Rural Health
Resources by Topic: Reimbursement and payment models
NHPCO Pediatric Facts and Figure, 2023 Edition
Provides an overview of pediatric hospice and palliative care in the United States. Includes information and data on patient characteristics, access to care, reimbursement, barriers and facilitators to care, and more. Section 3 compares the number and percentage of metropolitan and non-metropolitan counties with access to pediatric hospice and palliative care.
Date: 06/2023
Type: Document
Sponsoring organization: National Hospice and Palliative Care Organization
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Provides an overview of pediatric hospice and palliative care in the United States. Includes information and data on patient characteristics, access to care, reimbursement, barriers and facilitators to care, and more. Section 3 compares the number and percentage of metropolitan and non-metropolitan counties with access to pediatric hospice and palliative care.
Date: 06/2023
Type: Document
Sponsoring organization: National Hospice and Palliative Care Organization
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Rural Health on Life Support - The State of America's Rural Health Systems
Podcast episode discussing the rural health landscape and how policies affect rural healthcare systems and service delivery. Covers rural hospital closures, payment policy, workforce concerns, emergency medical services (EMS), the Rural Emergency Hospital designation, and more.
Date: 06/2023
Type: Audio
Sponsoring organization: Impact! Communications, Inc.
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Podcast episode discussing the rural health landscape and how policies affect rural healthcare systems and service delivery. Covers rural hospital closures, payment policy, workforce concerns, emergency medical services (EMS), the Rural Emergency Hospital designation, and more.
Date: 06/2023
Type: Audio
Sponsoring organization: Impact! Communications, Inc.
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The EMS and Community Paramedic Workforces Respond to COVID-19
Results of a study in which 17 key informant experts shared their perspectives on how the emergency medical services (EMS) and community paramedicine (CP) workforces responded to COVID-19 during the first year of the pandemic. Also describes how the pandemic has affected EMS and CP. Features statistics on participant characteristics, with breakdowns by rural and urban locations.
Author(s): Davis G. Patterson, Marieke S. van Eijk, Samantha W. Pollack, Benjamin A. Stubbs, Christopher Hanson
Date: 06/2023
Type: Document
Sponsoring organization: Center for Health Workforce Studies
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Results of a study in which 17 key informant experts shared their perspectives on how the emergency medical services (EMS) and community paramedicine (CP) workforces responded to COVID-19 during the first year of the pandemic. Also describes how the pandemic has affected EMS and CP. Features statistics on participant characteristics, with breakdowns by rural and urban locations.
Author(s): Davis G. Patterson, Marieke S. van Eijk, Samantha W. Pollack, Benjamin A. Stubbs, Christopher Hanson
Date: 06/2023
Type: Document
Sponsoring organization: Center for Health Workforce Studies
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Differences in the Merit-Based Incentive Payment System (MIPS) Performance of Clinicians in Metropolitan and Nonmetropolitan Counties in 2018
Provides a brief overview of the Merit-Based Incentive Payment System (MIPS) and describes rural clinician performance in MIPS in 2018. Compares rural and urban MIPS performance scores, payment adjustments, and risk-adjusted standardized Medicare Spending per Beneficiary (MSPB). Also compares rural and urban MIPS performance by practice size and the proportion of racial/ethnic minorities served. Presents the most frequently reported MIPS measures by urban and rural practices.
Date: 06/2023
Type: Document
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Provides a brief overview of the Merit-Based Incentive Payment System (MIPS) and describes rural clinician performance in MIPS in 2018. Compares rural and urban MIPS performance scores, payment adjustments, and risk-adjusted standardized Medicare Spending per Beneficiary (MSPB). Also compares rural and urban MIPS performance by practice size and the proportion of racial/ethnic minorities served. Presents the most frequently reported MIPS measures by urban and rural practices.
Date: 06/2023
Type: Document
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Critical Access Hospitals: Views on How Medicare Payment and Other Factors Affect Behavioral Health Services
Provides an overview of how Medicare payment policies for care provided by Critical Access Hospitals (CAHs). Explores how CAHs provide behavioral health services in their communities. Summarizes findings from interviews with officials from 10 CAHs, stakeholder organizations, the Centers for Medicare & Medicaid Services (CMS), and the Health Resources and Services Administration (HRSA) regarding how Medicare payment policies and other factors affect CAHs' ability to provide behavioral health services.
Additional links: Full Report
Date: 06/2023
Type: Document
Sponsoring organization: Government Accountability Office
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Provides an overview of how Medicare payment policies for care provided by Critical Access Hospitals (CAHs). Explores how CAHs provide behavioral health services in their communities. Summarizes findings from interviews with officials from 10 CAHs, stakeholder organizations, the Centers for Medicare & Medicaid Services (CMS), and the Health Resources and Services Administration (HRSA) regarding how Medicare payment policies and other factors affect CAHs' ability to provide behavioral health services.
Additional links: Full Report
Date: 06/2023
Type: Document
Sponsoring organization: Government Accountability Office
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Updated Simulation of a Prospective Payment System for Post-Acute Care
Updates a potential unified post-acute care (PAC) prospective payment system (PPS) and estimates the impact of a PAC PPS on providers and Medicare beneficiaries. Presents data comparing the estimated costs payments to actual payments by rurality and region.
Author(s): Doug Wissoker, Bowen Garrett
Date: 06/2023
Type: Document
Sponsoring organizations: Medicare Payment Advisory Commission, Urban Institute
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Updates a potential unified post-acute care (PAC) prospective payment system (PPS) and estimates the impact of a PAC PPS on providers and Medicare beneficiaries. Presents data comparing the estimated costs payments to actual payments by rurality and region.
Author(s): Doug Wissoker, Bowen Garrett
Date: 06/2023
Type: Document
Sponsoring organizations: Medicare Payment Advisory Commission, Urban Institute
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Using Population-Based Outcome Measures to Assess the Impact of Telehealth Expansion on Medicare Beneficiaries' Access to Care and Quality of Care
Explores the feasibility of using population-based measures to estimate the association between telehealth use, quality of care, and access to care when both telehealth and in-person visits are available to fee-for-service (FFS) Medicare beneficiaries. Compares data from the second half of 2019 to the second half of 2021 by the level of telehealth utilization in Hospital Service Areas (HSAs). Includes rural references throughout.
Author(s): Morteza Saharkhiz, Tanvi Rao, Sara Parker Lue, et al.
Date: 06/2023
Type: Document
Sponsoring organizations: American Institutes for Research, Medicare Payment Advisory Commission
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Explores the feasibility of using population-based measures to estimate the association between telehealth use, quality of care, and access to care when both telehealth and in-person visits are available to fee-for-service (FFS) Medicare beneficiaries. Compares data from the second half of 2019 to the second half of 2021 by the level of telehealth utilization in Hospital Service Areas (HSAs). Includes rural references throughout.
Author(s): Morteza Saharkhiz, Tanvi Rao, Sara Parker Lue, et al.
Date: 06/2023
Type: Document
Sponsoring organizations: American Institutes for Research, Medicare Payment Advisory Commission
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Improving Financial Access to Maternal and Infant Care in Rural Areas
A brief that discusses ways to improve maternal and infant healthcare access, with a focus on Medicaid initiatives, value-based care systems, and leveraging the perinatal workforce.
Date: 06/2023
Type: Document
Sponsoring organization: Association of State and Territorial Health Officials
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A brief that discusses ways to improve maternal and infant healthcare access, with a focus on Medicaid initiatives, value-based care systems, and leveraging the perinatal workforce.
Date: 06/2023
Type: Document
Sponsoring organization: Association of State and Territorial Health Officials
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MedPAC Report to the Congress: Medicare and the Health Care Delivery System, June 2023
Evaluates Medicare payment issues and provides recommendations to the U.S. Congress. Chapter 7 presents a report on the use, payment, and quality of telehealth services that Medicare pays for separately under the physician fee schedule (PFS). Also includes chapters on the cost of drugs covered under Medicare Part B, postsale rebates for prescription drugs in Medicare Part D, standardized benefits in Medicare Advantage plans, future directions for Medicare Advantage payment policy, disparities in outcomes for beneficiaries with different social risks, Medicare behavioral health services, the alignment of fee-for-service payment rates across ambulatory settings, and the evaluation of a post-acute care prospective payment system prototype.
Date: 06/2023
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Evaluates Medicare payment issues and provides recommendations to the U.S. Congress. Chapter 7 presents a report on the use, payment, and quality of telehealth services that Medicare pays for separately under the physician fee schedule (PFS). Also includes chapters on the cost of drugs covered under Medicare Part B, postsale rebates for prescription drugs in Medicare Part D, standardized benefits in Medicare Advantage plans, future directions for Medicare Advantage payment policy, disparities in outcomes for beneficiaries with different social risks, Medicare behavioral health services, the alignment of fee-for-service payment rates across ambulatory settings, and the evaluation of a post-acute care prospective payment system prototype.
Date: 06/2023
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Report to Congress on Medicaid and CHIP, June 2023
Semi-annual report to Congress from the Medicaid and CHIP Payment and Access Commission (MACPAC). Covers recommendations on disproportionate share hospital (DSH) payments, care integration for people who are dually eligible for Medicaid and Medicare, access to Medicaid coverage for adults leaving incarceration, and barriers to Medicaid home- and community-based services (HCBS). Includes rural references throughout.
Date: 06/2023
Type: Document
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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Semi-annual report to Congress from the Medicaid and CHIP Payment and Access Commission (MACPAC). Covers recommendations on disproportionate share hospital (DSH) payments, care integration for people who are dually eligible for Medicaid and Medicare, access to Medicaid coverage for adults leaving incarceration, and barriers to Medicaid home- and community-based services (HCBS). Includes rural references throughout.
Date: 06/2023
Type: Document
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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