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Rural Health Information Hub

Rural Health
Resources by Topic: Reimbursement and payment models

MedPAC Report to the Congress: Medicare Payment Policy, 2022
Annual review of Medicare payment policies, with recommendations to Congress. Includes discussion on Medicare payment policies directly affecting rural providers and beneficiaries. Addresses payment adequacy for healthcare facilities and services, improving Medicare payment for post-acute care, Medicare Advantage, Medicare Part D, and the impact of healthcare provider consolidation.
Date: 03/2022
Sponsoring organization: Medicare Payment Advisory Commission
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Vermont's All-Payer Accountable Care Organization Model: Mt. Ascutney Hospital and Health Center's Experience
Profiles Mt. Ascutney Hospital and Health Center (MAHHC), a Critical Access Hospital and health center partnership in central Vermont. Describes how MAHHC provides care differently as a participant in the OneCare Vermont accountable care organization (ACO). Discusses how MAHHC adapted healthcare delivery during the COVID-19 pandemic. Highlights challenges and financial implications of MAHHC's participation in OneCare Vermont.
Date: 03/2022
Sponsoring organization: Rural Health Value
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Report to Congress on Medicaid and CHIP, March 2022
Reports on five aspects of Medicaid: 1) transitioning Medicaid beneficiaries out of institutions and back into the community under the Money Follows the Person (MFP) demonstration program, 2) improving access to vaccines and vaccination rates for adults enrolled in Medicaid, and 3) reviewing hospital payment policy for the nation's safety-net hospitals. Chapter 3 examines the relationship between disproportionate share hospital (DSH) allotments to states and the number of uninsured individuals, the amounts and sources of hospitals' uncompensated care costs, and the amounts and sources of hospitals' uncompensated care costs. Table 3-1 details DSH spending for urban and rural hospitals and for Critical Access Hospitals.
Date: 03/2022
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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Indian Health Service: Information on Third-Party Collections and Processes to Procure Supplies and Services
Reviews the Indian Health Service (IHS) oversight of collections received from third-party payers such as Medicare, Medicaid, and private insurance for care provided to patients. Examines recent trends in third-party collections; describes IHS's processes to procure medical supplies, pharmaceuticals, and health care services; and discusses the extent to which IHS has entered into procurement contracts under the Buy Indian Act.
Additional links: Full Report
Date: 03/2022
Sponsoring organization: Government Accountability Office
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Stability of the Rural Health Safety Net: State and National Data Tables
Provides links to national and state data tables showing the financial impact of federal policies such as sequestration and bad debt reimbursement on rural hospital revenues, jobs, and gross domestic product. Presented at the February 2022 National Rural Health Association Policy Institute.
Date: 02/2022
Sponsoring organization: Chartis Center for Rural Health
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Medicare: Information on Geographic Adjustments to Physician Payments for Physicians' Time, Skills, and Effort
Provides an overview of the work geographic practice cost indices (GPCI), which the Centers for Medicare & Medicaid Services uses to adjust Medicare physician payments to account for differences in the costs of providing care across various geographic locations. Examines the extent to which the work GPCI accounts for geographic variation in physician earnings and how Medicare payments could change under potential modifications to the work GPCI.
Additional links: Full Report
Date: 02/2022
Sponsoring organization: Government Accountability Office
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Structural Factors That Impact Rural Life Expectancy
Policy position paper focused on challenges to improving life expectancy in rural areas. Offers policy recommendations to address health outcomes in rural populations.
Author(s): Bryan Price, Elizabeth Ruen, Wade Swenson
Date: 02/2022
Sponsoring organization: National Rural Health Association
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Rural Health Clinics
Policy position paper providing an overview of Rural Health Clinics. Offers policy recommendations regarding access to care, RHC reimbursement, and programmatic updates.
Author(s): Kelly Braun, Trent Bourland
Date: 02/2022
Sponsoring organization: National Rural Health Association
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Rural Emergency Hospital Conversion: Critical Factors for EMS Support
Policy position paper focused on emergency medical services (EMS) in communities with hospitals converting to Rural Emergency Hospital (REH) status. Outlines barriers to EMS delivery in rural areas including funding, workforce, and community engagement and support. Includes policy recommendations.
Author(s): Julie Bosak, Jed Hansen
Date: 02/2022
Sponsoring organization: National Rural Health Association
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Medicaid and Counties: Understanding the Program and Why It Matters to Counties
Discusses the importance of Medicaid in county-level healthcare. Describes the role Medicaid plays in financing and delivering healthcare for children, the elderly, the disabled, and rural residents. Highlights the impact of COVID-19 on the Medicaid program and challenges for county governments.
Date: 02/2022
Sponsoring organization: National Association of Counties
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