Rural Health
Resources by Topic: Reimbursement and payment models
Public Law 116-136: Coronavirus Aid, Relief, and Economic Security (CARES) Act
Text of the Coronavirus Aid, Relief, and Economic Security (CARES) Act, Public Law 116-136 (March 27, 2020). Outlines telehealth flexibilities to support providers and enhance access to care during the COVID-19 Public Health Emergency. Among other things, the CARES Act allows Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs) to serve as distant sites to provide telehealth services to patients in their homes during the public health emergency (PHE); establishes the Paycheck Protection Program (PPP); extends the ability to order home health services to physician assistants, nurse practitioners, and certified nurse specialists; and provides additional funding to the Federal Communications Commission (FCC) to enable the provision of telehealth services.
Date: 03/2020
Type: Document
Sponsoring organization: U.S. Congress
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Text of the Coronavirus Aid, Relief, and Economic Security (CARES) Act, Public Law 116-136 (March 27, 2020). Outlines telehealth flexibilities to support providers and enhance access to care during the COVID-19 Public Health Emergency. Among other things, the CARES Act allows Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs) to serve as distant sites to provide telehealth services to patients in their homes during the public health emergency (PHE); establishes the Paycheck Protection Program (PPP); extends the ability to order home health services to physician assistants, nurse practitioners, and certified nurse specialists; and provides additional funding to the Federal Communications Commission (FCC) to enable the provision of telehealth services.
Date: 03/2020
Type: Document
Sponsoring organization: U.S. Congress
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March 2020 MedPAC Meeting Transcript
Transcript from the Medicare Payment Advisory Commission's (MedPAC) March 2020 meeting. Covers Medicare Shared Savings Program vulnerabilities, the role of specialists in alternative payment models and 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: 03/2020
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Transcript from the Medicare Payment Advisory Commission's (MedPAC) March 2020 meeting. Covers Medicare Shared Savings Program vulnerabilities, the role of specialists in alternative payment models and 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: 03/2020
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Second Report to Congress: Social Risk Factors and Performance in Medicare's Value-Based Purchasing Programs
Analyzes the effect of individuals' social risk factors on quality measures, resource utilization, and other Medicare program measures using Medicare and non-Medicare data sources. Describes how Medicare value-based purchasing (VBP) programs impact providers who serve socially at-risk beneficiaries. Categorizes rurality as a social risk factor. Explores emerging trends among providers addressing social risk factors through cooperation with social services and community-based organizations. Offers policy recommendations for the U.S. Department of Health and Human Services to account for social risk factors in VBP programs and achieve better outcomes for those with social risk factors. Second of two reports required by the Improving Medicare Post-Acute Care Transformation (IMPACT) Act of 2014. See the first report.
Additional links: Executive Summary
Date: 03/2020
Type: Document
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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Analyzes the effect of individuals' social risk factors on quality measures, resource utilization, and other Medicare program measures using Medicare and non-Medicare data sources. Describes how Medicare value-based purchasing (VBP) programs impact providers who serve socially at-risk beneficiaries. Categorizes rurality as a social risk factor. Explores emerging trends among providers addressing social risk factors through cooperation with social services and community-based organizations. Offers policy recommendations for the U.S. Department of Health and Human Services to account for social risk factors in VBP programs and achieve better outcomes for those with social risk factors. Second of two reports required by the Improving Medicare Post-Acute Care Transformation (IMPACT) Act of 2014. See the first report.
Additional links: Executive Summary
Date: 03/2020
Type: Document
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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Interim Evaluation of California's Public Hospital Redesign and Incentives in Medi‐Cal (PRIME) Program
Reports on California's Public Hospital Redesign and Incentives in Medi-Cal Program (PRIME), approved by the Centers for Medicare and Medicaid Services (CMS) to modify Medicaid programs and implement innovative delivery reforms. PRIME uses evidence-based quality improvement methods that require hospitals to establish performance baselines, institute targets for improvement, and evaluate the success of quality improvement interventions on an ongoing basis. The analysis of the program included 52 designated public hospitals and district/municipal hospitals, with 17 of the latter being Critical Access Hospitals (CAHs).
Author(s): Nadereh Pourat, Xiao Chen, Ana E. Martinez, et al.
Date: 03/2020
Type: Document
Sponsoring organizations: California Department of Health Care Services, UCLA Center for Health Policy Research
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Reports on California's Public Hospital Redesign and Incentives in Medi-Cal Program (PRIME), approved by the Centers for Medicare and Medicaid Services (CMS) to modify Medicaid programs and implement innovative delivery reforms. PRIME uses evidence-based quality improvement methods that require hospitals to establish performance baselines, institute targets for improvement, and evaluate the success of quality improvement interventions on an ongoing basis. The analysis of the program included 52 designated public hospitals and district/municipal hospitals, with 17 of the latter being Critical Access Hospitals (CAHs).
Author(s): Nadereh Pourat, Xiao Chen, Ana E. Martinez, et al.
Date: 03/2020
Type: Document
Sponsoring organizations: California Department of Health Care Services, UCLA Center for Health Policy Research
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MedPAC Report to the Congress: Medicare Payment Policy, 2020
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.
Date: 03/2020
Type: Document
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.
Date: 03/2020
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Report to Congress on Medicaid and CHIP, March 2020
Reports on three aspects of Medicaid: improving the structure of Disproportionate Share Hospital (DSH) payments, state reporting on the quality of care for individuals covered by Medicaid or the State Children's Health Insurance Program (CHIP), and the timeliness and quality of Medicaid demonstration evaluations. Chapter 1 examines the relationship between DSH allotments to states and the number of uninsured individuals, the amounts and sources of hospitals' uncompensated care costs, and the amounts and sources of hospitals' uncompensated care costs. Table 1-1 details DSH spending for urban and rural hospitals and for Critical Access Hospitals.
Date: 03/2020
Type: Document
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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Reports on three aspects of Medicaid: improving the structure of Disproportionate Share Hospital (DSH) payments, state reporting on the quality of care for individuals covered by Medicaid or the State Children's Health Insurance Program (CHIP), and the timeliness and quality of Medicaid demonstration evaluations. Chapter 1 examines the relationship between DSH allotments to states and the number of uninsured individuals, the amounts and sources of hospitals' uncompensated care costs, and the amounts and sources of hospitals' uncompensated care costs. Table 1-1 details DSH spending for urban and rural hospitals and for Critical Access Hospitals.
Date: 03/2020
Type: Document
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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Healthcare from Anywhere: Telehealth Use and Perceptions in Rural Michigan
Examines the current state of telehealth services in rural Michigan. Discusses state and local policies related to access to telehealth services, perceptions of telehealth services, and how these services are used by physicians. Identifies barriers rural Michigan healthcare providers and residents face in utilizing telehealth services. Presents recommendations that would increase access to telehealth services for rural Michigan residents. Includes an overview of the telehealth policy environment of all 50 states, with a focus on states with moderate or progressive telehealth policy environments.
Date: 02/2020
Type: Document
Sponsoring organizations: AARP, Connected Nation, Michigan Health Endowment
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Examines the current state of telehealth services in rural Michigan. Discusses state and local policies related to access to telehealth services, perceptions of telehealth services, and how these services are used by physicians. Identifies barriers rural Michigan healthcare providers and residents face in utilizing telehealth services. Presents recommendations that would increase access to telehealth services for rural Michigan residents. Includes an overview of the telehealth policy environment of all 50 states, with a focus on states with moderate or progressive telehealth policy environments.
Date: 02/2020
Type: Document
Sponsoring organizations: AARP, Connected Nation, Michigan Health Endowment
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Medicare: Information on Medicare-Dependent Hospitals
Provides an overview of the Medicare-dependent hospital (MDH) program, how the MDH designation differs from other rural hospital designations, and how MDH hospitals have changed over time. Discusses the decrease in the number of MDHs over time. Examines a variety of operational and financial metrics across MDHs over time.
Additional links: Full Report
Date: 02/2020
Type: Document
Sponsoring organization: Government Accountability Office
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Provides an overview of the Medicare-dependent hospital (MDH) program, how the MDH designation differs from other rural hospital designations, and how MDH hospitals have changed over time. Discusses the decrease in the number of MDHs over time. Examines a variety of operational and financial metrics across MDHs over time.
Additional links: Full Report
Date: 02/2020
Type: Document
Sponsoring organization: Government Accountability Office
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How to Better Support Small Physician-led Accountable Care Organizations: Recent Program Updates, Challenges, and Policy Implications
Describes the strategies of successful small physician-led Accountable Care Organizations (ACOs). Discusses how policy changes contribute to the opportunities and challenges for these ACOs. Explores how "ACO Enablers" aid small ACOs in participating in risk-bearing models. Includes a brief discussion of how the ACO Investment Model program supported ACOs in rural and underserved areas with access to capital.
Author(s): Jonathan Gonzalez-Smith, Hannah Crook, Elizabeth Singletary, William Bleser, Robert Saunders
Date: 02/2020
Type: Document
Sponsoring organizations: Duke Margolis Center for Health Policy, Robert Wood Johnson Foundation
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Describes the strategies of successful small physician-led Accountable Care Organizations (ACOs). Discusses how policy changes contribute to the opportunities and challenges for these ACOs. Explores how "ACO Enablers" aid small ACOs in participating in risk-bearing models. Includes a brief discussion of how the ACO Investment Model program supported ACOs in rural and underserved areas with access to capital.
Author(s): Jonathan Gonzalez-Smith, Hannah Crook, Elizabeth Singletary, William Bleser, Robert Saunders
Date: 02/2020
Type: Document
Sponsoring organizations: Duke Margolis Center for Health Policy, Robert Wood Johnson Foundation
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Rural Health Predictions: Q&A with Alan Morgan
An interview with National Rural Health Association (NRHA) CEO Alan Morgan. Focuses on NRHA's work on rural health issues and shares rural health predictions for 2020.
Author(s): Allee Mead
Citation: Rural Monitor
Date: 02/2020
Type: Document
Sponsoring organization: Rural Health Information Hub
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An interview with National Rural Health Association (NRHA) CEO Alan Morgan. Focuses on NRHA's work on rural health issues and shares rural health predictions for 2020.
Author(s): Allee Mead
Citation: Rural Monitor
Date: 02/2020
Type: Document
Sponsoring organization: Rural Health Information Hub
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