Rural Health
Resources by Topic: Reimbursement and payment models
Sole Community Hospitals: Early Indications Show That TRICARE's Revised Reimbursement Rules Have Not Affected Access to Care
Reports on the impact of a January 2014 revision to TRICARE's reimbursement for Sole Community Hospitals (SCHs), which serve primarily rural areas. The new TRICARE reimbursement rules approximate Medicare's for these hospitals. Looks at the impact of revised SCH reimbursement on healthcare access for servicemembers and their dependents. Findings based on claims data, as well as interviews with 10 SCHs and with national stakeholders. Appendices include information on SCHs with a high number of TRICARE admissions.
Additional links: Full Report
Date: 04/2015
Sponsoring organization: Government Accountability Office
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Reports on the impact of a January 2014 revision to TRICARE's reimbursement for Sole Community Hospitals (SCHs), which serve primarily rural areas. The new TRICARE reimbursement rules approximate Medicare's for these hospitals. Looks at the impact of revised SCH reimbursement on healthcare access for servicemembers and their dependents. Findings based on claims data, as well as interviews with 10 SCHs and with national stakeholders. Appendices include information on SCHs with a high number of TRICARE admissions.
Additional links: Full Report
Date: 04/2015
Sponsoring organization: Government Accountability Office
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A Critique of the Office of the Inspector General's Report on Swing Beds in Critical Access Hospitals
Evaluates the methods and data of a March 2015 report from the Office of the Inspector General (OIG), U.S. Department of Health and Human Services, commenting on Medicare reimbursement policy for swing bed services in Critical Access Hospitals (CAHs).
Author(s): Kristin L. Reiter, G. Mark Holmes
Date: 03/2015
Sponsoring organization: North Carolina Rural Health Research Program
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Evaluates the methods and data of a March 2015 report from the Office of the Inspector General (OIG), U.S. Department of Health and Human Services, commenting on Medicare reimbursement policy for swing bed services in Critical Access Hospitals (CAHs).
Author(s): Kristin L. Reiter, G. Mark Holmes
Date: 03/2015
Sponsoring organization: North Carolina Rural Health Research Program
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MedPAC Report to the Congress: Medicare Payment Policy, 2015
Annual review of Medicare payment policies, with recommendations to Congress. Discussions of rural aspects of Medicare payment policies are included throughout the report.
Date: 03/2015
Sponsoring organization: Medicare Payment Advisory Commission
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Annual review of Medicare payment policies, with recommendations to Congress. Discussions of rural aspects of Medicare payment policies are included throughout the report.
Date: 03/2015
Sponsoring organization: Medicare Payment Advisory Commission
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Medicare Could Have Saved Billions at Critical Access Hospitals If Swing-Bed Services Were Reimbursed Using the Skilled Nursing Facility Prospective Payment System Rates
Reports the Inspector General's findings from a study of swing bed services and reimbursement at Critical Access Hospitals (CAHs). Addresses changes in swing bed usage over time and examines the potential impact to Medicare of reimbursing swing bed services at skilled nursing facility (SNF) prospective payment system (PPS) rates.
Date: 03/2015
Sponsoring organization: Office of Inspector General (HHS)
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Reports the Inspector General's findings from a study of swing bed services and reimbursement at Critical Access Hospitals (CAHs). Addresses changes in swing bed usage over time and examines the potential impact to Medicare of reimbursing swing bed services at skilled nursing facility (SNF) prospective payment system (PPS) rates.
Date: 03/2015
Sponsoring organization: Office of Inspector General (HHS)
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The Future of Rural Behavioral Health
Policy paper discussing the unique challenges of providing behavioral healthcare services in rural areas. Includes policy recommendations and interventions related to workforce development, reimbursement and financing, integration of care, and the use of technology in delivering behavioral healthcare.
Author(s): Will Wilson, Angela Bangs, Tammy Hatting
Date: 02/2015
Sponsoring organization: National Rural Health Association
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Policy paper discussing the unique challenges of providing behavioral healthcare services in rural areas. Includes policy recommendations and interventions related to workforce development, reimbursement and financing, integration of care, and the use of technology in delivering behavioral healthcare.
Author(s): Will Wilson, Angela Bangs, Tammy Hatting
Date: 02/2015
Sponsoring organization: National Rural Health Association
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CPC Practice Spotlights
A collection of short features on primary care practices that participated in the CMS Comprehensive Primary Care (CPC) initiative, a multi-payer initiative that offered population-based care management fees and shared savings opportunities to participating practices. Includes examples of practices serving rural areas.
Date: 01/2015
Sponsoring organization: Centers for Medicare and Medicaid Services
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A collection of short features on primary care practices that participated in the CMS Comprehensive Primary Care (CPC) initiative, a multi-payer initiative that offered population-based care management fees and shared savings opportunities to participating practices. Includes examples of practices serving rural areas.
Date: 01/2015
Sponsoring organization: Centers for Medicare and Medicaid Services
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Rural Health Care: Redefining Access
Discusses collaboration, recruitment and retention, providing specialty services and quality of care as methods to strengthen the health of North Carolina's rural communities.
Author(s): Chris Collins
Citation: North Carolina Medical Journal, 76(1), 20-23
Date: 01/2015
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Discusses collaboration, recruitment and retention, providing specialty services and quality of care as methods to strengthen the health of North Carolina's rural communities.
Author(s): Chris Collins
Citation: North Carolina Medical Journal, 76(1), 20-23
Date: 01/2015
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International Classification of Disease: CMS's Efforts to Prepare for the New Version of the Disease and Procedure Codes
Review of the efforts undertaken by the Centers for Medicare and Medicaid Services (CMS) to prepare for the transition to the 10th revision of the International Classification of Diseases (ICD-10) codes. Evaluates the materials developed and activities undertaken by CMS to help providers' transition and describes concerns of stakeholder organizations, including rural-specific considerations.
Additional links: Full Report
Date: 01/2015
Sponsoring organization: Government Accountability Office
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Review of the efforts undertaken by the Centers for Medicare and Medicaid Services (CMS) to prepare for the transition to the 10th revision of the International Classification of Diseases (ICD-10) codes. Evaluates the materials developed and activities undertaken by CMS to help providers' transition and describes concerns of stakeholder organizations, including rural-specific considerations.
Additional links: Full Report
Date: 01/2015
Sponsoring organization: Government Accountability Office
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The Need to Reform Medicare's Payments to Skilled Nursing Facilities Is as Strong as Ever
Compares payments made to skilled nursing facilities (SNFs) and costs over time to see if changes made by the Centers for Medicare and Medicaid Services (CMS) to the payment system have improved payment accuracy. Table 3 and Table 4 compare healthcare facility characteristics, including rural location.
Author(s): Carol Carter, Bowen Garrett, Doug Wissoker
Date: 01/2015
Sponsoring organizations: Medicare Payment Advisory Commission, Urban Institute
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Compares payments made to skilled nursing facilities (SNFs) and costs over time to see if changes made by the Centers for Medicare and Medicaid Services (CMS) to the payment system have improved payment accuracy. Table 3 and Table 4 compare healthcare facility characteristics, including rural location.
Author(s): Carol Carter, Bowen Garrett, Doug Wissoker
Date: 01/2015
Sponsoring organizations: Medicare Payment Advisory Commission, Urban Institute
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Authorities and Mechanisms for Purchased Care at the Department of Veterans Affairs
Presents an independent assessment of the Purchased Care component from the Veterans Access, Choice, and Accountability Act of 2014. Discusses the system used to fill in gaps in care for veterans that live in rural areas or far from a VA Medical Center (VAMC). Compares the VA's system to other payer models in the federal government.
Author(s): Michael D. Greenberg, Caroline Batka, Christine Buttorff, et al.
Date: 2015
Sponsoring organization: RAND Corporation
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Presents an independent assessment of the Purchased Care component from the Veterans Access, Choice, and Accountability Act of 2014. Discusses the system used to fill in gaps in care for veterans that live in rural areas or far from a VA Medical Center (VAMC). Compares the VA's system to other payer models in the federal government.
Author(s): Michael D. Greenberg, Caroline Batka, Christine Buttorff, et al.
Date: 2015
Sponsoring organization: RAND Corporation
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