Rural Health
Resources by Topic: Reimbursement and payment models
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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Telehealth: Use in Medicare and Medicaid
Discusses the extent to which telehealth is used by Medicare and Medicaid, the factors affecting the use of telehealth in Medicare, and how emerging payment and delivery models could affect future telehealth use. Includes rural-specific information throughout with particular attention paid to the role of rural healthcare facilities as originating sites.
Additional links: Full Report
Date: 07/2017
Type: Document
Sponsoring organization: Government Accountability Office
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Discusses the extent to which telehealth is used by Medicare and Medicaid, the factors affecting the use of telehealth in Medicare, and how emerging payment and delivery models could affect future telehealth use. Includes rural-specific information throughout with particular attention paid to the role of rural healthcare facilities as originating sites.
Additional links: Full Report
Date: 07/2017
Type: Document
Sponsoring organization: Government Accountability Office
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Changes in Hospital Quality Associated with Hospital Value-Based Purchasing
Examines whether quality improved more in acute care hospitals exposed to Medicare's Hospital Value-Based Purchasing (HVBP) program. Uses Critical Access Hospitals as a comparison for clinical process, patient experience, and mortality measures.
Author(s): Andrew M. Ryan, Sam Krinsky, Kristen A. Maurer, Justin B. Dimick
Citation: New England Journal of Medicine, 376(24), 2358-2366
Date: 06/2017
Type: Document
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Examines whether quality improved more in acute care hospitals exposed to Medicare's Hospital Value-Based Purchasing (HVBP) program. Uses Critical Access Hospitals as a comparison for clinical process, patient experience, and mortality measures.
Author(s): Andrew M. Ryan, Sam Krinsky, Kristen A. Maurer, Justin B. Dimick
Citation: New England Journal of Medicine, 376(24), 2358-2366
Date: 06/2017
Type: Document
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Development and Deployment of Community Health Workers in Delaware
A guide for establishing a Community Health Worker program in the state of Delaware. Includes information about certification requirements and reimbursement mechanisms, along with model programs from other states.
Date: 06/2017
Type: Document
Sponsoring organizations: Delaware Center for Health Innovation, Delaware Health and Social Services
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A guide for establishing a Community Health Worker program in the state of Delaware. Includes information about certification requirements and reimbursement mechanisms, along with model programs from other states.
Date: 06/2017
Type: Document
Sponsoring organizations: Delaware Center for Health Innovation, Delaware Health and Social Services
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Hospital Value-Based Purchasing: CMS Should Take Steps to Ensure Lower Quality Hospitals Do Not Qualify for Bonuses
Examines the scoring methodology used by the Hospital Value-Based Purchasing (HVBP) program, which measures quality and efficiency within multiple hospital types including small, rural, and safety-net hospitals. Addresses differences in how safety net, small rural, and small urban hospitals performed, how payment adjustments changed for them over time, and the impact of an efficiency score on payment adjustments. Supports revising the methodology to apply the standards more evenly.
Additional links: Full Report
Date: 06/2017
Type: Document
Sponsoring organization: Government Accountability Office
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Examines the scoring methodology used by the Hospital Value-Based Purchasing (HVBP) program, which measures quality and efficiency within multiple hospital types including small, rural, and safety-net hospitals. Addresses differences in how safety net, small rural, and small urban hospitals performed, how payment adjustments changed for them over time, and the impact of an efficiency score on payment adjustments. Supports revising the methodology to apply the standards more evenly.
Additional links: Full Report
Date: 06/2017
Type: Document
Sponsoring organization: Government Accountability Office
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MedPAC Report to the Congress: Medicare and the Health Care Delivery System, June 2017
Includes chapters on implementing a unified payment system for post-acute care, Part B drug payment policies, the redesign of the Merit-Based Incentive Payment System (MIPS) and other alternative payment models, drug and device manufacturer payments to physicians and teaching hospitals, stand-alone emergency departments, and skilled nursing facility use. Rural hospitals and rural patient populations are discussed throughout the report.
Date: 06/2017
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Includes chapters on implementing a unified payment system for post-acute care, Part B drug payment policies, the redesign of the Merit-Based Incentive Payment System (MIPS) and other alternative payment models, drug and device manufacturer payments to physicians and teaching hospitals, stand-alone emergency departments, and skilled nursing facility use. Rural hospitals and rural patient populations are discussed throughout the report.
Date: 06/2017
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Factors Affecting States' Ability to Respond to Federal Medicaid Cuts and Caps: Which States Are Most At Risk?
Examines 30 key factors that contribute to state-by-state differences in Medicaid per enrollee spending including rural population, and uses the factors to rank and identify which states are at greatest risk if federal Medicaid cuts or caps are enacted. Presents findings across five main areas: Medicaid policy, demographics, health status, available tax revenue and state budget choices, and healthcare markets.
Author(s): Robin Rudowitz, Allison Valentine, Petry Ubri, Julia Zur
Date: 06/2017
Type: Document
Sponsoring organization: KFF
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Examines 30 key factors that contribute to state-by-state differences in Medicaid per enrollee spending including rural population, and uses the factors to rank and identify which states are at greatest risk if federal Medicaid cuts or caps are enacted. Presents findings across five main areas: Medicaid policy, demographics, health status, available tax revenue and state budget choices, and healthcare markets.
Author(s): Robin Rudowitz, Allison Valentine, Petry Ubri, Julia Zur
Date: 06/2017
Type: Document
Sponsoring organization: KFF
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