Rural Health
Resources by Topic: Healthcare business and finance
Medicare Payment Basics: Inpatient Psychiatric Facilities Services Payment System
Overview of Medicare's payment system for inpatient psychiatric services provided in freestanding hospitals or specialized hospital-based units. Demonstrates how payments for these services are adjusted to reflect geographic differences in labor costs, and cost of care by facility and patient characteristics.
Date: 10/2024
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Overview of Medicare's payment system for inpatient psychiatric services provided in freestanding hospitals or specialized hospital-based units. Demonstrates how payments for these services are adjusted to reflect geographic differences in labor costs, and cost of care by facility and patient characteristics.
Date: 10/2024
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Medicare Payment Basics: Hospital Acute Inpatient Services Payment System
Overview of Medicare payments to hospitals for acute inpatient care. Includes information on rate setting, Medicare payments for medical education, payments to Medicare Disproportionate Share Hospitals (DSH), new technology payments special payments for rural hospitals, quality incentive payments and penalties, and payment rate updates.
Date: 10/2024
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Overview of Medicare payments to hospitals for acute inpatient care. Includes information on rate setting, Medicare payments for medical education, payments to Medicare Disproportionate Share Hospitals (DSH), new technology payments special payments for rural hospitals, quality incentive payments and penalties, and payment rate updates.
Date: 10/2024
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Medicare Payment Basics: Hospice Services Payment System
Overview of the Medicare hospice benefit and Medicare payments to hospice providers. Describes the four levels of care of the hospice prospective payment system and payment rates.
Date: 10/2024
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Overview of the Medicare hospice benefit and Medicare payments to hospice providers. Describes the four levels of care of the hospice prospective payment system and payment rates.
Date: 10/2024
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Medicare Payment Basics: Home Health Care Services Payment System
Overview of Medicare payments for home health care services. Includes information on rate-setting and payments for quality reporting and performance. Describes the Patient-Driven Groupings Model (PDGM) and the home health resource groups (HHRGs) based on clinical and functional status.
Date: 10/2024
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Overview of Medicare payments for home health care services. Includes information on rate-setting and payments for quality reporting and performance. Describes the Patient-Driven Groupings Model (PDGM) and the home health resource groups (HHRGs) based on clinical and functional status.
Date: 10/2024
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Medicare Payment Basics: Durable Medical Equipment Payment System
Overview of Medicare payments for medical equipment used to treat beneficiaries at home. Defines durable medical equipment (DME), details the DME fee schedule, and discusses the competitive bidding program (CBP) for DME. Includes information on adjustments to fee schedule payment rates outside of competitive bidding areas (CBAs).
Date: 10/2024
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Overview of Medicare payments for medical equipment used to treat beneficiaries at home. Defines durable medical equipment (DME), details the DME fee schedule, and discusses the competitive bidding program (CBP) for DME. Includes information on adjustments to fee schedule payment rates outside of competitive bidding areas (CBAs).
Date: 10/2024
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Medicare Payment Basics: Ambulance Services Payment System
Provides an overview of Medicare payments for ambulance services. Discusses rural add-on payment policies, geographic categories determining payment rates, super-rural ZIP codes, and ambulance fee schedules.
Date: 10/2024
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Provides an overview of Medicare payments for ambulance services. Discusses rural add-on payment policies, geographic categories determining payment rates, super-rural ZIP codes, and ambulance fee schedules.
Date: 10/2024
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Medicare Payment Basics: Accountable Care Organizations Payment Systems
Provides an overview of Medicare's Accountable Care Organization (ACO) programs. Discusses the payment mechanics of ACOs, including the maximum shared savings and losses of Medicare Shared Savings Program ACOs by track and level.
Date: 10/2024
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Provides an overview of Medicare's Accountable Care Organization (ACO) programs. Discusses the payment mechanics of ACOs, including the maximum shared savings and losses of Medicare Shared Savings Program ACOs by track and level.
Date: 10/2024
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Medicare Payment Basics: Critical Access Hospitals Payment System
Presents an overview of Medicare payments for Critical Access Hospitals (CAHs). Compares differences in Medicare payments for CAHs, Sole Community Hospitals, and Medicare-Dependent Hospitals.
Date: 10/2024
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Presents an overview of Medicare payments for Critical Access Hospitals (CAHs). Compares differences in Medicare payments for CAHs, Sole Community Hospitals, and Medicare-Dependent Hospitals.
Date: 10/2024
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Costs of Treat-and-Release Emergency Department Visits in the United States, 2021
Explores the cost of treat-and-release emergency department (ED) visits in the United States in 2021. Describes findings from an analysis of the 2021 Healthcare Cost and Utilization Project (HCUP) Nationwide Emergency Department Sample. Presents data on the aggregate costs, average cost, and number of ED visits by patient and hospital characteristics, including patient age; sex; primary expected payer; community-level income; and metropolitan, micropolitan, or rural status.
Date: 09/2024
Type: Document
Sponsoring organization: Agency for Healthcare Research and Quality
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Explores the cost of treat-and-release emergency department (ED) visits in the United States in 2021. Describes findings from an analysis of the 2021 Healthcare Cost and Utilization Project (HCUP) Nationwide Emergency Department Sample. Presents data on the aggregate costs, average cost, and number of ED visits by patient and hospital characteristics, including patient age; sex; primary expected payer; community-level income; and metropolitan, micropolitan, or rural status.
Date: 09/2024
Type: Document
Sponsoring organization: Agency for Healthcare Research and Quality
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States Could Better Leverage Coverage and Access Requirements To Promote Maternal Health Care Access in Medicaid Managed Care
Describes challenges to maternal healthcare access. Explores the provider coverage rules and network adequacy standards state Medicaid agencies have set for maternal healthcare in Medicaid managed care. Examines state oversight of quantitative network adequacy standards. Offers recommendations to the Centers for Medicare & Medicaid Services (CMS) to ensure access to pregnancy and postpartum care in Medicaid managed care. Includes rural references throughout.
Additional links: Report in Brief
Date: 09/2024
Type: Document
Sponsoring organization: Office of Inspector General (HHS)
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Describes challenges to maternal healthcare access. Explores the provider coverage rules and network adequacy standards state Medicaid agencies have set for maternal healthcare in Medicaid managed care. Examines state oversight of quantitative network adequacy standards. Offers recommendations to the Centers for Medicare & Medicaid Services (CMS) to ensure access to pregnancy and postpartum care in Medicaid managed care. Includes rural references throughout.
Additional links: Report in Brief
Date: 09/2024
Type: Document
Sponsoring organization: Office of Inspector General (HHS)
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