Rural Health
Resources by Topic: Reimbursement and payment models
Community Health Workers: Roles and Opportunities in Health Care Delivery System Reform
Identifies and discusses health services research on the utilization and integration of Community Health Workers (CHWs) into healthcare service delivery. Includes an analysis regarding the various CHW models, employment data, training and credentialing, and challenges associated with the development of this occupation.
Author(s): John E. Snyder
Date: 01/2016
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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Identifies and discusses health services research on the utilization and integration of Community Health Workers (CHWs) into healthcare service delivery. Includes an analysis regarding the various CHW models, employment data, training and credentialing, and challenges associated with the development of this occupation.
Author(s): John E. Snyder
Date: 01/2016
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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ACO Investment Model, Rural Hospital Collaboration
Highlights how 3 rural Minnesota hospitals implemented the Accountable Care Organization Investment Model (AIM), which encourages coordinated care in rural areas through upfront and ongoing Centers for Medicare & Medicaid Services (CMS) payments.
Date: 2016
Sponsoring organization: American Hospital Association Rural Health Services
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Highlights how 3 rural Minnesota hospitals implemented the Accountable Care Organization Investment Model (AIM), which encourages coordinated care in rural areas through upfront and ongoing Centers for Medicare & Medicaid Services (CMS) payments.
Date: 2016
Sponsoring organization: American Hospital Association Rural Health Services
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State Actions to Promote and Restrain Commercial Accountable Care Organizations
Identifies actions state governments can take to promote the benefits of Accountable Care Organizations (ACOs) while mitigating potential risks. Discusses rural-specific concerns related to solvency and exclusivity provisions. Also examines state policy tools that regulate and support both providers and payers. Section 2 offers ACO policy guidance specific to California.
Author(s): Nicholas C. Petris Center on Health Care Markets and Consumer Welfare
Date: 10/2015
Sponsoring organization: University of California - Berkeley
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Identifies actions state governments can take to promote the benefits of Accountable Care Organizations (ACOs) while mitigating potential risks. Discusses rural-specific concerns related to solvency and exclusivity provisions. Also examines state policy tools that regulate and support both providers and payers. Section 2 offers ACO policy guidance specific to California.
Author(s): Nicholas C. Petris Center on Health Care Markets and Consumer Welfare
Date: 10/2015
Sponsoring organization: University of California - Berkeley
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Rural Delivery System Reform Takes Center Stage for National Advisory Committee
Reports on discussion at a September 2015 meeting of the National Advisory Committee on Rural Health and Human Services focused on the need for rural healthcare providers to be involved in health system changes related to payment and service delivery.
Author(s): Kate Menzies, Brandon Baumbach
Citation: Rural Monitor
Date: 10/2015
Sponsoring organization: Rural Health Information Hub
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Reports on discussion at a September 2015 meeting of the National Advisory Committee on Rural Health and Human Services focused on the need for rural healthcare providers to be involved in health system changes related to payment and service delivery.
Author(s): Kate Menzies, Brandon Baumbach
Citation: Rural Monitor
Date: 10/2015
Sponsoring organization: Rural Health Information Hub
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National Advisory Committee Tackles Delivery System Reform, Child Poverty
Describes a September 2015 meeting of the National Advisory Committee on Rural Health and Human Services held in Mahnomen, Minnesota, which focused on rural child poverty and healthcare delivery system reform.
Citation: Rural Monitor
Date: 10/2015
Sponsoring organization: Rural Health Information Hub
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Describes a September 2015 meeting of the National Advisory Committee on Rural Health and Human Services held in Mahnomen, Minnesota, which focused on rural child poverty and healthcare delivery system reform.
Citation: Rural Monitor
Date: 10/2015
Sponsoring organization: Rural Health Information Hub
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Hospital Value-based Purchasing: Initial Results Show Modest Effects on Medicare Payments and No Apparent Change in Quality-of-Care Trends
Evaluates the initial effects of the Hospital Value-based Purchasing (HVBP) program on Medicare bonus payments and penalties, the quality of care provided, and selected quality improvement efforts during FY 2013-15. Analyzes data from safety net, small urban, and small rural hospitals.
Additional links: Full Report
Date: 10/2015
Sponsoring organization: Government Accountability Office
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Evaluates the initial effects of the Hospital Value-based Purchasing (HVBP) program on Medicare bonus payments and penalties, the quality of care provided, and selected quality improvement efforts during FY 2013-15. Analyzes data from safety net, small urban, and small rural hospitals.
Additional links: Full Report
Date: 10/2015
Sponsoring organization: Government Accountability Office
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Performance Measurement for Rural Low-Volume Providers: Final Report
Identifies challenges to measuring healthcare performance among low-volume rural providers, and presents recommendations to meet these challenges. Primary focus is on finding appropriate quality measures for use within Centers for Medicare and Medicaid Services' (CMS) pay-for-performance programs and encouraging rural participation in CMS quality improvement initiatives.
Date: 09/2015
Sponsoring organization: National Quality Forum
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Identifies challenges to measuring healthcare performance among low-volume rural providers, and presents recommendations to meet these challenges. Primary focus is on finding appropriate quality measures for use within Centers for Medicare and Medicaid Services' (CMS) pay-for-performance programs and encouraging rural participation in CMS quality improvement initiatives.
Date: 09/2015
Sponsoring organization: National Quality Forum
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Simulation and Analysis of an Alternative Medicare Home Health Payment System Not Based on Number of Therapy Visits
Outlines a possible approach to redesigning the Medicare home health payment system and describes the likely impacts of such a change. Includes statistics with breakdowns by number of therapy and non-therapy visits, payment-to-cost ratios, medical procedure or chronic illness, and type of health facility.
Author(s): Doug Wissoker, Bowen Garrett
Date: 08/2015
Sponsoring organization: Urban Institute
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Outlines a possible approach to redesigning the Medicare home health payment system and describes the likely impacts of such a change. Includes statistics with breakdowns by number of therapy and non-therapy visits, payment-to-cost ratios, medical procedure or chronic illness, and type of health facility.
Author(s): Doug Wissoker, Bowen Garrett
Date: 08/2015
Sponsoring organization: Urban Institute
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Hospital Policy Issues: Statement by Mark Miller, Medicare Payment Advisory Commission before Subcommittee on Health, Committee on Ways and Means, U.S. House of Representatives
Testimony from the Medicare Payment Advisory Commission's executive director presented at a July 22nd, 2015, Ways and Means subcommittee hearing concerning Medicare hospital payment issues, rural health issues, and beneficiary access to care. Discusses Medicare's rural hospital payment adjustments, how they impact access to care, and principles to consider in evaluating rural add-on payments. Also discusses MedPAC recommendations related to graduate medical education (GME), including some related to rural training.
Author(s): Mark E. Miller
Date: 07/2015
Sponsoring organizations: House Ways and Means Committee, Subcommittee on Health, Medicare Payment Advisory Commission
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Testimony from the Medicare Payment Advisory Commission's executive director presented at a July 22nd, 2015, Ways and Means subcommittee hearing concerning Medicare hospital payment issues, rural health issues, and beneficiary access to care. Discusses Medicare's rural hospital payment adjustments, how they impact access to care, and principles to consider in evaluating rural add-on payments. Also discusses MedPAC recommendations related to graduate medical education (GME), including some related to rural training.
Author(s): Mark E. Miller
Date: 07/2015
Sponsoring organizations: House Ways and Means Committee, Subcommittee on Health, Medicare Payment Advisory Commission
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Characteristics of Children in Medicaid Managed Care and Medicaid Fee-for-service, 2003-2005
Examines how children enrolled in Medicaid fee-for-service programs compare to those in comprehensive managed care programs. Includes information on sociodemographic, health, and geographic characteristics. Table 5 provides figures by type of Medicaid program for urban and rural enrollees.
Author(s): Patricia C. Lloyd, Alan E. Simon, Jennifer D. Parker
Date: 06/2015
Sponsoring organization: National Center for Health Statistics
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Examines how children enrolled in Medicaid fee-for-service programs compare to those in comprehensive managed care programs. Includes information on sociodemographic, health, and geographic characteristics. Table 5 provides figures by type of Medicaid program for urban and rural enrollees.
Author(s): Patricia C. Lloyd, Alan E. Simon, Jennifer D. Parker
Date: 06/2015
Sponsoring organization: National Center for Health Statistics
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