Rural Health
Resources by Topic: Reimbursement and payment models
Cost of Practice Transformation in Primary Care: Joining an Accountable Care Organization
Examines the cost of becoming part of an Accountable Care Organization (ACO) for Rural Health Clinics (RHCs) using data from over 800 RHCs in nine states. Compares the cost per patient of RHCs that were part of the Medicare Shared Savings Program to a similar group of RHCs that were not part of the program.
Author(s): Richard Hofler, Judith Ortiz, Brian Cote
Citation: Journal of Health Care Finance, 44(3), 1-16
Date: 2018
Type: Document
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Examines the cost of becoming part of an Accountable Care Organization (ACO) for Rural Health Clinics (RHCs) using data from over 800 RHCs in nine states. Compares the cost per patient of RHCs that were part of the Medicare Shared Savings Program to a similar group of RHCs that were not part of the program.
Author(s): Richard Hofler, Judith Ortiz, Brian Cote
Citation: Journal of Health Care Finance, 44(3), 1-16
Date: 2018
Type: Document
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Connected Care Toolkit: Chronic Care Management Resources for Health Care Professionals and Communities
A guide for healthcare professionals to support them in offering chronic care management (CCM) services. Provides links to CMS resources, including guides targeted to Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs). Also includes educational materials to help patients understand CCM services.
Date: 2018
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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A guide for healthcare professionals to support them in offering chronic care management (CCM) services. Provides links to CMS resources, including guides targeted to Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs). Also includes educational materials to help patients understand CCM services.
Date: 2018
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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What Are Rural Health Leaders Asking about Value-Based Care and Payment?
Brief highlights a survey of 60 rural healthcare leaders on value-based care and payment priorities. Details the survey questions, results, and the number of priorities ranked in top five by the participants.
Date: 2018
Type: Document
Sponsoring organization: Rural Health Value
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Brief highlights a survey of 60 rural healthcare leaders on value-based care and payment priorities. Details the survey questions, results, and the number of priorities ranked in top five by the participants.
Date: 2018
Type: Document
Sponsoring organization: Rural Health Value
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State Innovation Models (SIM) Round 2: Model Test Annual Report Two
Second annual report on the Round 2 State Innovation Models (SIM) program across eleven participating states - Colorado, Connecticut, Delaware, Idaho, Iowa, Michigan, New York, Ohio, Rhode Island, Tennessee, and Washington. Covers adoption of delivery models and payment reforms related to value-based purchasing and alternative payment models (APMs); strategies to support healthcare delivery transformation related to quality, health information technology, and workforce; and population health strategies.
Date: 2018
Type: Document
Sponsoring organizations: Centers for Medicare and Medicaid Services, RTI International
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Second annual report on the Round 2 State Innovation Models (SIM) program across eleven participating states - Colorado, Connecticut, Delaware, Idaho, Iowa, Michigan, New York, Ohio, Rhode Island, Tennessee, and Washington. Covers adoption of delivery models and payment reforms related to value-based purchasing and alternative payment models (APMs); strategies to support healthcare delivery transformation related to quality, health information technology, and workforce; and population health strategies.
Date: 2018
Type: Document
Sponsoring organizations: Centers for Medicare and Medicaid Services, RTI International
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Iowa's Marketplace Choice Summative Report
Summarizes an evaluation of the implementation of Iowa's Marketplace Choice Plan (MPC), a premium support health insurance plan for Iowans from 101-133% of the federal poverty level (FPL). Discusses the effects of the plan on member access to care, quality of care, insurance coverage gaps, and costs of providing care. Also examines the effects of the premium incentive and copayment disincentive programs on plan enrollees and the adequacy of the plan's provider network.
Author(s): Elizabeth T. Momany, Suzanne E. Bentler, Susan C. McKernan, et al.
Date: 12/2017
Type: Document
Sponsoring organization: University of Iowa Public Policy Center
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Summarizes an evaluation of the implementation of Iowa's Marketplace Choice Plan (MPC), a premium support health insurance plan for Iowans from 101-133% of the federal poverty level (FPL). Discusses the effects of the plan on member access to care, quality of care, insurance coverage gaps, and costs of providing care. Also examines the effects of the premium incentive and copayment disincentive programs on plan enrollees and the adequacy of the plan's provider network.
Author(s): Elizabeth T. Momany, Suzanne E. Bentler, Susan C. McKernan, et al.
Date: 12/2017
Type: Document
Sponsoring organization: University of Iowa Public Policy Center
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Getting to Healthcare Value: Redirecting the Policy Debate Toward Lower Costs and Better Quality
Report reflecting discussions and views of participants of the Healthcare Value Hub meeting in New Orleans, November 6-8, 2017. Includes a section on challenges and opportunities for healthcare value in rural areas.
Date: 12/2017
Type: Document
Sponsoring organization: Healthcare Value Hub
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Report reflecting discussions and views of participants of the Healthcare Value Hub meeting in New Orleans, November 6-8, 2017. Includes a section on challenges and opportunities for healthcare value in rural areas.
Date: 12/2017
Type: Document
Sponsoring organization: Healthcare Value Hub
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State Innovation Models (SIM) Round 2: Model Test Annual Report One
First annual report describing the design and progress of the Round 2 State Innovation Models (SIM) program across eleven participating states - Colorado, Connecticut, Delaware, Idaho, Iowa, Michigan, New York, Ohio, Rhode Island, Tennessee, and Washington. Includes information about the program's organization, data and methods, and implementation activities. Addresses challenges for rural areas throughout and shares highlights from each state's site visits.
Date: 12/2017
Type: Document
Sponsoring organizations: Centers for Medicare and Medicaid Services, RTI International
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First annual report describing the design and progress of the Round 2 State Innovation Models (SIM) program across eleven participating states - Colorado, Connecticut, Delaware, Idaho, Iowa, Michigan, New York, Ohio, Rhode Island, Tennessee, and Washington. Includes information about the program's organization, data and methods, and implementation activities. Addresses challenges for rural areas throughout and shares highlights from each state's site visits.
Date: 12/2017
Type: Document
Sponsoring organizations: Centers for Medicare and Medicaid Services, RTI International
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Medicaid Payment Policy for Federally Qualified Health Centers
Describes the role of Federally Qualified Health Centers (FQHCs) in Medicaid, and highlights current policy issues related to Medicaid FQHC payment. Also discusses the Medicaid FQHC prospective payment system (PPS), alternative payment methodologies, how FQHCs participate in managed care networks, and states' desire for increased flexibility in setting FQHC payment rates.
Date: 12/2017
Type: Document
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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Describes the role of Federally Qualified Health Centers (FQHCs) in Medicaid, and highlights current policy issues related to Medicaid FQHC payment. Also discusses the Medicaid FQHC prospective payment system (PPS), alternative payment methodologies, how FQHCs participate in managed care networks, and states' desire for increased flexibility in setting FQHC payment rates.
Date: 12/2017
Type: Document
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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Rural-Urban Enrollment in Part D Prescription Drug Plans: June 2017 Update
Updates prior policy briefs and shows state-to-state variation in stand-alone prescription drug plans and Medicare Advantage with Prescription Drug plans. Features statistics with breakdowns by rural and urban enrollment in 2008 and 2017.
Author(s): Paula Weigel, Fred Ullrich, Keith Mueller
Date: 12/2017
Type: Document
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Updates prior policy briefs and shows state-to-state variation in stand-alone prescription drug plans and Medicare Advantage with Prescription Drug plans. Features statistics with breakdowns by rural and urban enrollment in 2008 and 2017.
Author(s): Paula Weigel, Fred Ullrich, Keith Mueller
Date: 12/2017
Type: Document
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Emerging Strategies to Ensure Access to Health Care Services: Emergency Medical Center
Provides an overview of the emergency medical center (EMC) model, which would allow struggling hospitals to convert to EMC status and provide emergency and outpatient services, without having to provide inpatient acute care services. Also outlines rural-specific federal policy proposals that seek to create similar hospital designations, with the goal of improving access to and the delivery of care in underserved communities.
Date: 11/2017
Type: Document
Sponsoring organization: American Hospital Association
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Provides an overview of the emergency medical center (EMC) model, which would allow struggling hospitals to convert to EMC status and provide emergency and outpatient services, without having to provide inpatient acute care services. Also outlines rural-specific federal policy proposals that seek to create similar hospital designations, with the goal of improving access to and the delivery of care in underserved communities.
Date: 11/2017
Type: Document
Sponsoring organization: American Hospital Association
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