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Rural Health Information Hub
Rural Health Information Hub

Rural Health
News by Topic: Reimbursement and payment models

Nov 13, 2024 - Outlines current and projected funding challenges for Federally Qualified Health Centers. Discusses common sources of revenue, reimbursement rates, the 340B program, and policy opportunities for federal and state government. Notes that rural residents are a significant user base for Community Health Centers.
Source: The Commonwealth Fund
Nov 13, 2024 - Provides overview of recent research on rural medical debt. Notes that rural residents are more likely than urban residents to have problems paying medical bills, and identifies gender and racial disparities within rural survey respondents. Discusses the potential impacts of medical debt on the viability of rural hospitals.
Source: The Daily Yonder
Nov 12, 2024 - Notice of final rule from the Centers for Medicare & Medicaid Services (CMS) updating and revising the End-Stage Renal Disease (ESRD) Prospective Payment System (PPS) for calendar year 2025 and updates the payment rate for renal dialysis services furnished by an ESRD facility to individuals with acute kidney injury (AKI). This rule also updates the requirements for the Conditions for Coverage for ESRD facilities, the ESRD Quality Incentive Program, and the ESRD Treatment Choices Model. These regulations are effective January 1, 2025.
Source: Federal Register
Nov 7, 2024 - Notice of final rule from the Centers for Medicare & Medicaid Services (CMS) updating the home health payment rates for calendar year (CY) 2025. This rule also finalizes changes to the Home Health Quality Reporting Program (HH QRP) requirements and provides an update on potential approaches for integrating health equity in the Expanded Health Value-Based Purchasing (HHVBP) Model. Among other things, this rule also finalizes a new standard for acceptance to service policy in the home health conditions of participation (CoPs) and provides updates to provider and supplier enrollment requirements and changes to the long-term care reporting requirements for acute respiratory illnesses, among other things. These regulations are effective January 1, 2025.
Source: Federal Register
Nov 4, 2024 - Highlights the growth of community health worker (CHW) programs across the country. Notes that CHW programs in rural areas can help connect low-income and minority communities to health systems and navigate common barriers to care. Describes the impacts of a CHW program in Huron, South Dakota, which was created through a federal grant program and is now funded by Medicaid reimbursements.
Source: South Dakota Searchlight, KFF Health News
Nov 4, 2024 - Discusses telehealth and remote monitoring tool solutions for improving rural healthcare access. Highlights the role the COVID-19 pandemic played in increasing telehealth adoption and access barriers that remain in spite of wider telehealth adoption. Discusses workforce shortages, broadband challenges, and reimbursement for telehealth.
Source: TechTarget
Nov 1, 2024 - Announcement of new policies included in the 2025 Hospital Outpatient Prospective Payment System and Ambulatory Surgical Center final rule. Describes updated health and safety requirements for hospitals and Critical Access Hospitals (CAHs) to improve and expand access to quality maternal and behavioral health care. Notes policy changes including updated payment rates, staffing standards, quality assessments, training requirements, and expanded coverage for services provided outside the "four walls" of behavioral health clinics and clinics located in rural areas.
Source: Centers for Medicare & Medicaid Services
Oct 30, 2024 - Notice from the Centers for Medicare & Medicaid Services (CMS) seeking comments on the following information collections: 1) Section 1115 Demonstration Projects Regulations at 42 CFR 431.408, 431.412, 431.420, 431.424, and 431.428; 2) Reporting Requirements and Corrective Action Plans Under section 1902(tt) of the Social Security Act; 3) Application for Enrollment in Medicare Part B (Medical Insurance); 4) Application for Medicare Part A and Part B Special Enrollment Period (Exceptional Circumstances); and 5) Request for Enrollment in Supplementary Medical Insurance (SMI). Comments are due by December 30, 2024.
Source: Federal Register
Oct 29, 2024 - Highlights discussions at the Sanford Health event "Summit on the Future of Rural Health Care" regarding healthcare accessibility and workforce shortages. Discusses reimbursement issues and technology advances that may help close some accessibility gaps.
Source: KELO
Oct 25, 2024 - Notice from the Centers for Medicare & Medicaid Services (CMS) making technical corrections to the February 8, 2024, final rule. This correcting amendment is effective October 25, 2024.
Source: Federal Register