Rural Health
Resources by Topic: Reimbursement and payment models
Health Insurance Coverage and Access to Care among American Indians and Alaska Natives: Recent Trends and Key Challenges
Issue brief presenting data on rates of insurance coverage, Medicaid coverage, and access to healthcare for American Indians and Alaska Natives (AI/AN) using American Community Survey data. Discusses the impacts of health disparities, coverage expansions under the Affordable Care Act, and state Medicaid expansions on AI/AN populations.
Date: 06/2024
Type: Document
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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Issue brief presenting data on rates of insurance coverage, Medicaid coverage, and access to healthcare for American Indians and Alaska Natives (AI/AN) using American Community Survey data. Discusses the impacts of health disparities, coverage expansions under the Affordable Care Act, and state Medicaid expansions on AI/AN populations.
Date: 06/2024
Type: Document
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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2023 Immunization Profile Study: A Look at Immunization Capacity among Local Health Departments
Reports survey results from 422 local health departments (LHDs) on immunization workforce capacity, vaccine provision and uptake, funding and reimbursement, immunization data capacity, barriers to vaccination, and more in 2023. Includes data comparisons of small, medium, and large LHDs.
Author(s): Margaret C. Cunningham, Amy Maxson, Robin Mowson, et al.
Date: 06/2024
Type: Document
Sponsoring organization: National Association of County and City Health Officials
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Reports survey results from 422 local health departments (LHDs) on immunization workforce capacity, vaccine provision and uptake, funding and reimbursement, immunization data capacity, barriers to vaccination, and more in 2023. Includes data comparisons of small, medium, and large LHDs.
Author(s): Margaret C. Cunningham, Amy Maxson, Robin Mowson, et al.
Date: 06/2024
Type: Document
Sponsoring organization: National Association of County and City Health Officials
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MedPAC Comment on CMS's Proposed Rule on the Hospital Inpatient PPS and the Long-term Care Hospital PPS for FY 2025
Comments on a May 2, 2024, Federal Register proposed rule revising the hospital inpatient and long-term care hospital (LTCH) prospective payment systems (PPS). Discusses proposals on rate-setting in both the inpatient prospective payment systems (IPPS) and LTCH PPS; the Transforming Episode Accountability Model (TEAM), including the definition of rural hospitals eligible to participate in a lower-risk track; new payments to small, independent hospitals that establish and maintain a 6-month buffer supply of essential medicines; updates to wage index values and policies; and updates to outlier reconciliation thresholds.
Date: 06/2024
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Comments on a May 2, 2024, Federal Register proposed rule revising the hospital inpatient and long-term care hospital (LTCH) prospective payment systems (PPS). Discusses proposals on rate-setting in both the inpatient prospective payment systems (IPPS) and LTCH PPS; the Transforming Episode Accountability Model (TEAM), including the definition of rural hospitals eligible to participate in a lower-risk track; new payments to small, independent hospitals that establish and maintain a 6-month buffer supply of essential medicines; updates to wage index values and policies; and updates to outlier reconciliation thresholds.
Date: 06/2024
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Sources of Federal Funding for Health Care Facilities: Frequently Asked Questions
Provides an overview of how the federal government supports healthcare facilities, with a focus on hospitals. Discusses how Medicare and Medicaid pay acute care hospitals and for services rendered to beneficiaries and enrollees, as well as other payments these programs make. Identifies federal grants, loans, and technical assistance programs that can support health facilities. Describes how federal agencies, including the Health Resources and Services Administration (HRSA) and the U.S. Department of Agriculture (USDA), have supported healthcare facilities during emergencies.
Date: 06/2024
Type: Document
Sponsoring organization: Congressional Research Service
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Provides an overview of how the federal government supports healthcare facilities, with a focus on hospitals. Discusses how Medicare and Medicaid pay acute care hospitals and for services rendered to beneficiaries and enrollees, as well as other payments these programs make. Identifies federal grants, loans, and technical assistance programs that can support health facilities. Describes how federal agencies, including the Health Resources and Services Administration (HRSA) and the U.S. Department of Agriculture (USDA), have supported healthcare facilities during emergencies.
Date: 06/2024
Type: Document
Sponsoring organization: Congressional Research Service
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Merit-Based Incentive Payment System (MIPS): Traditional MIPS Scoring Guide for the 2024 Performance Year
Provides details on how scores are calculated for the Merit-Based Incentive Payment System (MIPS), one of two tracks under the Medicare Quality Payment Program. Explains the four performance categories that affect Medicare Physician Fee Schedule payments: quality, cost, improvement activities, and promoting interoperability. Includes information for small practices.
Date: 06/2024
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Provides details on how scores are calculated for the Merit-Based Incentive Payment System (MIPS), one of two tracks under the Medicare Quality Payment Program. Explains the four performance categories that affect Medicare Physician Fee Schedule payments: quality, cost, improvement activities, and promoting interoperability. Includes information for small practices.
Date: 06/2024
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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CMS Bundled Payments for Care Improvement Advanced Model: Fifth Annual Evaluation Report
Fifth annual report of the Bundled Payments for Care Improvement Advanced (BPCI Advanced) Model, which tests whether linking payments for a clinical episode of care can reduce Medicare expenditures while maintaining or improving the quality of care. Explores the impact of BPCI Advanced on episode payments, utilization, and quality of care, as well as estimates of Medicare program savings in Model Year 4. Describes changes to the model that were implemented in Model Year 4 and how BPCI Advanced relates to Medicare Accountable Care Organizations (ACOs). Analyzes BPCI Advanced outcomes for beneficiaries from populations that have been historically underserved. Includes rural references throughout.
Additional links: Appendices, Executive Summary, Findings at a Glance
Author(s): The Lewin Group, Abt Associates, GDIT, Telligen
Date: 05/2024
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Fifth annual report of the Bundled Payments for Care Improvement Advanced (BPCI Advanced) Model, which tests whether linking payments for a clinical episode of care can reduce Medicare expenditures while maintaining or improving the quality of care. Explores the impact of BPCI Advanced on episode payments, utilization, and quality of care, as well as estimates of Medicare program savings in Model Year 4. Describes changes to the model that were implemented in Model Year 4 and how BPCI Advanced relates to Medicare Accountable Care Organizations (ACOs). Analyzes BPCI Advanced outcomes for beneficiaries from populations that have been historically underserved. Includes rural references throughout.
Additional links: Appendices, Executive Summary, Findings at a Glance
Author(s): The Lewin Group, Abt Associates, GDIT, Telligen
Date: 05/2024
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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MedPAC Comment on CMS's Proposed Rule on the Payment System for Inpatient Psychiatric Facilities for FY 2025
Comment on an April 3, 2024, Federal Register proposed rule revising the Inpatient Psychiatric Facility Prospective Payment System (IPF PPS) for fiscal year 2025. Includes a discussion of rural IPF PPS payment adjustments.
Date: 05/2024
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Comment on an April 3, 2024, Federal Register proposed rule revising the Inpatient Psychiatric Facility Prospective Payment System (IPF PPS) for fiscal year 2025. Includes a discussion of rural IPF PPS payment adjustments.
Date: 05/2024
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Converting to Rural Emergency Hospitals
Podcast episode featuring a discussion with Rural Emergency Hospital (REH) Chief Executive Officers in New Mexico and Oklahoma regarding the conversion to REH status. Discusses the conversion process of each REH; how they built trust and buy-in from patients and communities, including state and federal policymakers; and financial considerations of conversion.
Date: 05/2024
Type: Audio
Sponsoring organization: American Hospital Association
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Podcast episode featuring a discussion with Rural Emergency Hospital (REH) Chief Executive Officers in New Mexico and Oklahoma regarding the conversion to REH status. Discusses the conversion process of each REH; how they built trust and buy-in from patients and communities, including state and federal policymakers; and financial considerations of conversion.
Date: 05/2024
Type: Audio
Sponsoring organization: American Hospital Association
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Time for Action: Securing A Strong Nursing Workforce for North Carolina
Offers 8 recommendations for developing the nursing workforce in North Carolina. Discusses the workforce pipeline, professional education, well-being and safety in the workplace, leadership, retention, advocacy, staffing standards, billing, and more. Discusses rural throughout.
Date: 05/2024
Type: Document
Sponsoring organization: North Carolina Institute of Medicine
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Offers 8 recommendations for developing the nursing workforce in North Carolina. Discusses the workforce pipeline, professional education, well-being and safety in the workplace, leadership, retention, advocacy, staffing standards, billing, and more. Discusses rural throughout.
Date: 05/2024
Type: Document
Sponsoring organization: North Carolina Institute of Medicine
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Telehealth Policies and Federally Qualified Health Centers, Spring 2024
Provides an overview of telehealth policies for Federally Qualified Health Centers (FQHCs). Covers originating and distance sites, reimbursement, services outside the four walls of the FQHC, and more. Includes a chart of FQHC Medicaid telehealth reimbursement eligibility policies by state.
Date: 05/2024
Type: Document
Sponsoring organization: Center for Connected Health Policy: The National Telehealth Policy Resource Center
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Provides an overview of telehealth policies for Federally Qualified Health Centers (FQHCs). Covers originating and distance sites, reimbursement, services outside the four walls of the FQHC, and more. Includes a chart of FQHC Medicaid telehealth reimbursement eligibility policies by state.
Date: 05/2024
Type: Document
Sponsoring organization: Center for Connected Health Policy: The National Telehealth Policy Resource Center
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