities for improving and optimizing efforts to develop and implement these models. Highlights rural considerations and examples throughout.
Date: 03/2022
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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Presents results of an environmental scan regarding population-based total cost of care (TCOC) payment models and the role these models can play in optimizing health care delivery and value-based transformation in the context of alternative payment models (APMs) and physician-focused payment models (PFPMs). Provides an overview of TCOC payment models, relevant performance and outcome measures used in reporting and evaluation, findings from research related to population-based models and programs that seek to reduce TCOC, barriers and challenges related to implementing population-based TCOC models, and opportunities for improving and optimizing efforts to develop and implement these models. Highlights rural considerations and examples throughout.
Date: 03/2022
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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Telehealth for FQHCs/RHCs: School-Based Telehealth
Offers a 3-part video series on school-based telehealth for Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs). Topics covered in part 1 include school-based telehealth resources and opportunities; part 2 offers information on school-based health clinic benefits, program development, payment, and technology considerations; and part 3 covers school based primary care, integrated behavioral health, virtual learning, and evolution of telehealth services. If viewed through YouTube, transcripts are available below description.
Additional links: Telehealth for FQHCs/RHCs: School-Based Telehealth Part 2, Telehealth for FQHCs/RHCs: School-Based Telehealth Part 3
Date: 03/2022
Sponsoring organization: National Consortium of Telehealth Resource Centers
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Offers a 3-part video series on school-based telehealth for Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs). Topics covered in part 1 include school-based telehealth resources and opportunities; part 2 offers information on school-based health clinic benefits, program development, payment, and technology considerations; and part 3 covers school based primary care, integrated behavioral health, virtual learning, and evolution of telehealth services. If viewed through YouTube, transcripts are available below description.
Additional links: Telehealth for FQHCs/RHCs: School-Based Telehealth Part 2, Telehealth for FQHCs/RHCs: School-Based Telehealth Part 3
Date: 03/2022
Sponsoring organization: National Consortium of Telehealth Resource Centers
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