Rural Health
Resources by Topic: Reimbursement and payment models
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
Type: Document
Sponsoring organization: NORC Walsh Center for Rural Health Analysis
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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
Type: Document
Sponsoring organization: NORC Walsh Center for Rural Health Analysis
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An Analysis of the Agreement of Financial Data Between the Medicare Cost Report and the Audited Hospital Financial Statement
Describes the results of a study of rural hospital financial measures, comparing Medicare Cost Reports with audited hospital financial statements.
Author(s): Li-Wu Chen, Julie Stoner, Catherine Makhanu, Kathy Minikus, Keith J. Mueller
Date: 05/2004
Type: Document
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Describes the results of a study of rural hospital financial measures, comparing Medicare Cost Reports with audited hospital financial statements.
Author(s): Li-Wu Chen, Julie Stoner, Catherine Makhanu, Kathy Minikus, Keith J. Mueller
Date: 05/2004
Type: Document
Sponsoring organization: RUPRI Center for Rural Health Policy 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
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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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
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (P.L. 108-173): A Summary of Provisions Important to Rural Health Care Delivery
Overview of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (P.L. 108-173) as it relates to rural healthcare. Includes information on how this Act impacts beneficiaries, healthcare access, and payments to rural healthcare providers.
Author(s): Keith J. Mueller
Date: 01/2004
Type: Document
Sponsoring organizations: RUPRI Center for Rural Health Policy Analysis, Rural Policy Research Institute
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Overview of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (P.L. 108-173) as it relates to rural healthcare. Includes information on how this Act impacts beneficiaries, healthcare access, and payments to rural healthcare providers.
Author(s): Keith J. Mueller
Date: 01/2004
Type: Document
Sponsoring organizations: RUPRI Center for Rural Health Policy Analysis, Rural Policy Research Institute
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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
Type: Document
Sponsoring organization: Federal Office of Rural Health Policy
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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
Type: Document
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
Type: Document
Sponsoring organization: North Carolina Rural Health Research Program
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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
Type: Document
Sponsoring organization: North Carolina Rural Health Research Program
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Medicare Physician Payment: Practice Expense
Describes the variation in Medicare payment for practice expense using the Geographic Practice Cost Indexes (GPCIs). Explains the factors that are used to calculate GPCIs and lists the 2003 GPCIs. Discusses potential impact of lower Medicare reimbursement to rural physicians for practice expense.
Author(s): A. Clinton MacKinney, Timothy D. McBride, Michael D. Shambaugh-Miller, Keith J. Mueller
Citation: RUPRI Rural Policy Brief, 8(9)
Date: 10/2003
Type: Document
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Describes the variation in Medicare payment for practice expense using the Geographic Practice Cost Indexes (GPCIs). Explains the factors that are used to calculate GPCIs and lists the 2003 GPCIs. Discusses potential impact of lower Medicare reimbursement to rural physicians for practice expense.
Author(s): A. Clinton MacKinney, Timothy D. McBride, Michael D. Shambaugh-Miller, Keith J. Mueller
Citation: RUPRI Rural Policy Brief, 8(9)
Date: 10/2003
Type: Document
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Ambulance Services: Medicare Payments Can be Better Targeted to Trips in Less Densely Populated Rural Areas
Covers factors that affect ambulance costs per trip, how these factors vary across geographic areas, and how well Medicare payments account for geographic cost differences.
Additional links: Full Report
Date: 09/2003
Type: Document
Sponsoring organization: Government Accountability Office
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Covers factors that affect ambulance costs per trip, how these factors vary across geographic areas, and how well Medicare payments account for geographic cost differences.
Additional links: Full Report
Date: 09/2003
Type: Document
Sponsoring organization: Government Accountability Office
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MedPAC Report to the Congress: Variation and Innovation in Medicare
Analyzes variation within the Medicare program and explores a variety of possible payment innovations. Includes some rural-specific information. Geographic, market, quality, hospital financial performance, and use of physician services variations are covered. Also examines Medicare's reimbursement for Part B drugs. Recommendations include quality incentives and competitive pricing.
Date: 06/2003
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Analyzes variation within the Medicare program and explores a variety of possible payment innovations. Includes some rural-specific information. Geographic, market, quality, hospital financial performance, and use of physician services variations are covered. Also examines Medicare's reimbursement for Part B drugs. Recommendations include quality incentives and competitive pricing.
Date: 06/2003
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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MedPAC Report to the Congress: Medicare Payment Policy, 2003
Report to the Congress. Reviews the Medicare prospective payment systems (PPSs) for seven sectors: hospital inpatient, hospital outpatient, physician, skilled nursing, home health, outpatient dialysis, and ambulatory surgical center services. Also discusses broader issues related to Medicare payments. Includes recommendations. Appendix with data on hospital financial performance for 1991-2000.
Date: 03/2003
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Report to the Congress. Reviews the Medicare prospective payment systems (PPSs) for seven sectors: hospital inpatient, hospital outpatient, physician, skilled nursing, home health, outpatient dialysis, and ambulatory surgical center services. Also discusses broader issues related to Medicare payments. Includes recommendations. Appendix with data on hospital financial performance for 1991-2000.
Date: 03/2003
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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