Rural Health
Resources by Topic: Reimbursement and payment models
Mental Health Systems Solutions Explorer
Interactive tool offering evidence-based solutions to increase mental healthcare utilization, increase access to care, and establish a continuum of care. Contains examples of each solution in practice. Solutions can be filtered to view those specifically of interest to rural communities.
Date: 01/2021
Sponsoring organization: RAND Corporation
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Interactive tool offering evidence-based solutions to increase mental healthcare utilization, increase access to care, and establish a continuum of care. Contains examples of each solution in practice. Solutions can be filtered to view those specifically of interest to rural communities.
Date: 01/2021
Sponsoring organization: RAND Corporation
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How to Transform the U.S. Mental Health System: Evidence-based Recommendations
Discusses evidence-based strategies to promote mental healthcare utilization, improve access to care, and establish a continuum of care. Offers 15 recommendations to improve mental healthcare, including policies regarding reimbursement, workforce growth, and digital and telehealth services, among other topics. Includes rural references throughout.
Additional links: Full Report, Research Brief: Transforming Mental Health Care in the United States
Author(s): Ryan K. McBain, Nicole K. Eberhart, Joshua Breslau, et al.
Date: 01/2021
Sponsoring organization: RAND Corporation
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Discusses evidence-based strategies to promote mental healthcare utilization, improve access to care, and establish a continuum of care. Offers 15 recommendations to improve mental healthcare, including policies regarding reimbursement, workforce growth, and digital and telehealth services, among other topics. Includes rural references throughout.
Additional links: Full Report, Research Brief: Transforming Mental Health Care in the United States
Author(s): Ryan K. McBain, Nicole K. Eberhart, Joshua Breslau, et al.
Date: 01/2021
Sponsoring organization: RAND Corporation
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Medicare Severe Wound Care: Spending Declines May Reflect Site of Care Changes; Limited Information Is Available on Quality
Reports on an analysis of where Medicare beneficiaries received care for severe wounds in 2018 and Medicare payment for these services. Provides an overview of the implementation of a dual payment system for long-term care hospitals in 2016, and examines how the dual payment system affected the availability and quality of severe wound care for Medicare beneficiaries. Includes data on severe wound care by facility type in addition to Medicare spending by urban and rural location.
Additional links: Full Report
Date: 01/2021
Sponsoring organization: Government Accountability Office
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Reports on an analysis of where Medicare beneficiaries received care for severe wounds in 2018 and Medicare payment for these services. Provides an overview of the implementation of a dual payment system for long-term care hospitals in 2016, and examines how the dual payment system affected the availability and quality of severe wound care for Medicare beneficiaries. Includes data on severe wound care by facility type in addition to Medicare spending by urban and rural location.
Additional links: Full Report
Date: 01/2021
Sponsoring organization: Government Accountability Office
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Telehealth Policies Impacting Federally Qualified Health Centers in Face of COVID‐19
Provides an overview of changes to federal, California Medicaid, and private insurer telehealth policies in response to COVID-19. Discusses opportunities and limitations Federally Qualified Health Centers and Rural Health Clinics may face in expanding telehealth services. Offers recommendations for removing barriers for providers in rural and underserved areas.
Author(s): Miku Sodhi
Citation: Journal of Rural Health, 37(1), 158-160
Date: 01/2021
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Provides an overview of changes to federal, California Medicaid, and private insurer telehealth policies in response to COVID-19. Discusses opportunities and limitations Federally Qualified Health Centers and Rural Health Clinics may face in expanding telehealth services. Offers recommendations for removing barriers for providers in rural and underserved areas.
Author(s): Miku Sodhi
Citation: Journal of Rural Health, 37(1), 158-160
Date: 01/2021
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Economics of Using Telemedicine to Supplement Hospice Care in Rural Areas
Describes a tele-hospice program implemented in 2015 by Hospice Services, Inc., a community-based hospice provider that serves rural and frontier counties in northwest and north central Kansas, in partnership with the University of Kansas Medical Center. Explores the financial impact of the tele-hospice intervention, comparing tele-hospice costs with costs of in-person services. Also identifies cost savings related to the use of virtual technology to conduct administrative meetings.
Author(s): Adam F. Lomenick, Sandy J. Kuhlman, Joe L. Barnes, et al.
Citation: Journal of Palliative Medicine, 24(10), 1461–1466
Date: 2021
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Describes a tele-hospice program implemented in 2015 by Hospice Services, Inc., a community-based hospice provider that serves rural and frontier counties in northwest and north central Kansas, in partnership with the University of Kansas Medical Center. Explores the financial impact of the tele-hospice intervention, comparing tele-hospice costs with costs of in-person services. Also identifies cost savings related to the use of virtual technology to conduct administrative meetings.
Author(s): Adam F. Lomenick, Sandy J. Kuhlman, Joe L. Barnes, et al.
Citation: Journal of Palliative Medicine, 24(10), 1461–1466
Date: 2021
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Implementing High-Quality Primary Care: Rebuilding the Foundation of Health Care
Examines the current state of primary care in the United States, and describes an implementation plan to strengthen high-quality primary care. Discusses value-based care and reimbursement, access to care, primary care workforce recruitment and training, and the role of health information technology. Includes rural references throughout.
Additional links: Read Online
Author(s): Board on Health Care Services
Date: 2021
Sponsoring organization: Health and Medicine Division (HMD), National Academies of Sciences, Engineering, and Medicine
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Examines the current state of primary care in the United States, and describes an implementation plan to strengthen high-quality primary care. Discusses value-based care and reimbursement, access to care, primary care workforce recruitment and training, and the role of health information technology. Includes rural references throughout.
Additional links: Read Online
Author(s): Board on Health Care Services
Date: 2021
Sponsoring organization: Health and Medicine Division (HMD), National Academies of Sciences, Engineering, and Medicine
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Rural Federally Qualified Health Centers Financial and Operational Performance Analysis 2016-2019
Examines financial and operational characteristics of rural Federally Qualified Health Centers (FQHCs). Explores FQHC patient and payer mix, revenue and growth mix, financial performance, quality of care, and more. Compares data on rural FQHCs to urban and national FQHC data.
Date: 2021
Sponsoring organization: Capital Link
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Examines financial and operational characteristics of rural Federally Qualified Health Centers (FQHCs). Explores FQHC patient and payer mix, revenue and growth mix, financial performance, quality of care, and more. Compares data on rural FQHCs to urban and national FQHC data.
Date: 2021
Sponsoring organization: Capital Link
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Public Law 116–260: Consolidated Appropriations Act, 2021
Text of the Consolidated Appropriations Act, 2021, Public Law 116-260 (December 27, 2020). Section 125 establishes the Rural Emergency Hospital designation. Section 127 makes changes to direct graduate medical education (GME) and indirect GME payments to teaching hospitals that train residents in Rural Training Programs.
Date: 12/2020
Sponsoring organization: U.S. Congress
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Text of the Consolidated Appropriations Act, 2021, Public Law 116-260 (December 27, 2020). Section 125 establishes the Rural Emergency Hospital designation. Section 127 makes changes to direct graduate medical education (GME) and indirect GME payments to teaching hospitals that train residents in Rural Training Programs.
Date: 12/2020
Sponsoring organization: U.S. Congress
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December 2020 MedPAC Meeting Transcript
Transcript from the Medicare Payment Advisory Commission's (MedPAC) December 2020 meeting. Covers payment adequacy and updates for hospital inpatient and outpatient services and the mandated report on expanding the post-acute care transfer policy to hospice, ambulatory surgical center services, outpatient dialysis services, physician and other health professional services, hospice services, and a status report and benchmark policy option on the Medicare Advantage program. Includes rural references throughout.
Date: 12/2020
Sponsoring organization: Medicare Payment Advisory Commission
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Transcript from the Medicare Payment Advisory Commission's (MedPAC) December 2020 meeting. Covers payment adequacy and updates for hospital inpatient and outpatient services and the mandated report on expanding the post-acute care transfer policy to hospice, ambulatory surgical center services, outpatient dialysis services, physician and other health professional services, hospice services, and a status report and benchmark policy option on the Medicare Advantage program. Includes rural references throughout.
Date: 12/2020
Sponsoring organization: Medicare Payment Advisory Commission
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Rural Health Clinics Modernization Policy Explained
Recording of a webinar (updated December 31, 2020) providing an overview of statutory revisions to the Rural Health Clinic (RHC) payment methodology. Explains the impact of the changes on both capped and uncapped RHCs. Includes information on telehealth reimbursement for RHCs. Part of the Rural Health Clinic Technical Assistance Series.
Additional links: Presentation Slides
Author(s): Bill Finerfrock, Nathan Baugh
Date: 12/2020
Sponsoring organization: National Association of Rural Health Clinics
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Recording of a webinar (updated December 31, 2020) providing an overview of statutory revisions to the Rural Health Clinic (RHC) payment methodology. Explains the impact of the changes on both capped and uncapped RHCs. Includes information on telehealth reimbursement for RHCs. Part of the Rural Health Clinic Technical Assistance Series.
Additional links: Presentation Slides
Author(s): Bill Finerfrock, Nathan Baugh
Date: 12/2020
Sponsoring organization: National Association of Rural Health Clinics
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