Rural Health
Resources by Topic: Reimbursement and payment models
Rural Hospital Experiences in the Colorado Hospital Transformation Program
Provides an overview of the Colorado Hospital Transformation Program (CO HTP), a 5-year program that ties Medicaid supplemental payments to hospitals' ability to meet performance targets through September 2026. Describes the experiences of three Critical Access Hospitals (CAHs) and explores how CO HTP impacts rural hospitals. Covers planning and community engagement, quality of care, and healthcare costs.
Date: 10/2023
Type: Document
Sponsoring organization: Rural Health Value
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Provides an overview of the Colorado Hospital Transformation Program (CO HTP), a 5-year program that ties Medicaid supplemental payments to hospitals' ability to meet performance targets through September 2026. Describes the experiences of three Critical Access Hospitals (CAHs) and explores how CO HTP impacts rural hospitals. Covers planning and community engagement, quality of care, and healthcare costs.
Date: 10/2023
Type: Document
Sponsoring organization: Rural Health Value
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Health Panel Comment Letter – Encouraging Rural Participation in Population-Based Total Cost of Care Models
Offers comments in response to the Physician-Focused Payment Model Technical Advisory Committee (PTAC) Request for Information regarding rural participation in population-based total cost of care models. Covers considerations for determining the most relevant definition of rural, barriers that impact rural providers' participation in alternative payment models (APMs), service delivery models and resources that are effective in encouraging value-based care (VBC) transformation in rural areas, and more.
Date: 10/2023
Type: Document
Sponsoring organization: Rural Policy Research Institute Rural Health Panel
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Offers comments in response to the Physician-Focused Payment Model Technical Advisory Committee (PTAC) Request for Information regarding rural participation in population-based total cost of care models. Covers considerations for determining the most relevant definition of rural, barriers that impact rural providers' participation in alternative payment models (APMs), service delivery models and resources that are effective in encouraging value-based care (VBC) transformation in rural areas, and more.
Date: 10/2023
Type: Document
Sponsoring organization: Rural Policy Research Institute Rural Health Panel
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Provision of Hospice Services by Critical Access Hospitals: Strengths and Challenges
Describes the characteristics of Critical Access Hospitals (CAHs) that report providing hospice services by analyzing data from the 2021 American Hospital Association (AHA) annual survey. Presents findings from qualitative interviews with seven CAHs who report providing hospice care, including how CAHs provide hospice services, the advantages CAHs may have when providing end-of-life care, and what CAH-specific barriers exist in providing such care.
Author(s): Robert Barclay, Megan Lahr, Hannah MacDougall, Abigail Wenninger
Date: 10/2023
Type: Document
Sponsoring organization: Flex Monitoring Team
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Describes the characteristics of Critical Access Hospitals (CAHs) that report providing hospice services by analyzing data from the 2021 American Hospital Association (AHA) annual survey. Presents findings from qualitative interviews with seven CAHs who report providing hospice care, including how CAHs provide hospice services, the advantages CAHs may have when providing end-of-life care, and what CAH-specific barriers exist in providing such care.
Author(s): Robert Barclay, Megan Lahr, Hannah MacDougall, Abigail Wenninger
Date: 10/2023
Type: Document
Sponsoring organization: Flex Monitoring Team
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Medicare: Performance-Based and Geographic Adjustments to Physician Payments
Statement to the U.S. House of Representatives Committee on Energy and Commerce, Subcommittee on Health, summarizing the Government Accountability Organization's (GAO) 2021 reports on the Quality Payment Program and the two tracks it established to incentivize Medicare providers and its 2022 report on geographic adjustments to physician payments. Includes information on the participation of providers in rural and underserved areas in Advanced Alternative Payment Models (APMs) and the challenges these providers face in transitioning to APMs.
Additional links: Full Report
Date: 10/2023
Type: Document
Sponsoring organization: Government Accountability Office
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Statement to the U.S. House of Representatives Committee on Energy and Commerce, Subcommittee on Health, summarizing the Government Accountability Organization's (GAO) 2021 reports on the Quality Payment Program and the two tracks it established to incentivize Medicare providers and its 2022 report on geographic adjustments to physician payments. Includes information on the participation of providers in rural and underserved areas in Advanced Alternative Payment Models (APMs) and the challenges these providers face in transitioning to APMs.
Additional links: Full Report
Date: 10/2023
Type: Document
Sponsoring organization: Government Accountability Office
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MedPAC Payment Basics
Series of briefs providing an of Medicare payment systems. Covers payments systems including Accountable Care Organizations (ACO), Critical Access Hospitals (CAH), Federally Qualified Health Centers and Rural Health Clinics, hospital acute inpatient services, and more.
Date: 10/2023
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Series of briefs providing an of Medicare payment systems. Covers payments systems including Accountable Care Organizations (ACO), Critical Access Hospitals (CAH), Federally Qualified Health Centers and Rural Health Clinics, hospital acute inpatient services, and more.
Date: 10/2023
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Exploring Patient Care Navigation in the Medicare Program
Presents an overview of patient navigation programs through an environmental scan of literature published between 2013 and 2023 and discussions with key informants at four healthcare organizations. Describes the variety of patient navigation services, types of patients targeted, settings that offer navigation services, staffing, funding, clinical outcomes, and more. Includes a brief discussion of programs targeting patients in rural areas. Identifies implementation and policy considerations and potential barriers to supporting patient navigation services.
Additional links: Annex, Executive Summary
Author(s): Zachary Predmore, Joachim Hero, Stephanie Dellva, et al.
Date: 09/2023
Type: Document
Sponsoring organizations: HHS Office of the Assistant Secretary for Planning and Evaluation, RAND Health Care
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Presents an overview of patient navigation programs through an environmental scan of literature published between 2013 and 2023 and discussions with key informants at four healthcare organizations. Describes the variety of patient navigation services, types of patients targeted, settings that offer navigation services, staffing, funding, clinical outcomes, and more. Includes a brief discussion of programs targeting patients in rural areas. Identifies implementation and policy considerations and potential barriers to supporting patient navigation services.
Additional links: Annex, Executive Summary
Author(s): Zachary Predmore, Joachim Hero, Stephanie Dellva, et al.
Date: 09/2023
Type: Document
Sponsoring organizations: HHS Office of the Assistant Secretary for Planning and Evaluation, RAND Health Care
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Environmental Scan on Encouraging Rural Participation in Population-Based TCOC Models
Presents results of an environmental scan regarding population-based total cost of care (PB-TCOC) payment models and encouraging rural participation in these models. Describes challenges affecting rural patients and providers; opportunities for alternative payment models (APMs) and PB-TCOC models to address challenges in rural areas; trends in rural providers' participation in APMs; driving care delivery transformation in rural providers, including models that include or target rural participants in their model designs; leveraging financial incentives to improve rural health care; adoption and use of health information technology, including telehealth and data analytics among rural providers; and the measurement of rural providers' performance in APMs.
Date: 09/2023
Type: Document
Sponsoring organizations: HHS Office of the Assistant Secretary for Planning and Evaluation, NORC at the University of Chicago
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Presents results of an environmental scan regarding population-based total cost of care (PB-TCOC) payment models and encouraging rural participation in these models. Describes challenges affecting rural patients and providers; opportunities for alternative payment models (APMs) and PB-TCOC models to address challenges in rural areas; trends in rural providers' participation in APMs; driving care delivery transformation in rural providers, including models that include or target rural participants in their model designs; leveraging financial incentives to improve rural health care; adoption and use of health information technology, including telehealth and data analytics among rural providers; and the measurement of rural providers' performance in APMs.
Date: 09/2023
Type: Document
Sponsoring organizations: HHS Office of the Assistant Secretary for Planning and Evaluation, NORC at the University of Chicago
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Sustaining Essential Rural Health Services Through Changes in Payment and Related Public Policies
Presentation slides that discuss payment policies and models, Medicare and Medicaid, Accountable Care Organizations (ACOs), commercial plans, value-based care, and more, with data and maps illustrating impacts in specific areas.
Author(s): Keith J. Mueller
Date: 09/2023
Type: Presentation Slides
Sponsoring organizations: Iowa Department of Health Management and Policy, Rural Policy Research Institute
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Presentation slides that discuss payment policies and models, Medicare and Medicaid, Accountable Care Organizations (ACOs), commercial plans, value-based care, and more, with data and maps illustrating impacts in specific areas.
Author(s): Keith J. Mueller
Date: 09/2023
Type: Presentation Slides
Sponsoring organizations: Iowa Department of Health Management and Policy, Rural Policy Research Institute
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MedPAC Response to a Congressional Request for Information on Improving Access to Health Care in Rural and Underserved Areas
Letter to the House Committee on Ways and Means request for information on improving access to healthcare in rural and underserved areas. Covers MedPAC recommendations for policies to target payments to better support rural and vulnerable beneficiaries' access to care, including the Rural Emergency Hospital program and a proposed Medicare Safety-Net Index; changes to the hospital wage index to address geographic inequities; and the alignment of payment rates across ambulatory settings for certain services.
Date: 09/2023
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Letter to the House Committee on Ways and Means request for information on improving access to healthcare in rural and underserved areas. Covers MedPAC recommendations for policies to target payments to better support rural and vulnerable beneficiaries' access to care, including the Rural Emergency Hospital program and a proposed Medicare Safety-Net Index; changes to the hospital wage index to address geographic inequities; and the alignment of payment rates across ambulatory settings for certain services.
Date: 09/2023
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Merit-Based Incentive Payment System (MIPS): Small Practice Countdown to Performance Year 2023 Data Submission Checklist
Checklist outlining the steps small practices must follow to submit Merit-based Incentive Payment System (MIPS) 2023 performance year data. Highlights key dates and links to key resources for small practices.
Date: 09/2023
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Checklist outlining the steps small practices must follow to submit Merit-based Incentive Payment System (MIPS) 2023 performance year data. Highlights key dates and links to key resources for small practices.
Date: 09/2023
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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