Rural Health
Resources by Topic: Reimbursement and payment models
Who Will Answer the Call? An Abstract of Challenges Facing Michigan's Rural EMS Agencies
Provides an overview of challenges experienced by Michigan's rural emergency medical services (EMS) agencies, such as reimbursement, access to care, recruitment and retention, workforce shortages and training, and more.
Date: 09/2021
Sponsoring organization: Rural Subcommittee of the EMS Coordinating Committee
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Provides an overview of challenges experienced by Michigan's rural emergency medical services (EMS) agencies, such as reimbursement, access to care, recruitment and retention, workforce shortages and training, and more.
Date: 09/2021
Sponsoring organization: Rural Subcommittee of the EMS Coordinating Committee
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Addressing Health-Related Social Needs to Improve Rural Health: Ideas to Action
Identifies strategies for building community and regional systems of care to better address the social needs of patients and inform the design of community-level rural health transformation initiatives, pilots, or demonstrations in rural Maine. Examines existing literature and evidence from similar initiatives in Vermont, Idaho, and Oregon, and highlights key observations. Describes key components of a demonstration designed to build, implement, and test strategies for aligning health, social service, and other systems in order to advance whole-person care.
Author(s): Andrew F. Coburn, Deborah A. Deatrick
Date: 09/2021
Sponsoring organizations: Maine Rural Health Action Network, New England Rural Health Association
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Identifies strategies for building community and regional systems of care to better address the social needs of patients and inform the design of community-level rural health transformation initiatives, pilots, or demonstrations in rural Maine. Examines existing literature and evidence from similar initiatives in Vermont, Idaho, and Oregon, and highlights key observations. Describes key components of a demonstration designed to build, implement, and test strategies for aligning health, social service, and other systems in order to advance whole-person care.
Author(s): Andrew F. Coburn, Deborah A. Deatrick
Date: 09/2021
Sponsoring organizations: Maine Rural Health Action Network, New England Rural Health Association
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Health Panel Comment Letter – Rural Emergency Hospitals (REH)
Offers comments in response to the Centers for Medicare and Medicaid Services (CMS) Request for Information on Rural Emergency Hospitals (REH). Addresses the type and scope of services REHs could offer, conditions of participation, health equity, collaboration and care coordination, quality measurement, payment, and enrollment.
Date: 09/2021
Sponsoring organization: Rural Policy Research Institute Rural Health Panel
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Offers comments in response to the Centers for Medicare and Medicaid Services (CMS) Request for Information on Rural Emergency Hospitals (REH). Addresses the type and scope of services REHs could offer, conditions of participation, health equity, collaboration and care coordination, quality measurement, payment, and enrollment.
Date: 09/2021
Sponsoring organization: Rural Policy Research Institute Rural Health Panel
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Identifying Allowable Expenses for COVID-19 Programs
Recording of a September 23, 2021, webinar on the Rural Health Clinic (RHC) COVID-19 Testing Program and RHC COVID-19 Testing and Mitigation Program. Discusses allowable and unallowable expenses for these programs, as well as reimbursable and unreimbursable expenses.
Additional links: Presentation Slides, Transcript
Date: 09/2021
Sponsoring organization: National Association of Rural Health Clinics
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Recording of a September 23, 2021, webinar on the Rural Health Clinic (RHC) COVID-19 Testing Program and RHC COVID-19 Testing and Mitigation Program. Discusses allowable and unallowable expenses for these programs, as well as reimbursable and unreimbursable expenses.
Additional links: Presentation Slides, Transcript
Date: 09/2021
Sponsoring organization: National Association of Rural Health Clinics
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Evaluation of the Rural Community Hospital Demonstration: Report Covering 2005-2017 (Interim Report 1)
Provides an overview of the Rural Community Hospital Demonstration (RCHD). Describes the characteristics of RCHD participants that entered the demonstration between 2005-2012, the Medicare payments received under program, and the impact of the RCHD on hospital finances between 2005-2017.
Additional links: Findings at a Glance
Date: 09/2021
Sponsoring organization: Centers for Medicare and Medicaid Services
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Provides an overview of the Rural Community Hospital Demonstration (RCHD). Describes the characteristics of RCHD participants that entered the demonstration between 2005-2012, the Medicare payments received under program, and the impact of the RCHD on hospital finances between 2005-2017.
Additional links: Findings at a Glance
Date: 09/2021
Sponsoring organization: Centers for Medicare and Medicaid Services
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MedPAC Comment on CMS's Proposed Rule on Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems and Quality Reporting Programs for CY 2022
Comments on an August 4, 2021, Federal Register proposed rule revising the Medicare Hospital Outpatient Prospective Payment System (OPPS) and Medicare Ambulatory Surgical Center (ACS) payment system for calendar year 2022. Includes considerations for Rural Emergency Hospital payments and emergency department staffing requirements.
Date: 09/2021
Sponsoring organization: Medicare Payment Advisory Commission
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Comments on an August 4, 2021, Federal Register proposed rule revising the Medicare Hospital Outpatient Prospective Payment System (OPPS) and Medicare Ambulatory Surgical Center (ACS) payment system for calendar year 2022. Includes considerations for Rural Emergency Hospital payments and emergency department staffing requirements.
Date: 09/2021
Sponsoring organization: Medicare Payment Advisory Commission
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Air Ambulance Use and Surprise Billing
Provides an overview of air ambulance services, including the types and number of air ambulance providers and suppliers, utilization rates by patients, average costs, and the potential for balance billing for air ambulance transport. Summarizes key policies and legislation related to air ambulances, including the No Surprises Act. Presents data on air ambulance utilization by rurality between 2014-2018.
Author(s): Gina Turrini, Joel Ruhter, Andre R. Chappel, Nancy De Lew
Date: 09/2021
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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Provides an overview of air ambulance services, including the types and number of air ambulance providers and suppliers, utilization rates by patients, average costs, and the potential for balance billing for air ambulance transport. Summarizes key policies and legislation related to air ambulances, including the No Surprises Act. Presents data on air ambulance utilization by rurality between 2014-2018.
Author(s): Gina Turrini, Joel Ruhter, Andre R. Chappel, Nancy De Lew
Date: 09/2021
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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MedPAC Comment on CMS's Proposed Rule on the Physician Fee Schedule and Other Revisions to Part B for CY 2022
Comment on a July 23, 2021, Federal Register proposed rule revising the physician fee schedule to improve payment systems for physicians and other Medicare Part B revisions. Includes a discussion of the expansion of telehealth service coverage after the COVID-19 public health emergency, as well as reimbursement rates to Rural Health Clinics and Federally Qualified Health Centers for telehealth mental health services.
Date: 09/2021
Sponsoring organization: Medicare Payment Advisory Commission
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Comment on a July 23, 2021, Federal Register proposed rule revising the physician fee schedule to improve payment systems for physicians and other Medicare Part B revisions. Includes a discussion of the expansion of telehealth service coverage after the COVID-19 public health emergency, as well as reimbursement rates to Rural Health Clinics and Federally Qualified Health Centers for telehealth mental health services.
Date: 09/2021
Sponsoring organization: Medicare Payment Advisory Commission
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Medicare Covers a Lower Percentage of Outpatient Costs in Hospitals Located in Rural Areas
Policy brief describing differences in Medicare Outpatient Prospective Payment System (OPPS) payments between urban and rural hospitals. Features statistics on OPPS payments as a percent of total net patient revenue, as a percent of Medicare outpatient cost by hospital payment classification, and as a percent of Medicare outpatient cost by number of acute beds, with breakdowns by urban and rural location.
Author(s): Pranathi Sana, George H. Pink
Date: 09/2021
Sponsoring organization: North Carolina Rural Health Research Program
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Policy brief describing differences in Medicare Outpatient Prospective Payment System (OPPS) payments between urban and rural hospitals. Features statistics on OPPS payments as a percent of total net patient revenue, as a percent of Medicare outpatient cost by hospital payment classification, and as a percent of Medicare outpatient cost by number of acute beds, with breakdowns by urban and rural location.
Author(s): Pranathi Sana, George H. Pink
Date: 09/2021
Sponsoring organization: North Carolina Rural Health Research Program
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A Qualitative Assessment of Barriers and Facilitators Associated with Addressing Social Determinants of Health among Members of a Health Collaborative in the Rural Midwest
Examines capacities and barriers in addressing social determinants of health for patients in rural Northeastern Minnesota and Northwestern Wisconsin based on interviews from 37 participants of a healthcare collaborative. Discusses specific needs of rural providers, including access to community-based social services, aligned payment models, and capacity for collaboration, among others.
Author(s): Kim Nichols Dauner, Lacey Loomer
Citation: BMC Health Services Research, 21
Date: 08/2021
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Examines capacities and barriers in addressing social determinants of health for patients in rural Northeastern Minnesota and Northwestern Wisconsin based on interviews from 37 participants of a healthcare collaborative. Discusses specific needs of rural providers, including access to community-based social services, aligned payment models, and capacity for collaboration, among others.
Author(s): Kim Nichols Dauner, Lacey Loomer
Citation: BMC Health Services Research, 21
Date: 08/2021
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