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Rural Health
Resources by Topic: Reimbursement and payment models

Report to Congress on Medicaid and CHIP, June 2020
Semi-annual report to Congress from the Medicaid and CHIP Payment and Access Commission (MACPAC). Discusses care integration for beneficiaries dually eligible for Medicaid and Medicare, recommendations for increasing enrollment in Medicare Shared Savings Programs, the role of Medicaid in relation to TRICARE, how to address increasing mortality and morbidity among pregnant and postpartum women, and the effects of substance use disorder on pregnant and postpartum women and their infants. Includes rural references throughout.
Date: 06/2020
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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Telehealth and Telemedicine in Missouri
Discusses telehealth programs in Missouri, including the early contributions of the Missouri Telehealth Network to the growth of telehealth and the MO HealthNet program. Discusses telehealth's impact on rural healthcare access and state-level approaches to reimbursement, licensing, restrictions, and telemedicine delivery.
Author(s): Mirna Becevic, Lincoln R. Sheets, Emmanuelle Wallach, et al.
Citation: Missouri Medicine, 117(3), 228-234
Date: 05/2020
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Health Panel Comment Letter – Maternal and Infant Health Care in Rural Communities
Offers comments in response to the CMS Maternal and Infant Health Care in Rural Communities Request for Information. Describes Medicare cost reporting challenges for obstetric services at Critical Access Hospitals and possible changes to maternal health coverage under Medicaid.
Date: 05/2020
Sponsoring organization: Rural Policy Research Institute Rural Health Panel
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Fact Sheet: Rural Community Hospital (RCH) Demonstration
Provides an overview of the Rural Community Hospital demonstration program. Describes reimbursement challenges that rural hospitals face and the early results of the program.
Date: 05/2020
Sponsoring organization: American Hospital Association
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COVID-19's Current Impact on Rural Healthcare Delivery: Q&A with Brock Slabach
An interview with Brock Slabach, the National Rural Health Association's Senior Vice President for Member Services. Discusses the impact of COVID-19 on rural healthcare facilities, policy changes impacting rural providers, collaboration among rural communities to help share solutions, and the use of telehealth during the pandemic.
Author(s): Kay Miller Temple
Citation: Rural Monitor
Date: 05/2020
Sponsoring organization: Rural Health Information Hub
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Estimated Reduction in CAH Profitability from Loss of Cost-Based Reimbursement for Swing Beds
Examines the impact of proposed legislation recommending changes to swing bed reimbursements for Critical Access Hospitals (CAHs) from cost-based to the Skilled Nursing Facility Prospective Payment System (SNF PPS). Estimates CAH profitability using reimbursement formulas from Medicare cost reports and discusses the characteristics of CAHs most affected by a change in swing bed reimbursement.
Author(s): Drake M. Broussard, Kristin L. Reiter
Date: 05/2020
Sponsoring organization: North Carolina Rural Health Research Program
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An Initiative to Implement Immediate Postpartum Long-Acting Reversible Contraception in Rural New Mexico
Study examining 7 rural hospitals in New Mexico and their efforts to implement immediate postpartum (IPP) long-acting reversible contraception (LARC) through a program offered by the New Mexico Perinatal Collaborative. Discusses challenges to implementing the program, including reimbursement obstacles, based on interviews with 20 key staff members.
Author(s): Hannah C. Palm, James H. Degnan, Sharla D. Biefeld, et al.
Citation: American Journal of Obstetrics and Gynecology, 222, S911, 1-7
Date: 04/2020
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Medicaid: State Views on Program Administration Challenges
Describes four federal Medicaid policies that pose barriers to effective program administration. Highlights the requirement for states to pay Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs) under the prospective payment system as a challenge for states. Identifies three issues for federal policymakers to consider when addressing these administrative challenges.
Additional links: Full Report
Date: 04/2020
Sponsoring organization: Government Accountability Office
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Selected Health Provisions in Title III of the CARES Act (P.L. 116-136)
Provides an overview of the healthcare-related provisions of the Coronavirus Aid, Relief, and Economic Security (CARES) Act, passed in response to the COVID-19 pandemic. Focuses on sections of the law addressing medical supply shortages, testing and preventative services, and support for the healthcare workforce. Discusses provisions related to telehealth services and rural healthcare systems.
Date: 04/2020
Sponsoring organization: Congressional Research Service
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Confronting Rural America's Health Care Crisis
Offers policy recommendations to stabilize the rural healthcare infrastructure and ensuring local access to care. Discusses strategies to provide financial relief to rural providers, preserve obstetric services, expand telehealth services, and address workforce shortages. Includes brief references to policy actions taken in response to the COVID-19 pandemic.
Additional links: Rural Hospital Transformation Models, Summary, The Case for Expanding Telehealth Services, July 2020
Date: 04/2020
Sponsoring organization: Bipartisan Policy Center
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