Rural Health
Resources by Topic: Reimbursement and payment models
MedPAC Data Book: Health Care Spending and the Medicare Program, 2023
Provides an overview of Medicare spending and highlights data on Medicare beneficiary demographics, dual-eligible beneficiaries, quality of care provided through the Medicare program, and other payer liability. Examines settings of care, including rural-specific provider sites, as they relate to spending, access to care, and profit margins. Compares rural and urban beneficiaries and providers throughout. Chart 6-2 addresses rural hospital closures.
Date: 07/2023
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
view details
Provides an overview of Medicare spending and highlights data on Medicare beneficiary demographics, dual-eligible beneficiaries, quality of care provided through the Medicare program, and other payer liability. Examines settings of care, including rural-specific provider sites, as they relate to spending, access to care, and profit margins. Compares rural and urban beneficiaries and providers throughout. Chart 6-2 addresses rural hospital closures.
Date: 07/2023
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
view details
Changes in Telehealth Experienced by Advanced Practice RNs During COVID-19
Summarizes 7,467 advanced practice RNs' national survey responses from June-September 2020 about the use of telehealth before and during the pandemic, and analyzes free-text comments about how the use of telehealth changed during the pandemic. Discusses challenges in rural areas, including provider shortages and lack of broadband access.
Author(s): Mavis N. Schorn, Carole R. Myers, Julie Barroso, et al.
Citation: Computers, Informatics, Nursing, 41(7), 507–513
Date: 07/2023
Type: Document
view details
Summarizes 7,467 advanced practice RNs' national survey responses from June-September 2020 about the use of telehealth before and during the pandemic, and analyzes free-text comments about how the use of telehealth changed during the pandemic. Discusses challenges in rural areas, including provider shortages and lack of broadband access.
Author(s): Mavis N. Schorn, Carole R. Myers, Julie Barroso, et al.
Citation: Computers, Informatics, Nursing, 41(7), 507–513
Date: 07/2023
Type: Document
view details
Evaluation of the Vermont All-Payer Accountable Care Organization Model: Third Evaluation Report
Evaluates the first four and a half performance years of the Vermont All-Payer Accountable Care Organization Model (VTAPM), which aims to assess whether scaling an Accountable Care Organization (ACO) across all payers in the state can reduce program expenditures while preserving or improving care quality. Discusses the implementation of the model, provider engagement, efforts to address population health goals; characteristics of participating hospitals, practitioners, and beneficiaries; and the model's impacts on Medicare spending, utilization, and quality of care. Describes trends in substance use disorder diagnosis and treatment for Medicaid members. Outlines challenges and lessons learned, as well as areas for future research.
Additional links: Findings at a Glance, Technical Appendices
Date: 07/2023
Type: Document
Sponsoring organizations: Centers for Medicare and Medicaid Services, NORC at the University of Chicago
view details
Evaluates the first four and a half performance years of the Vermont All-Payer Accountable Care Organization Model (VTAPM), which aims to assess whether scaling an Accountable Care Organization (ACO) across all payers in the state can reduce program expenditures while preserving or improving care quality. Discusses the implementation of the model, provider engagement, efforts to address population health goals; characteristics of participating hospitals, practitioners, and beneficiaries; and the model's impacts on Medicare spending, utilization, and quality of care. Describes trends in substance use disorder diagnosis and treatment for Medicaid members. Outlines challenges and lessons learned, as well as areas for future research.
Additional links: Findings at a Glance, Technical Appendices
Date: 07/2023
Type: Document
Sponsoring organizations: Centers for Medicare and Medicaid Services, NORC at the University of Chicago
view details
2021 Quality Payment Program Experience Report
Reports on the clinician experience for those participating in the Quality Payment Program in 2021. Presents data on Merit-based Incentive Payment System (MIPS) eligibility and participation rates for clinicians in small practices and rural areas, as well as their mean payment adjustment scores.
Date: 07/2023
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
view details
Reports on the clinician experience for those participating in the Quality Payment Program in 2021. Presents data on Merit-based Incentive Payment System (MIPS) eligibility and participation rates for clinicians in small practices and rural areas, as well as their mean payment adjustment scores.
Date: 07/2023
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
view details
Billing for Telehealth Encounters: An Introductory Guide on Fee-for-Service
Presents an overview of how to bill fee-for-service Medicare and Medicaid for telehealth encounters. Includes information on originating and distant sites, virtual healthcare, and coding telehealth services. Lists types of practice sites, including Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs), and implications for billing telehealth services. Provides contact information for Regional Telehealth Research Centers (RTRC).
Date: 07/2023
Type: Document
Sponsoring organization: Center for Connected Health Policy: The National Telehealth Policy Resource Center
view details
Presents an overview of how to bill fee-for-service Medicare and Medicaid for telehealth encounters. Includes information on originating and distant sites, virtual healthcare, and coding telehealth services. Lists types of practice sites, including Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs), and implications for billing telehealth services. Provides contact information for Regional Telehealth Research Centers (RTRC).
Date: 07/2023
Type: Document
Sponsoring organization: Center for Connected Health Policy: The National Telehealth Policy Resource Center
view details
Impact of Higher Payments for Rural Home Health Episodes on Rehospitalizations
Examines the impact of home health rural add-on payments on beneficiary outcomes, specifically on rehospitalizations. Uses Medicare data from 2007 to 2014 to compare rehospitalizations between rural and urban post-acute home health episodes before and after the implementation of the add-on payments in 2010. Discusses the implications of the findings on home health payment policy.
Author(s): Lacey Loomer, Momotazur Rahman, Tracy M. Mroz, Pedro L. Gozalo, Vincent Mor
Citation: Journal of Rural Health, 39(3), 604-610
Date: 06/2023
Type: Document
view details
Examines the impact of home health rural add-on payments on beneficiary outcomes, specifically on rehospitalizations. Uses Medicare data from 2007 to 2014 to compare rehospitalizations between rural and urban post-acute home health episodes before and after the implementation of the add-on payments in 2010. Discusses the implications of the findings on home health payment policy.
Author(s): Lacey Loomer, Momotazur Rahman, Tracy M. Mroz, Pedro L. Gozalo, Vincent Mor
Citation: Journal of Rural Health, 39(3), 604-610
Date: 06/2023
Type: Document
view details
A Rural Accountable Care Organization's Journey
Profiles South East Rural Physicians Alliance Accountable Care Organization (SERPA‐ACO), a physician‐led ACO consisting of 16 Nebraska clinics - 13 of which are rural. Describes various value-based payment models SERPA-ACO clinics participated in and activities the clinics use to succeed in these models. Includes recommendations for primary care clinics considering joining an ACO.
Date: 06/2023
Type: Document
Sponsoring organization: Rural Health Value
view details
Profiles South East Rural Physicians Alliance Accountable Care Organization (SERPA‐ACO), a physician‐led ACO consisting of 16 Nebraska clinics - 13 of which are rural. Describes various value-based payment models SERPA-ACO clinics participated in and activities the clinics use to succeed in these models. Includes recommendations for primary care clinics considering joining an ACO.
Date: 06/2023
Type: Document
Sponsoring organization: Rural Health Value
view details
A Path Forward: The Rural Healthcare System of the Future
Presentation slides that discuss federal and state healthcare policies, implementation of new models of care, and plans to transform patient modalities of care. Includes U.S. county-level map on the Medicare Shared Savings Program Accountable Care Organizations (ACO) assigned beneficiary population as well as county-level data on ACO attributed lives in Illinois and residents enrolled in Medicare advantage.
Author(s): Keith J. Mueller
Date: 06/2023
Type: Presentation Slides
Sponsoring organizations: Iowa Department of Health Management and Policy, Rural Policy Research Institute
view details
Presentation slides that discuss federal and state healthcare policies, implementation of new models of care, and plans to transform patient modalities of care. Includes U.S. county-level map on the Medicare Shared Savings Program Accountable Care Organizations (ACO) assigned beneficiary population as well as county-level data on ACO attributed lives in Illinois and residents enrolled in Medicare advantage.
Author(s): Keith J. Mueller
Date: 06/2023
Type: Presentation Slides
Sponsoring organizations: Iowa Department of Health Management and Policy, Rural Policy Research Institute
view details
Health Care-Related Expiring Provisions of the 118th Congress, First Session
Outlines the healthcare-related funding and governmental authorities that will expire during the first session of the 118th Congress, calendar year 2023, if not extended through congressional action. Highlights similar provisions that expired during the 117th Congress (2021-2022). Includes rural references throughout.
Date: 06/2023
Type: Document
Sponsoring organization: Congressional Research Service
view details
Outlines the healthcare-related funding and governmental authorities that will expire during the first session of the 118th Congress, calendar year 2023, if not extended through congressional action. Highlights similar provisions that expired during the 117th Congress (2021-2022). Includes rural references throughout.
Date: 06/2023
Type: Document
Sponsoring organization: Congressional Research Service
view details
Ambulance Deserts: Geographic Disparities in the Provision of Ambulance Services
Webinar recording presenting key findings from a chartbook that analyzes 41 states in 2021-2022 and identifies places and people in ambulance deserts, defined as locations that are more than 25 minutes from an ambulance station.
Additional links: Presentation Slides, Transcript
Author(s): Yvonne Jonk
Date: 06/2023
Type: Video/Multimedia
Sponsoring organizations: Maine Rural Health Research Center, Rural Health Research Gateway
view details
Webinar recording presenting key findings from a chartbook that analyzes 41 states in 2021-2022 and identifies places and people in ambulance deserts, defined as locations that are more than 25 minutes from an ambulance station.
Additional links: Presentation Slides, Transcript
Author(s): Yvonne Jonk
Date: 06/2023
Type: Video/Multimedia
Sponsoring organizations: Maine Rural Health Research Center, Rural Health Research Gateway
view details