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Rural Health Information Hub

Rural Health
Resources by Topic: Reimbursement and payment models

The Centers for Medicare & Medicaid Services Could Improve Its Wage Index Adjustment for Hospitals in Areas With the Lowest Wages
Analyzes characteristics of hospitals with area wage indexes (AWI) in the bottom quartile in 2020, including rurality, geography, Medicaid expansion status, and hourly wages. Provides an overview of the hospital wage index system and AWI, circularity, and the impact of these policies on prospective payment system (PPS) hospitals. Offers policy recommendations to the Centers for Medicare and Medicaid Services regarding future adjustments.
Date: 12/2020
Sponsoring organization: Office of Inspector General (HHS)
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NRHA Rapid Response Policy Brief: Telehealth
Policy position brief outlining the National Rural Health Association's policy statements and recommendations to encourage the adoption of telehealth services in rural America. Discusses reimbursement, healthcare quality, broadband access, and other telehealth policy topics.
Author(s): Pat Schou, Sarah Huling, Brady Beecham, Leslie Marsh, Rachael Sherard
Date: 12/2020
Sponsoring organization: National Rural Health Association
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How to Design Value‐based Care Models for Rural Participant Success: A Summit Findings Report
Summarizes a July 2020 virtual summit of rural participants in value‐based care (VBC) models and programs. Details six themes on VBC model design, implementation, and operation that can influence rural organization participation in VBC models. Provides recommendations for VBC model designers to improve rural healthcare provider participation and success in VBC models.
Author(s): Keith Mueller, Clint MacKinney, Jennifer Lundblad, Karla Weng
Date: 12/2020
Sponsoring organization: Rural Health Value
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Case Study: Exploring Options to Deploy Capitated Payments to Enhance Primary Care in Rural Settings
Discusses the need for primary care services in rural areas. Provides an overview of healthcare delivery models that utilize capitated payments. Presents examples of capitated payment agreements aimed at increasing the use and quality of primary care services in rural communities, and offers lessons learned.
Date: 12/2020
Sponsoring organization: American Hospital Association
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An Observational Study of Telemental Care Delivery and the Context for Involuntary Commitment for Mental Health Patients in a Group of Rural Emergency Departments
Examines telemental healthcare delivery in Critical Access Hospital (CAH) emergency departments (ED) in 4 Indiana counties, with a focus on the context surrounding subsequent psychiatric involuntary commitment (IC) or noninvoluntary commitment (non-IC) of mental health patients who presented to the participating EDs. Provides information on patient demographics, ED wait time and length of stay, ED costs and reimbursement, and telehealth parity laws.
Author(s): Roseanne Fairchild, Shiaw-Fen Ferng-Kuo, Hicham Rahmouni, Daniel Hardesty
Citation: Telemedicine Reports, 1(1), 22-35
Date: 11/2020
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Rural Health Clinic COVID-19 Testing Program
Recording of a November 16, 2020, webinar providing information about HRSA's allocation of funds to Rural Health Clinics (RHCs) for COVID-19 testing and HRSA's RHC testing terms and conditions. Includes information on the RHC COVID-19 Reporting Portal, a list of frequently asked questions, and contact information for COVID-19 testing technical assistance. Part of the Rural Health Clinic Technical Assistance Series.
Additional links: Presentation Slides, Transcript
Date: 11/2020
Sponsoring organization: National Association of Rural Health Clinics
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Rural Challenges, Strategies, and Recommendations to Advance Value-Based Payment and Care During and Beyond the COVID-19 Crisis
Describes the key challenges rural primary care and behavioral health providers have faced in delivering care since COVID-19, in addition to the policy changes implemented in response to those challenges. Offers state-level policy recommendations for improving rural primary care and behavioral health services.
Author(s): Angel Bourgoin, Jim Maxwell, Yvette Cho, Rachel Tobey
Date: 11/2020
Sponsoring organization: Delta Center for a Thriving Safety Net
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The Future of State Telehealth Policy
Provides an overview of state and federal telehealth flexibilities implemented during the COVID-19 pandemic. Discusses long-term considerations for governors regarding the impact of these flexibilities on healthcare delivery and payment and the appropriateness of these policies in the future.
Date: 11/2020
Sponsoring organization: National Governors Association
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Rethinking Rural Health: FY 2020 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 2020. Focuses on nine priority areas: COVID-19, maternal health, Medicare Advantage (MA) and the Federally-facilitated Marketplace (FFM), quality improvement, practitioner engagement, patient empowerment and person-centered care, Medicare and Medicaid payment and policy, models and demonstrations, and telehealth.
Date: 11/2020
Sponsoring organization: Centers for Medicare and Medicaid Services
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Overview of Emergency Department Visits Related to Injuries, by Cause of Injury, 2017
Presents statistics on emergency department (ED) visits related to injuries in 2017. Includes the number of ED visits related to each cause of injury; the percentage of visits that resulted in the patient being admitted or transferred to another hospital; rate of ED visit due to injuries by different population characteristics including age, sex, income, and rural status; and the distribution of primary expected payer for ED visits related to injuries.
Author(s): Audrey J. Weiss, Lawrence D. Reid, Marguerite L. Barrett
Date: 11/2020
Sponsoring organization: Agency for Healthcare Research and Quality
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