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Rural Health
Resources by Topic: Reimbursement and payment models

MedPAC Comment on CMS's Proposed Rule on Hospice for FY 2020
Comments on an April 25, 2019, Federal Register proposed rule updating payments for hospice and hospice quality reporting. Addresses proposed changes to the wage index system that would adjust for geographical differences, potentially impacting rural areas.
Date: 06/2019
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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MedPAC Comment on CMS's Proposed Rule on the Inpatient Rehabilitation Facility PPS for FY 2020
Comments on an April 24, 2019, Federal Register proposed rule updating payments for Inpatient Rehabilitation Facilities (IRFs) and IRF quality reporting. Addresses proposed changes to the wage index system that would adjust for geographical differences, potentially impacting rural areas.
Date: 06/2019
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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MedPAC Report to the Congress: Medicare and the Health Care Delivery System, June 2019
Evaluates Medicare payment issues and offers recommendations to the U.S. Congress. Includes a chapter on access to primary care for Medicare beneficiaries that addresses rural access to care and programs supporting it, such as the National Health Service Corps. Other sections of the report addressing rural concerns focus on Medicare enrollment, changes in hospice and post-acute care after implementing the long-term care hospital dual payment-rate structure, and Medicare fee-for-service spending for emergency department services.
Additional links: Executive Summary
Date: 06/2019
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Infectious Diseases Society of America Position Statement on Telehealth and Telemedicine as Applied to the Practice of Infectious Diseases
Position statement to educate members of the Infectious Diseases Society of America on telehealth and to promote use of this technology in clinical care, research, and education. Explores the potential to increase access to subspecialist care in rural areas, and describes reimbursement policies of private insurers, Medicare, and Medicaid, for telehealth services provided to patients in rural areas. Also describes HIPAA requirements for telehealth interactions and protected health information.
Author(s): Jeremy D. Young, Rima Abdel-Massih, Thomas Herchline, et al.
Citation: Clinical Infectious Diseases, 68(9), 1437-1443
Date: 05/2019
Type: Document
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Supporting Rural Health: Practical Solutions for State Policymakers
Reports on 3 regional meetings of state health policy leaders and national experts regarding top rural health concerns and successful models for addressing them. Highlights lessons for policymakers from rural health initiatives focused on community health, strategies for expanding rural health workforce capacity, and examples of states working with research centers to develop evidence-based policies. Includes models from several states for each area discussed.
Author(s): Emily Whelan Parento
Date: 05/2019
Type: Document
Sponsoring organization: Milbank Memorial Fund
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Medicaid Financing Cliff: Implications for the Health Care Systems in Puerto Rico and USVI
Issue brief providing an overview of the status of healthcare systems and Medicaid programs in Puerto Rico and the U.S. Virgin Islands (USVI) a year and a half after hurricanes hit the islands in September 2017. Focuses on challenges and includes an analysis of the implications for the islands' Medicaid finances, as most of the temporary disaster relief funding is set to expire in September 2019. Features statistics on the two territories' past and projected Medicaid spending.
Author(s): Robin Rudowitz, Cornelia Hall, Barbara Lyons
Date: 05/2019
Type: Document
Sponsoring organization: KFF
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Rural/Urban and Regional Variation in the 2019 CMS Hospital Wage Index
Findings brief describing the geographic variation in the 2019 Centers for Medicare and Medicaid Services (CMS) hospital wage index by rural and urban definitions. Includes data comparisons for rural and urban definitions by Census region, frontier and remote (FAR) codes, and state.
Author(s): Kristie W. Thompson, Ann Howard, George H. Pink
Date: 05/2019
Type: Document
Sponsoring organization: North Carolina Rural Health Research Program
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Opportunities to Advance Complex Care in Rural and Frontier Areas
Examines obstacles rural and frontier healthcare organizations face in providing complex care based on interviews with experts around the U.S. Focuses on rural social determinants of health, workforce shortages, and rural community relationships. Includes examples of models related to community collaboration, care coordination, social determinants of health, the health workforce, technology, and payment.
Author(s): Jim Lloyd
Date: 05/2019
Type: Document
Sponsoring organization: Center for Health Care Strategies
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Medicare Physician Payment Reform After Two Years: Examining MACRA Implementation and the Road Ahead
Provides a recording of a U.S. Senate Committee on Finance hearing on physician payment reforms under the Medicare Access and CHIP Reauthorization Act (MACRA). Features testimonies about what is working well and challenges faced, including provisions and challenges for small and rural practices. Contains testimonies from the American Medical Association, American Academy of Family Physicians, American College of Surgeons, American Medical Group Association, and Brookings Institution.
Additional links: American Medical Association Testimony, John Cullen Testimony, Scott Hines Testimony
Date: 05/2019
Type: Video/Multimedia
Sponsoring organization: Senate Committee on Finance
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Toward a High Performing Rural Health Care System: Key Issues and Recommendations from Rural Health Care System Innovators
Summarizes key themes and recommendations from a meeting of rural health leaders regarding innovations in rural healthcare financing and service delivery to inform state and national policy discussions. Offers recommendations, examples, and discussion on 3 areas: financing rural health system innovation, creating an infrastructure to support rural health innovation, and promoting governance models that support innovation.
Author(s): Keith J. Mueller, Charlie Alfero, Andrew F. Coburn, et al.
Date: 05/2019
Type: Document
Sponsoring organization: Rural Policy Research Institute Rural Health Panel
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