Rural Health
Resources by Topic: Reimbursement and payment models
Medicare Fee-for-Service: Information on the Second Year of Nationwide Reduced Payment Rates for Durable Medical Equipment
Analyzes 2017 Medicare claims data to describe changes in the number of beneficiaries receiving and suppliers furnishing Medicare beneficiaries with rate-adjusted versus non-adjusted items in non-bid areas. Includes information on changes in rural and non-rural non-bid areas.
Additional links: Full Report
Date: 12/2018
Type: Document
Sponsoring organization: Government Accountability Office
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Analyzes 2017 Medicare claims data to describe changes in the number of beneficiaries receiving and suppliers furnishing Medicare beneficiaries with rate-adjusted versus non-adjusted items in non-bid areas. Includes information on changes in rural and non-rural non-bid areas.
Additional links: Full Report
Date: 12/2018
Type: Document
Sponsoring organization: Government Accountability Office
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Using Telehealth to Support Opioid Use Disorder Treatment
Provides an issue brief on how telehealth can increase access to medication-assisted treatment (MAT) for opioid use disorder (OUD). Addresses how telehealth is used, implemented, and reimbursed, highlighting the implications for MAT.
Date: 11/2018
Type: Document
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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Provides an issue brief on how telehealth can increase access to medication-assisted treatment (MAT) for opioid use disorder (OUD). Addresses how telehealth is used, implemented, and reimbursed, highlighting the implications for MAT.
Date: 11/2018
Type: Document
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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The Rural Hospital and Health System Affiliation Landscape - A Brief Review
Describes choices available to rural hospitals and health systems when considering affiliations with urban-based hospitals, examines motivations for these affiliations, and presents a list of some affiliation structures with examples. Features statistics showing trends in hospital system affiliation by census region from 2007-2016, with breakdowns by metropolitan and nonmetropolitan hospitals and nonmetropolitan Critical Access Hospitals.
Author(s): Onyinye Oyeka, Fred Ullrich, A. Clinton MacKinney, Joseph Lupica, Keith J. Mueller
Date: 11/2018
Type: Document
Sponsoring organization: Rural Policy Research Institute
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Describes choices available to rural hospitals and health systems when considering affiliations with urban-based hospitals, examines motivations for these affiliations, and presents a list of some affiliation structures with examples. Features statistics showing trends in hospital system affiliation by census region from 2007-2016, with breakdowns by metropolitan and nonmetropolitan hospitals and nonmetropolitan Critical Access Hospitals.
Author(s): Onyinye Oyeka, Fred Ullrich, A. Clinton MacKinney, Joseph Lupica, Keith J. Mueller
Date: 11/2018
Type: Document
Sponsoring organization: Rural Policy Research Institute
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Significant Vulnerabilities Exist in the Hospital Wage Index System for Medicare Payments
Reports on 41 examinations of wage data of individual acute care hospitals from 2004 to 2017 to describe significant vulnerabilities observed in the wage index system for Medicare payments. Includes discussion on the rural floor wage index and the effects it has on wage index accuracy. Offers recommendations to reform the hospital wage index system.
Date: 11/2018
Type: Document
Sponsoring organization: Office of Inspector General (HHS)
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Reports on 41 examinations of wage data of individual acute care hospitals from 2004 to 2017 to describe significant vulnerabilities observed in the wage index system for Medicare payments. Includes discussion on the rural floor wage index and the effects it has on wage index accuracy. Offers recommendations to reform the hospital wage index system.
Date: 11/2018
Type: Document
Sponsoring organization: Office of Inspector General (HHS)
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Changes to the Merit-based Incentive Payment System Pertinent to Small and Rural Practices, 2018
Describes the importance of legislative changes to the Merit-Based Incentive Payment System that occurred as part of the Bipartisan Budget Act of 2018. Includes an appendix comparing the original framework for the system with changes for 2018/2019.
Author(s): Abiodun Salako, A. Clinton MacKinney, Fred Ullrich, Keith Mueller
Date: 11/2018
Type: Document
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Describes the importance of legislative changes to the Merit-Based Incentive Payment System that occurred as part of the Bipartisan Budget Act of 2018. Includes an appendix comparing the original framework for the system with changes for 2018/2019.
Author(s): Abiodun Salako, A. Clinton MacKinney, Fred Ullrich, Keith Mueller
Date: 11/2018
Type: Document
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Report to Congress: Rural Community Hospital Demonstration
Summarizes findings from the Rural Community Hospital Demonstration (RCHD) over the twelve years authorized by the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) and the Patient Protection and Affordable Care Act (ACA). Reports on the characteristics of the participating hospitals and the effect of the demonstration on hospital finances and other outcomes. Also discusses steps the hospitals expected to take at the end of the demonstration, if it had not been extended for an additional five years by the 21st Century Cures Act of 2016.
Date: 10/2018
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Summarizes findings from the Rural Community Hospital Demonstration (RCHD) over the twelve years authorized by the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) and the Patient Protection and Affordable Care Act (ACA). Reports on the characteristics of the participating hospitals and the effect of the demonstration on hospital finances and other outcomes. Also discusses steps the hospitals expected to take at the end of the demonstration, if it had not been extended for an additional five years by the 21st Century Cures Act of 2016.
Date: 10/2018
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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MedPAC Comment on CMS's Proposed Rule on Medicare Shared Savings Program ACOs
Comments on an August 17, 2018, Federal Register proposed rule changing the Medicare Shared Savings Program (MSSP). Focuses on the proposed changes for Accountable Care Organizations (ACOs), including a move to two-sided risk models, using regional spending benchmarks, and more. Addresses potential impacts for small ACOs, which include rural ACOs.
Date: 10/2018
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Comments on an August 17, 2018, Federal Register proposed rule changing the Medicare Shared Savings Program (MSSP). Focuses on the proposed changes for Accountable Care Organizations (ACOs), including a move to two-sided risk models, using regional spending benchmarks, and more. Addresses potential impacts for small ACOs, which include rural ACOs.
Date: 10/2018
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Developing Telemental Health Partnerships Between State Medical Schools and Federally Qualified Health Centers: Navigating the Regulatory Landscape and Policy Recommendations
Provides recommendations for overcoming barriers to promoting telemental health services partnerships between medical schools and health centers. Discusses rural-urban disparities in provision of mental health services, credentialing, remote electronic health records access, insurance issues, and billing.
Author(s): John C. Fortney, Richard C. Veith, Amy M. Bauer, et al.
Citation: Journal of Rural Health, 35(3), 287-297
Date: 10/2018
Type: Document
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Provides recommendations for overcoming barriers to promoting telemental health services partnerships between medical schools and health centers. Discusses rural-urban disparities in provision of mental health services, credentialing, remote electronic health records access, insurance issues, and billing.
Author(s): John C. Fortney, Richard C. Veith, Amy M. Bauer, et al.
Citation: Journal of Rural Health, 35(3), 287-297
Date: 10/2018
Type: Document
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CMS Bundled Payments for Care Improvement Initiative Models 2-4: Year 5 Evaluation & Monitoring Annual Report
Shares findings from an evaluation of Models 2, 3, and 4 of the Bundled Payments for Care Improvement (BPCI) initiative, linking provider payments for an episode of care with the goal of decreasing cost of care while improving quality. Includes information specific to rural BPCI-participating hospitals.
Author(s): The Lewin Group, Abt Associates, GDIT, Telligen
Date: 10/2018
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Shares findings from an evaluation of Models 2, 3, and 4 of the Bundled Payments for Care Improvement (BPCI) initiative, linking provider payments for an episode of care with the goal of decreasing cost of care while improving quality. Includes information specific to rural BPCI-participating hospitals.
Author(s): The Lewin Group, Abt Associates, GDIT, Telligen
Date: 10/2018
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Ensuring Access to Quality Health Care in Vulnerable Communities
Highlights the health characteristics and conditions of vulnerable populations in rural and urban communities, and the essential healthcare services as identified by the American Hospital Association Task Force on Ensuring Access in Vulnerable Communities. Discusses several strategies recommended by the task force to address social determinants of health, enhance virtual care services to reform healthcare delivery and payment methods, and support hospitals in their efforts to provide the needed health services.
Author(s): Jay Bhatt, Priya Bathija
Citation: Academic Medicine, 93(9), 1271-1275
Date: 09/2018
Type: Document
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Highlights the health characteristics and conditions of vulnerable populations in rural and urban communities, and the essential healthcare services as identified by the American Hospital Association Task Force on Ensuring Access in Vulnerable Communities. Discusses several strategies recommended by the task force to address social determinants of health, enhance virtual care services to reform healthcare delivery and payment methods, and support hospitals in their efforts to provide the needed health services.
Author(s): Jay Bhatt, Priya Bathija
Citation: Academic Medicine, 93(9), 1271-1275
Date: 09/2018
Type: Document
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