Rural Health
Resources by Topic: Reimbursement and payment models
Bridging The Home-Based Primary Care Gap In Rural Areas
Discusses challenges with offering home-based primary care (HBPC) in rural communities for older adults and people with disabilities, notably workforce shortages, insufficient infrastructure, and funding. Offers HBPC redesign suggestions with these challenges in mind, discussing community health workers, technology and telehealth, leveraging community resources and partnerships, training, scope of practice laws, payment models, and infrastructure investments.
Author(s): Ginny Rogers, Montgomery Smith, Jonathan Gonzalez-Smith, Robert S. Saunders
Citation: Health Affairs Forefront
Date: 02/2024
Type: Document
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Discusses challenges with offering home-based primary care (HBPC) in rural communities for older adults and people with disabilities, notably workforce shortages, insufficient infrastructure, and funding. Offers HBPC redesign suggestions with these challenges in mind, discussing community health workers, technology and telehealth, leveraging community resources and partnerships, training, scope of practice laws, payment models, and infrastructure investments.
Author(s): Ginny Rogers, Montgomery Smith, Jonathan Gonzalez-Smith, Robert S. Saunders
Citation: Health Affairs Forefront
Date: 02/2024
Type: Document
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2024 MIPS Eligibility Decision Tree
Presents information to determine if providers are eligible to participate in the Merit-Based Incentive Payment System (MIPS) in the 2024 Performance Year. Includes information on the low-volume threshold criteria.
Date: 02/2024
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Presents information to determine if providers are eligible to participate in the Merit-Based Incentive Payment System (MIPS) in the 2024 Performance Year. Includes information on the low-volume threshold criteria.
Date: 02/2024
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Early Impacts of the Pennsylvania Rural Health Model on Potentially Avoidable Utilization
Assesses the impact of the Pennsylvania Rural Health Model (PARHM) on potentially avoidable utilization rates between 2016 and 2022 by comparing participating and non-participating hospitals. Discusses the potential impact of COVID-19 on results.
Author(s): Donald S. Bourne, Eric T. Roberts, Lindsay M. Sabik
Citation: Health Affairs Scholar, 2(2)
Date: 02/2024
Type: Document
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Assesses the impact of the Pennsylvania Rural Health Model (PARHM) on potentially avoidable utilization rates between 2016 and 2022 by comparing participating and non-participating hospitals. Discusses the potential impact of COVID-19 on results.
Author(s): Donald S. Bourne, Eric T. Roberts, Lindsay M. Sabik
Citation: Health Affairs Scholar, 2(2)
Date: 02/2024
Type: Document
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Critical Access Hospital Telehealth Guide
Provides practical guidance on implementing and sustaining telehealth in Critical Access Hospitals, to optimize healthcare delivery, expand access, enhance care coordination, and address health inequity. Focuses on Medicare outpatient telehealth services, but also includes information on Medicaid coverage and remote services that may not strictly be considered telehealth.
Date: 02/2024
Type: Document
Sponsoring organizations: National Rural Health Resource Center, Northwest Regional Telehealth Resource Center
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Provides practical guidance on implementing and sustaining telehealth in Critical Access Hospitals, to optimize healthcare delivery, expand access, enhance care coordination, and address health inequity. Focuses on Medicare outpatient telehealth services, but also includes information on Medicaid coverage and remote services that may not strictly be considered telehealth.
Date: 02/2024
Type: Document
Sponsoring organizations: National Rural Health Resource Center, Northwest Regional Telehealth Resource Center
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Value-Based Care Assessment Tool
Online tool that assesses 80 different value-based care capacities in eight categories and creates a value-based care readiness report that can be used to support strategic planning. Tool is designed to be used by your healthcare organization's senior leadership team.
Date: 02/2024
Type: Tool
Sponsoring organization: Rural Health Value
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Online tool that assesses 80 different value-based care capacities in eight categories and creates a value-based care readiness report that can be used to support strategic planning. Tool is designed to be used by your healthcare organization's senior leadership team.
Date: 02/2024
Type: Tool
Sponsoring organization: Rural Health Value
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Implementation Costs of Technology-Enhanced Transitional Palliative Care for Rural Caregivers
Examines the feasibility and sustainability of a family caregiver-focused transitional palliative care intervention that uses telehealth technologies. Presents results of a budget impact analysis of a randomized control trial, community-dwelling rural caregivers of hospitalized patients with a serious, life-limiting illness and receiving palliative care during hospitalization. Describes potential reimbursement mechanisms available to offset health system costs to providing transitional palliative care to support caregivers, including transitional care management and chronic care management service reimbursement.
Author(s): Brystana G. Kaufman, Diane E. Holland, Catherine E. Vanderboom, Cory Ingram, et al.
Citation: American Journal of Hospice and Palliative Care, 41(1), 38-44
Date: 01/2024
Type: Document
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Examines the feasibility and sustainability of a family caregiver-focused transitional palliative care intervention that uses telehealth technologies. Presents results of a budget impact analysis of a randomized control trial, community-dwelling rural caregivers of hospitalized patients with a serious, life-limiting illness and receiving palliative care during hospitalization. Describes potential reimbursement mechanisms available to offset health system costs to providing transitional palliative care to support caregivers, including transitional care management and chronic care management service reimbursement.
Author(s): Brystana G. Kaufman, Diane E. Holland, Catherine E. Vanderboom, Cory Ingram, et al.
Citation: American Journal of Hospice and Palliative Care, 41(1), 38-44
Date: 01/2024
Type: Document
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AHIP Value-Based Care Workgroup
Presentation slides from a January 23, 2024, presentation to the AHIP Value-Based Care Workgroup. Provides an overview of rural healthcare. Discusses rural-relevant engagement and rural value-based care and payment model design considerations. Highlights examples of rural providers successfully participating in value-based payment programs, including Medicare Shared Savings Programs and Accountable Care Organizations (ACOs).
Date: 01/2024
Type: Presentation Slides
Sponsoring organization: Rural Health Value
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Presentation slides from a January 23, 2024, presentation to the AHIP Value-Based Care Workgroup. Provides an overview of rural healthcare. Discusses rural-relevant engagement and rural value-based care and payment model design considerations. Highlights examples of rural providers successfully participating in value-based payment programs, including Medicare Shared Savings Programs and Accountable Care Organizations (ACOs).
Date: 01/2024
Type: Presentation Slides
Sponsoring organization: Rural Health Value
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States Advancing All-Payer Health Equity Approaches and Development (AHEAD) Model
Recording of a January 29, 2024, webinar regarding the Centers for Medicare & Medicaid Services' States Advancing All-Payer Health Equity Approaches and Development (AHEAD) Model. Discusses the AHEAD Model's timeline, key elements, opportunities, and requirements from a rural perspective. Identifies potential implications for rural hospital and primary care participation.
Additional links: Presentation Slides
Author(s): Clint MacKinney
Date: 01/2024
Type: Document
Sponsoring organization: Rural Health Value
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Recording of a January 29, 2024, webinar regarding the Centers for Medicare & Medicaid Services' States Advancing All-Payer Health Equity Approaches and Development (AHEAD) Model. Discusses the AHEAD Model's timeline, key elements, opportunities, and requirements from a rural perspective. Identifies potential implications for rural hospital and primary care participation.
Additional links: Presentation Slides
Author(s): Clint MacKinney
Date: 01/2024
Type: Document
Sponsoring organization: Rural Health Value
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The State of Rural Healthcare: Research Report and Outlook for 2024
Presents results of a survey of 106 rural healthcare organizations across 25 states regarding their financial health and strategic priorities. Identifies the top challenges identified by the surveyed organizations. Discusses how providers are addressing three strategic priorities in 2024, including people management, revenue capture, and digital capabilities.
Date: 01/2024
Type: Document
Sponsoring organization: Wipfli, LLP
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Presents results of a survey of 106 rural healthcare organizations across 25 states regarding their financial health and strategic priorities. Identifies the top challenges identified by the surveyed organizations. Discusses how providers are addressing three strategic priorities in 2024, including people management, revenue capture, and digital capabilities.
Date: 01/2024
Type: Document
Sponsoring organization: Wipfli, LLP
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Value-Based Care and North Dakota
Slides presented to the North Dakota legislature on January 30, 2024, providing an overview of an initiative assisting rural North Dakota Critical Access Hospitals (CAHs) in preparing for value-based care and payment. Discusses principles of the transition from volume-based to value-based payment. Outlines the technical assistance the initiative provides to five core CAHs in the state and a summary of a high-level financial analysis.
Author(s): Clint MacKinney
Date: 01/2024
Type: Document
Sponsoring organization: Rural Health Value
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Slides presented to the North Dakota legislature on January 30, 2024, providing an overview of an initiative assisting rural North Dakota Critical Access Hospitals (CAHs) in preparing for value-based care and payment. Discusses principles of the transition from volume-based to value-based payment. Outlines the technical assistance the initiative provides to five core CAHs in the state and a summary of a high-level financial analysis.
Author(s): Clint MacKinney
Date: 01/2024
Type: Document
Sponsoring organization: Rural Health Value
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