Rural Health
Resources by Topic: Medicare
ACO Primary Care Flex Model
Provides information on the Centers for Medicare & Medicaid Services (CMS) Innovation Center's ACO Primary Care Flex Model, which will test how prospective payments and increased funding for primary care in accountable care organizations (ACOs) impact health outcomes, quality, and costs of care. Aims to increase the number of low-revenue ACOs participating in the Medicare Shared Savings Program (SSP), including ACOs serving rural and underserved populations.
Type: Website
Sponsoring organization: Centers for Medicare and Medicaid Services
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Provides information on the Centers for Medicare & Medicaid Services (CMS) Innovation Center's ACO Primary Care Flex Model, which will test how prospective payments and increased funding for primary care in accountable care organizations (ACOs) impact health outcomes, quality, and costs of care. Aims to increase the number of low-revenue ACOs participating in the Medicare Shared Savings Program (SSP), including ACOs serving rural and underserved populations.
Type: Website
Sponsoring organization: Centers for Medicare and Medicaid Services
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Hospital Price Transparency
Offers resources for healthcare providers and consumers regarding hospital price transparency regulations and policies. Includes links to a GitHub repository of resources for templates and technical instructions and tools to support hospitals in meeting accessibility and machine-readable file requirements.
Additional links: GitHub Repository
Type: Website
Sponsoring organization: Centers for Medicare and Medicaid Services
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Offers resources for healthcare providers and consumers regarding hospital price transparency regulations and policies. Includes links to a GitHub repository of resources for templates and technical instructions and tools to support hospitals in meeting accessibility and machine-readable file requirements.
Additional links: GitHub Repository
Type: Website
Sponsoring organization: Centers for Medicare and Medicaid Services
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CMS Cross Cutting Initiative: Rural Health
A fact sheet that provides examples of how the Centers for Medicare & Medicaid Services (CMS) is working to eliminate disparities in rural healthcare access related to workforce shortages, facility closures, and infrastructure issues. Discusses innovative healthcare payment models from 2023 that address barriers to value-based care in rural healthcare delivery.
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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A fact sheet that provides examples of how the Centers for Medicare & Medicaid Services (CMS) is working to eliminate disparities in rural healthcare access related to workforce shortages, facility closures, and infrastructure issues. Discusses innovative healthcare payment models from 2023 that address barriers to value-based care in rural healthcare delivery.
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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NARHC REF Lookup Tool Portal
Interactive tool providing data on the Healthcare Common Procedure Coding System (HCPCS) codes and Current Procedural Terminology (CPT) codes used by Rural Health Clinics (RHCs) for services provided to Medicare beneficiaries. Uses a statistically adjusted sample of health care claims data and carrier file claims from 2019-2021. Data are searchable by claim year, code, and percentage and frequency of use.
Type: Tool
Sponsoring organizations: Catherine Cutler Institute, National Association of Rural Health Clinics, National Association of Rural Health Clinics Research and Education Foundation
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Interactive tool providing data on the Healthcare Common Procedure Coding System (HCPCS) codes and Current Procedural Terminology (CPT) codes used by Rural Health Clinics (RHCs) for services provided to Medicare beneficiaries. Uses a statistically adjusted sample of health care claims data and carrier file claims from 2019-2021. Data are searchable by claim year, code, and percentage and frequency of use.
Type: Tool
Sponsoring organizations: Catherine Cutler Institute, National Association of Rural Health Clinics, National Association of Rural Health Clinics Research and Education Foundation
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Medicare Learning Network: Chronic Care Management Services
Provides general information about payable chronic care management service elements, practitioners able to bill for CCM services, patient eligibility, service codes, concurrent billing, and Medicare Physician Fee Schedule (PFS) billing requirements. Includes information on Rural Health Clinic (RHC) and Federally Qualified Health Center (FQHC) billing for CCM services.
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Provides general information about payable chronic care management service elements, practitioners able to bill for CCM services, patient eligibility, service codes, concurrent billing, and Medicare Physician Fee Schedule (PFS) billing requirements. Includes information on Rural Health Clinic (RHC) and Federally Qualified Health Center (FQHC) billing for CCM services.
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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States Advancing All-Payer Health Equity Approaches and Development (AHEAD) Model
Provides information on the Centers for Medicare & Medicaid Services (CMS) Innovation Center's States Advancing All-Payer Health Equity Approaches and Development (AHEAD) Model, a voluntary state total cost of care model that will test state accountability for controlling overall growth in health expenditures while increasing investment in primary care and improving population health outcomes.
Type: Website
Sponsoring organization: Centers for Medicare and Medicaid Services
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Provides information on the Centers for Medicare & Medicaid Services (CMS) Innovation Center's States Advancing All-Payer Health Equity Approaches and Development (AHEAD) Model, a voluntary state total cost of care model that will test state accountability for controlling overall growth in health expenditures while increasing investment in primary care and improving population health outcomes.
Type: Website
Sponsoring organization: Centers for Medicare and Medicaid Services
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State Operations Manual Appendix B - Guidance for Surveyors: Home Health Agencies
Presents interpretive guidelines clarifying statutory and regulatory requirements for home health agencies.
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Presents interpretive guidelines clarifying statutory and regulatory requirements for home health agencies.
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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State Operations Manual Appendix M - Guidance for Surveyors: Hospice
Details the hospice survey process and presents interpretive guidelines clarifying statutory and regulatory requirements.
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Details the hospice survey process and presents interpretive guidelines clarifying statutory and regulatory requirements.
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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State Operations Manual Appendix G - Guidance for Surveyors: Rural Health Clinics (RHCs)
Provides details and interpretive guidelines clarifying the Rural Health Clinic (RHC) survey and certification processes.
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Provides details and interpretive guidelines clarifying the Rural Health Clinic (RHC) survey and certification processes.
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Medicare Shared Savings Program
Provides an overview of the Medicare Shared Savings Program. Offers links to program resources, including application information, program data, and program statutes and regulations.
Type: Website
Sponsoring organization: Centers for Medicare and Medicaid Services
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Provides an overview of the Medicare Shared Savings Program. Offers links to program resources, including application information, program data, and program statutes and regulations.
Type: Website
Sponsoring organization: Centers for Medicare and Medicaid Services
view details