Rural Health
Resources by Topic: Reimbursement and payment models
Final CY 2022 Physician Fee Schedule
Fact sheet addressing the Centers for Medicare and Medicaid Services policies for Medicare beginning on January 1, 2022. Includes sections on telehealth services, the Consolidated Appropriations Act, audio-only services, communications technology based services, Federally Qualified Health Centers and Rural Health Clinics, and additional policies.
Date: 11/2021
Sponsoring organization: Center for Connected Health Policy: The National Telehealth Policy Resource Center
view details
Fact sheet addressing the Centers for Medicare and Medicaid Services policies for Medicare beginning on January 1, 2022. Includes sections on telehealth services, the Consolidated Appropriations Act, audio-only services, communications technology based services, Federally Qualified Health Centers and Rural Health Clinics, and additional policies.
Date: 11/2021
Sponsoring organization: Center for Connected Health Policy: The National Telehealth Policy Resource Center
view details
Assessment of State and Federal Health Policies for Opioid Use Disorder Treatment During the COVID-19 Pandemic and Beyond
Examines state-level policy data from government and nonprofit agencies related to treatment access and treatment retention for patients with Opioid Use Disorder (OUD) during the COVID-19 pandemic. Describes policy changes affecting telehealth coverage, delivery, and payment; issues of licensing and security; and the initiation and dispensing of treatment medications.
Author(s): Seema Chosky Pessar, Anne Boustead, Yimin Ge, Rosanna Smart, Rosalie Liccardo Pacula
Citation: JAMA Health Forum, 2(11), e213833
Date: 11/2021
view details
Examines state-level policy data from government and nonprofit agencies related to treatment access and treatment retention for patients with Opioid Use Disorder (OUD) during the COVID-19 pandemic. Describes policy changes affecting telehealth coverage, delivery, and payment; issues of licensing and security; and the initiation and dispensing of treatment medications.
Author(s): Seema Chosky Pessar, Anne Boustead, Yimin Ge, Rosanna Smart, Rosalie Liccardo Pacula
Citation: JAMA Health Forum, 2(11), e213833
Date: 11/2021
view details
Improving Health in Rural Communities: FY 2021 Year in Review
Provides an overview of Centers for Medicaid and Medicare Services (CMS) programs and activities that have affected rural health and healthcare in fiscal year 2021. Focuses on 10 priority areas: COVID-19, Federally-facilitated and State Marketplaces; Medicare payment and policy; practitioner workforce; Medicaid and Children's Health Insurance Program (CHIP) enrollment, payment, and policy; long-term services and supports; maternal health; mental health and substance use disorders; models and demonstrations, and quality and equity.
Date: 11/2021
Sponsoring organization: Centers for Medicare and Medicaid Services
view details
Provides an overview of Centers for Medicaid and Medicare Services (CMS) programs and activities that have affected rural health and healthcare in fiscal year 2021. Focuses on 10 priority areas: COVID-19, Federally-facilitated and State Marketplaces; Medicare payment and policy; practitioner workforce; Medicaid and Children's Health Insurance Program (CHIP) enrollment, payment, and policy; long-term services and supports; maternal health; mental health and substance use disorders; models and demonstrations, and quality and equity.
Date: 11/2021
Sponsoring organization: Centers for Medicare and Medicaid Services
view details
Medicare: Information on the Transition to Alternative Payment Models by Providers in Rural, Health Professional Shortage, or Underserved Areas
Describes the participation of providers in rural and health professional shortage areas in Advanced APMs from 2017 through 2019. Discusses challenges providers in rural, shortage, and underserved areas face in transitioning to APMs, as well as actions CMS takes to help these providers transition to APMs. Includes data by practice and provider type.
Additional links: Full Report
Date: 11/2021
Sponsoring organization: Government Accountability Office
view details
Describes the participation of providers in rural and health professional shortage areas in Advanced APMs from 2017 through 2019. Discusses challenges providers in rural, shortage, and underserved areas face in transitioning to APMs, as well as actions CMS takes to help these providers transition to APMs. Includes data by practice and provider type.
Additional links: Full Report
Date: 11/2021
Sponsoring organization: Government Accountability Office
view details
Using CPT Charges as an Economic Proxy for Telehealth and Non-telehealth Emergency Department Utilization
Explores the characteristics of a dataset comprising rural hospitals' reported Current Procedural Terminology (CPT) codes and associated charges for a sample of telehealth and non-telehealth emergency department (ED) visits. Features statistics including number of ED cases and controls selected by diagnosis, and demographics on select ED samples with breakdowns by 4 CPT codes.
Author(s): Marcia M. Ward, Knute D. Carter, Fred Ullrich, Kimberly A.S. Merchant
Date: 11/2021
Sponsoring organization: Rural Telehealth Research Center
view details
Explores the characteristics of a dataset comprising rural hospitals' reported Current Procedural Terminology (CPT) codes and associated charges for a sample of telehealth and non-telehealth emergency department (ED) visits. Features statistics including number of ED cases and controls selected by diagnosis, and demographics on select ED samples with breakdowns by 4 CPT codes.
Author(s): Marcia M. Ward, Knute D. Carter, Fred Ullrich, Kimberly A.S. Merchant
Date: 11/2021
Sponsoring organization: Rural Telehealth Research Center
view details
Rural Emergency Hospital: Policy Brief and Recommendations to the Secretary
Describes the development of the Rural Emergency Hospital (REH) designation in response to rural hospital closures and issues accessing emergency care. Lists statutory requirements for hospitals wishing to become an REH, and offers policy recommendations related to participation conditions, quality reporting, reimbursement, and emergency medical transfer agreement.
Date: 10/2021
Sponsoring organization: National Advisory Committee on Rural Health and Human Services
view details
Describes the development of the Rural Emergency Hospital (REH) designation in response to rural hospital closures and issues accessing emergency care. Lists statutory requirements for hospitals wishing to become an REH, and offers policy recommendations related to participation conditions, quality reporting, reimbursement, and emergency medical transfer agreement.
Date: 10/2021
Sponsoring organization: National Advisory Committee on Rural Health and Human Services
view details
Rural Nevada EMS Capacity Assessment
Presents results of a 2020 survey of 36 rural EMS agencies, addressing transporting patients, funding and billing, workforce and recruitment issues, health information technology, and more.
Author(s): Laima Etchegoyhen, John Packham, Tabor Griswold, Jeannine Warner
Date: 10/2021
Sponsoring organization: Nevada Health Workforce Research Center
view details
Presents results of a 2020 survey of 36 rural EMS agencies, addressing transporting patients, funding and billing, workforce and recruitment issues, health information technology, and more.
Author(s): Laima Etchegoyhen, John Packham, Tabor Griswold, Jeannine Warner
Date: 10/2021
Sponsoring organization: Nevada Health Workforce Research Center
view details
2021 CMS Hospital Quality Star Ratings of Rural Hospitals
Results of a study comparing the 2021 Centers for Medicare & Medicaid Services (CMS) Hospital Quality Star Rating results for rural and urban hospitals, comparing the 2021 and 2016 results for rural hospitals, and identifying implications for the usefulness of these ratings for rural hospitals. Features statistics including percentages of hospitals by Star Ratings with breakdowns by urban or rural location, and numbers of unrated rural hospitals by Medicare payment classification, net patient revenue, and census region.
Author(s): Laura Bozovich, Randall John, Kristie Thompson, George H. Pink
Date: 10/2021
Sponsoring organization: North Carolina Rural Health Research Program
view details
Results of a study comparing the 2021 Centers for Medicare & Medicaid Services (CMS) Hospital Quality Star Rating results for rural and urban hospitals, comparing the 2021 and 2016 results for rural hospitals, and identifying implications for the usefulness of these ratings for rural hospitals. Features statistics including percentages of hospitals by Star Ratings with breakdowns by urban or rural location, and numbers of unrated rural hospitals by Medicare payment classification, net patient revenue, and census region.
Author(s): Laura Bozovich, Randall John, Kristie Thompson, George H. Pink
Date: 10/2021
Sponsoring organization: North Carolina Rural Health Research Program
view details
Driving Health System Transformation - A Strategy for the CMS Innovation Center's Second Decade
White paper describing the new vision and strategic objectives for the Center for Medicare and Medicaid Innovation (CMS Innovation Center) for the next 10 years that seeks to achieve equitable health outcomes through the provision of high-quality, affordable, person-centered care. Shares beneficiary and healthcare provider goals for each strategic objective in Table 2. Strategic objectives include: driving accountable care, advancing health equity, supporting innovation, addressing affordability, and partnering to achieve healthcare system transformation. Includes discussion on models focused on improving rural health and ways of increasing participation in those models in rural and underserved areas.
Additional links: At a Glance
Date: 10/2021
Sponsoring organization: Centers for Medicare and Medicaid Services
view details
White paper describing the new vision and strategic objectives for the Center for Medicare and Medicaid Innovation (CMS Innovation Center) for the next 10 years that seeks to achieve equitable health outcomes through the provision of high-quality, affordable, person-centered care. Shares beneficiary and healthcare provider goals for each strategic objective in Table 2. Strategic objectives include: driving accountable care, advancing health equity, supporting innovation, addressing affordability, and partnering to achieve healthcare system transformation. Includes discussion on models focused on improving rural health and ways of increasing participation in those models in rural and underserved areas.
Additional links: At a Glance
Date: 10/2021
Sponsoring organization: Centers for Medicare and Medicaid Services
view details
Medicare: Provider Performance and Experiences Under the Merit-Based Incentive Payment System
Examines Centers for Medicare and Medicaid Services (CMS) data on Merit-Based Incentive Payment System (MIPS) performance category scores, final scores, and payment adjustments from performance years 2017 through 2019. Summarizes interviews with 11 stakeholder groups and identifies strengths and challenges of the MIPS program. Presents data on MIPS performance scores and related payment adjustments by practice size, geographic location, method of participation, and specialty.
Additional links: Full Report
Date: 10/2021
Sponsoring organization: Government Accountability Office
view details
Examines Centers for Medicare and Medicaid Services (CMS) data on Merit-Based Incentive Payment System (MIPS) performance category scores, final scores, and payment adjustments from performance years 2017 through 2019. Summarizes interviews with 11 stakeholder groups and identifies strengths and challenges of the MIPS program. Presents data on MIPS performance scores and related payment adjustments by practice size, geographic location, method of participation, and specialty.
Additional links: Full Report
Date: 10/2021
Sponsoring organization: Government Accountability Office
view details