Rural Health
Resources by Topic: Reimbursement and payment models
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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Changes in Hospital Utilization Three Years into Maryland's Global Budget Program for Rural Hospitals
Examines the impact of Maryland's global budget program for acute care hospitals, with a focus on Medicare beneficiaries served by rural hospitals. Compares changes in hospital use and hospital spending between the rural hospitals participating in the global budget program and a control group during a 3-year period. Discusses the policy implications for other states considering alternate payment models.
Author(s): Eric T. Roberts, Laura A. Hatfield, J. Michael McWilliams, et al.
Citation: Health Affairs, 37(4), 644-653
Date: 04/2018
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Examines the impact of Maryland's global budget program for acute care hospitals, with a focus on Medicare beneficiaries served by rural hospitals. Compares changes in hospital use and hospital spending between the rural hospitals participating in the global budget program and a control group during a 3-year period. Discusses the policy implications for other states considering alternate payment models.
Author(s): Eric T. Roberts, Laura A. Hatfield, J. Michael McWilliams, et al.
Citation: Health Affairs, 37(4), 644-653
Date: 04/2018
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Market Characteristics Associated with Rural Hospitals' Provision of Post-Acute Care
Findings brief summarizing hospital- and market-level factors related to post-acute care (PAC) provided in rural hospitals from 2012-2015. Features statistics from 2012-2015 rural Medicare cost reports, PAC provision by census region in 2015, and percent of hospitals in frontier and remote areas in 2015 with breakdowns by type and PAC provision.
Author(s): Abby F. Hoffman, Randy K. Randolph, Alex R. Schulte, George H. Pink
Date: 04/2018
Sponsoring organization: North Carolina Rural Health Research Program
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Findings brief summarizing hospital- and market-level factors related to post-acute care (PAC) provided in rural hospitals from 2012-2015. Features statistics from 2012-2015 rural Medicare cost reports, PAC provision by census region in 2015, and percent of hospitals in frontier and remote areas in 2015 with breakdowns by type and PAC provision.
Author(s): Abby F. Hoffman, Randy K. Randolph, Alex R. Schulte, George H. Pink
Date: 04/2018
Sponsoring organization: North Carolina Rural Health Research Program
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