Rural Health
Resources by Topic: Reimbursement and payment models
340B Discount Drug Program Reform Policy Principles
Policy position paper on the 340B program. Explores ways in which the program benefits rural health systems and patients, and the impact of restrictions by drug manufacturers on rural safety net providers .
Date: 2024
Type: Document
Sponsoring organization: National Rural Health Association
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Policy position paper on the 340B program. Explores ways in which the program benefits rural health systems and patients, and the impact of restrictions by drug manufacturers on rural safety net providers .
Date: 2024
Type: Document
Sponsoring organization: National Rural Health Association
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Expanding Behavioral Health Care Workforce Participation in Medicare, Medicaid, and Marketplace Plans
Report highlights barriers to obtaining behavioral health treatment on Medicare, Medicaid, and Marketplace plans. Discusses barriers specific to rural and tribal communities. Details behavioral workforce needs and makes policy recommendations.
Additional links: Full Report
Author(s): Board on Health Care Services
Date: 2024
Type: Document
Sponsoring organization: Health and Medicine Division (HMD), National Academies of Sciences, Engineering, and Medicine
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Report highlights barriers to obtaining behavioral health treatment on Medicare, Medicaid, and Marketplace plans. Discusses barriers specific to rural and tribal communities. Details behavioral workforce needs and makes policy recommendations.
Additional links: Full Report
Author(s): Board on Health Care Services
Date: 2024
Type: Document
Sponsoring organization: Health and Medicine Division (HMD), National Academies of Sciences, Engineering, and Medicine
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RPM for FQHCs and RHCs: 10 Things to Consider
Details issues related to remote patient monitoring (RPM) and remote therapeutic monitoring (RTM) in Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs). Covers reimbursement and billing, implementation, and quality of care.
Date: 2024
Type: Document
Sponsoring organization: Southeastern Telehealth Resource Center
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Details issues related to remote patient monitoring (RPM) and remote therapeutic monitoring (RTM) in Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs). Covers reimbursement and billing, implementation, and quality of care.
Date: 2024
Type: Document
Sponsoring organization: Southeastern Telehealth Resource Center
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Behavioral Health Workforce, 2023
Offers data on the supply and distribution of the behavioral health workforce and factors impacting that workforce. Includes projected workforce shortages to 2036 and compares rural and urban shortages. Discusses unmet needs for different populations, scope of practice, reimbursement rates, retention, and workforce wellbeing. Describes strategies to improve access to behavioral healthcare around integrated care, community health workers, and telehealth.
Date: 12/2023
Type: Document
Sponsoring organization: National Center for Health Workforce Analysis
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Offers data on the supply and distribution of the behavioral health workforce and factors impacting that workforce. Includes projected workforce shortages to 2036 and compares rural and urban shortages. Discusses unmet needs for different populations, scope of practice, reimbursement rates, retention, and workforce wellbeing. Describes strategies to improve access to behavioral healthcare around integrated care, community health workers, and telehealth.
Date: 12/2023
Type: Document
Sponsoring organization: National Center for Health Workforce Analysis
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Rural Long-Term Care Services and Supports
Policy position paper regarding challenges related to providing high-quality long-term care for older adults in rural areas. Describes how workforce shortages, long-term care financing, and administrative burden impact rural providers. Outlines policy recommendations for policy reforms to address these challenges and improve access to quality long-term care services.
Author(s): Shakeerah McCoy, Jeff Dunbar, Lex Pierre
Date: 12/2023
Type: Document
Sponsoring organization: National Rural Health Association
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Policy position paper regarding challenges related to providing high-quality long-term care for older adults in rural areas. Describes how workforce shortages, long-term care financing, and administrative burden impact rural providers. Outlines policy recommendations for policy reforms to address these challenges and improve access to quality long-term care services.
Author(s): Shakeerah McCoy, Jeff Dunbar, Lex Pierre
Date: 12/2023
Type: Document
Sponsoring organization: National Rural Health Association
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Medicare Advantage Growth and Its Impact on Rural Health Care
Policy position paper regarding the impact of the increase of Medicare Advantage (MA) enrollment in rural areas on healthcare access, delivery, and financial viability. Offers policy recommendations to support rural MA beneficiaries, healthcare providers, and hospitals at a local level, as well as rural healthcare provision within the MA framework.
Author(s): Carrie Shaver, Kevin Lambing, Lisa Rantz
Date: 12/2023
Type: Document
Sponsoring organization: National Rural Health Association
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Policy position paper regarding the impact of the increase of Medicare Advantage (MA) enrollment in rural areas on healthcare access, delivery, and financial viability. Offers policy recommendations to support rural MA beneficiaries, healthcare providers, and hospitals at a local level, as well as rural healthcare provision within the MA framework.
Author(s): Carrie Shaver, Kevin Lambing, Lisa Rantz
Date: 12/2023
Type: Document
Sponsoring organization: National Rural Health Association
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December 2023 MedPAC Meeting Transcript
Transcript from the Medicare Payment Advisory Commission's (MedPAC) December 2023 meeting. Covers payment adequacy and updates for physician and other health professional services, hospital inpatient and outpatient services, hospice services, outpatient dialysis services, ambulatory surgical center services, skilled nursing facilities, skilled nursing facility services, home health services, and inpatient rehabilitation facility services. Includes rural references throughout.
Date: 12/2023
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Transcript from the Medicare Payment Advisory Commission's (MedPAC) December 2023 meeting. Covers payment adequacy and updates for physician and other health professional services, hospital inpatient and outpatient services, hospice services, outpatient dialysis services, ambulatory surgical center services, skilled nursing facilities, skilled nursing facility services, home health services, and inpatient rehabilitation facility services. Includes rural references throughout.
Date: 12/2023
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Merit-Based Incentive Payment System (MIPS): 2024 Reporting MIPS Quality Measures through Medicare Part B Claims Quick Start Guide for Small Practices
Provides details on how small practices can report quality measures through Medicare Part B claims measures. Highlights changes to these measures in 2024, score redistribution policies for small practices, and information for clinicians at Critical Access Hospitals.
Date: 12/2023
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Provides details on how small practices can report quality measures through Medicare Part B claims measures. Highlights changes to these measures in 2024, score redistribution policies for small practices, and information for clinicians at Critical Access Hospitals.
Date: 12/2023
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Alternative Payment Models in the Quality Payment Program as of December 2023
A set of three tables that list brief information about Alternative Payment Models (APMs) that the Centers for Medicare and Medicaid Services (CMS) operates or has announced, as of December 2023. Identifies Advanced APMs, Merit Based Incentive Program (MIPs) APMs, and Other Payer Advanced APMs, which include Medicaid Other Payer Advanced APMs, Medicare Health Plan Payment Arrangements, and commercial payment arrangements.
Date: 12/2023
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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A set of three tables that list brief information about Alternative Payment Models (APMs) that the Centers for Medicare and Medicaid Services (CMS) operates or has announced, as of December 2023. Identifies Advanced APMs, Merit Based Incentive Program (MIPs) APMs, and Other Payer Advanced APMs, which include Medicaid Other Payer Advanced APMs, Medicare Health Plan Payment Arrangements, and commercial payment arrangements.
Date: 12/2023
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Independent Evaluation of Comprehensive Primary Care Plus (CPC+): Final Annual Report
Reports on the Comprehensive Primary Care Plus (CPC+) model, a CMS primary care payment and delivery reform effort that ran from 2017-2021. Outlines key findings from the model, including CPC+ supports to practices, care delivery changes made by practices, impacts on outcomes for Medicare fee-for-service beneficiaries, and implications for primary care models. Describes the experiences of payers, practices, health IT vendors, and patients. Includes rural references throughout.
Additional links: Appendices to the Final Report, Volume 1, Appendices to the Final Report, Volume 2, Findings at a Glance
Date: 12/2023
Type: Document
Sponsoring organizations: Centers for Medicare and Medicaid Services, Mathematica
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Reports on the Comprehensive Primary Care Plus (CPC+) model, a CMS primary care payment and delivery reform effort that ran from 2017-2021. Outlines key findings from the model, including CPC+ supports to practices, care delivery changes made by practices, impacts on outcomes for Medicare fee-for-service beneficiaries, and implications for primary care models. Describes the experiences of payers, practices, health IT vendors, and patients. Includes rural references throughout.
Additional links: Appendices to the Final Report, Volume 1, Appendices to the Final Report, Volume 2, Findings at a Glance
Date: 12/2023
Type: Document
Sponsoring organizations: Centers for Medicare and Medicaid Services, Mathematica
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