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Rural Health
Resources by Topic: Reimbursement and payment models

Home Health Payment Reform: Trends in the Supply of Rural Agencies and Availability of Home-Based Skilled Services
Reports on changes in the supply of home health agencies in rural and urban areas before and after the Balanced Budget Act (BBA) of 1997, which changed reimbursement for home health. Also looks at provision of physical therapy, occupational therapy, speech therapy, and medical social work by rural and urban home health agencies.
Author(s): Janet P. Sutton
Date: 03/2005
Sponsoring organization: NORC Walsh Center for Rural Health Analysis
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Medicare Physician Fees: Geographic Adjustment Indices Are Valid in Design, but Data and Methods Need Refinement
Discusses Medicare's geographic practice cost indices (GPCI). Includes discussion of how these indices impact rural physicians, physician incomes, location, recruitment, and retention.
Additional links: Full Report
Date: 03/2005
Sponsoring organization: Government Accountability Office
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Impacts of the Medicare Modernization Act on Rural Health Systems and Beneficiaries
Offers an analysis of rural-pertinent provisions of the Medicare Modernization Act of 2003. Summarizes legislative and regulatory provisions of special significance to rural beneficiaries and health care systems.
Author(s): Keith Mueller, Andrew Coburn, Charles Fluharty, et al.
Date: 02/2005
Sponsoring organization: Rural Policy Research Institute Rural Health Panel
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Medicare Hospice Care: Modifications to Payment Methodology May Be Warranted
Discusses proposed adjustments to Medicare payments for hospice services. Includes some information on rural aspects of hospice and Medicare reimbursement.
Additional links: Full Report
Date: 10/2004
Sponsoring organization: Government Accountability Office
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Medicare: Information Needed to Assess Adequacy of Rate-Setting Methodology for Payments for Hospital Outpatient Services
Examines whether the outpatient prospective payment system (OPPS) rate-setting methodology results in payment rates that uniformly reflect hospitals' costs for providing drugs and devices. Includes information specific to rural hospitals and the OPPS.
Additional links: Full Report
Date: 09/2004
Sponsoring organization: Government Accountability Office
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Exploring the Impact of Medicare's Post-Acute Care Transfer Payment Policy on Rural Hospitals
Describes a change in Medicare post-acute transfer payment policy and its impact on rural and urban hospitals. Includes data on the financial impact and hospital discharge behavior before and after the change.
Author(s): Julie A. Schoenman
Date: 07/2004
Sponsoring organization: NORC Walsh Center for Rural Health Analysis
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Rural Implications of Medicare's Post-Acute Care Transfer Payment Policy
Reports results of a study that examines the behavioral and financial impacts of a change in Medicare payment to pay acute-care hospital cases in 10 DRGs as transfers instead of discharges when the patient is discharged to a targeted post-acute care (PAC) provider after a short inpatient stay. Also projects the likely financial impact of extending the policy to cover additional DRGs or discharges to swing beds.
Author(s): Julie A. Schoenman
Date: 06/2004
Sponsoring organization: NORC Walsh Center for Rural Health Analysis
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MedPAC Report to the Congress: Medicare Payment Policy, 2004
Annual review of Medicare payment policies, with recommendations to Congress. Discussion of rural aspects of Medicare payment policies are included throughout the report. Includes discussion of the growth of Medicare spending and quality of care Medicare recipients receive.
Date: 03/2004
Sponsoring organization: Medicare Payment Advisory Commission
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Modeling the Frontier Extended Stay Clinic Conditions of Participation and Reimbursement Methodologies
Discusses the financial feasibility of the Frontier Extended Stay Clinic (FESC), a proposed provider type to expand services in remote and isolated primary care clinics. Compares Medicare reimbursement for FESC status with Federally Qualified Health Center (FQHC), Rural Health Clinic (RHC), and Critical Access Hospital (CAH) reimbursement. Includes detailed examples of financial impact for seven clinics in rural Alaska, Nevada, Washington, and Wyoming.
Date: 2004
Sponsoring organization: Federal Office of Rural Health Policy
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Rural-Urban Issues in the Wage Index Adjustment for Prospective Payment in Skilled Nursing Facilities
Discusses the use of the hospital wage index for the skilled nursing facility prospective payment system (SNF PPS) and how a change to an SNF wage index would impact rural and urban skilled nursing facilities. Also identifies some related issues that impact reimbursement to SNFs in both urban and rural areas.
Additional links: Findings Brief, January 2004
Author(s): Kathleen Dalton, Rebecca Slifkin
Date: 11/2003
Sponsoring organization: North Carolina Rural Health Research Program
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