Rural Health
Resources by Topic: Reimbursement and payment models
MedPAC Comment on CMS's Proposed Rule on the Physician Prospective Payment System for FY 2024
Comment on the August 7, 2023, Federal Register proposed rule revising the physician fee schedule to improve payment systems for physicians and other Medicare Part B revisions. Includes discussions on payment rates for Medicare telehealth services; the Medicare Shared Savings Program, including regional adjustments; incorporating Medicare Advantage data into public reporting; and more.
Date: 09/2023
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Comment on the August 7, 2023, Federal Register proposed rule revising the physician fee schedule to improve payment systems for physicians and other Medicare Part B revisions. Includes discussions on payment rates for Medicare telehealth services; the Medicare Shared Savings Program, including regional adjustments; incorporating Medicare Advantage data into public reporting; and more.
Date: 09/2023
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Rural Health Value Summit: Driving Value Through Community-Based Partnerships
Provides an overview of a June 2023 summit regarding the intersection of rural providers and communities, value-based care and payment models, and social determinants of health (SDOH). Describes the efforts of Arkansas, Michigan, Oregon, and South Carolina communities that had representatives at the summit. Discusses opportunities for policymakers, payers, and health system leaders to build and support infrastructure to address social determinants of health in rural communities and offers possible next steps.
Date: 09/2023
Type: Document
Sponsoring organization: Rural Health Value
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Provides an overview of a June 2023 summit regarding the intersection of rural providers and communities, value-based care and payment models, and social determinants of health (SDOH). Describes the efforts of Arkansas, Michigan, Oregon, and South Carolina communities that had representatives at the summit. Discusses opportunities for policymakers, payers, and health system leaders to build and support infrastructure to address social determinants of health in rural communities and offers possible next steps.
Date: 09/2023
Type: Document
Sponsoring organization: Rural Health Value
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Further Extension of Grace Period Related to the "Four Walls" Requirement under 42 C.F.R. ยง 440.90 for Indian Health Service and Tribal Facilities to February 11, 2025
Guidance announcing the extension of a grace period permitting Indian Health Service (IHS) and tribal facilities to claim Medicaid reimbursement under the clinic services benefit for services provided outside of the "four walls" of the facility through February 11, 2025. Provides an overview of the history of this flexibility during the COVID-19 public health emergency (PHE) and previous guidance.
Date: 09/2023
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Guidance announcing the extension of a grace period permitting Indian Health Service (IHS) and tribal facilities to claim Medicaid reimbursement under the clinic services benefit for services provided outside of the "four walls" of the facility through February 11, 2025. Provides an overview of the history of this flexibility during the COVID-19 public health emergency (PHE) and previous guidance.
Date: 09/2023
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Emergency Department Interventions for Opioid Use Disorder: Overview of the Landscape, Key Components, and Analysis of Five Case Studies
Provides an overview of the evidence base for emergency department (ED)-based programs to address and treat opioid use disorders (OUD). Describes factors that motivated the development of these programs, how they are structured and financed, and barriers and facilitators to ED-based OUD treatment. Features case studies of five ED-based programs, including Marshall Medical Center in rural California.
Date: 08/2023
Type: Document
Sponsoring organizations: Brandeis University, HHS Office of the Assistant Secretary for Planning and Evaluation
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Provides an overview of the evidence base for emergency department (ED)-based programs to address and treat opioid use disorders (OUD). Describes factors that motivated the development of these programs, how they are structured and financed, and barriers and facilitators to ED-based OUD treatment. Features case studies of five ED-based programs, including Marshall Medical Center in rural California.
Date: 08/2023
Type: Document
Sponsoring organizations: Brandeis University, HHS Office of the Assistant Secretary for Planning and Evaluation
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MedPAC Comment on CMS's Proposed Rule on the Home Health Prospective Payment System for FY 2024
Comments on a July 10, 2023, Federal Register proposed rule related to Medicare payment policies for home health agencies. Includes comments on expanding the Home Health Value-Based Purchasing Model nationwide, wage index adjustments, the Hospice Special Focus Program (SFP), and more.
Date: 08/2023
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Comments on a July 10, 2023, Federal Register proposed rule related to Medicare payment policies for home health agencies. Includes comments on expanding the Home Health Value-Based Purchasing Model nationwide, wage index adjustments, the Hospice Special Focus Program (SFP), and more.
Date: 08/2023
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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MedPAC Comment on CMS's Proposed Rule on the End-Stage Renal Disease Payment System Update for FY 2024
Comments on a June 30, 2023, Federal Register proposed rule related to Medicare payment policies for end-stage renal disease (ESRD). Includes comments addressing the low-volume payment adjustment (LVPA) and recommending the development of a new payment adjustment based on geographic isolation.
Date: 08/2023
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Comments on a June 30, 2023, Federal Register proposed rule related to Medicare payment policies for end-stage renal disease (ESRD). Includes comments addressing the low-volume payment adjustment (LVPA) and recommending the development of a new payment adjustment based on geographic isolation.
Date: 08/2023
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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An Examination of Practices and Barriers of Procedures Performed by Physicians in Rural Hawai'i
Surveys 47 rural Hawaiian physicians to evaluate their scope of practice for procedures and learn the barriers to performing procedures. Discusses specialty care, reimbursement, training, time management, resource access, and more.
Author(s): Joseph W. Turban, Eun Ah Cho, Weston McCue, Kelley Withy
Citation: Hawai'i Journal of Health & Social Welfare, 82(8), 183-187
Date: 08/2023
Type: Document
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Surveys 47 rural Hawaiian physicians to evaluate their scope of practice for procedures and learn the barriers to performing procedures. Discusses specialty care, reimbursement, training, time management, resource access, and more.
Author(s): Joseph W. Turban, Eun Ah Cho, Weston McCue, Kelley Withy
Citation: Hawai'i Journal of Health & Social Welfare, 82(8), 183-187
Date: 08/2023
Type: Document
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A Consensus Panel Approach to Estimating the Start-Up and Annual Service Costs for Rural Ambulance Agencies
Policy brief exploring the costs of running ambulance services for 3 population-based service tiers. Establishes a minimum access standard for ambulances servicing a 25-minute travel time from the ambulance station, and enables policymakers and community stakeholders to develop strategic plans for the financing and provision of ambulance services. Features statistics on number of calls, population ranges of service areas, and fixed, depreciation, variable, and administrative costs.
Author(s): Yvonne Jonk, Gary Wingrove, Nikiah Nudell, Kevin McGinnis
Date: 08/2023
Type: Document
Sponsoring organization: Maine Rural Health Research Center
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Policy brief exploring the costs of running ambulance services for 3 population-based service tiers. Establishes a minimum access standard for ambulances servicing a 25-minute travel time from the ambulance station, and enables policymakers and community stakeholders to develop strategic plans for the financing and provision of ambulance services. Features statistics on number of calls, population ranges of service areas, and fixed, depreciation, variable, and administrative costs.
Author(s): Yvonne Jonk, Gary Wingrove, Nikiah Nudell, Kevin McGinnis
Date: 08/2023
Type: Document
Sponsoring organization: Maine Rural Health Research Center
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Merit-Based Incentive Payment System (MIPS): 2024 Payment Year - Payment Adjustment User Guide
Provides information on Merit-Based Incentive Payment System (MIPS) payment adjustments for calendar year 2024. Describes how 2022 MIPS scores relate to 2024 payment adjustments and how payment adjustments are applied. Offers answers to frequently asked questions.
Date: 08/2023
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Provides information on Merit-Based Incentive Payment System (MIPS) payment adjustments for calendar year 2024. Describes how 2022 MIPS scores relate to 2024 payment adjustments and how payment adjustments are applied. Offers answers to frequently asked questions.
Date: 08/2023
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Participation in a Medicare Advanced Primary Care Model and the Delivery of High-Value Services
Examines if participation in the Comprehensive Primary Care Plus Initiative (CPC+) impacted the high-value services delivered by primary care providers. Utilizes multiple national data sets to estimate the association of CPC+ and services such as annual wellness visits (AWVs), advance care planning (ACP), flu shots, tobacco prevention counseling, and depression screening. Provides data on intervention groups and comparison groups by patient demographics as well as provider demographics, specialty, and location, including urban, large rural, small rural, and isolated rural.
Author(s): Fang He, Angela Gasdaska, Lindsay White, Yan Tang, Chris Beadles
Citation: Health Services Research, 58(6), 1266-1291
Date: 08/2023
Type: Document
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Examines if participation in the Comprehensive Primary Care Plus Initiative (CPC+) impacted the high-value services delivered by primary care providers. Utilizes multiple national data sets to estimate the association of CPC+ and services such as annual wellness visits (AWVs), advance care planning (ACP), flu shots, tobacco prevention counseling, and depression screening. Provides data on intervention groups and comparison groups by patient demographics as well as provider demographics, specialty, and location, including urban, large rural, small rural, and isolated rural.
Author(s): Fang He, Angela Gasdaska, Lindsay White, Yan Tang, Chris Beadles
Citation: Health Services Research, 58(6), 1266-1291
Date: 08/2023
Type: Document
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