Rural Health
Resources by Topic: Reimbursement and payment models
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
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
view details
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
view details
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
view details
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
view details
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, collaboration and care coordination, quality measurement, payment, and more.
Date: 09/2021
Sponsoring organization: Rural Policy Research Institute Rural Health Panel
view details
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, collaboration and care coordination, quality measurement, payment, and more.
Date: 09/2021
Sponsoring organization: Rural Policy Research Institute Rural Health Panel
view details
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
view details
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
view details
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
view details
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
view details
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
view details
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
view details
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
view details
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
view details
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
view details
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
view details