Rural Health Resources by Topic: Reimbursement and payment models
Modeling the Frontier Extended Stay Clinic Conditions of Participation and Reimbursement Methodologies
Discusses the financial feasibility of the Frontier Extended Stay Clinic (FESC), a proposed provider type to expand services in remote and isolated primary care clinics. Compares Medicare reimbursement for FESC status with Federally Qualified Health Center (FQHC), Rural Health Clinic (RHC), and Critical Access Hospital (CAH) reimbursement. Includes detailed examples of financial impact for seven clinics in rural Alaska, Nevada, Washington, and Wyoming.
Date: 2004 Type: Document Sponsoring organization: Federal Office of Rural Health Policy view details
Medicare Physician Payment: Practice Expense
Describes the variation in Medicare payment for practice expense using the Geographic Practice Cost Indexes (GPCIs). Explains the factors that are used to calculate GPCIs and lists the 2003 GPCIs. Discusses potential impact of lower Medicare reimbursement to rural physicians for practice expense.
Author(s): A. Clinton MacKinney, Timothy D. McBride, Michael D. Shambaugh-Miller, Keith J. Mueller Citation: RUPRI Rural Policy Brief, 8(9) Date: 10/2003 Type: Document Sponsoring organization: RUPRI Center for Rural Health Policy Analysis view details
MedPAC Report to the Congress: Variation and Innovation in Medicare
Analyzes variation within the Medicare program and explores a variety of possible payment innovations. Includes some rural-specific information. Geographic, market, quality, hospital financial performance, and use of physician services variations are covered. Also examines Medicare's reimbursement for Part B drugs. Recommendations include quality incentives and competitive pricing.
Date: 06/2003 Type: Document Sponsoring organization: Medicare Payment Advisory Commission view details
MedPAC Report to the Congress: Medicare Payment Policy, 2003
Report to the Congress. Reviews the Medicare prospective payment systems (PPSs) for seven sectors: hospital inpatient, hospital outpatient, physician, skilled nursing, home health, outpatient dialysis, and ambulatory surgical center services. Also discusses broader issues related to Medicare payments. Includes recommendations. Appendix with data on hospital financial performance for 1991-2000.
Date: 03/2003 Type: Document Sponsoring organization: Medicare Payment Advisory Commission view details
Medicare Physician Payment
Provides an overview of how physicians are paid by Medicare, with a focus on the adjustments made related to geographic practice cost indexes (GPCIs). Discusses rural issues related to Medicare physician payment, including impact on physician recruitment and retention and healthcare access.
Author(s): A. Clinton MacKinney, Michael D. Shambaugh-Miller, Keith Mueller Citation: RUPRI Rural Policy Brief, 8(2) Date: 01/2003 Type: Document Sponsoring organization: RUPRI Center for Rural Health Policy Analysis view details
Financial Incentives for Rural Hospitals to Expand the Scope of Their Services
Examines the financial incentives that rural hospitals have to conduct surgery and treat more complex medical conditions. Evaluates whether rural hospitals that offer broader services are more profitable than hospitals with very limited inpatient services. A low-volume adjustment considered by the Medicare Payment Advisory Commissions (MedPAC) is discussed.
Author(s): Jeffrey Stensland, Michelle Brasure, Ira Moscovice, Tiffany Radcliff Date: 06/2002 Type: Document Sponsoring organization: University of Minnesota Rural Health Research Center view details