Rural Health
Resources by Topic: Reimbursement and payment models
Tackling America's Mental Health and Addiction Crisis Through Primary Care Integration
Explores how primary and behavioral healthcare integration can overcome the unmet needs for mental health and substance use services. Discusses barriers to integrated care delivery. Offers policy recommendations to improve the integration of primary and behavioral healthcare services through enhanced payments, training, and technical assistance, and improving access to behavioral health providers for consultation and referral.
Additional links: Infographic
Date: 03/2021
Sponsoring organization: Bipartisan Policy Center
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Explores how primary and behavioral healthcare integration can overcome the unmet needs for mental health and substance use services. Discusses barriers to integrated care delivery. Offers policy recommendations to improve the integration of primary and behavioral healthcare services through enhanced payments, training, and technical assistance, and improving access to behavioral health providers for consultation and referral.
Additional links: Infographic
Date: 03/2021
Sponsoring organization: Bipartisan Policy Center
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Update to Rural Health Clinic (RHC) Payment Limits
Provides an overview of the updates to Rural Health Clinic (RHC) payment limits per visit beginning April 1, 2021, through 2028.
Date: 03/2021
Sponsoring organization: Centers for Medicare and Medicaid Services
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Provides an overview of the updates to Rural Health Clinic (RHC) payment limits per visit beginning April 1, 2021, through 2028.
Date: 03/2021
Sponsoring organization: Centers for Medicare and Medicaid Services
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Which Hospitals Could Be Financially Affected by a Public Option?
Describes the potential impacts of a public option health insurance plan on hospital finances, including rural hospitals. Analyzes hospital discharge data to identify hospitals that had a greater share of total charges paid by private insurance across 25 states. Presents data by hospital and patient characteristics.
Author(s): Anuj Gangopadhyaya, Claire O'Brien
Date: 03/2021
Sponsoring organization: Urban Institute
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Describes the potential impacts of a public option health insurance plan on hospital finances, including rural hospitals. Analyzes hospital discharge data to identify hospitals that had a greater share of total charges paid by private insurance across 25 states. Presents data by hospital and patient characteristics.
Author(s): Anuj Gangopadhyaya, Claire O'Brien
Date: 03/2021
Sponsoring organization: Urban Institute
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MedPAC Report to the Congress: Medicare Payment Policy, 2021
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. Contains information on the effects of the COVID-19 pandemic on Medicare beneficiary healthcare access, mortality, and service use. Presents an option for Medicare's coverage of telehealth beyond the public health emergency.
Date: 03/2021
Sponsoring organization: Medicare Payment Advisory Commission
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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. Contains information on the effects of the COVID-19 pandemic on Medicare beneficiary healthcare access, mortality, and service use. Presents an option for Medicare's coverage of telehealth beyond the public health emergency.
Date: 03/2021
Sponsoring organization: Medicare Payment Advisory Commission
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Report to Congress on Medicaid and CHIP, March 2021
Reports on five aspects of Medicaid: 1) improving Medicaid's responsiveness during economic downturns; 2) addressing concerns about high rates of maternal morbidity and mortality; 3) reexamining Medicaid's estate recovery policies; 4) integrating care for people who are dually eligible for Medicaid and Medicare; and 5) improving hospital payment policy for the nation's safety-net hospitals. Chapter 5 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 number of hospitals with high levels of uncompensated care that also provide essential community services. Table 5-1 details DSH spending for urban and rural hospitals and for Critical Access Hospitals.
Date: 03/2021
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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Reports on five aspects of Medicaid: 1) improving Medicaid's responsiveness during economic downturns; 2) addressing concerns about high rates of maternal morbidity and mortality; 3) reexamining Medicaid's estate recovery policies; 4) integrating care for people who are dually eligible for Medicaid and Medicare; and 5) improving hospital payment policy for the nation's safety-net hospitals. Chapter 5 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 number of hospitals with high levels of uncompensated care that also provide essential community services. Table 5-1 details DSH spending for urban and rural hospitals and for Critical Access Hospitals.
Date: 03/2021
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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2021 RHC Billing and Coding Update
Recording of a March 9, 2021, webinar providing an overview of coding and billing changes relevant to Rural Health Clinics (RHCs). Discusses guidelines for reporting COVID-19 immunizations and monoclonal antibody infusions, telehealth coding and billing during the COVID-19 public health emergency, ICD-10-CM diagnosis coding for COVID-19, and RHC lab billing and COVID test reporting. Part of the Rural Health Clinic Technical Assistance Series.
Additional links: AMA Code & Guideline Changes, COVID Vaccine Log, Presentation Slides, Transcript
Date: 03/2021
Sponsoring organization: National Association of Rural Health Clinics
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Recording of a March 9, 2021, webinar providing an overview of coding and billing changes relevant to Rural Health Clinics (RHCs). Discusses guidelines for reporting COVID-19 immunizations and monoclonal antibody infusions, telehealth coding and billing during the COVID-19 public health emergency, ICD-10-CM diagnosis coding for COVID-19, and RHC lab billing and COVID test reporting. Part of the Rural Health Clinic Technical Assistance Series.
Additional links: AMA Code & Guideline Changes, COVID Vaccine Log, Presentation Slides, Transcript
Date: 03/2021
Sponsoring organization: National Association of Rural Health Clinics
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Medicare Hospital Payments: Adjusting for Variation in Geographic Area Wages
Provides an overview of the use of the hospital wage index applied to the Medicare inpatient prospective payment system (IPPS) to account for geographic differences in hospitals' labor costs. Discusses the effect of the wage index on Medicare payments for inpatient hospital services, exceptions to wage index adjustments, and proposals for wage index reforms.
Date: 03/2021
Sponsoring organization: Congressional Research Service
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Provides an overview of the use of the hospital wage index applied to the Medicare inpatient prospective payment system (IPPS) to account for geographic differences in hospitals' labor costs. Discusses the effect of the wage index on Medicare payments for inpatient hospital services, exceptions to wage index adjustments, and proposals for wage index reforms.
Date: 03/2021
Sponsoring organization: Congressional Research Service
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Sustainability Strategies for Community-based Palliative Care
Summarizes themes from two roundtable discussions conducted in late 2018 with 9 rural palliative care programs in Minnesota and surrounding states. Offers examples and resources for sustainability strategies to support community-based palliative care programs.
Date: 03/2021
Sponsoring organization: Stratis Health
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Summarizes themes from two roundtable discussions conducted in late 2018 with 9 rural palliative care programs in Minnesota and surrounding states. Offers examples and resources for sustainability strategies to support community-based palliative care programs.
Date: 03/2021
Sponsoring organization: Stratis Health
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Primary Care in the United States: A Chartbook of Facts and Statistics
Examines aspects of primary care in the United States, including facts and figures on patient contact with primary care, frequency and range of conditions seen in primary care, care coordination, scope of practice, payment models, and preventive care visit utilization. Features statistics on percentage of primary care physicians by geography, with breakdowns by urban, large rural, small rural, and isolated rural location.
Author(s): Brian Antono, Andrew Bazemore, Irene Dankwa-Mullan, et al.
Date: 02/2021
Sponsoring organization: Robert Graham Center
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Examines aspects of primary care in the United States, including facts and figures on patient contact with primary care, frequency and range of conditions seen in primary care, care coordination, scope of practice, payment models, and preventive care visit utilization. Features statistics on percentage of primary care physicians by geography, with breakdowns by urban, large rural, small rural, and isolated rural location.
Author(s): Brian Antono, Andrew Bazemore, Irene Dankwa-Mullan, et al.
Date: 02/2021
Sponsoring organization: Robert Graham Center
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Medicare Reimbursement in Rural America
Policy brief discussing Medicare reimbursement for services provided at rural hospitals and how it impacts hospital finances. Provides policy recommendations for rural health reimbursement, and identifies and other considerations for addressing rural healthcare sustainability.
Author(s): Eric Schlidt, Cody Wilkinson
Date: 02/2021
Sponsoring organization: National Rural Health Association
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Policy brief discussing Medicare reimbursement for services provided at rural hospitals and how it impacts hospital finances. Provides policy recommendations for rural health reimbursement, and identifies and other considerations for addressing rural healthcare sustainability.
Author(s): Eric Schlidt, Cody Wilkinson
Date: 02/2021
Sponsoring organization: National Rural Health Association
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