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Rural Health
Resources by Topic: Reimbursement and payment models

Change in Profitability and Financial Distress of Critical Access Hospitals from Loss of Cost-Based Reimbursement
Examines how proposed changes to Critical Access Hospital (CAH) cost-based reimbursement would affect the financial vulnerability of CAHs. Uses models to forecast the financial impact of 20 and 30 percent reductions in Medicare revenue, and the resulting implications for rural healthcare access.
Author(s): Mark Holmes, George H. Pink
Date: 12/2013
Type: Document
Sponsoring organization: North Carolina Rural Health Research Program
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CAH Method II Physician Participation in the Medicare EHR Incentive Program: Fact Sheet
Reports on physicians who assign their reimbursement and billing to a Critical Access Hospital (CAH) under Method II (CAH IIs) and how they are now eligible to participate in the Medicare Electronic Health Record (EHR) Incentive Program as eligible professionals (EPs).
Date: 12/2013
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Dental Services: Information on Coverage, Payments, and Fee Variation
Describes trends in dental services coverage and payments, and the extent of variation in dental fees in selected communities. Appendix II includes statistics comparing dental visit rates in urban and rural areas.
Additional links: Full Report
Date: 09/2013
Type: Document
Sponsoring organization: Government Accountability Office
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Rural Implications of Changes to the Medicare Hospice Benefit
Policy brief highlights an April 2013 meeting in Grand Junction, Colorado, of the National Advisory Committee on Rural Health and Human Services. Presents the committee's recommendations and analyses of ACA provisions which may have rural implications regarding challenges and innovations in hospice and palliative care in rural and frontier areas.
Date: 08/2013
Type: Document
Sponsoring organization: National Advisory Committee on Rural Health and Human Services
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The Impact of Payment Reform on Rural Medicare Advantage Enrollment and Quality
Describes implications resulting from changes in Medicare Advantage (MA) payments due to the Affordable Care Act of 2010. Covers changes to the Centers for Medicare and Medicaid (CMS) demonstration of quality-based bonus payments. Discusses MA quality in both rural and urban areas and methods to monitor the effects of the payment policies on quality improvement.
Author(s): Leah M. Kemper, Timothy D. McBride, Abigail R. Barker
Date: 06/2013
Type: Document
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Rural Implications of the Primary Care Incentive Payment Program
Reports on eligibility trends among urban and rural primary care providers for the Primary Care Incentive Payment (PCIP) established in the Affordable Care Act (ACA). Discusses reasons the current PCIP eligibility requirements may be harder for rural family medicine providers to meet.
Author(s): Fred Ullrich, Clinton MacKinney, Keith Mueller
Date: 06/2013
Type: Document
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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MedPAC Report to the Congress: Medicare and the Health Care Delivery System, June 2013
Includes chapters on Medicare and ambulatory settings, bundling payments for post acute care, hospice, reducing hospital admissions, dual eligible beneficiaries, and Medicare payments for ambulance services, physicians, and outpatient therapy. Mentions rural throughout.
Date: 06/2013
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Receipt of Medicaid and Medicare EHR Incentive Payments by Physicians in New York
Examines variation in the characteristics of licensed physicians who received payments from either the Medicare or Medicaid Electronic Health Records (EHR) Incentive Programs through September 2012. Addresses rural/urban differences in Medicare EHR incentive program enrollment.
Author(s): Sandra McGinnis, Jean Moore, Gaetano Forte, Margaret Langelier
Date: 05/2013
Type: Document
Sponsoring organization: Center for Health Workforce Studies
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Summary of the Affordable Care Act
Summarizes the comprehensive 2010 healthcare reform law, including changes made to it by subsequent legislation. Focuses on provisions to expand coverage, control costs, and improve healthcare delivery systems.
Date: 04/2013
Type: Document
Sponsoring organization: KFF
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MedPAC Report to the Congress: Medicare Payment Policy, 2013
Annual review of Medicare payment policies, with recommendations to Congress. Discussions of rural aspects of Medicare payment policies are included throughout the report.
Date: 03/2013
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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