Rural Health
Resources by Topic: Reimbursement and payment models
Center for Medicare and Medicaid Innovation: 2024 Report to Congress
Reports to Congress on payment and service delivery models and initiatives tested or announced by the Center for Medicare and Medicaid Innovation between October 2022 and September 2024. Includes summaries and updates on multiple rural-relevant models and initiatives, including the Accountable Care Organization Realizing Equity, Access, and Community Health (ACO REACH) Model, the Transforming Maternal Health Model, the Pennsylvania Rural Health Model (PARHM), the Vermont All-Payer Accountable Care Organization Model, and more.
Date: 12/2024
Sponsoring organizations: Centers for Medicare and Medicaid Services, U.S. Department of Health and Human Services
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Reports to Congress on payment and service delivery models and initiatives tested or announced by the Center for Medicare and Medicaid Innovation between October 2022 and September 2024. Includes summaries and updates on multiple rural-relevant models and initiatives, including the Accountable Care Organization Realizing Equity, Access, and Community Health (ACO REACH) Model, the Transforming Maternal Health Model, the Pennsylvania Rural Health Model (PARHM), the Vermont All-Payer Accountable Care Organization Model, and more.
Date: 12/2024
Sponsoring organizations: Centers for Medicare and Medicaid Services, U.S. Department of Health and Human Services
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Texas Value-Based Payment and Quality Improvement Advisory Committee Recommendations to the 89th Texas Legislature
Identifies trends and provides policy recommendations related to value based care and quality improvement in Texas. Discusses rural healthcare access and workforce throughout and highlights key reports focusing on rural health.
Date: 12/2024
Sponsoring organization: Texas Health and Human Services
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Identifies trends and provides policy recommendations related to value based care and quality improvement in Texas. Discusses rural healthcare access and workforce throughout and highlights key reports focusing on rural health.
Date: 12/2024
Sponsoring organization: Texas Health and Human Services
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Calendar Year (CY) 2015 Rural Health Clinic (RHC) and Federally Qualified Health Centers (FQHC) Updates: Payment Rate Increases for RHCs and FQHCs Billing Under the All-Inclusive Rate System (AIR), and Urban and Rural Designations for FQHCs Billing Under the AIR
Provides updates for RHCs and FQHCs that are submitting claims to Medicare Administrative Contractors (MACs) for services to Medicare beneficiaries.
Date: 12/2024
Sponsoring organization: Centers for Medicare and Medicaid Services
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Provides updates for RHCs and FQHCs that are submitting claims to Medicare Administrative Contractors (MACs) for services to Medicare beneficiaries.
Date: 12/2024
Sponsoring organization: Centers for Medicare and Medicaid Services
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Dashboard: Arkansas Healthcare Expenditures
Interactive dashboard providing data on medical, pharmacy, and dental expenditures in Arkansas, utilizing the Arkansas Healthcare Transparency Initiative's All-Payer Claims Database for the years 2021-2023. Allows sorting by year, type of coverage, and type of service for individuals, total expenditures, or average annualized expenditures. Breaks down data at the county level by sex, age, payer type, and race/ethnicity.
Date: 11/2024
Sponsoring organization: Arkansas Center for Health Improvement
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Interactive dashboard providing data on medical, pharmacy, and dental expenditures in Arkansas, utilizing the Arkansas Healthcare Transparency Initiative's All-Payer Claims Database for the years 2021-2023. Allows sorting by year, type of coverage, and type of service for individuals, total expenditures, or average annualized expenditures. Breaks down data at the county level by sex, age, payer type, and race/ethnicity.
Date: 11/2024
Sponsoring organization: Arkansas Center for Health Improvement
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Strengthening Independent Primary Care Practice in California: Understanding Small Practice Perspectives
Examines business and financial factors influencing independent primary care practice in California through interviews with physicians in California's Riverside, San Bernardino, and Humboldt counties and other healthcare leaders and subject matter experts. Identifies common concerns and provides recommendations related to healthcare economics, reimbursement, and policy. Discusses topics related to rural practice, including the Rural Health Clinic designation.
Author(s): Jill M. Yegian
Date: 11/2024
Sponsoring organization: California Health Care Foundation
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Examines business and financial factors influencing independent primary care practice in California through interviews with physicians in California's Riverside, San Bernardino, and Humboldt counties and other healthcare leaders and subject matter experts. Identifies common concerns and provides recommendations related to healthcare economics, reimbursement, and policy. Discusses topics related to rural practice, including the Rural Health Clinic designation.
Author(s): Jill M. Yegian
Date: 11/2024
Sponsoring organization: California Health Care Foundation
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RHC Regulatory Changes in 2025 - Medicare Physician Fee Schedule Updates You Need to Know!
Recording of a November 18, 2024, webinar providing an overview of telehealth payment rates for Rural Health Clinics (RHCs) and other regulatory updates and potential changes for 2025. Covers Medicare vaccine reimbursement changes, the elimination of productivity standards, lab requirement changes, intensive outpatient program (IOP) services, telehealth regulations, and more. Part of the Rural Health Clinic Technical Assistance Series.
Additional links: Presentation Slides
Date: 11/2024
Sponsoring organization: National Association of Rural Health Clinics
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Recording of a November 18, 2024, webinar providing an overview of telehealth payment rates for Rural Health Clinics (RHCs) and other regulatory updates and potential changes for 2025. Covers Medicare vaccine reimbursement changes, the elimination of productivity standards, lab requirement changes, intensive outpatient program (IOP) services, telehealth regulations, and more. Part of the Rural Health Clinic Technical Assistance Series.
Additional links: Presentation Slides
Date: 11/2024
Sponsoring organization: National Association of Rural Health Clinics
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State Telehealth Laws and Reimbursement Policies Report, Fall 2024
Provides an overview of state telehealth policies as of early September 2024. Covers Medicaid reimbursement, private payer laws, and professional requirements.
Additional links: Executive Summary, Infographic, State Summary Chart
Date: 11/2024
Sponsoring organization: Center for Connected Health Policy: The National Telehealth Policy Resource Center
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Provides an overview of state telehealth policies as of early September 2024. Covers Medicaid reimbursement, private payer laws, and professional requirements.
Additional links: Executive Summary, Infographic, State Summary Chart
Date: 11/2024
Sponsoring organization: Center for Connected Health Policy: The National Telehealth Policy Resource Center
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January 2025 Annual Rural Emergency Hospital (REH) Monthly Facility Payment Amount
Presents the monthly Rural Emergency Hospital (REH) monthly facility payment amount for Calendar Year 2025.
Date: 11/2024
Sponsoring organization: Centers for Medicare and Medicaid Services
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Presents the monthly Rural Emergency Hospital (REH) monthly facility payment amount for Calendar Year 2025.
Date: 11/2024
Sponsoring organization: Centers for Medicare and Medicaid Services
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Advancing Health Care in Rural, Tribal, and Geographically Isolated Communities: FY2024 Year in Review
Summarizes Centers for Medicare & Medicaid Services (CMS) activities in fiscal year 2024 to advance health and ensure affordable healthcare for people living in rural, tribal, and geographically isolated communities. Covers 6 priority focus areas: applying a community-informed geographic lens; increasing the collection and use of standardized data; strengthening and supporting healthcare professionals; optimizing medical and communication technology; expanding access to comprehensive healthcare coverage, benefits, and services and supports; and driving innovation and value-based care.
Date: 11/2024
Sponsoring organization: Centers for Medicare and Medicaid Services
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Summarizes Centers for Medicare & Medicaid Services (CMS) activities in fiscal year 2024 to advance health and ensure affordable healthcare for people living in rural, tribal, and geographically isolated communities. Covers 6 priority focus areas: applying a community-informed geographic lens; increasing the collection and use of standardized data; strengthening and supporting healthcare professionals; optimizing medical and communication technology; expanding access to comprehensive healthcare coverage, benefits, and services and supports; and driving innovation and value-based care.
Date: 11/2024
Sponsoring organization: Centers for Medicare and Medicaid Services
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Calendar Year (CY) 2025 Medicare Physician Fee Schedule Final Rule
Fact sheet providing an overview of the Centers for Medicare & Medicaid Services (CMS) final rule regarding updates and changes to the Medicare payments under the Physician Fee Schedule (PFS) and other Medicare Part B issues for calendar year 2025. Summarizes provisions related to telehealth services; advanced primary care management services; behavioral health services; opioid treatment programs; dental and oral health services; Rural Health Clinic (RHC) and Federally Qualified Health Center (FQHC) care coordination services, telecommunication services, intensive outpatient program (IOP) services, and payment for vaccine costs; and more.
Date: 11/2024
Sponsoring organization: Centers for Medicare and Medicaid Services
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Fact sheet providing an overview of the Centers for Medicare & Medicaid Services (CMS) final rule regarding updates and changes to the Medicare payments under the Physician Fee Schedule (PFS) and other Medicare Part B issues for calendar year 2025. Summarizes provisions related to telehealth services; advanced primary care management services; behavioral health services; opioid treatment programs; dental and oral health services; Rural Health Clinic (RHC) and Federally Qualified Health Center (FQHC) care coordination services, telecommunication services, intensive outpatient program (IOP) services, and payment for vaccine costs; and more.
Date: 11/2024
Sponsoring organization: Centers for Medicare and Medicaid Services
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