Rural Health
Resources by Topic: Reimbursement and payment models
The Financial Importance of Medicare Post-Acute and Hospice Care to Rural Hospitals
Findings brief describing variation in the number of hospitals in rural areas providing Medicare post-acute care (PAC) and hospice care, average amount of revenue generated for these services, and financial importance to rural hospitals. Includes statistics on 2015 Medicare PAC and hospice care revenue as percentage of patient revenue in 1,205 Critical Access Hospitals and 964 Prospective Payment System hospitals.
Author(s): Alex Schulte, H. Ann Howard, George H. Pink
Date: 07/2017
Sponsoring organization: North Carolina Rural Health Research Program
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Findings brief describing variation in the number of hospitals in rural areas providing Medicare post-acute care (PAC) and hospice care, average amount of revenue generated for these services, and financial importance to rural hospitals. Includes statistics on 2015 Medicare PAC and hospice care revenue as percentage of patient revenue in 1,205 Critical Access Hospitals and 964 Prospective Payment System hospitals.
Author(s): Alex Schulte, H. Ann Howard, George H. Pink
Date: 07/2017
Sponsoring organization: North Carolina Rural Health Research Program
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Telehealth: Use in Medicare and Medicaid
Discusses the extent to which telehealth is used by Medicare and Medicaid, the factors affecting the use of telehealth in Medicare, and how emerging payment and delivery models could affect future telehealth use. Includes rural-specific information throughout with particular attention paid to the role of rural healthcare facilities as originating sites.
Additional links: Full Report
Date: 07/2017
Sponsoring organization: Government Accountability Office
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Discusses the extent to which telehealth is used by Medicare and Medicaid, the factors affecting the use of telehealth in Medicare, and how emerging payment and delivery models could affect future telehealth use. Includes rural-specific information throughout with particular attention paid to the role of rural healthcare facilities as originating sites.
Additional links: Full Report
Date: 07/2017
Sponsoring organization: Government Accountability Office
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Changes in Hospital Quality Associated with Hospital Value-Based Purchasing
Examines whether quality improved more in acute care hospitals exposed to Medicare's Hospital Value-Based Purchasing (HVBP) program. Uses Critical Access Hospitals as a comparison for clinical process, patient experience, and mortality measures.
Author(s): Andrew M. Ryan, Sam Krinsky, Kristen A. Maurer, Justin B. Dimick
Citation: New England Journal of Medicine, 376(24), 2358-2366
Date: 06/2017
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Examines whether quality improved more in acute care hospitals exposed to Medicare's Hospital Value-Based Purchasing (HVBP) program. Uses Critical Access Hospitals as a comparison for clinical process, patient experience, and mortality measures.
Author(s): Andrew M. Ryan, Sam Krinsky, Kristen A. Maurer, Justin B. Dimick
Citation: New England Journal of Medicine, 376(24), 2358-2366
Date: 06/2017
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Hospital Value-Based Purchasing: CMS Should Take Steps to Ensure Lower Quality Hospitals Do Not Qualify for Bonuses
Examines the scoring methodology used by the Hospital Value-Based Purchasing (HVBP) program, which measures quality and efficiency within multiple hospital types including small, rural, and safety-net hospitals. Addresses differences in how safety net, small rural, and small urban hospitals performed, how payment adjustments changed for them over time, and the impact of an efficiency score on payment adjustments. Supports revising the methodology to apply the standards more evenly.
Additional links: Full Report
Date: 06/2017
Sponsoring organization: Government Accountability Office
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Examines the scoring methodology used by the Hospital Value-Based Purchasing (HVBP) program, which measures quality and efficiency within multiple hospital types including small, rural, and safety-net hospitals. Addresses differences in how safety net, small rural, and small urban hospitals performed, how payment adjustments changed for them over time, and the impact of an efficiency score on payment adjustments. Supports revising the methodology to apply the standards more evenly.
Additional links: Full Report
Date: 06/2017
Sponsoring organization: Government Accountability Office
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MedPAC Report to the Congress: Medicare and the Health Care Delivery System, June 2017
Includes chapters on implementing a unified payment system for post-acute care, Part B drug payment policies, the redesign of the Merit-Based Incentive Payment System (MIPS) and other alternative payment models, drug and device manufacturer payments to physicians and teaching hospitals, stand-alone emergency departments, and skilled nursing facility use. Rural hospitals and rural patient populations are discussed throughout the report.
Date: 06/2017
Sponsoring organization: Medicare Payment Advisory Commission
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Includes chapters on implementing a unified payment system for post-acute care, Part B drug payment policies, the redesign of the Merit-Based Incentive Payment System (MIPS) and other alternative payment models, drug and device manufacturer payments to physicians and teaching hospitals, stand-alone emergency departments, and skilled nursing facility use. Rural hospitals and rural patient populations are discussed throughout the report.
Date: 06/2017
Sponsoring organization: Medicare Payment Advisory Commission
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Factors Affecting States' Ability to Respond to Federal Medicaid Cuts and Caps: Which States Are Most At Risk?
Examines 30 key factors that contribute to state-by-state differences in Medicaid per enrollee spending including rural population, and uses the factors to rank and identify which states are at greatest risk if federal Medicaid cuts or caps are enacted. Presents findings across five main areas: Medicaid policy, demographics, health status, available tax revenue and state budget choices, and healthcare markets.
Author(s): Robin Rudowitz, Allison Valentine, Petry Ubri, Julia Zur
Date: 06/2017
Sponsoring organization: KFF
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Examines 30 key factors that contribute to state-by-state differences in Medicaid per enrollee spending including rural population, and uses the factors to rank and identify which states are at greatest risk if federal Medicaid cuts or caps are enacted. Presents findings across five main areas: Medicaid policy, demographics, health status, available tax revenue and state budget choices, and healthcare markets.
Author(s): Robin Rudowitz, Allison Valentine, Petry Ubri, Julia Zur
Date: 06/2017
Sponsoring organization: KFF
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Federal Health Centers: An Overview
Explains the Federal Health Center program, with information relating to the statutory authority, program requirements, funding, location, patient populations, health outcomes, and more. Also discusses the Federally Qualified Health Center (FQHC) designation, and how this designation affects Medicare and Medicaid payment levels.
Date: 05/2017
Sponsoring organization: Congressional Research Service
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Explains the Federal Health Center program, with information relating to the statutory authority, program requirements, funding, location, patient populations, health outcomes, and more. Also discusses the Federally Qualified Health Center (FQHC) designation, and how this designation affects Medicare and Medicaid payment levels.
Date: 05/2017
Sponsoring organization: Congressional Research Service
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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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