Rural Health
Resources by Topic: Reimbursement and payment models
Separate Payment for Essential Medicines – New Biweekly Interim Payments for the Inpatient Prospective Payment System
Provides an overview of payment adjustments to small, independent hospitals for establishing and maintaining access to buffer stocks of essential medicines for cost report periods beginning on or after October 1, 2024.
Date: 10/2024
Sponsoring organization: Centers for Medicare and Medicaid Services
view details
Provides an overview of payment adjustments to small, independent hospitals for establishing and maintaining access to buffer stocks of essential medicines for cost report periods beginning on or after October 1, 2024.
Date: 10/2024
Sponsoring organization: Centers for Medicare and Medicaid Services
view details
Dashboard: Acute Behavioral Health Events Along the Birthing Journey in Arkansas
Provides data on acute behavioral health events, including mental health and substance abuse diagnoses, among Arkansas mothers, utilizing 2019-2022 Arkansas Healthcare Transparency Initiative (HTI) data. Features clinical, demographic, and payer data associated with patients and individual encounters, recurring encounters, and outpatient visits, and can be sorted by region and county.
Date: 10/2024
Sponsoring organization: Arkansas Center for Health Improvement
view details
Provides data on acute behavioral health events, including mental health and substance abuse diagnoses, among Arkansas mothers, utilizing 2019-2022 Arkansas Healthcare Transparency Initiative (HTI) data. Features clinical, demographic, and payer data associated with patients and individual encounters, recurring encounters, and outpatient visits, and can be sorted by region and county.
Date: 10/2024
Sponsoring organization: Arkansas Center for Health Improvement
view details
The Rural Emergency Hospital Model: Year Two Progress Report
Provides an overview of the Rural Emergency Hospital (REH) payment designation, including the growth in REHs through September 1, 2024, factors that contribute to a hospital seeking REH conversion, and the impacts of REH conversion. Outlines concerns identified by REH leaders, facilities considering converting to REH status, and other rural stakeholders related to the REH designation, as well as policy recommendations to address these concerns.
Author(s): Emma Sheffert, Julia Harris, Marilyn Werber Serafini
Date: 10/2024
Sponsoring organization: Bipartisan Policy Center
view details
Provides an overview of the Rural Emergency Hospital (REH) payment designation, including the growth in REHs through September 1, 2024, factors that contribute to a hospital seeking REH conversion, and the impacts of REH conversion. Outlines concerns identified by REH leaders, facilities considering converting to REH status, and other rural stakeholders related to the REH designation, as well as policy recommendations to address these concerns.
Author(s): Emma Sheffert, Julia Harris, Marilyn Werber Serafini
Date: 10/2024
Sponsoring organization: Bipartisan Policy Center
view details
Northern Maine Medical Center: A Rural Hospital Gaining Momentum in its Work Toward Quality Improvement
Profiles a prospective payment hospital in northern Maine that engaged in the 2022-2023 Rural Healthcare Provider Transition Project (RHPTP), focusing on financial sustainability, cost efficiency, and quality improvement. Highlights hospital accomplishments and improvements via participation of the project.
Date: 10/2024
Sponsoring organization: National Rural Health Resource Center
view details
Profiles a prospective payment hospital in northern Maine that engaged in the 2022-2023 Rural Healthcare Provider Transition Project (RHPTP), focusing on financial sustainability, cost efficiency, and quality improvement. Highlights hospital accomplishments and improvements via participation of the project.
Date: 10/2024
Sponsoring organization: National Rural Health Resource Center
view details
Health Care Workforce: Key Issues, Challenges, and the Path Forward
Provides an overview of the supply and distribution of physicians, nurses, direct care workers, behavioral health workers, and oral healthcare providers. Describes persistent challenges related to the healthcare workforce, including supply and distribution of healthcare workers, especially in rural communities; burnout; compensation; and administrative burden. Identifies opportunities to address these challenges and efforts supported by the U.S. Department of Health and Human Services to address these issues.
Date: 10/2024
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
view details
Provides an overview of the supply and distribution of physicians, nurses, direct care workers, behavioral health workers, and oral healthcare providers. Describes persistent challenges related to the healthcare workforce, including supply and distribution of healthcare workers, especially in rural communities; burnout; compensation; and administrative burden. Identifies opportunities to address these challenges and efforts supported by the U.S. Department of Health and Human Services to address these issues.
Date: 10/2024
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
view details
What to Know About Medicare Coverage of Telehealth
Discusses telehealth use by Medicare patients before, during, and after declaration of the COVID-19 public health emergency. Notes temporary telehealth provisions set to expire December 31, 2024, telehealth provisions made permanent, and trends in use since 2020. Includes rural and urban comparisons of telehealth use since 2020. Discusses payment models for Medicare and Medicare Advantage, current policies related to telehealth, fraud, and the cost of coverage through Medicare.
Author(s): Alex Cottrill, Juliette Cubanski, Tricia Neuman
Date: 10/2024
Sponsoring organization: KFF
view details
Discusses telehealth use by Medicare patients before, during, and after declaration of the COVID-19 public health emergency. Notes temporary telehealth provisions set to expire December 31, 2024, telehealth provisions made permanent, and trends in use since 2020. Includes rural and urban comparisons of telehealth use since 2020. Discusses payment models for Medicare and Medicare Advantage, current policies related to telehealth, fraud, and the cost of coverage through Medicare.
Author(s): Alex Cottrill, Juliette Cubanski, Tricia Neuman
Date: 10/2024
Sponsoring organization: KFF
view details
CMS Guide for Medical Technology Companies and Other Interested Parties
Discusses processes used to determine coverage, coding, and payment for new technologies under the Medicare fee-for-service program. Guide is intended as a general summary for interested parties, including medical device, pharmaceutical, and biotechnology companies.
Date: 09/2024
Sponsoring organization: Centers for Medicare and Medicaid Services
view details
Discusses processes used to determine coverage, coding, and payment for new technologies under the Medicare fee-for-service program. Guide is intended as a general summary for interested parties, including medical device, pharmaceutical, and biotechnology companies.
Date: 09/2024
Sponsoring organization: Centers for Medicare and Medicaid Services
view details
Final Report of the Rural Texas Obstetrics Study
Uses data analysis, interviews, and surveys to report on rural obstetrics access issues in Texas. Discusses facility closures, distance to care, provider shortages, reimbursements, and healthcare quality. Offers an analysis of 15 facilities that closed OB departments to understand potential drivers of closures. Email address required to access report.
Date: 09/2024
Sponsoring organization: Stroudwater Associates
view details
Uses data analysis, interviews, and surveys to report on rural obstetrics access issues in Texas. Discusses facility closures, distance to care, provider shortages, reimbursements, and healthcare quality. Offers an analysis of 15 facilities that closed OB departments to understand potential drivers of closures. Email address required to access report.
Date: 09/2024
Sponsoring organization: Stroudwater Associates
view details
September 2024 MedPAC Meeting Transcript
Transcript from the Medicare Payment Advisory Commission's (MedPAC) September 2024 meeting. Covers Medicare's overall financial situation, cost-sharing for outpatient services at Critical Access Hospitals, and experiences and challenges of measuring the quality of care provided by rural providers.
Additional links: Cost Sharing for Outpatient Services at Critical Access Hospitals - Presentation Slides, Medicare's Measurement of Rural Provider Quality - Presentation Slides
Date: 09/2024
Sponsoring organization: Medicare Payment Advisory Commission
view details
Transcript from the Medicare Payment Advisory Commission's (MedPAC) September 2024 meeting. Covers Medicare's overall financial situation, cost-sharing for outpatient services at Critical Access Hospitals, and experiences and challenges of measuring the quality of care provided by rural providers.
Additional links: Cost Sharing for Outpatient Services at Critical Access Hospitals - Presentation Slides, Medicare's Measurement of Rural Provider Quality - Presentation Slides
Date: 09/2024
Sponsoring organization: Medicare Payment Advisory Commission
view details
Exploring the State of Value-Based Care
Slides presented to the South Dakota Rural Health Equity Summit on September 5, 2024. Provides an overview of value-based care and payment models and progress toward value-based care models. Describes potential strategies state agencies and organizations may use to assist rural healthcare organizations to deliver value-based care and receive value-based payments. Highlights state-level engagements to advance rural value-based care and payment in North Dakota and Pennsylvania.
Author(s): Karla Weng
Date: 09/2024
Sponsoring organization: Rural Health Value
view details
Slides presented to the South Dakota Rural Health Equity Summit on September 5, 2024. Provides an overview of value-based care and payment models and progress toward value-based care models. Describes potential strategies state agencies and organizations may use to assist rural healthcare organizations to deliver value-based care and receive value-based payments. Highlights state-level engagements to advance rural value-based care and payment in North Dakota and Pennsylvania.
Author(s): Karla Weng
Date: 09/2024
Sponsoring organization: Rural Health Value
view details