Rural Health
Resources by Topic: Reimbursement and payment models
MedPAC Report to the Congress: Medicare and the Health Care Delivery System, June 2020
Evaluates Medicare payment issues and offers recommendations to the U.S. Congress. Includes chapters on value-based payment in Medicare, Accountable Care Organizations (ACOs), the Medicare Advantage quality bonus program, the impact of changes in the 21st Century Cures Act to risk adjustment for Medicare Advantage enrollees, Medicare Part D, separately payable drugs in the hospital outpatient prospective payment system, and the Medicare end-stage renal disease prospective payment system. Examines the current payment policy for low-volume and rural dialysis facilities and proposes changes.
Additional links: Executive Summary
Date: 06/2020
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
view details
Evaluates Medicare payment issues and offers recommendations to the U.S. Congress. Includes chapters on value-based payment in Medicare, Accountable Care Organizations (ACOs), the Medicare Advantage quality bonus program, the impact of changes in the 21st Century Cures Act to risk adjustment for Medicare Advantage enrollees, Medicare Part D, separately payable drugs in the hospital outpatient prospective payment system, and the Medicare end-stage renal disease prospective payment system. Examines the current payment policy for low-volume and rural dialysis facilities and proposes changes.
Additional links: Executive Summary
Date: 06/2020
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
view details
Report to Congress on Medicaid and CHIP, June 2020
Semi-annual report to Congress from the Medicaid and CHIP Payment and Access Commission (MACPAC). Discusses care integration for beneficiaries dually eligible for Medicaid and Medicare, recommendations for increasing enrollment in Medicare Shared Savings Programs, the role of Medicaid in relation to TRICARE, how to address increasing mortality and morbidity among pregnant and postpartum women, and the effects of substance use disorder on pregnant and postpartum women and their infants. Includes rural references throughout.
Date: 06/2020
Type: Document
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
view details
Semi-annual report to Congress from the Medicaid and CHIP Payment and Access Commission (MACPAC). Discusses care integration for beneficiaries dually eligible for Medicaid and Medicare, recommendations for increasing enrollment in Medicare Shared Savings Programs, the role of Medicaid in relation to TRICARE, how to address increasing mortality and morbidity among pregnant and postpartum women, and the effects of substance use disorder on pregnant and postpartum women and their infants. Includes rural references throughout.
Date: 06/2020
Type: Document
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
view details
RHC COVID-19 Testing Funds: What You Need to Know
Recording of a May 26, 2020, webinar providing information about the funding appropriated by the Congress as part of the Coronavirus Aid, Relief, and Economic Security (CARES) Act for Rural Health Clinics (RHCs) to support COVID-19 testing and related activities. Discusses the specific terms and conditions RHCs will have to meet when spending the money to defeat the pandemic. Part of the Rural Health Clinic Technical Assistance Series.
Additional links: Presentation Slides, Transcript
Date: 05/2020
Type: Video/Multimedia
Sponsoring organization: National Association of Rural Health Clinics
view details
Recording of a May 26, 2020, webinar providing information about the funding appropriated by the Congress as part of the Coronavirus Aid, Relief, and Economic Security (CARES) Act for Rural Health Clinics (RHCs) to support COVID-19 testing and related activities. Discusses the specific terms and conditions RHCs will have to meet when spending the money to defeat the pandemic. Part of the Rural Health Clinic Technical Assistance Series.
Additional links: Presentation Slides, Transcript
Date: 05/2020
Type: Video/Multimedia
Sponsoring organization: National Association of Rural Health Clinics
view details
Health Panel Comment Letter – Maternal and Infant Health Care in Rural Communities
Offers comments in response to the CMS Maternal and Infant Health Care in Rural Communities Request for Information. Describes Medicare cost reporting challenges for obstetric services at Critical Access Hospitals and possible changes to maternal health coverage under Medicaid.
Date: 05/2020
Type: Document
Sponsoring organization: Rural Policy Research Institute Rural Health Panel
view details
Offers comments in response to the CMS Maternal and Infant Health Care in Rural Communities Request for Information. Describes Medicare cost reporting challenges for obstetric services at Critical Access Hospitals and possible changes to maternal health coverage under Medicaid.
Date: 05/2020
Type: Document
Sponsoring organization: Rural Policy Research Institute Rural Health Panel
view details
Fact Sheet: Rural Community Hospital (RCH) Demonstration
Provides an overview of the Rural Community Hospital demonstration program. Describes reimbursement challenges that rural hospitals face and the early results of the program.
Date: 05/2020
Type: Document
Sponsoring organization: American Hospital Association
view details
Provides an overview of the Rural Community Hospital demonstration program. Describes reimbursement challenges that rural hospitals face and the early results of the program.
Date: 05/2020
Type: Document
Sponsoring organization: American Hospital Association
view details
COVID-19's Current Impact on Rural Healthcare Delivery: Q&A with Brock Slabach
An interview with Brock Slabach, the National Rural Health Association's Senior Vice President for Member Services. Discusses the impact of COVID-19 on rural healthcare facilities, policy changes impacting rural providers, collaboration among rural communities to help share solutions, and the use of telehealth during the pandemic.
Author(s): Kay Miller Temple
Citation: Rural Monitor
Date: 05/2020
Type: Document
Sponsoring organization: Rural Health Information Hub
view details
An interview with Brock Slabach, the National Rural Health Association's Senior Vice President for Member Services. Discusses the impact of COVID-19 on rural healthcare facilities, policy changes impacting rural providers, collaboration among rural communities to help share solutions, and the use of telehealth during the pandemic.
Author(s): Kay Miller Temple
Citation: Rural Monitor
Date: 05/2020
Type: Document
Sponsoring organization: Rural Health Information Hub
view details
Estimated Reduction in CAH Profitability from Loss of Cost-Based Reimbursement for Swing Beds
Examines the impact of proposed legislation recommending changes to swing bed reimbursements for Critical Access Hospitals (CAHs) from cost-based to the Skilled Nursing Facility Prospective Payment System (SNF PPS). Estimates CAH profitability using reimbursement formulas from Medicare cost reports and discusses the characteristics of CAHs most affected by a change in swing bed reimbursement.
Author(s): Drake M. Broussard, Kristin L. Reiter
Date: 05/2020
Type: Document
Sponsoring organization: North Carolina Rural Health Research Program
view details
Examines the impact of proposed legislation recommending changes to swing bed reimbursements for Critical Access Hospitals (CAHs) from cost-based to the Skilled Nursing Facility Prospective Payment System (SNF PPS). Estimates CAH profitability using reimbursement formulas from Medicare cost reports and discusses the characteristics of CAHs most affected by a change in swing bed reimbursement.
Author(s): Drake M. Broussard, Kristin L. Reiter
Date: 05/2020
Type: Document
Sponsoring organization: North Carolina Rural Health Research Program
view details
April 2020 MedPAC Meeting Transcript
Transcript from the Medicare Payment Advisory Commission's (MedPAC) April 2020 meeting. Covers value-based payment in Medicare, challenges in maintaining and increasing savings from accountable care organizations, incentives in Medicare Part D, the Medicare Advantage quality bonus program, and Medicare's end-stage renal disease (ESRD) prospective payment system. Includes a discussion of ESRD payment adjustments for rural and low-volume providers.
Date: 04/2020
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
view details
Transcript from the Medicare Payment Advisory Commission's (MedPAC) April 2020 meeting. Covers value-based payment in Medicare, challenges in maintaining and increasing savings from accountable care organizations, incentives in Medicare Part D, the Medicare Advantage quality bonus program, and Medicare's end-stage renal disease (ESRD) prospective payment system. Includes a discussion of ESRD payment adjustments for rural and low-volume providers.
Date: 04/2020
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
view details
An Initiative to Implement Immediate Postpartum Long-Acting Reversible Contraception in Rural New Mexico
Study examining 7 rural hospitals in New Mexico and their efforts to implement immediate postpartum (IPP) long-acting reversible contraception (LARC) through a program offered by the New Mexico Perinatal Collaborative. Discusses challenges to implementing the program, including reimbursement obstacles, based on interviews with 20 key staff members.
Author(s): Hannah C. Palm, James H. Degnan, Sharla D. Biefeld, et al.
Citation: American Journal of Obstetrics and Gynecology, 222, S911, 1-7
Date: 04/2020
Type: Document
view details
Study examining 7 rural hospitals in New Mexico and their efforts to implement immediate postpartum (IPP) long-acting reversible contraception (LARC) through a program offered by the New Mexico Perinatal Collaborative. Discusses challenges to implementing the program, including reimbursement obstacles, based on interviews with 20 key staff members.
Author(s): Hannah C. Palm, James H. Degnan, Sharla D. Biefeld, et al.
Citation: American Journal of Obstetrics and Gynecology, 222, S911, 1-7
Date: 04/2020
Type: Document
view details
How & What Will Medicare Pay for RHC Telehealth Visits
Recording of an April 20, 2020 webinar providing information about the Coronavirus Aid, Relief, and Economic Security Act (CARES Act) authorizing Rural Health Clinics (RHCs) to provide telehealth services to Medicare beneficiaries during the COVID-19 public health emergency. Discusses payment procedures for telehealth visits, commonly used telehealth coding, and appropriate cost reporting. Part of the Rural Health Clinic Technical Assistance Series.
Additional links: Presentation Slides, Transcript
Date: 04/2020
Type: Video/Multimedia
Sponsoring organization: National Association of Rural Health Clinics
view details
Recording of an April 20, 2020 webinar providing information about the Coronavirus Aid, Relief, and Economic Security Act (CARES Act) authorizing Rural Health Clinics (RHCs) to provide telehealth services to Medicare beneficiaries during the COVID-19 public health emergency. Discusses payment procedures for telehealth visits, commonly used telehealth coding, and appropriate cost reporting. Part of the Rural Health Clinic Technical Assistance Series.
Additional links: Presentation Slides, Transcript
Date: 04/2020
Type: Video/Multimedia
Sponsoring organization: National Association of Rural Health Clinics
view details