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Rural Health
Resources by Topic: Reimbursement and payment models

The Implementation of Pay-For-Performance in Rural Hospitals: Lessons from the Hospital Quality Incentive Demonstration Project
Reports the findings of a national study designed to identify institutional, organizational, and environmental factors that influence the experience of rural hospitals in the Hospital Quality Incentive Demonstration Project.
Author(s): Walter Gregg, Ira Moscovice, Denise Remus
Date: 09/2006
Sponsoring organization: Upper Midwest Rural Health Research Center
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A Primer on the Occupational Mix Adjustment to the Medicare Hospital Wage Index
Focuses on the occupational mix adjustment (OMA) to the labor-related share in the hospital inpatient prospective payment system. Explains what the OMA is, why it is needed, and how it has been calculated. Discusses reasons the effect of the OMA has been less than some rural advocates anticipated.
Author(s): Kristin Reiter, Rebecca Slifkin, Mark Holmes
Date: 09/2006
Sponsoring organization: North Carolina Rural Health Research Program
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Medicare Physician Payments: Trends in Service Utilization, Spending, and Fees Prompt Consideration of Alternative Payment Approaches
Statement discussing the sustainable growth rate (SGR) system, which Medicare uses to determine annual changes to physician fees. Includes some rural-specific information.
Additional links: Full Report
Author(s): A. Bruce Steinwald
Date: 07/2006
Sponsoring organization: Government Accountability Office
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Comparison of the Rural Health Clinic and Federally Qualified Health Center Programs
Provides a general comparison of the financial components of the Rural Health Clinic (RHC) and Federally Qualified Health Center (FQHC) programs under Medicare and Medicaid.
Date: 06/2006
Sponsoring organization: Health Resources and Services Administration
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MedPAC Report to the Congress: Medicare Payment Policy, 2006
Annual review of Medicare payment policies, with recommendations to Congress. Discussions of rural aspects of Medicare payment policies are included throughout the report.
Date: 03/2006
Sponsoring organization: Medicare Payment Advisory Commission
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Trends in Skilled Nursing and Swing-bed Use in Rural Areas, 1996-2003
Examines trends in the delivery of skilled nursing facility (SNF) services in rural areas during a period of dramatic change in Medicare payments. Focuses on the role of rural hospitals in providing SNF services, as a number of regulatory changes occurred between 1998 and 2002 that could potentially influence hospital provision of skilled nursing care.
Author(s): Kathleen Dalton, Jeongyoung Park, Ann Howard, Rebecca Slifkin
Date: 12/2005
Sponsoring organization: North Carolina Rural Health Research Program
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Revisions to Medicare's Disproportionate Share Payment Policy to Incorporate Bad Debt and Charity Care
Investigates the impact of possible changes to the Medicare disproportionate share (DSH) payment policy, designed to incorporate information on the hospital's uncompensated care burden as well as to improve the payment formula. These analyses are intended to help policymakers evaluate the likely impact of revising the DSH payment methodology.
Author(s): Julie A. Schoenman, Janet P. Sutton, Lan Zhao
Date: 09/2005
Sponsoring organization: NORC Walsh Center for Rural Health Analysis
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Utilization of Home Health Services Among Rural Medicare Beneficiaries Before and After the PPS: Final Report
Describes the results of a study on the rural effects of the Medicare prospective payment system (PPS), including whether the PPS contributed to changes in the demographic and clinical characteristics of home care users; the likelihood of using each of six home care disciplines; and the intensity of services.
Author(s): Janet P. Sutton
Date: 08/2005
Sponsoring organization: NORC Walsh Center for Rural Health Analysis
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Health Centers and Rural Clinics: State and Federal Implementation Issues for Medicaid's New Payment System
Reviews states' implementation of the prospective payment system (PPS) for Medicaid payments to Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs). Includes recommendations for CMS on guidance and oversight for states.
Additional links: Full Report
Date: 06/2005
Sponsoring organization: Government Accountability Office
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MedPAC Report to the Congress: Medicare Payment Policy, 2005
Annual review of Medicare payment policies, with recommendations to Congress. Discussions of rural aspects of Medicare payment policies are included throughout the report. Includes discussion of strategies to improve care, including pay for performance and information technology.
Date: 03/2005
Sponsoring organization: Medicare Payment Advisory Commission
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