Rural Health
Resources by Topic: Reimbursement and payment models
MedPAC Report to the Congress: Medicare and the Health Care Delivery System, June 2020
Evaluates Medicare payment issues and offers recommendations to the U.S. Congress. Includes chapters on value-based payment in Medicare, Accountable Care Organizations (ACOs), the Medicare Advantage quality bonus program, the impact of changes in the 21st Century Cures Act to risk adjustment for Medicare Advantage enrollees, Medicare Part D, separately payable drugs in the hospital outpatient prospective payment system, and the Medicare end-stage renal disease prospective payment system. Examines the current payment policy for low-volume and rural dialysis facilities and proposes changes.
Additional links: Executive Summary
Date: 06/2020
Sponsoring organization: Medicare Payment Advisory Commission
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Evaluates Medicare payment issues and offers recommendations to the U.S. Congress. Includes chapters on value-based payment in Medicare, Accountable Care Organizations (ACOs), the Medicare Advantage quality bonus program, the impact of changes in the 21st Century Cures Act to risk adjustment for Medicare Advantage enrollees, Medicare Part D, separately payable drugs in the hospital outpatient prospective payment system, and the Medicare end-stage renal disease prospective payment system. Examines the current payment policy for low-volume and rural dialysis facilities and proposes changes.
Additional links: Executive Summary
Date: 06/2020
Sponsoring organization: Medicare Payment Advisory Commission
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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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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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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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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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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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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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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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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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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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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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