Rural Health
Resources by Topic: Reimbursement and payment models
Preventing Medical Debt among Rural Residents: Example Programs from Hospitals in Minnesota and Montana
Highlights the ways some rural hospitals are working to reduce medical debt for their patients. Presents a number of strategies from hospitals in Minnesota and Montana that aim to reduce patient medical debts through financial assistance programs and cost-cutting measures. Features case-studies reviewing the structure of each hospital's debt reduction efforts.
Author(s): Katie Rydberg, Sushma Shankar, Mariana Tuttle, Carrie Henning-Smith
Date: 06/2025
Sponsoring organization: University of Minnesota Rural Health Research Center
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Highlights the ways some rural hospitals are working to reduce medical debt for their patients. Presents a number of strategies from hospitals in Minnesota and Montana that aim to reduce patient medical debts through financial assistance programs and cost-cutting measures. Features case-studies reviewing the structure of each hospital's debt reduction efforts.
Author(s): Katie Rydberg, Sushma Shankar, Mariana Tuttle, Carrie Henning-Smith
Date: 06/2025
Sponsoring organization: University of Minnesota Rural Health Research Center
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Quality Payment Program (QPP) 2023: Participation and Payment Results At-a-Glance
Provides an overview of the results of the Quality Payment Program (QPP) for the 2023 performance year. Highlights the percentages of small and rural providers receiving negative, neutral, and positive payment adjustments for 2025.
Date: 06/2025
Sponsoring organization: Centers for Medicare and Medicaid Services
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Provides an overview of the results of the Quality Payment Program (QPP) for the 2023 performance year. Highlights the percentages of small and rural providers receiving negative, neutral, and positive payment adjustments for 2025.
Date: 06/2025
Sponsoring organization: Centers for Medicare and Medicaid Services
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Association of a State-Wide Alternative Payment Model for Rural Hospitals with Bypass for Elective Surgeries
Examines the impact of the payment model, Pennsylvania Rural Health Model (PARHM), on rural hospital bypass for elective surgeries. Utilizes 2016-2022 all-payer visit-level inpatient discharge data to measure 175,138 surgeries in Pennsylvania, with data on risk level of elective surgery, hospital type, payer type, and more.
Author(s): Donald S. Bourne, Zhaojun Sun, Bruce L. Jacobs, et al.
Citation: Health Services Research, 60(3), e14442
Date: 06/2025
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Examines the impact of the payment model, Pennsylvania Rural Health Model (PARHM), on rural hospital bypass for elective surgeries. Utilizes 2016-2022 all-payer visit-level inpatient discharge data to measure 175,138 surgeries in Pennsylvania, with data on risk level of elective surgery, hospital type, payer type, and more.
Author(s): Donald S. Bourne, Zhaojun Sun, Bruce L. Jacobs, et al.
Citation: Health Services Research, 60(3), e14442
Date: 06/2025
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Medicare Care Management Billing Strategies
Webinar recording featuring speakers from Eide Bailly and the NORC Walsh Center for Rural Health Analysis discussing new 2025 Medicare care management billing codes and how they can be used to support care coordination to improve care quality for Medicare beneficiaries
Additional links: Audio Recording, Webinar Slides
Date: 05/2025
Sponsoring organization: Rural Health Information Hub
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Webinar recording featuring speakers from Eide Bailly and the NORC Walsh Center for Rural Health Analysis discussing new 2025 Medicare care management billing codes and how they can be used to support care coordination to improve care quality for Medicare beneficiaries
Additional links: Audio Recording, Webinar Slides
Date: 05/2025
Sponsoring organization: Rural Health Information Hub
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Negotiated Prices for Care at Independent and System-Affiliated Rural Hospitals
Compares negotiated prices for procedural and imaging services at independent rural hospitals versus system-affiliated rural hospitals. Analyzes commercially negotiated price data with their associated hospital and evaluates number of negotiated prices for services. Discusses policies for rural hospital financial sustainability.
Author(s): Cody Lendon Mullens, Mitchell Mead, James D Lee, et al.
Citation: JAMA Network Open, 8(5)
Date: 05/2025
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Compares negotiated prices for procedural and imaging services at independent rural hospitals versus system-affiliated rural hospitals. Analyzes commercially negotiated price data with their associated hospital and evaluates number of negotiated prices for services. Discusses policies for rural hospital financial sustainability.
Author(s): Cody Lendon Mullens, Mitchell Mead, James D Lee, et al.
Citation: JAMA Network Open, 8(5)
Date: 05/2025
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Environmental Scan on Reducing Barriers to Participation in Population-Based Total Cost of Care (PB-TCOC) Models and Supporting Primary and Specialty Care Transformation
Presents results of an environmental scan on reducing barriers to participation in population-based total cost of care (PB-TCOC) models and supporting primary and specialty care transformation. Discusses identifying pathways for maximizing participation of different kinds of organizations in PB-TCOC models; an assessment of and approaches to reducing organization-level barriers; approaches to support primary and specialty care transformation; an assessment of factors that influence the ability of PB-TCOC models to be competitive; and a summary of relevant features in previously submitted Physician-Focused Payment Model Technical Advisory Committee (PTAC) proposals. Includes rural references throughout.
Date: 05/2025
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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Presents results of an environmental scan on reducing barriers to participation in population-based total cost of care (PB-TCOC) models and supporting primary and specialty care transformation. Discusses identifying pathways for maximizing participation of different kinds of organizations in PB-TCOC models; an assessment of and approaches to reducing organization-level barriers; approaches to support primary and specialty care transformation; an assessment of factors that influence the ability of PB-TCOC models to be competitive; and a summary of relevant features in previously submitted Physician-Focused Payment Model Technical Advisory Committee (PTAC) proposals. Includes rural references throughout.
Date: 05/2025
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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Securing a Better Future for Rural Health
Slides presented at the 2025 National Rural Health Association Annual Conference summarizing findings from a November 2024 summit of rural health services delivery and finance experts. Covers financing rural health services, payment policies, workforce considerations, the use of technology and data, and more.
Author(s): Keith J. Mueller
Date: 05/2025
Sponsoring organization: Rural Policy Research Institute
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Slides presented at the 2025 National Rural Health Association Annual Conference summarizing findings from a November 2024 summit of rural health services delivery and finance experts. Covers financing rural health services, payment policies, workforce considerations, the use of technology and data, and more.
Author(s): Keith J. Mueller
Date: 05/2025
Sponsoring organization: Rural Policy Research Institute
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Merit-Based Incentive Payment System (MIPS): 2025 Reporting Options Comparison Resource
Provides an overview of the similarities and differences among the three Merit-Based Incentive Payment System (MIPS) reporting options: Traditional MIPS, MIPS Value Pathways (MVP), and Alternative Payment Model (APM) Performance Pathway (APP). Designed to help providers understand which reporting options may be best for their practice. Includes information on reporting flexibilities and scoring for small and rural practices.
Additional links: 2025 Merit-Based Incentive Payment System (MIPS) At-A-Glance Reporting Options for Small Practices
Date: 05/2025
Sponsoring organization: Centers for Medicare and Medicaid Services
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Provides an overview of the similarities and differences among the three Merit-Based Incentive Payment System (MIPS) reporting options: Traditional MIPS, MIPS Value Pathways (MVP), and Alternative Payment Model (APM) Performance Pathway (APP). Designed to help providers understand which reporting options may be best for their practice. Includes information on reporting flexibilities and scoring for small and rural practices.
Additional links: 2025 Merit-Based Incentive Payment System (MIPS) At-A-Glance Reporting Options for Small Practices
Date: 05/2025
Sponsoring organization: Centers for Medicare and Medicaid Services
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CMS Innovation Center Strategic Direction
Describes the vision and strategic objectives for the Center for Medicare and Medicaid Innovation (CMS Innovation Center). Strategic objectives include promoting evidence-based prevention, empowering people to achieve their health goals, and driving choice and competition.
Additional links: Frequently Asked Questions, White Paper: The CMS Innovation Center's Strategy to Make America Healthy Again
Date: 05/2025
Sponsoring organization: Centers for Medicare and Medicaid Services
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Describes the vision and strategic objectives for the Center for Medicare and Medicaid Innovation (CMS Innovation Center). Strategic objectives include promoting evidence-based prevention, empowering people to achieve their health goals, and driving choice and competition.
Additional links: Frequently Asked Questions, White Paper: The CMS Innovation Center's Strategy to Make America Healthy Again
Date: 05/2025
Sponsoring organization: Centers for Medicare and Medicaid Services
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Community Health Centers Are Increasingly Important to Medicare Beneficiaries
Presents data on health center Medicare patient characteristics, service utilization, and revenue between 2019-2023. Compares sociodemographic and health characteristics of health center patients with those of the general Medicare population. Discusses the impact of managed care plans on health center finances.
Author(s): Elizabeth Dutta, Marsha Regenstein, Feygele Jacobs
Date: 05/2025
Sponsoring organization: Geiger Gibson Program in Community Health
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Presents data on health center Medicare patient characteristics, service utilization, and revenue between 2019-2023. Compares sociodemographic and health characteristics of health center patients with those of the general Medicare population. Discusses the impact of managed care plans on health center finances.
Author(s): Elizabeth Dutta, Marsha Regenstein, Feygele Jacobs
Date: 05/2025
Sponsoring organization: Geiger Gibson Program in Community Health
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