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Rural Health
Resources by Topic: Reimbursement and payment models

Addressing Rural Hospital Closures Through Infrastructure Reform
Provides a historical overview of rural Medicare reimbursement and provider designations and discusses their impact on hospital closures. Supports changing the rural health infrastructure to provide more flexibility for rural hospitals and to emphasize primary care and emergency care access.
Author(s): Eleni Salyers
Date: 08/2019
Type: Document
Sponsoring organization: Bipartisan Policy Center
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Accelerating Value-Based Payment in California's Federally Qualified Health Centers: Options for Medicaid Health Plans
Highlights examples of value-based payment (VBP) models for Federally Qualified Health Centers (FQHCs), including a rural Hawaii model and a Colorado model that incorporates rural FQHCs. Covers Accountable Care Organization (ACO) models, state-led Capitated Alternative Payment Models (APMs), state-led quality payment adjustments, and Medicaid shared savings ACO models. Addresses how FQHCs and health plans can overcome challenges when launching new VBP models and offers recommendations for California's health plans.
Author(s): Greg Howe, Tricia McGinnis, Rob Houston
Date: 08/2019
Type: Document
Sponsoring organization: Center for Health Care Strategies
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Geriatrician Roles and the Value of Geriatrics in an Evolving Healthcare System
Research report focusing on how geriatric roles are changing as healthcare systems and organizations reorganize care. Features information on ways telemedicine is used in geriatric care delivery in rural areas, including the TeleECHO (Extension for Community Health Outcomes) model.
Author(s): Timothy Bates, Aubri Kottek, Joanne Spetz
Date: 07/2019
Type: Document
Sponsoring organization: University of California San Francisco Health Workforce Research Center on Long-Term Care
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Medicaid: States' Use and Distribution of Supplemental Payments to Hospitals
Examines the use of disproportionate share hospital (DSH) payments given to hospitals with more Medicaid and uninsured patients. Addresses differences in state Medicaid expansion status, uninsured percentage, and uncompensated care in relation to DSH payments. Includes state data on DSH payments and uncompensated care costs by rural/urban hospital location, as well as data on Critical Access Hospital (CAH) and Sole Community Hospital DSH payments by state.
Additional links: Full Report
Date: 07/2019
Type: Document
Sponsoring organization: Government Accountability Office
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When Will the U.S. Territories Exhaust Federal Medicaid Funding?
Issue brief exploring the projected effects on healthcare expense funding in American Samoa, the Northern Mariana Islands, Guam, Puerto Rico, and the U.S. Virgin Islands if all sources of federal funding are allowed to expire in 2019. Features statistics for Medicaid funding and spending in the territories for fiscal year 2018, and sources of federal Medicaid funding and periods during which the funding is available.
Date: 07/2019
Type: Document
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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Texas Area Health Education Centers, Managed Care Areas, and Texas Workforce Board
Offers map showing Texas Area Health Education Center regions, managed care areas, and Texas Workforce Board regions.
Date: 06/2019
Type: Map/Mapping System
Sponsoring organization: Texas Organization of Rural & Community Hospitals
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A Rural Health Crisis: The Changing Landscape of the 1980s and Beyond
Brief video overview of issues in the 1980s that resulted in a wave of rural hospital closures, including an economic shift from manufacturing, farm closures, and changes in the Medicare payment system.
Date: 06/2019
Type: Video/Multimedia
Sponsoring organization: Rural Health Information Hub
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Accountable Care Organizations Exiting the Medicare Shared Savings Program: Policy and Organizational Determinants
Poster presented at the 2019 AcademyHealth Annual Research Meeting on trends in Accountable Care Organization (ACO) exits. Identifies organizational factors such as rural/urban location affecting ACO exit, as well as policy-related motivations, such as financial incentives.
Author(s): Huang Huang, Xi Zhu, Keith Mueller, Clinton MacKinney
Date: 06/2019
Type: Document
Sponsoring organization: University of Iowa College of Public Health
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MedPAC Comment on CMS's Proposed Rule on the Hospital Inpatient Prospective Payment System and the Long-term Care Hospital Prospective Payment System for FY 2020
Comments on a May 3, 2019, Federal Register proposed rule revising the hospital inpatient and long-term care hospital (LTCH) prospective payment systems. Addresses proposed changes to the hospital wage index, including rural floor calculations, uncompensated care measurements that affect disproportionate share (DSH) payments, inpatient and outpatient proposals related to drugs and devices, and the LTCH prospective payment system.
Date: 06/2019
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Lower Health Care Costs Act
Recording of a U.S. Senate Committee on Health, Education, Labor and Pensions hearing on the Lower Health Care Costs Act, which covers access to healthcare, surprise medical bills, market competition, drug prices, and other issues. Includes testimony from an organization that works primarily with small and rural practices, the American Hospital Association, American Enterprise Institute, and others.
Additional links: Benedic N. Ippolito Testimony, Sean Cavanaugh Testimony, Tom Nickels Testimony
Date: 06/2019
Type: Video/Multimedia
Sponsoring organization: Senate Committee on Health, Education, Labor & Pensions
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