Rural Health
Resources by Topic: Reimbursement and payment models
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
Sponsoring organization: Senate Committee on Finance
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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
Sponsoring organization: Senate Committee on Finance
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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
Sponsoring organization: Centers for Medicare and Medicaid Services
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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
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
Sponsoring organizations: Centers for Medicare and Medicaid Services, Mathematica Policy Research
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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
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
Sponsoring organization: Texas Public Health Association
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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
Sponsoring organization: Texas Public Health Association
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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
Sponsoring organization: Medicare Payment Advisory Commission
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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
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
Sponsoring organization: Medicare Payment Advisory Commission
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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
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
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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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
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
Sponsoring organization: Center for Connected Health Policy: The National Telehealth Policy Resource Center
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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
Sponsoring organization: Center for Connected Health Policy: The National Telehealth Policy Resource Center
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Rural Report: Challenges Facing Rural Communities and the Roadmap to Ensure Local Access to High-Quality, Affordable Care
Reports on continuing, current, and emerging challenges for rural hospitals working to provide access to healthcare services in rural communities. Includes discussion on policy recommendations to improve access and covers new models of care, reimbursement policies, regulatory requirements, telehealth, workforce issues, and prescription drug costs.
Additional links: Executive Summary, Infographic
Date: 02/2019
Sponsoring organization: American Hospital Association
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Reports on continuing, current, and emerging challenges for rural hospitals working to provide access to healthcare services in rural communities. Includes discussion on policy recommendations to improve access and covers new models of care, reimbursement policies, regulatory requirements, telehealth, workforce issues, and prescription drug costs.
Additional links: Executive Summary, Infographic
Date: 02/2019
Sponsoring organization: American Hospital Association
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Technical Assistance for Hospitals Applying to the Pennsylvania Rural Health Model — A CMMI-Sponsored Rural Hospital Global Budget Model
Describes the experiences of the Rural Health Value program in coaching hospitals in Pennsylvania that were interested in participating in a global budget model. Explains a process to quickly develop a plan focused on community health rather than exclusively on clinical services, to facilitate the transition from volume to value.
Date: 2019
Sponsoring organization: Rural Health Value
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Describes the experiences of the Rural Health Value program in coaching hospitals in Pennsylvania that were interested in participating in a global budget model. Explains a process to quickly develop a plan focused on community health rather than exclusively on clinical services, to facilitate the transition from volume to value.
Date: 2019
Sponsoring organization: Rural Health Value
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