Rural Health
Resources by Topic: Reimbursement and payment models
Public and Individual Health Insurance Trends in Rural Minnesota: Enrollment During Implementation of the Affordable Care Act
Report focuses on rural Minnesotans' enrollment in non-employer provided insurance coverage as impacted by the Affordable Care Act (ACA) since 2010. Includes a discussion of Medical Assistance and MinnesotaCare increases as well as the individual market. Data and statistics by county type (entirely rural, small town/rural mix, urban/small town/rural, entirely urban) also provided.
Date: 04/2017
Sponsoring organization: Minnesota Department of Health - Office of Rural Health and Primary Care
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Report focuses on rural Minnesotans' enrollment in non-employer provided insurance coverage as impacted by the Affordable Care Act (ACA) since 2010. Includes a discussion of Medical Assistance and MinnesotaCare increases as well as the individual market. Data and statistics by county type (entirely rural, small town/rural mix, urban/small town/rural, entirely urban) also provided.
Date: 04/2017
Sponsoring organization: Minnesota Department of Health - Office of Rural Health and Primary Care
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Finance in Rural and Urban Hospitals
Summary of the impact of the Affordable Care Act (ACA) on the insurance coverage rates and reimbursement methods in rural hospitals in Minnesota. Includes a discussion of public and private insurance programs, uncompensated care, and operating margins. Includes data and statistic comparisons for Critical Access Hospitals (CAHs), other rural hospitals, and urban hospitals.
Date: 04/2017
Sponsoring organization: Minnesota Department of Health - Office of Rural Health and Primary Care
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Summary of the impact of the Affordable Care Act (ACA) on the insurance coverage rates and reimbursement methods in rural hospitals in Minnesota. Includes a discussion of public and private insurance programs, uncompensated care, and operating margins. Includes data and statistic comparisons for Critical Access Hospitals (CAHs), other rural hospitals, and urban hospitals.
Date: 04/2017
Sponsoring organization: Minnesota Department of Health - Office of Rural Health and Primary Care
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Report to Congress on Medicaid and CHIP, March 2017
Reports on three aspects of Medicaid: Disproportionate Share Hospital (DSH) payments to states and providers, access to Medicaid, and children's coverage under CHIP. Chapter 2 includes the second annual report on DSH payments, which provide support to safety-net hospitals to help offset uncompensated care costs for Medicaid and uninsured patients. Table 2-1 identifies DSH spending for urban and rural hospitals and for Critical Access Hospitals. Chapter 3 examines state policies for distributing DSH payments to hospitals, including which states target rural or Critical Access Hospitals.
Date: 03/2017
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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Reports on three aspects of Medicaid: Disproportionate Share Hospital (DSH) payments to states and providers, access to Medicaid, and children's coverage under CHIP. Chapter 2 includes the second annual report on DSH payments, which provide support to safety-net hospitals to help offset uncompensated care costs for Medicaid and uninsured patients. Table 2-1 identifies DSH spending for urban and rural hospitals and for Critical Access Hospitals. Chapter 3 examines state policies for distributing DSH payments to hospitals, including which states target rural or Critical Access Hospitals.
Date: 03/2017
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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Global Budget Process as an Alternative Payment Model
Analyzes the all-payer hospital rate-setting system of McCready Health in rural Maryland. Discusses the Total Patient Revenue (TPR) system and corresponding essential functions such as rate setting, strategic planning, and care coordination.
Date: 03/2017
Sponsoring organization: Rural Health Value
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Analyzes the all-payer hospital rate-setting system of McCready Health in rural Maryland. Discusses the Total Patient Revenue (TPR) system and corresponding essential functions such as rate setting, strategic planning, and care coordination.
Date: 03/2017
Sponsoring organization: Rural Health Value
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MedPAC Report to the Congress: Medicare Payment Policy, 2017
Provides an annual review of Medicare payment policies, with recommendations to Congress. Includes discussions on Medicare payment policies that directly affect rural providers and beneficiaries. Analyses payment adequacy for home health, skilled nursing, long-term care hospitals, hospice, ambulatory surgical centers, and rehabilitation facilities.
Date: 03/2017
Sponsoring organization: Medicare Payment Advisory Commission
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Provides an annual review of Medicare payment policies, with recommendations to Congress. Includes discussions on Medicare payment policies that directly affect rural providers and beneficiaries. Analyses payment adequacy for home health, skilled nursing, long-term care hospitals, hospice, ambulatory surgical centers, and rehabilitation facilities.
Date: 03/2017
Sponsoring organization: Medicare Payment Advisory Commission
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Getting Started with the Quality Payment Program: An Overview of MIPS for Small, Rural, and Underserved Practices
Provides a webinar recording discussing the effects of the Merit-Based Incentive Payment System (MIPS) on small, rural, and underserved practices. Includes sections on eligibility, participation, reporting, performance categories, and submission and scoring methods. Outlines specific eligibility requirements for Rural Health Clinics (RHCs), Federally Qualified Health Centers (FQHCs), and Critical Access Hospitals (CAHs), and provides a checklist for preparing and participating in MIPS.
Additional links: Presentation Slides, Transcript, Webinar Playlist by Section
Date: 02/2017
Sponsoring organization: Centers for Medicare and Medicaid Services
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Provides a webinar recording discussing the effects of the Merit-Based Incentive Payment System (MIPS) on small, rural, and underserved practices. Includes sections on eligibility, participation, reporting, performance categories, and submission and scoring methods. Outlines specific eligibility requirements for Rural Health Clinics (RHCs), Federally Qualified Health Centers (FQHCs), and Critical Access Hospitals (CAHs), and provides a checklist for preparing and participating in MIPS.
Additional links: Presentation Slides, Transcript, Webinar Playlist by Section
Date: 02/2017
Sponsoring organization: Centers for Medicare and Medicaid Services
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Telemedicine and Primary Care Obesity Management in Rural Areas – Innovative Approach for Older Adults?
Explores telemedicine as a potential delivery tool for the Medicare Obesity Benefit in primary care settings. Describes challenges in implementing the benefit in rural areas, including increasing older adult populations, shortages in primary care and specialized healthcare providers, reimbursement issues, and transportation barriers. Presents the potential utility of telemedicine in rural obesity care and non-physician staff delivery options, which require regulatory changes.
Author(s): John Batsis, Sarah Pletcher, James Stahl
Citation: BMC Geriatrics, 17, 6
Date: 01/2017
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Explores telemedicine as a potential delivery tool for the Medicare Obesity Benefit in primary care settings. Describes challenges in implementing the benefit in rural areas, including increasing older adult populations, shortages in primary care and specialized healthcare providers, reimbursement issues, and transportation barriers. Presents the potential utility of telemedicine in rural obesity care and non-physician staff delivery options, which require regulatory changes.
Author(s): John Batsis, Sarah Pletcher, James Stahl
Citation: BMC Geriatrics, 17, 6
Date: 01/2017
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Social Determinants of Health
Policy brief informed by a September 2016 National Advisory Committee on Rural Health and Human Services meeting held in Albuquerque, New Mexico, with site visits to update the committee about factors that affect health outcomes. Identifies emerging payment models and financing strategies, and provides policy recommendations for addressing the social determinants of health in rural communities.
Date: 01/2017
Sponsoring organization: National Advisory Committee on Rural Health and Human Services
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Policy brief informed by a September 2016 National Advisory Committee on Rural Health and Human Services meeting held in Albuquerque, New Mexico, with site visits to update the committee about factors that affect health outcomes. Identifies emerging payment models and financing strategies, and provides policy recommendations for addressing the social determinants of health in rural communities.
Date: 01/2017
Sponsoring organization: National Advisory Committee on Rural Health and Human Services
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Accounting for Social Risk Factors in Medicare Payment
Fifth and final report in a series designed to identify social risk factors that affect the health outcomes of Medicare beneficiaries and methods to account for these factors in Medicare payment programs. Offers thoughts about selecting the best methods to account for social risk factors and achieve policy goals. Chapter 2 includes a discussion about urbanicity and rurality, and suggests that a beneficiary's place of residence is a stronger indicator of social risk than their provider's location. Report was assembled by an ad hoc committee under the direction of the U.S. Department of Health and Human Services, Office of the Assistant Secretary of Planning and Evaluation.
Additional links: Read Online
Author(s): Committee on Accounting for Socioeconomic Status in Medicare Payment Programs
Date: 01/2017
Sponsoring organization: Health and Medicine Division (HMD), National Academies of Sciences, Engineering, and Medicine
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Fifth and final report in a series designed to identify social risk factors that affect the health outcomes of Medicare beneficiaries and methods to account for these factors in Medicare payment programs. Offers thoughts about selecting the best methods to account for social risk factors and achieve policy goals. Chapter 2 includes a discussion about urbanicity and rurality, and suggests that a beneficiary's place of residence is a stronger indicator of social risk than their provider's location. Report was assembled by an ad hoc committee under the direction of the U.S. Department of Health and Human Services, Office of the Assistant Secretary of Planning and Evaluation.
Additional links: Read Online
Author(s): Committee on Accounting for Socioeconomic Status in Medicare Payment Programs
Date: 01/2017
Sponsoring organization: Health and Medicine Division (HMD), National Academies of Sciences, Engineering, and Medicine
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State Law Fact Sheet: A Summary of State Community Health Worker Laws
Details the state laws pertaining to community health workers as of June 30, 2016. Includes laws defining scope of practice, team-based care models, reimbursement, and the core certification process.
Date: 2017
Sponsoring organization: Centers for Disease Control and Prevention
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Details the state laws pertaining to community health workers as of June 30, 2016. Includes laws defining scope of practice, team-based care models, reimbursement, and the core certification process.
Date: 2017
Sponsoring organization: Centers for Disease Control and Prevention
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