Rural Health
Resources by Topic: Reimbursement and payment models
MedPAC Report to the Congress: Regional Variation in Medicare Part A, Part B, and Part D Spending and Service Use
Compares Medicare spending and service use based on geographic location, including across metropolitan and nonmetropolitan areas. Seeks to identify factors that influence regional variation and determine if higher service use and/or spending results in higher quality care and outcomes. Utilizes updated data to build on findings that were published in the January 2011 Report to the Congress: Regional Variation in Medicare Service Use. Data is adjusted to account for differences in payment rates to certain providers, such as Critical Access Hospitals.
Date: 09/2017
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Compares Medicare spending and service use based on geographic location, including across metropolitan and nonmetropolitan areas. Seeks to identify factors that influence regional variation and determine if higher service use and/or spending results in higher quality care and outcomes. Utilizes updated data to build on findings that were published in the January 2011 Report to the Congress: Regional Variation in Medicare Service Use. Data is adjusted to account for differences in payment rates to certain providers, such as Critical Access Hospitals.
Date: 09/2017
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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State Innovation Models (SIM) Initiative Evaluation: Model Test Year Three Annual Report
Third annual report detailing the findings of CMS's State Innovation Models (SIM) Initiative, which tests the ability of the governments in six states - Arkansas, Maine, Massachusetts, Minnesota, Oregon, and Vermont - to accelerate health system transformation in the areas of delivery systems, payment models, information technology, workforce development, and more. Focuses on sharing cross-state progress and findings, state-specific findings and lessons learned, and lessons for policymakers. Additional emphasis is placed on monitoring healthcare experience, utilization, and expenditures in participating SIM states.
Date: 09/2017
Type: Document
Sponsoring organizations: Centers for Medicare and Medicaid Services, RTI International
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Third annual report detailing the findings of CMS's State Innovation Models (SIM) Initiative, which tests the ability of the governments in six states - Arkansas, Maine, Massachusetts, Minnesota, Oregon, and Vermont - to accelerate health system transformation in the areas of delivery systems, payment models, information technology, workforce development, and more. Focuses on sharing cross-state progress and findings, state-specific findings and lessons learned, and lessons for policymakers. Additional emphasis is placed on monitoring healthcare experience, utilization, and expenditures in participating SIM states.
Date: 09/2017
Type: Document
Sponsoring organizations: Centers for Medicare and Medicaid Services, RTI International
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State Innovation Models (SIM) Round 2: Model Design Final Report
Shares results from a federal evaluation of the Round 2 State Innovation Models (SIM) Initiative awards, which focused on reforming payment and delivery systems, health information exchanges, workforce development, and sustainability. Provides a summary and review of each awardees' final State Health System Innovations Plan (SHSIP). Includes several suggestions and recommendations for improving rural healthcare delivery, payment, and access.
Author(s): Donald Nichols, Kathleen Farrell, Marisa Morrison, et al.
Date: 08/2017
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Shares results from a federal evaluation of the Round 2 State Innovation Models (SIM) Initiative awards, which focused on reforming payment and delivery systems, health information exchanges, workforce development, and sustainability. Provides a summary and review of each awardees' final State Health System Innovations Plan (SHSIP). Includes several suggestions and recommendations for improving rural healthcare delivery, payment, and access.
Author(s): Donald Nichols, Kathleen Farrell, Marisa Morrison, et al.
Date: 08/2017
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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The Status of Telemedicine in Missouri
Provides background information on rural healthcare issues in Missouri and discusses the value of using telehealth to improve rural healthcare access. Discusses policy recommendations such as broadband access and details about eligibility and payment requirements for telemedicine.
Author(s): Dave Dillon, Jim Mikes
Date: 08/2017
Type: Document
Sponsoring organization: Missouri Hospital Association
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Provides background information on rural healthcare issues in Missouri and discusses the value of using telehealth to improve rural healthcare access. Discusses policy recommendations such as broadband access and details about eligibility and payment requirements for telemedicine.
Author(s): Dave Dillon, Jim Mikes
Date: 08/2017
Type: Document
Sponsoring organization: Missouri Hospital Association
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Home is Where the Heart Is: Insights on the Coordination and Delivery of Home Health Services in Rural America
Identifies facilitators and barriers to providing home health services in rural areas, discusses how rural home health services are currently provided, and offers thoughts about the provision of home health services in the future. Addresses electronic health records, reimbursement issues, workforce challenges, value-based payment, and more.
Author(s): Alana Knudson, Britta Anderson, Kellie Schueler, Emily Arsen
Date: 08/2017
Type: Document
Sponsoring organization: Rural Health Reform Policy Research Center
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Identifies facilitators and barriers to providing home health services in rural areas, discusses how rural home health services are currently provided, and offers thoughts about the provision of home health services in the future. Addresses electronic health records, reimbursement issues, workforce challenges, value-based payment, and more.
Author(s): Alana Knudson, Britta Anderson, Kellie Schueler, Emily Arsen
Date: 08/2017
Type: Document
Sponsoring organization: Rural Health Reform Policy Research Center
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An Emerging Approach to Payment Reform: All-Payer Global Budgets for Large Safety-Net Hospital Systems
Examines the possibility of implementing global all-payer budgets in safety-net hospital systems throughout the U.S. Provides background on the all-payer model, and discusses the experiences of rural hospitals in Maryland and Pennsylvania, where current global budgeting demonstrations are ongoing.
Author(s): Joshua M. Sharfstein, Sule Gerovich, Elizabeth Moriarty, David Chin
Date: 08/2017
Type: Document
Sponsoring organization: Commonwealth Fund
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Examines the possibility of implementing global all-payer budgets in safety-net hospital systems throughout the U.S. Provides background on the all-payer model, and discusses the experiences of rural hospitals in Maryland and Pennsylvania, where current global budgeting demonstrations are ongoing.
Author(s): Joshua M. Sharfstein, Sule Gerovich, Elizabeth Moriarty, David Chin
Date: 08/2017
Type: Document
Sponsoring organization: Commonwealth Fund
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Evaluation of the Round Two Health Care Innovation Awards (HCIA R2): Second Annual Report
Summarizes the second year evaluation results of the 39 Health Care Innovation Awards Round Two projects. Describes implementation experiences during the second program year and examines pre-enrollment characteristics of participants. Focuses on program enrollment, implementation of service delivery models, development and implementation of payment models, and sustainability plans. Provides findings for the individual grantees, which include projects that serve rural areas.
Date: 08/2017
Type: Document
Sponsoring organizations: Centers for Medicare and Medicaid Services, Mathematica Policy Research
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Summarizes the second year evaluation results of the 39 Health Care Innovation Awards Round Two projects. Describes implementation experiences during the second program year and examines pre-enrollment characteristics of participants. Focuses on program enrollment, implementation of service delivery models, development and implementation of payment models, and sustainability plans. Provides findings for the individual grantees, which include projects that serve rural areas.
Date: 08/2017
Type: Document
Sponsoring organizations: Centers for Medicare and Medicaid Services, Mathematica Policy Research
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Telehealth Private Payer Laws: Impact and Issues
Analyzes the body of state-level telehealth reimbursement policies, which has grown rapidly in both size and scope since 2010. Seeks to understand how these policies impact telehealth utilization, and the effect private payer laws have on selected commercial payers. Includes information on payment parity laws, modalities, site restrictions, Medicaid policies, and more.
Additional links: Executive Summary
Date: 08/2017
Type: Document
Sponsoring organizations: Center for Connected Health Policy: The National Telehealth Policy Resource Center, Milbank Memorial Fund
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Analyzes the body of state-level telehealth reimbursement policies, which has grown rapidly in both size and scope since 2010. Seeks to understand how these policies impact telehealth utilization, and the effect private payer laws have on selected commercial payers. Includes information on payment parity laws, modalities, site restrictions, Medicaid policies, and more.
Additional links: Executive Summary
Date: 08/2017
Type: Document
Sponsoring organizations: Center for Connected Health Policy: The National Telehealth Policy Resource Center, Milbank Memorial Fund
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Rethinking Rural Hospitals
Discusses the various factors associated with rural hospital closures, and makes the case for adopting new, innovative approaches to rural healthcare delivery.
Author(s): Diana J. Mason
Citation: JAMA: Journal of the American Medical Association, 318(2), 114-115
Date: 07/2017
Type: Document
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Discusses the various factors associated with rural hospital closures, and makes the case for adopting new, innovative approaches to rural healthcare delivery.
Author(s): Diana J. Mason
Citation: JAMA: Journal of the American Medical Association, 318(2), 114-115
Date: 07/2017
Type: Document
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The Financial Importance of Medicare Post-Acute and Hospice Care to Rural Hospitals
Findings brief describing variation in the number of hospitals in rural areas providing Medicare post-acute care (PAC) and hospice care, average amount of revenue generated for these services, and financial importance to rural hospitals. Includes statistics on 2015 Medicare PAC and hospice care revenue as percentage of patient revenue in 1,205 Critical Access Hospitals and 964 Prospective Payment System hospitals.
Author(s): Alex Schulte, H. Ann Howard, George H. Pink
Date: 07/2017
Type: Document
Sponsoring organization: North Carolina Rural Health Research Program
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Findings brief describing variation in the number of hospitals in rural areas providing Medicare post-acute care (PAC) and hospice care, average amount of revenue generated for these services, and financial importance to rural hospitals. Includes statistics on 2015 Medicare PAC and hospice care revenue as percentage of patient revenue in 1,205 Critical Access Hospitals and 964 Prospective Payment System hospitals.
Author(s): Alex Schulte, H. Ann Howard, George H. Pink
Date: 07/2017
Type: Document
Sponsoring organization: North Carolina Rural Health Research Program
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