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Rural Health
Resources by Topic: Reimbursement and payment models

Geographic Adjustment in Medicare Payment Phase I: Improving Accuracy, Second Edition
Report brief that expands on recommendations made in an earlier report for improving how the Medicare program calculates geographic practice cost indexes that result in payments to hospitals, physicians, and other clinical practitioners based on their geographic locations.
Additional links: Read Online
Date: 2012
Type: Document
Sponsoring organization: Institute of Medicine
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Physician Value-Based Payment Modifier Program
Discusses provisions from the Patient Protection and Affordable Care Act including the Physician Payment Modifier (VBM) program, which provides differential payment to physicians or physician groups based on the quality of care provided compared to the cost of providing care.
Date: 12/2011
Type: Document
Sponsoring organization: National Advisory Committee on Rural Health and Human Services
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Medicare Copayments for Critical Access Hospital Outpatient Services - 2009 Update
Discusses the impact of Part B coinsurance on beneficiaries receiving outpatient services at Critical Access Hospitals.
Author(s): Sara Freeman, Kathleen Dalton
Date: 12/2011
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Effect of Swing Bed Use on Medicare Average Daily Cost and Reimbursement in Critical Access Hospitals
Estimates the average net cost to Medicare of a skilled nursing facility swing day by simulating the elimination of all Medicare skilled nursing facility swing bed days in Critical Access Hospitals in 2009.
Author(s): Kristin L. Reiter, George M. Holmes, George H. Pink, Victoria A. Freeman
Date: 12/2011
Type: Document
Sponsoring organization: North Carolina Rural Health Research Program
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Value-Based Purchasing Demonstrations for Critical Access and Small PPS Hospitals
White paper discussing the expanded quality reporting programs for Critical Access Hospitals (CAHs) and hospitals excluded from the inpatient Value-Based Purchasing (VBP) program due to a low number of cases. Includes recommendations to the Secretary of Health and Human Services on the rural implications from the Affordable Care Act (ACA) provision on inpatient hospital VBP program.
Date: 09/2011
Type: Document
Sponsoring organization: National Advisory Committee on Rural Health and Human Services
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Will Bundling Work in Rural America? Analysis of the Feasibility and Consequences of Bundled Payments for Rural Health Providers and Patients
Assesses how bundled payments may affect both healthcare quality and access among rural providers, and explains the financial and operational challenges associated with implementing bundled payments in low-volume providers such as Critical Access Hospitals (CAHs).
Author(s): Robert Town, Walter Gregg, Ira Moscovice, Shailendra Prasad, Jill Klingner
Date: 09/2011
Type: Document
Sponsoring organization: Upper Midwest Rural Health Research Center
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National Advisory Committee on Rural Health & Human Services Meeting Minutes, Traverse City, Michigan, June 15-17, 2011
Provides a summary of the National Advisory Committee on Rural Health and Human Services' (NACRHHS) 68th meeting, which included discussions on the following topics: rural health in Michigan, the Affordable Care Act's value-based purchasing demonstrations for rural hospitals, primary care training and placement, and aging.
Date: 06/2011
Type: Document
Sponsoring organization: National Advisory Committee on Rural Health and Human Services
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The 2011 Report to the Secretary: Rural Health and Human Services Issues
Report to the Secretary of the U.S. Department of Health and Human Services focused on rural childhood obesity, place-based initiatives for rural early childhood development, and rural implications of accountable care organizations and payment bundling. Includes recommendations to address these issues and provides appendices describing the 2010 site visits.
Date: 03/2011
Type: Document
Sponsoring organization: National Advisory Committee on Rural Health and Human Services
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MedPAC Report to the Congress: Medicare Payment Policy, 2011
Annual review of Medicare payment policies, with recommendations to Congress. Discussions of rural aspects of Medicare payment policies are included in the report.
Date: 03/2011
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Home Health Study Report: Literature Review
Presents a literature search which was used as a background to aid the development of a study and report on potential revisions to the Home Health Prospective Payment System (HH PPS). Report includes rural and underserved populations.
Author(s): Judy Goldberg Dey, Margaret Johnson, William Pajerowski, Myra Tanamor, Alyson Ward
Date: 01/2011
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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