Rural Health
Resources by Topic: Reimbursement and payment models
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
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
Sponsoring organization: Southeastern Telehealth Resource Center
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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
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
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
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
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
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
Sponsoring organization: Medicare Payment Advisory Commission
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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
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
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
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
Sponsoring organizations: Centers for Medicare and Medicaid Services, Mathematica
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CMS Final Rules Overview - Impact for RHCs Beginning January 1, 2024
Recording of a December 11, 2023, webinar providing an overview of telehealth payment rates for Rural Health Clinics (RHCs) and other regulatory updates and potential changes for 2024. Covers new billable providers for RHCs, changes to care management services and billing, telehealth regulations, intensive outpatient program (IOP) services, and more. Part of the Rural Health Clinic Technical Assistance Series.
Additional links: Presentation Slides
Date: 12/2023
Sponsoring organization: National Association of Rural Health Clinics
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Recording of a December 11, 2023, webinar providing an overview of telehealth payment rates for Rural Health Clinics (RHCs) and other regulatory updates and potential changes for 2024. Covers new billable providers for RHCs, changes to care management services and billing, telehealth regulations, intensive outpatient program (IOP) services, and more. Part of the Rural Health Clinic Technical Assistance Series.
Additional links: Presentation Slides
Date: 12/2023
Sponsoring organization: National Association of Rural Health Clinics
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Participation in a Medicare Advanced Primary Care Model and the Delivery of High-Value Services
Examines if participation in the Comprehensive Primary Care Plus Initiative (CPC+) impacted the high-value services delivered by primary care providers. Utilizes multiple national data sets to estimate the association of CPC+ and services such as annual wellness visits (AWVs), advance care planning (ACP), flu shots, tobacco prevention counseling, and depression screening. Provides data on intervention groups and comparison groups by patient demographics as well as provider demographics, specialty, and location, including urban, large rural, small rural, and isolated rural.
Author(s): Fang He, Angela Gasdaska, Lindsay White, Yan Tang, Chris Beadles
Citation: Health Services Research, 58(6), 1266-1291
Date: 12/2023
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Examines if participation in the Comprehensive Primary Care Plus Initiative (CPC+) impacted the high-value services delivered by primary care providers. Utilizes multiple national data sets to estimate the association of CPC+ and services such as annual wellness visits (AWVs), advance care planning (ACP), flu shots, tobacco prevention counseling, and depression screening. Provides data on intervention groups and comparison groups by patient demographics as well as provider demographics, specialty, and location, including urban, large rural, small rural, and isolated rural.
Author(s): Fang He, Angela Gasdaska, Lindsay White, Yan Tang, Chris Beadles
Citation: Health Services Research, 58(6), 1266-1291
Date: 12/2023
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Medicare Advantage in Rural Areas: Implications for Hospital Sustainability
Explores the relationship between Medicare Advantage (MA) penetration levels in rural areas and acute care hospital financial distress and closure between 2008 and 2019. Analyzes data from Healthcare Cost and Utilization Project (HCUP) State Inpatient Databases from 14 states to describe rural acute care hospitals with low and high MA penetration.
Author(s): Rachel Mosher Henke, Kathryn R. Fingar, Lan Liang, H. Joanna Jiang
Citation: American Journal of Managed Care, 29(11), 594–600
Date: 11/2023
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Explores the relationship between Medicare Advantage (MA) penetration levels in rural areas and acute care hospital financial distress and closure between 2008 and 2019. Analyzes data from Healthcare Cost and Utilization Project (HCUP) State Inpatient Databases from 14 states to describe rural acute care hospitals with low and high MA penetration.
Author(s): Rachel Mosher Henke, Kathryn R. Fingar, Lan Liang, H. Joanna Jiang
Citation: American Journal of Managed Care, 29(11), 594–600
Date: 11/2023
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Beyond the Waiting Room: The State of Dental Care Access in West Virginia
Discusses dental care access in West Virginia, highlighting workforce shortages and underserved populations including rural residents. Offers policy recommendations to decrease disparities including interprofessional care, reimbursement structures, and more.
Date: 11/2023
Sponsoring organizations: Harmony Health Foundation, West Virginia Oral Health Coalition
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Discusses dental care access in West Virginia, highlighting workforce shortages and underserved populations including rural residents. Offers policy recommendations to decrease disparities including interprofessional care, reimbursement structures, and more.
Date: 11/2023
Sponsoring organizations: Harmony Health Foundation, West Virginia Oral Health Coalition
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