Rural Health
Resources by Topic: Reimbursement and payment models
Small and Rural Practices' Experiences in Previous Programs and Expected Performance in the Merit-Based Incentive Payment System
Examines how small and rural physician practices fared in legacy Medicare programs and reviews the projected effect of Merit-Based Incentive Payment System (MIPS). Discusses Medicare legacy program challenges small and rural physician practices experience including technology, financial and staff resources, and legacy program requirements. Covers efforts to assist small and rural physician practices participate in MIPS. Includes 2014 and 2015 data on Medicare legacy payment incentive programs by rural and urban status.
Additional links: Full Report
Date: 07/2018
Sponsoring organization: Government Accountability Office
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Examines how small and rural physician practices fared in legacy Medicare programs and reviews the projected effect of Merit-Based Incentive Payment System (MIPS). Discusses Medicare legacy program challenges small and rural physician practices experience including technology, financial and staff resources, and legacy program requirements. Covers efforts to assist small and rural physician practices participate in MIPS. Includes 2014 and 2015 data on Medicare legacy payment incentive programs by rural and urban status.
Additional links: Full Report
Date: 07/2018
Sponsoring organization: Government Accountability Office
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Estimate of Federal Payment Reductions to Hospitals Following the ACA 2010-2028: Estimates and Methodology
Examines cumulative federal payment reductions to hospitals for 2010-2028. Addresses the impact of sequestration, changes in Medicare payments for bad debt including to Critical Access Hospitals, federal Medicaid Disproportionate Share Hospital (DSH) allotments, and other legislation affecting hospital reimbursement.
Author(s): Allen Dobson, Joan DaVanzo, Randy Haught, Phap-Hoa Luu
Date: 06/2018
Sponsoring organizations: American Hospital Association, Dobson DaVanzo & Associates, Federation of American Hospitals
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Examines cumulative federal payment reductions to hospitals for 2010-2028. Addresses the impact of sequestration, changes in Medicare payments for bad debt including to Critical Access Hospitals, federal Medicaid Disproportionate Share Hospital (DSH) allotments, and other legislation affecting hospital reimbursement.
Author(s): Allen Dobson, Joan DaVanzo, Randy Haught, Phap-Hoa Luu
Date: 06/2018
Sponsoring organizations: American Hospital Association, Dobson DaVanzo & Associates, Federation of American Hospitals
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Evaluation of the Round Two Health Care Innovation Awards (HCIA R2): Third Annual Report
Summarizes the third year evaluation results of 38 Health Care Innovation Awards Round Two projects, one awardee of the original 39 having left the program in September 2016. Focuses on implementation effectiveness, developing payment models, planning for sustainability, and some preliminary work related to evaluating program impacts. Provides findings for the individual awardees, which include projects that serve rural areas.
Date: 06/2018
Sponsoring organizations: Centers for Medicare and Medicaid Services, Mathematica Policy Research
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Summarizes the third year evaluation results of 38 Health Care Innovation Awards Round Two projects, one awardee of the original 39 having left the program in September 2016. Focuses on implementation effectiveness, developing payment models, planning for sustainability, and some preliminary work related to evaluating program impacts. Provides findings for the individual awardees, which include projects that serve rural areas.
Date: 06/2018
Sponsoring organizations: Centers for Medicare and Medicaid Services, Mathematica Policy Research
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MedPAC Report to the Congress: Medicare and the Health Care Delivery System, June 2018
Evaluates Medicare payment issues and offers recommendations to the U.S. Congress. Includes a chapter on ensuring appropriate access to and use of hospital emergency department (ED) services that provides extensive information on rural access to ED services and identifies examples of rural off-campus emergency departments. Other sections of the report addressing rural concerns focus on post-acute care, quality and value payment programs, and medical device payment policies. Also includes a report on the effects of the Hospital Readmissions Reduction Program.
Additional links: Fact Sheet
Date: 06/2018
Sponsoring organization: Medicare Payment Advisory Commission
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Evaluates Medicare payment issues and offers recommendations to the U.S. Congress. Includes a chapter on ensuring appropriate access to and use of hospital emergency department (ED) services that provides extensive information on rural access to ED services and identifies examples of rural off-campus emergency departments. Other sections of the report addressing rural concerns focus on post-acute care, quality and value payment programs, and medical device payment policies. Also includes a report on the effects of the Hospital Readmissions Reduction Program.
Additional links: Fact Sheet
Date: 06/2018
Sponsoring organization: Medicare Payment Advisory Commission
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Geographic Variation in Uncompensated Care Between Rural and Urban Hospitals
Findings brief describing how uncompensated hospital care varies across regions of the country, using data from the 2014-2016 Medicare Cost Report Worksheet S-10. Features statistics including breakdowns by Critical Access Hospitals (CAHs), other rural hospitals, and urban hospitals.
Author(s): Krystal G. Garcia, Kristie Thompson, Hilda A. Howard, George H. Pink
Date: 06/2018
Sponsoring organization: North Carolina Rural Health Research Program
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Findings brief describing how uncompensated hospital care varies across regions of the country, using data from the 2014-2016 Medicare Cost Report Worksheet S-10. Features statistics including breakdowns by Critical Access Hospitals (CAHs), other rural hospitals, and urban hospitals.
Author(s): Krystal G. Garcia, Kristie Thompson, Hilda A. Howard, George H. Pink
Date: 06/2018
Sponsoring organization: North Carolina Rural Health Research Program
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The Evolution of Annual Wellness Visits at Bellin Health Partners Next Generation Accountable Care Organization
Features a primarily rural Accountable Care Organization serving Michigan's upper peninsula and northeastern Wisconsin. Outlines their initiative to maximize the benefits of annual wellness visits using a care team and health information technology. Addresses provider incentives and efforts to improve care team communications, as well as the initiative's results and next steps.
Date: 05/2018
Sponsoring organization: Centers for Medicare and Medicaid Services
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Features a primarily rural Accountable Care Organization serving Michigan's upper peninsula and northeastern Wisconsin. Outlines their initiative to maximize the benefits of annual wellness visits using a care team and health information technology. Addresses provider incentives and efforts to improve care team communications, as well as the initiative's results and next steps.
Date: 05/2018
Sponsoring organization: Centers for Medicare and Medicaid Services
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Telemedicine Reimbursement
Policy position brief showing how telemedicine can help safety net providers care for people who live and work in rural and underserved areas. Lists types of programs, explores reimbursement issues, gives examples of innovative programs with telemedicine components, and offers recommendations for increasing access and improving outcomes.
Author(s): Becky Sanders, Zach Allen, Greg Maurer
Date: 05/2018
Sponsoring organization: National Rural Health Association
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Policy position brief showing how telemedicine can help safety net providers care for people who live and work in rural and underserved areas. Lists types of programs, explores reimbursement issues, gives examples of innovative programs with telemedicine components, and offers recommendations for increasing access and improving outcomes.
Author(s): Becky Sanders, Zach Allen, Greg Maurer
Date: 05/2018
Sponsoring organization: National Rural Health Association
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Demonstrations and Pilots: Rural Centric Transformation
Policy brief describing the need for an intentional increase in funding for rural centric innovation for demonstration projects and pilot programs. Analyzes current national policies and National Rural Health Association (NRHA) policy positions, and covers the need for rural specific demonstration project data. Includes policy recommendations.
Author(s): Kathy Whitmire, Sue Grafstrom, Erin Tanenbaum
Date: 05/2018
Sponsoring organization: National Rural Health Association
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Policy brief describing the need for an intentional increase in funding for rural centric innovation for demonstration projects and pilot programs. Analyzes current national policies and National Rural Health Association (NRHA) policy positions, and covers the need for rural specific demonstration project data. Includes policy recommendations.
Author(s): Kathy Whitmire, Sue Grafstrom, Erin Tanenbaum
Date: 05/2018
Sponsoring organization: National Rural Health Association
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Toward Hospital Global Budgeting: State Considerations
Overview of hospital global budgeting, using case studies from Maryland, Pennsylvania, and Vermont. Explores ways in which global budgets can offer some financial stability for rural hospitals.
Author(s): Robert Murray
Date: 05/2018
Sponsoring organization: State Health & Value Strategies
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Overview of hospital global budgeting, using case studies from Maryland, Pennsylvania, and Vermont. Explores ways in which global budgets can offer some financial stability for rural hospitals.
Author(s): Robert Murray
Date: 05/2018
Sponsoring organization: State Health & Value Strategies
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Toolkit: State Strategies to Develop Value-Based Payment Methodologies for Federally Qualified Health Centers
Designed to help policymakers implement Medicaid value-based payment (VBP) methodologies by providing background information, key considerations, and state strategies. Table 1 in the Payment Methodologies section gives an overview of select state VBP methodologies for Federally Qualified Health Centers (FQHCs). Addresses challenges for small and rural FQHCs.
Author(s): Rachel Donlon, Hannah Dorr, Kitty Purington
Date: 05/2018
Sponsoring organization: National Academy for State Health Policy
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Designed to help policymakers implement Medicaid value-based payment (VBP) methodologies by providing background information, key considerations, and state strategies. Table 1 in the Payment Methodologies section gives an overview of select state VBP methodologies for Federally Qualified Health Centers (FQHCs). Addresses challenges for small and rural FQHCs.
Author(s): Rachel Donlon, Hannah Dorr, Kitty Purington
Date: 05/2018
Sponsoring organization: National Academy for State Health Policy
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