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Rural Health
Resources by Topic: Reimbursement and payment models

Medicare Physician Payment
Provides an overview of how physicians are paid by Medicare, with a focus on the adjustments made related to geographic practice cost indexes (GPCIs). Discusses rural issues related to Medicare physician payment, including impact on physician recruitment and retention and healthcare access.
Author(s): A. Clinton MacKinney, Michael D. Shambaugh-Miller, Keith Mueller
Citation: RUPRI Rural Policy Brief, 8(2)
Date: 01/2003
Type: Document
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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State Licensure Laws and the Mental Health Professions: Implications for the Rural Mental Health Workforce
Examines licensure statutes and administrative rules for social workers, psychologists, professional counselors, and marriage and family therapists in the 40 states that have at least 10% of the population living in rural areas. Covers scope of practice, training and supervision, and reimbursement.
Additional links: Executive Summary, May 2002
Author(s): David Hartley, Erika C. Ziller, David Lambert, Stephenie L. Loux, Donna C. Bird
Date: 10/2002
Type: Document
Sponsoring organization: Maine Rural Health Research Center
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Trends in Special Medicare Payments and Service Utilization for Rural Areas in the 1990s
Presents the findings of an analysis of payment trends for providers qualifying under Medicare special payment provisions for rural providers. Covers payment trends for rural hospitals, Rural Health Clinics, Federally Qualified Health Centers, and physicians.
Author(s): Donna O. Farley, Lisa R. Shugarman, Pat Taylor, et al.
Date: 06/2002
Type: Document
Sponsoring organization: RAND Corporation
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Financial Incentives for Rural Hospitals to Expand the Scope of Their Services
Examines the financial incentives that rural hospitals have to conduct surgery and treat more complex medical conditions. Evaluates whether rural hospitals that offer broader services are more profitable than hospitals with very limited inpatient services. A low-volume adjustment considered by the Medicare Payment Advisory Commissions (MedPAC) is discussed.
Author(s): Jeffrey Stensland, Michelle Brasure, Ira Moscovice, Tiffany Radcliff
Date: 06/2002
Type: Document
Sponsoring organization: University of Minnesota Rural Health Research Center
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Inequitable Access: Medicare+Choice Program Fails to Serve Rural America
Describes the impact that the Medicare+ Choice plans have had in rural areas and discusses payment policy implications.
Author(s): Timothy McBride, Keith Mueller
Citation: RUPRI Rural Policy Brief, 7(2)
Date: 02/2002
Type: Document
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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MedPAC Report to the Congress: Medicare in Rural America, 2001
Overview of Medicare and rural healthcare. Covers rural access to care, quality of care, and Medicare payments. Also examines rural beneficiaries' access to Medicare+Choice health plans.
Date: 06/2001
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Can Payment Policies Attract M+C Plans to Rural Areas?
Identifies factors that discourage insurance plans from offering Medicare managed care plans in nonmetropolitan counties. Provides data on nonmetro Medicare+Choice plan availability for 1997-2000. Discusses impact of the Balanced Budget Act of 1997 (BBA), the Balanced Budget Refinement Act of 1999 (BBRA), and the Medicare, Medicaid, & SCHIP Benefits Improvement and Protection Act of 2000 (BIPA) on Medicare managed care enrollment.
Author(s): Timothy McBride, Joan Penrod, Keith Mueller, Courtney Andrews, Micah Hughes
Citation: RUPRI Rural Policy Brief, 6(8)
Date: 05/2001
Type: Document
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Update on Medicare+Choice: Rural Medicare Beneficiaries Enrolled in Medicare+Choice Plans through October 2000
Describes enrollment in Medicare+Choice in rural counties through October 2000.
Author(s): Timothy McBride, Courtney Andrews, Keith Mueller
Citation: RUPRI Rural Policy Brief, 6(7)
Date: 03/2001
Type: Document
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Rural Implications of the Medicare, Medicaid, and SCHIP Benefits Improvement and Protection Act of 2000: Concerns, Legislation, and Next Steps
Overview of the Medicare, Medicaid, and SCHIP Benefits Improvement and Protection Act of 2000 (BIPA) as it impacted rural health. Identifies impacts related to Medicare payments to specific types of facilities and for specific services. Also lists BIPA-mandated studies and demonstrations.
Date: 01/2001
Type: Document
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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PPS Inpatient Payment and the Area Wage Index
Discusses how Medicare inpatient rates were calculated as of 2001, the role of the wage index, and issues surrounding the wage index and reimbursement to rural hospitals by Medicare under the Prospective Payment System (PPS).
Author(s): Kathleen Dalton, Rebecca T. Slifkin
Date: 01/2001
Type: Document
Sponsoring organization: North Carolina Rural Health Research Program
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