Rural Health
Resources by Topic: Reimbursement and payment models
Independent Evaluation of Comprehensive Primary Care Plus (CPC+): Fourth Annual Report
Reports on the first four 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 regarding care delivery and outcomes for Medicare fee-for-service beneficiaries.
Additional links: Appendices, Findings at a Glance
Date: 05/2022
Sponsoring organizations: Centers for Medicare and Medicaid Services, Mathematica
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Reports on the first four 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 regarding care delivery and outcomes for Medicare fee-for-service beneficiaries.
Additional links: Appendices, Findings at a Glance
Date: 05/2022
Sponsoring organizations: Centers for Medicare and Medicaid Services, Mathematica
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The Future of Telehealth Roundtable: The Potential Impact of Emerging Technologies on Health Equity
Presents insights and key ideas from a roundtable on the future of telehealth following the COVID-19 pandemic, covering barriers to telehealth delivery, opportunities for equitable care, and policy and regulatory issues impacting telehealth access. Includes rural mentions throughout.
Date: 05/2022
Sponsoring organization: National Committee for Quality Assurance
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Presents insights and key ideas from a roundtable on the future of telehealth following the COVID-19 pandemic, covering barriers to telehealth delivery, opportunities for equitable care, and policy and regulatory issues impacting telehealth access. Includes rural mentions throughout.
Date: 05/2022
Sponsoring organization: National Committee for Quality Assurance
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The Impact of COVID-19 on the Rural Health Care Landscape: Challenges and Opportunities
Presents an overview of key findings from interviews with stakeholders in eight states - Iowa, Minnesota, Montana, Nebraska, Nevada, North Dakota, South Dakota, and Wyoming - regarding the rural healthcare landscape. Discusses rural hospital financial health, rural hospital transformation models, challenges facing the rural healthcare workforce, and the role of telehealth in increasing access to care. Provides recommendations aimed at further advancing the use of virtual care in all communities, including rural and frontier areas, beyond the temporary federal COVID-19 public health emergency flexibilities.
Author(s): Sabah Bhatnagar, Julia Harris, Tara Hartnett, et al.
Date: 05/2022
Sponsoring organization: Bipartisan Policy Center
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Presents an overview of key findings from interviews with stakeholders in eight states - Iowa, Minnesota, Montana, Nebraska, Nevada, North Dakota, South Dakota, and Wyoming - regarding the rural healthcare landscape. Discusses rural hospital financial health, rural hospital transformation models, challenges facing the rural healthcare workforce, and the role of telehealth in increasing access to care. Provides recommendations aimed at further advancing the use of virtual care in all communities, including rural and frontier areas, beyond the temporary federal COVID-19 public health emergency flexibilities.
Author(s): Sabah Bhatnagar, Julia Harris, Tara Hartnett, et al.
Date: 05/2022
Sponsoring organization: Bipartisan Policy Center
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The Role of Social Determinants of Health in Value-Based Payment Models During COVID-19: An Evolving Rural Perspective
Recording of an April 2022 webinar discussing how some rural health providers address social determinants of health in their communities and mitigate hardships associated with COVID-19. Highlights strategies using value-based payment models and collaboration with community partners. Transcript is available in the video description.
Additional links: Presentation Slides
Author(s): Alana Knudson
Date: 04/2022
Sponsoring organizations: National Rural Health Resource Center, NORC Walsh Center for Rural Health Analysis
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Recording of an April 2022 webinar discussing how some rural health providers address social determinants of health in their communities and mitigate hardships associated with COVID-19. Highlights strategies using value-based payment models and collaboration with community partners. Transcript is available in the video description.
Additional links: Presentation Slides
Author(s): Alana Knudson
Date: 04/2022
Sponsoring organizations: National Rural Health Resource Center, NORC Walsh Center for Rural Health Analysis
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Rural Health Quality: How CMS Initiatives Improve How We Measure and Address Gaps in Care
Recording of an April 2022 webinar regarding healthcare quality measurement in rural areas. Discusses measurement challenges in rural areas and how CMS is working to mitigate these issues. Presents resources and programs for rural providers to improve healthcare quality. Transcript is available by clicking the three dots above the video description, then selecting Show Transcript.
Additional links: Presentation Slides
Date: 04/2022
Sponsoring organization: Centers for Medicare and Medicaid Services
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Recording of an April 2022 webinar regarding healthcare quality measurement in rural areas. Discusses measurement challenges in rural areas and how CMS is working to mitigate these issues. Presents resources and programs for rural providers to improve healthcare quality. Transcript is available by clicking the three dots above the video description, then selecting Show Transcript.
Additional links: Presentation Slides
Date: 04/2022
Sponsoring organization: Centers for Medicare and Medicaid Services
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April 2022 MedPAC Meeting Transcript
Transcript from the Medicare Payment Advisory Commission's (MedPAC) April 2022 meeting. Covers high prices of drugs covered under Medicare Part B, initial findings from MedPAC's analysis of Part D data on drug rebates and discounts, segmentation in the stand-alone Part D prescription drug plan market, leveraging Medicare policies to address social determinants of health, an approach to streamline and harmonize Medicare's portfolio of alternative payment models, and aligning fee-for-service payment rates across ambulatory settings. Includes rural references throughout.
Date: 04/2022
Sponsoring organization: Medicare Payment Advisory Commission
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Transcript from the Medicare Payment Advisory Commission's (MedPAC) April 2022 meeting. Covers high prices of drugs covered under Medicare Part B, initial findings from MedPAC's analysis of Part D data on drug rebates and discounts, segmentation in the stand-alone Part D prescription drug plan market, leveraging Medicare policies to address social determinants of health, an approach to streamline and harmonize Medicare's portfolio of alternative payment models, and aligning fee-for-service payment rates across ambulatory settings. Includes rural references throughout.
Date: 04/2022
Sponsoring organization: Medicare Payment Advisory Commission
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Medicare's Prospective Payment System for Inpatient Psychiatric Facilities at 15 Years
Examine how Medicare enrollees' use of inpatient psychiatric facility (IPF) services and the characteristics of IPFs have changed since the introduction of the IPF-PPS in 2005. Explores whether there have been changes in events that occur before or after IPF stays that may indicate potential changes in the quality of services. Includes information on per diem costs for rural IPFs compared to urban facilities.
Date: 04/2022
Sponsoring organizations: Medicare Payment Advisory Commission, Urban Institute
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Examine how Medicare enrollees' use of inpatient psychiatric facility (IPF) services and the characteristics of IPFs have changed since the introduction of the IPF-PPS in 2005. Explores whether there have been changes in events that occur before or after IPF stays that may indicate potential changes in the quality of services. Includes information on per diem costs for rural IPFs compared to urban facilities.
Date: 04/2022
Sponsoring organizations: Medicare Payment Advisory Commission, Urban Institute
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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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