Rural Health
Resources by Topic: Reimbursement and payment models
Reaching the Quadruple Aim: Workforce and Service Delivery Within Certified Community Behavioral Health Clinics
Summary of data collected between February and August 2019 on the Certified Community Behavioral Health Clinic (CCBHC) model's impact on the behavioral workforce and the aims of improving patient and provider experiences, improving the health of populations, and reducing costs. Discusses access and barriers to care, workforce capacity, primary care and behavioral healthcare integration, and offers recommendations for enhancing financing and reimbursement. Features statistics including populations served by CCBHCs, with breakdowns by urban, rural, and tribal locations.
Author(s): Dana Foney, Shannon Mace, Adriano Boccanelli
Date: 08/2019
Sponsoring organizations: National Council for Mental Wellbeing, University of Michigan Behavioral Health Workforce Research Center
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Summary of data collected between February and August 2019 on the Certified Community Behavioral Health Clinic (CCBHC) model's impact on the behavioral workforce and the aims of improving patient and provider experiences, improving the health of populations, and reducing costs. Discusses access and barriers to care, workforce capacity, primary care and behavioral healthcare integration, and offers recommendations for enhancing financing and reimbursement. Features statistics including populations served by CCBHCs, with breakdowns by urban, rural, and tribal locations.
Author(s): Dana Foney, Shannon Mace, Adriano Boccanelli
Date: 08/2019
Sponsoring organizations: National Council for Mental Wellbeing, University of Michigan Behavioral Health Workforce Research Center
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Small Rural Hospital Transition (SRHT) Project Guide: A Rural Hospital Guide to Improving Care Management: 2019 Update
A guide for rural hospital leadership that identifies best practices in care management. Addresses care management roles and staffing needs and covers utilization review and discharge planning. Helps identify opportunities for process improvement. Also discusses competencies needed to transition to a value-based reimbursement environment focused on population health.
Date: 08/2019
Sponsoring organizations: National Rural Health Resource Center, Stroudwater Associates
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A guide for rural hospital leadership that identifies best practices in care management. Addresses care management roles and staffing needs and covers utilization review and discharge planning. Helps identify opportunities for process improvement. Also discusses competencies needed to transition to a value-based reimbursement environment focused on population health.
Date: 08/2019
Sponsoring organizations: National Rural Health Resource Center, Stroudwater Associates
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Rural Care Coordination and Population Health Management Summit: Summit Findings
Provides guidance to rural hospitals, clinics, and healthcare networks on incorporating community care coordination planning to prepare for population health management. Identifies tools and resources to support the transition to value-based payment models. Summarizes findings from a series of summits with national experts.
Author(s): Rebecca Jolley
Date: 08/2019
Sponsoring organizations: National Rural Health Resource Center, Rural Health Association of Tennessee
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Provides guidance to rural hospitals, clinics, and healthcare networks on incorporating community care coordination planning to prepare for population health management. Identifies tools and resources to support the transition to value-based payment models. Summarizes findings from a series of summits with national experts.
Author(s): Rebecca Jolley
Date: 08/2019
Sponsoring organizations: National Rural Health Resource Center, Rural Health Association of Tennessee
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The Evolving Policy Landscape of Telehealth Services Delivered in the Home and Other Nonclinical Settings
Issue brief identifying key findings for state officials considering adopting new policies for home-based telehealth services. Describes Medicaid and Medicare coverage for telehealth services, including those provided in rural and Health Professional Shortage Areas, Critical Access Hospitals, and Rural Health Clinics.
Author(s): Brittany Lazur, Andrea Bennett, Valerie King
Date: 08/2019
Sponsoring organization: Milbank Memorial Fund
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Issue brief identifying key findings for state officials considering adopting new policies for home-based telehealth services. Describes Medicaid and Medicare coverage for telehealth services, including those provided in rural and Health Professional Shortage Areas, Critical Access Hospitals, and Rural Health Clinics.
Author(s): Brittany Lazur, Andrea Bennett, Valerie King
Date: 08/2019
Sponsoring organization: Milbank Memorial Fund
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MedPAC Comment on CMS's Proposed Rule on the CY 2020 Home Health PPS Update and Home Infusion Therapy
Comments on a July 18, 2019, Federal Register proposed rule related to Medicare payment policies for home health agencies. Includes comments addressing the proposed rural add-on payments for calendar years 2019 through 2022.
Date: 08/2019
Sponsoring organization: Medicare Payment Advisory Commission
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Comments on a July 18, 2019, Federal Register proposed rule related to Medicare payment policies for home health agencies. Includes comments addressing the proposed rural add-on payments for calendar years 2019 through 2022.
Date: 08/2019
Sponsoring organization: Medicare Payment Advisory Commission
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Addressing Rural Hospital Closures Through Infrastructure Reform
Provides a historical overview of rural Medicare reimbursement and provider designations and discusses their impact on hospital closures. Supports changing the rural health infrastructure to provide more flexibility for rural hospitals and to emphasize primary care and emergency care access.
Author(s): Eleni Salyers
Date: 08/2019
Sponsoring organization: Bipartisan Policy Center
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Provides a historical overview of rural Medicare reimbursement and provider designations and discusses their impact on hospital closures. Supports changing the rural health infrastructure to provide more flexibility for rural hospitals and to emphasize primary care and emergency care access.
Author(s): Eleni Salyers
Date: 08/2019
Sponsoring organization: Bipartisan Policy Center
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Accelerating Value-Based Payment in California's Federally Qualified Health Centers: Options for Medicaid Health Plans
Highlights examples of value-based payment (VBP) models for Federally Qualified Health Centers (FQHCs), including a rural Hawaii model and a Colorado model that incorporates rural FQHCs. Covers Accountable Care Organization (ACO) models, state-led Capitated Alternative Payment Models (APMs), state-led quality payment adjustments, and Medicaid shared savings ACO models. Addresses how FQHCs and health plans can overcome challenges when launching new VBP models and offers recommendations for California's health plans.
Author(s): Greg Howe, Tricia McGinnis, Rob Houston
Date: 08/2019
Sponsoring organization: Center for Health Care Strategies
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Highlights examples of value-based payment (VBP) models for Federally Qualified Health Centers (FQHCs), including a rural Hawaii model and a Colorado model that incorporates rural FQHCs. Covers Accountable Care Organization (ACO) models, state-led Capitated Alternative Payment Models (APMs), state-led quality payment adjustments, and Medicaid shared savings ACO models. Addresses how FQHCs and health plans can overcome challenges when launching new VBP models and offers recommendations for California's health plans.
Author(s): Greg Howe, Tricia McGinnis, Rob Houston
Date: 08/2019
Sponsoring organization: Center for Health Care Strategies
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Geriatrician Roles and the Value of Geriatrics in an Evolving Healthcare System
Research report focusing on how geriatric roles are changing as healthcare systems and organizations reorganize care. Features information on ways telemedicine is used in geriatric care delivery in rural areas, including the TeleECHO (Extension for Community Health Outcomes) model.
Author(s): Timothy Bates, Aubri Kottek, Joanne Spetz
Date: 07/2019
Sponsoring organization: University of California San Francisco Health Workforce Research Center on Long-Term Care
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Research report focusing on how geriatric roles are changing as healthcare systems and organizations reorganize care. Features information on ways telemedicine is used in geriatric care delivery in rural areas, including the TeleECHO (Extension for Community Health Outcomes) model.
Author(s): Timothy Bates, Aubri Kottek, Joanne Spetz
Date: 07/2019
Sponsoring organization: University of California San Francisco Health Workforce Research Center on Long-Term Care
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Medicaid: States' Use and Distribution of Supplemental Payments to Hospitals
Examines the use of disproportionate share hospital (DSH) payments given to hospitals with more Medicaid and uninsured patients. Addresses differences in state Medicaid expansion status, uninsured percentage, and uncompensated care in relation to DSH payments. Includes state data on DSH payments and uncompensated care costs by rural/urban hospital location, as well as data on Critical Access Hospital (CAH) and Sole Community Hospital DSH payments by state.
Additional links: Full Report
Date: 07/2019
Sponsoring organization: Government Accountability Office
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Examines the use of disproportionate share hospital (DSH) payments given to hospitals with more Medicaid and uninsured patients. Addresses differences in state Medicaid expansion status, uninsured percentage, and uncompensated care in relation to DSH payments. Includes state data on DSH payments and uncompensated care costs by rural/urban hospital location, as well as data on Critical Access Hospital (CAH) and Sole Community Hospital DSH payments by state.
Additional links: Full Report
Date: 07/2019
Sponsoring organization: Government Accountability Office
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When Will the U.S. Territories Exhaust Federal Medicaid Funding?
Issue brief exploring the projected effects on healthcare expense funding in American Samoa, the Northern Mariana Islands, Guam, Puerto Rico, and the U.S. Virgin Islands if all sources of federal funding are allowed to expire in 2019. Features statistics for Medicaid funding and spending in the territories for fiscal year 2018, and sources of federal Medicaid funding and periods during which the funding is available.
Date: 07/2019
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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Issue brief exploring the projected effects on healthcare expense funding in American Samoa, the Northern Mariana Islands, Guam, Puerto Rico, and the U.S. Virgin Islands if all sources of federal funding are allowed to expire in 2019. Features statistics for Medicaid funding and spending in the territories for fiscal year 2018, and sources of federal Medicaid funding and periods during which the funding is available.
Date: 07/2019
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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