Rural Health
Resources by Topic: Reimbursement and payment models
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
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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
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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
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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
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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
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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
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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 & Medicaid Services
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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 & Medicaid Services
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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
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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
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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
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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
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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
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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
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Environmental Scan on Identifying a Pathway Toward Maximizing Participation in Population-Based Total Cost of Care (PB-TCOC) Models
Presents results of an environmental scan on the identification of a pathway toward maximizing participation in population-based total cost of care (PB-TCOC) models. Describes the Center for Medicare & Medicaid Services's (CMS's) goal of having all Medicare beneficiaries with Parts A and B in accountable care relationships by 2030. Discusses challenges and technical issues related to maximizing participation in PB-TCOC models, including organizational structure, payment, and risk adjustment. Summarizes relevant features of CMS Innovation Center (CMMI) models identified in previous Physician-Focused Payment Model Technical Advisory Committee (PTAC) proposals. Includes rural references and considerations throughout.
Date: 09/2024
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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Presents results of an environmental scan on the identification of a pathway toward maximizing participation in population-based total cost of care (PB-TCOC) models. Describes the Center for Medicare & Medicaid Services's (CMS's) goal of having all Medicare beneficiaries with Parts A and B in accountable care relationships by 2030. Discusses challenges and technical issues related to maximizing participation in PB-TCOC models, including organizational structure, payment, and risk adjustment. Summarizes relevant features of CMS Innovation Center (CMMI) models identified in previous Physician-Focused Payment Model Technical Advisory Committee (PTAC) proposals. Includes rural references and considerations throughout.
Date: 09/2024
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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Rural Emergency Hospitals Fact Sheet
Provides a brief overview of the Rural Emergency Hospital (REH) provider designation. Outlines REH payment, services, eligibility requirements, and how to apply for REH designation.
Date: 09/2024
Sponsoring organization: Centers for Medicare & Medicaid Services
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Provides a brief overview of the Rural Emergency Hospital (REH) provider designation. Outlines REH payment, services, eligibility requirements, and how to apply for REH designation.
Date: 09/2024
Sponsoring organization: Centers for Medicare & Medicaid Services
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Financial Performance of Rural and Urban Hospitals in the Medicare Shared Savings Program
Presents financial performance trends of hospitals that participated in Medicare's Shared Savings Program (SSP) from 2011-2018. Compares trends in 6 financial outcomes between SSP and non-SSP hospitals, and differences in these trends among rural and urban hospitals.
Author(s): Huang Huang, Xi Zhu, Fred Ullrich, A. Clinton MacKinney, Keith Mueller
Date: 09/2024
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Presents financial performance trends of hospitals that participated in Medicare's Shared Savings Program (SSP) from 2011-2018. Compares trends in 6 financial outcomes between SSP and non-SSP hospitals, and differences in these trends among rural and urban hospitals.
Author(s): Huang Huang, Xi Zhu, Fred Ullrich, A. Clinton MacKinney, Keith Mueller
Date: 09/2024
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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