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Rural Health
Resources by Topic: Reimbursement and payment models

2019 Wage Index Diļ¬€erences and Selected Characteristics of Rural and Urban Hospitals
Findings brief describing and comparing rural and urban hospitals by Medicare payment classification, amount of patient revenue, and number of beds. Features statistics with breakdowns by urban and rural locations.
Author(s): George H. Pink, Kristie W. Thompson, H. Ann Howard
Date: 05/2019
Type: Document
Sponsoring organization: North Carolina Rural Health Research Program
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The Center for Medicare and Medicaid Innovation 2018 Report to Congress
Reports to Congress on payment and service delivery models and initiatives tested or announced by the Center for Medicare and Medicaid Innovation between October 2016 and 2018. Addresses Accountable Care Organization (ACO) models, population-based payment models, bundled payment models, and models that integrated Medicaid and Medicare beneficiary care. Identifies model adaptations for rural health organizations, such as the ACO Investment model, and includes a section on the Pennsylvania Rural Health Model.
Date: 04/2019
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Independent Evaluation of Comprehensive Primary Care Plus (CPC+): First Annual Report
Provides an overview of first-year findings for CPC+, including who participated, the supports practices received, how practices implemented CPC+, and the impacts on cost, service use, and outcomes for Medicare beneficiaries. Features statistics with breakdowns by rural, suburban, or urban location.
Additional links: Appendices to the Supplemental Volume, Findings at a Glance, Supplemental Volume
Author(s): Deborah Peikes, Grace Anglin, Mary Harrington, et al.
Date: 04/2019
Type: Document
Sponsoring organizations: Centers for Medicare and Medicaid Services, Mathematica Policy Research
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Oral Health: Targeting Rural Areas
Compiles articles from a special issue of the Texas Public Health Journal focusing on rural oral health in Texas, Louisiana, and Oklahoma. Covers emergency department use in Texas for oral health needs in rural versus urban counties, geriatric oral health and workforce options such as teledentistry, a Delivery System Reform Incentive Payment project under a state waiver targeting rural communities, partnerships to reach underserved areas and pregnant women, and oral health initiatives in Louisiana and Oklahoma.
Citation: Texas Public Health Journal, 71(2), 2-16
Date: 04/2019
Type: Document
Sponsoring organization: Texas Public Health Association
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Facility-Based Ambulatory Care Provided to Rural Medicare Beneficiaries in 2014
Chartbook describing claims, costs, and common diagnoses in facility-based ambulatory care provided to rural Medicare patients. Features statistics in various categories with breakdowns by Federally Qualified Health Centers in rural and urban areas, Rural Health Clinics, Critical Access Hospitals, and Prospective Payment Systems in rural and urban areas.
Author(s): Alex R. Schulte, Denise A. Kirk, Kristie W. Thompson, George H. Pink
Date: 03/2019
Type: Document
Sponsoring organization: North Carolina Rural Health Research Program
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Comparing Rural and Urban Medicare Advantage Beneficiary Characteristics
Describes differences in rural and urban populations enrolled in the Medicare Advantage (MA) program. Features statistics from the 2012-13 Medicare Current Beneficiary Survey, including measures of access by MA Beneficiaries, with breakdowns by rural and urban residence.
Author(s): Abigail Barker, Lindsey Nienstedt, Leah Kemper, Timothy McBride, Keith Mueller
Date: 03/2019
Type: Document
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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MedPAC Report to the Congress: Medicare Payment Policy: Hospital Inpatient and Outpatient Services: Chapter 3
Examines the adequacy of Medicare payments to hospitals in 2017 and offers recommendations for changes. Includes a discussion of rural hospital closures and provides rural/urban breakdowns for hospital occupancy rates, Medicare inpatient discharges, and Medicare margins.
Date: 03/2019
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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MedPAC Report to the Congress: Medicare Payment Policy, 2019
Annual review of Medicare payment policies, with recommendations to Congress. Includes discussion on Medicare payment policies directly affecting rural providers and beneficiaries. Addresses opioids, Medicare Part D, Medicare Advantage, Medicare's quality incentive program for hospitals, and payment adequacy for healthcare facilities and services.
Date: 03/2019
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Report to Congress on Medicaid and CHIP, March 2019
Reports on three aspects of Medicaid: improving the structure of Disproportionate Share Hospital (DSH) payment reductions, oversight of upper payment limits for supplemental payments to hospitals, and Disproportionate Share Hospital (DSH) payments to states. Chapter 3 includes the annual report on DSH payments, which provide support to safety-net hospitals to help offset uncompensated care costs for Medicaid and uninsured patients. Table 3-1 identifies DSH spending for urban and rural hospitals and for Critical Access Hospitals.
Date: 03/2019
Type: Document
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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2019 Telehealth Reimbursement
Provides an overview of Medicare reimbursement for telehealth services and discusses factors, policies, and legislation affecting reimbursement including: geographic and originating site restrictions; provider restrictions; service restrictions; payment for remote communication technology; chronic care management and remote monitoring; Medicare Advantage; Accountable Care Organizations, bundled care, and telehealth. Covers Medicaid and private payer telehealth reimbursement policies.
Date: 02/2019
Type: Document
Sponsoring organization: Center for Connected Health Policy: The National Telehealth Policy Resource Center
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