Rural Health
Resources by Topic: Reimbursement and payment models
States' Medicaid Fee-for-Service Nursing Facility Payment Policies
Spreadsheet outlining each state's Medicaid fee-for-service (FFS) nursing facility payment policy. Lists how each state sets the payment rate and any adjustments and supplemental payments. Includes information on rural/urban aspects of setting or adjustment to the payment in each state.
Date: 10/2019
Type: Document
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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Spreadsheet outlining each state's Medicaid fee-for-service (FFS) nursing facility payment policy. Lists how each state sets the payment rate and any adjustments and supplemental payments. Includes information on rural/urban aspects of setting or adjustment to the payment in each state.
Date: 10/2019
Type: Document
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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Financial Alignment Initiative South Carolina Healthy Connections Prime: First Evaluation Report
Evaluation of the first year of the South Carolina Healthy Connections Prime demonstration to integrate care for the state's Medicare-Medicaid beneficiaries. Discusses access and other challenges for rural enrollees and how the program has worked to address rural needs.
Date: 09/2019
Type: Document
Sponsoring organizations: Centers for Medicare and Medicaid Services, RTI International
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Evaluation of the first year of the South Carolina Healthy Connections Prime demonstration to integrate care for the state's Medicare-Medicaid beneficiaries. Discusses access and other challenges for rural enrollees and how the program has worked to address rural needs.
Date: 09/2019
Type: Document
Sponsoring organizations: Centers for Medicare and Medicaid Services, RTI International
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Serving Rural America: Health Insurance Providers at Work
Offers 5 case studies to showcase the ways in which health insurance providers are working to ensure access to high quality healthcare in rural areas. Examples feature 8 insurance providers in Maryland, Pennsylvania, California, and Oregon sharing different approaches to healthcare delivery, financing, and community engagement.
Date: 09/2019
Type: Document
Sponsoring organization: AHIP
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Offers 5 case studies to showcase the ways in which health insurance providers are working to ensure access to high quality healthcare in rural areas. Examples feature 8 insurance providers in Maryland, Pennsylvania, California, and Oregon sharing different approaches to healthcare delivery, financing, and community engagement.
Date: 09/2019
Type: Document
Sponsoring organization: AHIP
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Evaluation of the Accountable Care Organization Investment Model: AIM Implementation and Impacts over Two Performance Years
Evaluation examining the first two years of the ACO Investment Model (AIM), which tests the use of prepaid shared savings to encourage new ACOs to form in rural and underserved areas (Test 1) and to encourage current Medicare Shared Savings Program ACOs to transition to arrangements with greater financial risk (Test 2). Reports on AIM ACO composition, including rurality. Appendices include detailed information on each AIM ACO.
Additional links: Appendices, Findings at a Glance
Date: 09/2019
Type: Document
Sponsoring organizations: Abt Associates, Centers for Medicare and Medicaid Services
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Evaluation examining the first two years of the ACO Investment Model (AIM), which tests the use of prepaid shared savings to encourage new ACOs to form in rural and underserved areas (Test 1) and to encourage current Medicare Shared Savings Program ACOs to transition to arrangements with greater financial risk (Test 2). Reports on AIM ACO composition, including rurality. Appendices include detailed information on each AIM ACO.
Additional links: Appendices, Findings at a Glance
Date: 09/2019
Type: Document
Sponsoring organizations: Abt Associates, Centers for Medicare and Medicaid Services
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2019 Rural Emergency Care Integration Summit: Flex Program Support for Rural EMS: Moving from Loaded Miles to Value-Based Models
Provides an overview of the March 2019 Rural Emergency Care Summit convened by the National Rural Health Resource Center. Explores the role of emergency medical services (EMS) as the healthcare system transitions from volume-based to value-based care. Addresses challenges to EMS and hospital collaboration and strategies for future integration. Discusses how Flex Programs could support rural EMS improvements.
Date: 08/2019
Type: Document
Sponsoring organization: National Rural Health Resource Center
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Provides an overview of the March 2019 Rural Emergency Care Summit convened by the National Rural Health Resource Center. Explores the role of emergency medical services (EMS) as the healthcare system transitions from volume-based to value-based care. Addresses challenges to EMS and hospital collaboration and strategies for future integration. Discusses how Flex Programs could support rural EMS improvements.
Date: 08/2019
Type: Document
Sponsoring organization: National Rural Health Resource Center
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Factors that Influence Access to Medication-Assisted Treatment
Results of a study examining factors that influence access to medication-assisted treatment and substance use disorder treatment, including rural location, stigma, shortage of providers, and insurance coverage. Uses data from an electronic survey distributed to 59 State Opioid Treatment Authorities or Single State Authorities in the spring of 2019.
Additional links: Policy Brief
Author(s): Dana Foney, Shannon Mace
Date: 08/2019
Type: Document
Sponsoring organizations: National Council for Mental Wellbeing, University of Michigan Behavioral Health Workforce Research Center
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Results of a study examining factors that influence access to medication-assisted treatment and substance use disorder treatment, including rural location, stigma, shortage of providers, and insurance coverage. Uses data from an electronic survey distributed to 59 State Opioid Treatment Authorities or Single State Authorities in the spring of 2019.
Additional links: Policy Brief
Author(s): Dana Foney, Shannon Mace
Date: 08/2019
Type: Document
Sponsoring organizations: National Council for Mental Wellbeing, University of Michigan Behavioral Health Workforce Research Center
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Reaching the Quadruple Aim: Workforce and Service Delivery Within Certified Community Behavioral Health Clinics
Summary of data collected between February and August 2019 on the Certified Community Behavioral Health Clinic (CCBHC) model's impact on the behavioral workforce and the aims of improving patient and provider experiences, improving the health of populations, and reducing costs. Discusses access and barriers to care, workforce capacity, primary care and behavioral healthcare integration, and offers recommendations for enhancing financing and reimbursement. Features statistics including populations served by CCBHCs, with breakdowns by urban, rural, and tribal locations.
Author(s): Dana Foney, Shannon Mace, Adriano Boccanelli
Date: 08/2019
Type: Document
Sponsoring organizations: National Council for Mental Wellbeing, University of Michigan Behavioral Health Workforce Research Center
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Summary of data collected between February and August 2019 on the Certified Community Behavioral Health Clinic (CCBHC) model's impact on the behavioral workforce and the aims of improving patient and provider experiences, improving the health of populations, and reducing costs. Discusses access and barriers to care, workforce capacity, primary care and behavioral healthcare integration, and offers recommendations for enhancing financing and reimbursement. Features statistics including populations served by CCBHCs, with breakdowns by urban, rural, and tribal locations.
Author(s): Dana Foney, Shannon Mace, Adriano Boccanelli
Date: 08/2019
Type: Document
Sponsoring organizations: National Council for Mental Wellbeing, University of Michigan Behavioral Health Workforce Research Center
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Small Rural Hospital Transition (SRHT) Project Guide: A Rural Hospital Guide to Improving Care Management: 2019 Update
A guide for rural hospital leadership that identifies best practices in care management. Addresses care management roles and staffing needs and covers utilization review and discharge planning. Helps identify opportunities for process improvement. Also discusses competencies needed to transition to a value-based reimbursement environment focused on population health.
Date: 08/2019
Type: Document
Sponsoring organizations: National Rural Health Resource Center, Stroudwater Associates
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A guide for rural hospital leadership that identifies best practices in care management. Addresses care management roles and staffing needs and covers utilization review and discharge planning. Helps identify opportunities for process improvement. Also discusses competencies needed to transition to a value-based reimbursement environment focused on population health.
Date: 08/2019
Type: Document
Sponsoring organizations: National Rural Health Resource Center, Stroudwater Associates
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Rural Care Coordination and Population Health Management Summit: Summit Findings
Provides guidance to rural hospitals, clinics, and healthcare networks on incorporating community care coordination planning to prepare for population health management. Identifies tools and resources to support the transition to value-based payment models. Summarizes findings from a series of summits with national experts.
Author(s): Rebecca Jolley
Date: 08/2019
Type: Document
Sponsoring organizations: National Rural Health Resource Center, Rural Health Association of Tennessee
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Provides guidance to rural hospitals, clinics, and healthcare networks on incorporating community care coordination planning to prepare for population health management. Identifies tools and resources to support the transition to value-based payment models. Summarizes findings from a series of summits with national experts.
Author(s): Rebecca Jolley
Date: 08/2019
Type: Document
Sponsoring organizations: National Rural Health Resource Center, Rural Health Association of Tennessee
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The Evolving Policy Landscape of Telehealth Services Delivered in the Home and Other Nonclinical Settings
Issue brief identifying key findings for state officials considering adopting new policies for home-based telehealth services. Describes Medicaid and Medicare coverage for telehealth services, including those provided in rural and Health Professional Shortage Areas, Critical Access Hospitals, and Rural Health Clinics.
Author(s): Brittany Lazur, Andrea Bennett, Valerie King
Date: 08/2019
Type: Document
Sponsoring organization: Milbank Memorial Fund
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Issue brief identifying key findings for state officials considering adopting new policies for home-based telehealth services. Describes Medicaid and Medicare coverage for telehealth services, including those provided in rural and Health Professional Shortage Areas, Critical Access Hospitals, and Rural Health Clinics.
Author(s): Brittany Lazur, Andrea Bennett, Valerie King
Date: 08/2019
Type: Document
Sponsoring organization: Milbank Memorial Fund
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