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Rural Health Information Hub

Rural Health
Resources by Topic: Reimbursement and payment models

Oklahoma State Innovation Model (OSIM)
Reports on Oklahoma's State Innovation Model (SIM) grant efforts. The final draft of the State Health System Innovation Plan outlines Oklahoma's model for transforming state-purchased healthcare by linking reimbursement with care quality and health outcomes. Addresses the challenges rural regions may face with implementing the model and rural/urban differences throughout.
Additional links: Oklahoma State Health System Innovation Plan
Type: Website
Sponsoring organization: Oklahoma State Department of Health
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Care Coordination Services and Payment for Rural Health Clinics (RHCs) and Federally-Qualified Health Centers (FQHCs)
Provides instructions for payment to Rural Health Clinics (RHCs) billing under the all-inclusive rate and Federally Qualified Health Centers (FQHCs) billing under the prospective payment system for care coordination services provided to Medicare beneficiaries on or after January 1, 2018.
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Eligible Professional / Eligible Clinician eCQMs
Features updated electronic clinical quality measures (eCQMs) for eligible clinicians and professionals participating in the Centers for Medicare & Medicaid Services (CMS) Quality Payment Program (QPP), including the Merit-Based Incentive Payment System (MIPS) and Advanced Alternative Payment Models (Advanced APMs) programs.
Type: Website
Sponsoring organization: Centers for Medicare and Medicaid Services
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Small Rural Hospital Improvement Grant Program (SHIP)
Resources for hospitals related to value-based purchasing, Accountable Care Organizations, and payment bundling. Developed for hospitals participating in the Small Rural Hospital Improvement Grant Program (SHIP).
Type: Website
Sponsoring organization: National Rural Health Resource Center
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List of Skilled Nursing Facility (SNF) Federal Regulations
Lists federal regulations and notices related to the Prospective Payment System (PPS) for Skilled Nursing Facilities (SNFs), including information on annual payment rate updates. Contains copies of proposed and final rules, along with any relevant corrections, as published in the Federal Register.
Type: Website
Sponsoring organization: Centers for Medicare and Medicaid Services
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End-Stage Renal Disease (ESRD) Payment Regulations and Notices
Lists federal regulations and notices related to the End-Stage Renal Disease (ESRD) Prospective Payment System (PPS), including information on annual payment rate updates. Contains copies of proposed and final rules, along with any relevant corrections, as published in the Federal Register.
Type: Website
Sponsoring organization: Centers for Medicare and Medicaid Services
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Physician Fee Schedule (PFS) Federal Regulation Notices
Lists federal regulations and notices related to the Medicare Physician Fee Schedule (PFS), including information on annual payment rate updates. Contains copies of proposed and final rules, along with any relevant corrections, as published in the Federal Register.
Type: Website
Sponsoring organization: Centers for Medicare and Medicaid Services
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Long-Term Care Hospital (LTCH) Prospective Payment System (PPS) Regulations and Notices
Lists federal regulations and notices related to the Long-Term Care Hospital (LTCH) Prospective Payment System (PPS), including information on annual payment rate updates. Contains copies of proposed and final rules, along with any relevant corrections, as published in the Federal Register.
Type: Website
Sponsoring organization: Centers for Medicare and Medicaid Services
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Hospital Outpatient Regulations and Notices
Lists federal regulations and notices related to the Hospital Outpatient Prospective Payment System (OPPS), including information on annual payment rate updates. Contains copies of proposed and final rules, along with any relevant corrections, as published in the Federal Register.
Type: Website
Sponsoring organization: Centers for Medicare and Medicaid Services
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Hospice Regulations and Notices
Lists federal regulations and notices related to Medicare hospice payment, including information on annual payment rate updates. Contains copies of proposed and final rules, along with any relevant corrections, as published in the Federal Register.
Type: Website
Sponsoring organization: Centers for Medicare and Medicaid Services
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