Rural Health
Resources by Topic: Reimbursement and payment models
Telehealth Parity Laws
Policy brief discussing federal and state activities related to telehealth, as well as Medicaid and private insurer reimbursement for telehealth services. Identifies the arguments in favor of and against paying for telehealth at parity with in-person care. Discusses the role telehealth can play in rural access to healthcare.
Citation: Health Affairs
Date: 08/2016
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Policy brief discussing federal and state activities related to telehealth, as well as Medicaid and private insurer reimbursement for telehealth services. Identifies the arguments in favor of and against paying for telehealth at parity with in-person care. Discusses the role telehealth can play in rural access to healthcare.
Citation: Health Affairs
Date: 08/2016
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Costs of Accountable Care Organization Participation for Primary Care Providers: Early Stage Results
Analyzes data from 2012 and 2013 Medicare cost reports to determine whether joining an Accountable Care Organization (ACO) is associated with an increase in a Rural Health Clinic's (RHC) per visit cost, particularly during the first two years of participation.
Author(s): Richard A. Hofler, Judith Ortiz
Citation: BMC Health Services Research, 16(315)
Date: 07/2016
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Analyzes data from 2012 and 2013 Medicare cost reports to determine whether joining an Accountable Care Organization (ACO) is associated with an increase in a Rural Health Clinic's (RHC) per visit cost, particularly during the first two years of participation.
Author(s): Richard A. Hofler, Judith Ortiz
Citation: BMC Health Services Research, 16(315)
Date: 07/2016
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Hospital Closures and the Current Healthcare Climate: The Future of Rural Hospitals in the USA
Discusses impact of Affordable Care Act on rural hospitals, including financial considerations, and explores steps that may be taken in order to ensure that these facilities remain open.
Author(s): Somasekar Balasubramanian, Erick Jones
Citation: Rural and Remote Health, 16(3), 3935
Date: 07/2016
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Discusses impact of Affordable Care Act on rural hospitals, including financial considerations, and explores steps that may be taken in order to ensure that these facilities remain open.
Author(s): Somasekar Balasubramanian, Erick Jones
Citation: Rural and Remote Health, 16(3), 3935
Date: 07/2016
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Medicare Access and CHIP Reauthorization Act of 2015: Ensuring Successful Implementation of Physician Payment Reforms
Recording of a July 13, 2016, U.S. Senate Finance Committee hearing regarding the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). Andy Slavitt, Acting Administrator for the Centers for Medicare and Medicaid Services, discusses the input received from stakeholders and the resulting focus on patient-first, physician-driven, collaborative care. He also emphasizes the need to support small, rural practices and those in underserved areas to achieve success.
Additional links: Andrew M. Slavitt, Centers for Medicare & Medicaid Services - Testimony
Date: 07/2016
Sponsoring organization: Senate Committee on Finance
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Recording of a July 13, 2016, U.S. Senate Finance Committee hearing regarding the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). Andy Slavitt, Acting Administrator for the Centers for Medicare and Medicaid Services, discusses the input received from stakeholders and the resulting focus on patient-first, physician-driven, collaborative care. He also emphasizes the need to support small, rural practices and those in underserved areas to achieve success.
Additional links: Andrew M. Slavitt, Centers for Medicare & Medicaid Services - Testimony
Date: 07/2016
Sponsoring organization: Senate Committee on Finance
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Medicare Copayments for Critical Access Hospital Outpatient Services - Update
Estimates the impact of Medicare Part B coinsurance on beneficiaries receiving outpatient services at Critical Access Hospitals (CAHs), and identifies the Medicare fee-for-service (FFS) proportion of key services provided in CAHs.
Author(s): Allison Briggs, Matthew Toth, Sara Freeman
Date: 06/2016
Sponsoring organization: Medicare Payment Advisory Commission
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Estimates the impact of Medicare Part B coinsurance on beneficiaries receiving outpatient services at Critical Access Hospitals (CAHs), and identifies the Medicare fee-for-service (FFS) proportion of key services provided in CAHs.
Author(s): Allison Briggs, Matthew Toth, Sara Freeman
Date: 06/2016
Sponsoring organization: Medicare Payment Advisory Commission
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Global Budgets for Rural Hospitals
Discusses the financial and budgetary challenges faced by rural hospitals, explains how some rural hospitals have responded, and presents the case for using global budgets as an alternative payment model. Includes information on some of the proposed policy solutions such as Maryland's all-payer system and the Save Rural Hospitals Act.
Author(s): Joshua M. Sharfstein
Citation: The Milbank Quarterly, 94(2), 255-259
Date: 06/2016
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Discusses the financial and budgetary challenges faced by rural hospitals, explains how some rural hospitals have responded, and presents the case for using global budgets as an alternative payment model. Includes information on some of the proposed policy solutions such as Maryland's all-payer system and the Save Rural Hospitals Act.
Author(s): Joshua M. Sharfstein
Citation: The Milbank Quarterly, 94(2), 255-259
Date: 06/2016
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Stroudwater Population Health
An 8-part video series designed to help rural healthcare organizations transition from payment for volume to payment for value and advance population health strategies. Each part discusses an important strategy for achieving population health, including: quality and efficiency, network relationships and service rationalization, employer-sponsored health plans and fee-for-service payments, shared savings plans, and full risk payments and capitation.
Date: 06/2016
Sponsoring organization: Stroudwater Associates
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An 8-part video series designed to help rural healthcare organizations transition from payment for volume to payment for value and advance population health strategies. Each part discusses an important strategy for achieving population health, including: quality and efficiency, network relationships and service rationalization, employer-sponsored health plans and fee-for-service payments, shared savings plans, and full risk payments and capitation.
Date: 06/2016
Sponsoring organization: Stroudwater Associates
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MedPAC Report to the Congress: Medicare and the Health Care Delivery System, June 2016
Includes chapters on pricing and payment systems, Medicare drug spending, Part B drug and oncology payment policy issues, improving Part D, improving efficiency and preserving access to emergency care in rural areas, telehealth services and Medicare, and issues affecting dual-eligible beneficiaries. Rural providers and rural patient populations are discussed throughout the report.
Date: 06/2016
Sponsoring organization: Medicare Payment Advisory Commission
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Includes chapters on pricing and payment systems, Medicare drug spending, Part B drug and oncology payment policy issues, improving Part D, improving efficiency and preserving access to emergency care in rural areas, telehealth services and Medicare, and issues affecting dual-eligible beneficiaries. Rural providers and rural patient populations are discussed throughout the report.
Date: 06/2016
Sponsoring organization: Medicare Payment Advisory Commission
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Association Between the Value-Based Purchasing Pay for Performance Program and Patient Mortality in US Hospitals: Observational Study
Examines the impact of Medicare's Hospital Value-Based Purchasing (HVBP) program on mortality for pneumonia, heart failure, and acute myocardial infarction by comparing data from acute care hospitals participating in the program to data from over 1,300 Critical Access Hospitals (CAHs) and 44 hospitals in Maryland not in the program.
Author(s): Jose F. Figueroa, Yusuke Tsugawa, Jie Zheng, E. John Orav, Ashish K. Jha
Citation: BMJ, 9(353), i2214
Date: 05/2016
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Examines the impact of Medicare's Hospital Value-Based Purchasing (HVBP) program on mortality for pneumonia, heart failure, and acute myocardial infarction by comparing data from acute care hospitals participating in the program to data from over 1,300 Critical Access Hospitals (CAHs) and 44 hospitals in Maryland not in the program.
Author(s): Jose F. Figueroa, Yusuke Tsugawa, Jie Zheng, E. John Orav, Ashish K. Jha
Citation: BMJ, 9(353), i2214
Date: 05/2016
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FQHC and RHC Supplemental Payment Requirements and FQHC, RHC, and FBC Network Sufficiency under Medicaid and CHIP Managed Care
Provides state health officials with guidance on Federally-qualified Health Center (FQHC) and Rural Health Clinic (RHC) payment methodologies under both Medicaid and Children's Health Insurance Program (CHIP) managed care delivery systems. Also provides guidance on FQHC, RHC, and freestanding birth center (FBC) network sufficiency standards applicable to a Medicaid managed care delivery system.
Date: 04/2016
Sponsoring organization: Centers for Medicare and Medicaid Services
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Provides state health officials with guidance on Federally-qualified Health Center (FQHC) and Rural Health Clinic (RHC) payment methodologies under both Medicaid and Children's Health Insurance Program (CHIP) managed care delivery systems. Also provides guidance on FQHC, RHC, and freestanding birth center (FBC) network sufficiency standards applicable to a Medicaid managed care delivery system.
Date: 04/2016
Sponsoring organization: Centers for Medicare and Medicaid Services
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