Rural Health
Resources by Topic: Reimbursement and payment models
Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs): CMS Flexibilities to Fight COVID-19
Outlines specific regulatory waivers and Medicare flexibilities for Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs) issued in response to the COVID-19 pandemic. Includes information on payments for telehealth services, COVID-19 vaccines, therapeutics, and more. Identifies whether each waiver or flexibility was terminated, ended at the conclusion of the public health emergency, was extended, or became permanent.
Date: 05/2023
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Outlines specific regulatory waivers and Medicare flexibilities for Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs) issued in response to the COVID-19 pandemic. Includes information on payments for telehealth services, COVID-19 vaccines, therapeutics, and more. Identifies whether each waiver or flexibility was terminated, ended at the conclusion of the public health emergency, was extended, or became permanent.
Date: 05/2023
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Study of Telehealth Expansion and Payment Parity: Preliminary Report to the Minnesota Legislature 2023
Provides an overview of telehealth usage in Minnesota, with a focus on the impacts of the COVID-19 pandemic on telehealth; issues of access, quality, satisfaction, and equity; payment parity; audio-only telehealth; and more. Includes 2021 Minnesota Health Access (MNHA) Survey data about telehealth satisfaction for various populations, including rural, as well as telehealth implications for rural areas.
Date: 05/2023
Type: Document
Sponsoring organization: Minnesota Department of Health
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Provides an overview of telehealth usage in Minnesota, with a focus on the impacts of the COVID-19 pandemic on telehealth; issues of access, quality, satisfaction, and equity; payment parity; audio-only telehealth; and more. Includes 2021 Minnesota Health Access (MNHA) Survey data about telehealth satisfaction for various populations, including rural, as well as telehealth implications for rural areas.
Date: 05/2023
Type: Document
Sponsoring organization: Minnesota Department of Health
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Achieving Behavioral Health Care Integration in Rural America
Provides an overview of behavioral health and primary care integration and how integration may be different in rural areas than in urban and suburban areas. Examines the barriers to integration in rural areas and opportunities for policies that can improve access to care. Offers policy recommendations to better coordinate and integrate primary care and behavioral health services for high-risk groups and expand the ability of primary care providers to handle the lower-acuity behavioral health needs of patients through enhanced payments, training, and improved access to behavioral health providers for consultation and referral. Builds on the March 2021 report, Tackling America's Mental Health and Addiction Crisis Through Primary Care Integration.
Author(s): Kendall Strong, Michele Gilbert, Julia Harris, et al.
Date: 05/2023
Type: Document
Sponsoring organization: Bipartisan Policy Center
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Provides an overview of behavioral health and primary care integration and how integration may be different in rural areas than in urban and suburban areas. Examines the barriers to integration in rural areas and opportunities for policies that can improve access to care. Offers policy recommendations to better coordinate and integrate primary care and behavioral health services for high-risk groups and expand the ability of primary care providers to handle the lower-acuity behavioral health needs of patients through enhanced payments, training, and improved access to behavioral health providers for consultation and referral. Builds on the March 2021 report, Tackling America's Mental Health and Addiction Crisis Through Primary Care Integration.
Author(s): Kendall Strong, Michele Gilbert, Julia Harris, et al.
Date: 05/2023
Type: Document
Sponsoring organization: Bipartisan Policy Center
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New England Health System CEOs Address Rural Healthcare Crisis In A Live Conversation
Recording of a May 22, 2023, roundtable discussion with the chief executive officers (CEOs) of Dartmouth Health, MaineHealth, and the University of Vermont Health Network regarding the challenges rural healthcare providers face. Covers workforce challenges, regulatory and inflation challenges, and innovations to preserve access to care. Transcript is available in the video description.
Date: 05/2023
Type: Video/Multimedia
Sponsoring organization: Dartmouth Health
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Recording of a May 22, 2023, roundtable discussion with the chief executive officers (CEOs) of Dartmouth Health, MaineHealth, and the University of Vermont Health Network regarding the challenges rural healthcare providers face. Covers workforce challenges, regulatory and inflation challenges, and innovations to preserve access to care. Transcript is available in the video description.
Date: 05/2023
Type: Video/Multimedia
Sponsoring organization: Dartmouth Health
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Ambulance Deserts: Geographic Disparities in the Provision of Ambulance Services
Chartbook presenting data on ambulance deserts from 41 states in 2021-2022, and identifying places and people that are more than 25 minutes from an ambulance station. Include maps of ambulance desert locations and health care facility locations for every state with available data, and documents coverage gaps in the provision of ambulance services across geographic areas across the United States.
Author(s): Yvonne Jonk, Carly Milkowski, Zachariah Croll, Karen Pearson
Date: 05/2023
Type: Document
Sponsoring organization: Maine Rural Health Research Center
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Chartbook presenting data on ambulance deserts from 41 states in 2021-2022, and identifying places and people that are more than 25 minutes from an ambulance station. Include maps of ambulance desert locations and health care facility locations for every state with available data, and documents coverage gaps in the provision of ambulance services across geographic areas across the United States.
Author(s): Yvonne Jonk, Carly Milkowski, Zachariah Croll, Karen Pearson
Date: 05/2023
Type: Document
Sponsoring organization: Maine Rural Health Research Center
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Barriers to Rural Health Care From the Provider Perspective
Results of a study using data from interviews with 20 healthcare providers in rural areas of western Pennsylvania. Explores barriers to care, including cost and insurance, geographic dispersion, and provider shortage and burnout. Offers strategies for improvement, including use of telehealth, mobile clinics, and increased use of advanced practice providers.
Author(s): Avinash Maganty, Mary E. Byrnes, Megan Hamm, et al.
Citation: Rural and Remote Health, 23(2), 7769
Date: 05/2023
Type: Document
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Results of a study using data from interviews with 20 healthcare providers in rural areas of western Pennsylvania. Explores barriers to care, including cost and insurance, geographic dispersion, and provider shortage and burnout. Offers strategies for improvement, including use of telehealth, mobile clinics, and increased use of advanced practice providers.
Author(s): Avinash Maganty, Mary E. Byrnes, Megan Hamm, et al.
Citation: Rural and Remote Health, 23(2), 7769
Date: 05/2023
Type: Document
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Improving Health Care Access in Rural Communities: Obstacles and Opportunities
Presents the U.S. Senate Committee on Finance, Subcommittee on Health Care hearing on improving access to high-quality, affordable healthcare in rural communities. Discusses workforce issues, education pipeline, transportation, broadband, school-based health centers, payment models and value-based care, and rural-friendly policies. Features testimonies from representatives of Frances Mahon Deaconess Hospital, Choptank Community Health System, Essentia Health, and the Sheps Center For Health Services Research.
Additional links: Testimony by David Herman, Testimony by Erin Aune, Testimony by Mark Holmes, Testimony by Sara Rich
Date: 05/2023
Type: Video/Multimedia
Sponsoring organization: Senate Committee on Finance, Subcommittee on Health Care
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Presents the U.S. Senate Committee on Finance, Subcommittee on Health Care hearing on improving access to high-quality, affordable healthcare in rural communities. Discusses workforce issues, education pipeline, transportation, broadband, school-based health centers, payment models and value-based care, and rural-friendly policies. Features testimonies from representatives of Frances Mahon Deaconess Hospital, Choptank Community Health System, Essentia Health, and the Sheps Center For Health Services Research.
Additional links: Testimony by David Herman, Testimony by Erin Aune, Testimony by Mark Holmes, Testimony by Sara Rich
Date: 05/2023
Type: Video/Multimedia
Sponsoring organization: Senate Committee on Finance, Subcommittee on Health Care
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How Regional Partnerships Bolster Rural Hospitals
Explores how Critical Access Hospitals (CAHs) and other rural providers partner to overcome challenges. Profiles six regional partnerships that address staffing, quality improvement, contracts with payers, value-based payment, and community development. Offers lessons learned that could inform policy changes to strengthen rural providers.
Author(s): Martha Hostetter, Sarah Klein
Date: 05/2023
Type: Document
Sponsoring organization: Commonwealth Fund
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Explores how Critical Access Hospitals (CAHs) and other rural providers partner to overcome challenges. Profiles six regional partnerships that address staffing, quality improvement, contracts with payers, value-based payment, and community development. Offers lessons learned that could inform policy changes to strengthen rural providers.
Author(s): Martha Hostetter, Sarah Klein
Date: 05/2023
Type: Document
Sponsoring organization: Commonwealth Fund
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340B Drug Discount Program: Information about Hospitals That Received an Eligibility Exception as a Result of COVID-19
Provides an overview of a provision of the Consolidated Appropriations Act, 2022, that allowed hospitals to request an exception to the disproportionate share hospital (DSH) percentage eligibility requirement if they were unable to meet it due to the COVID-19 pandemic. Explores the exception process and provides information on hospitals that received the exception. Discusses the amount of 340B drug purchases and discounts that excepted hospitals indicated they had in 2020 and 2021; the extent to which excepted hospitals indicated providing discounts on 340B drugs to low-income, uninsured patients; and results of the Health Resources and Services Administration's audits and oversight activities to assess program compliance.
Additional links: Full Report
Date: 05/2023
Type: Document
Sponsoring organization: Government Accountability Office
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Provides an overview of a provision of the Consolidated Appropriations Act, 2022, that allowed hospitals to request an exception to the disproportionate share hospital (DSH) percentage eligibility requirement if they were unable to meet it due to the COVID-19 pandemic. Explores the exception process and provides information on hospitals that received the exception. Discusses the amount of 340B drug purchases and discounts that excepted hospitals indicated they had in 2020 and 2021; the extent to which excepted hospitals indicated providing discounts on 340B drugs to low-income, uninsured patients; and results of the Health Resources and Services Administration's audits and oversight activities to assess program compliance.
Additional links: Full Report
Date: 05/2023
Type: Document
Sponsoring organization: Government Accountability Office
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Access to Maternity Providers: Midwives and Birth Centers
Provides an overview of the role of certified nurse-midwives and birth centers in Medicaid and how beneficiaries use these services. Describes policy issues and barriers to expanding access to midwives and birth centers, including payment policies; contracting with managed care organizations; licensure, certification, and accreditation; scope of practice; and limited supply. Includes rural considerations throughout.
Date: 05/2023
Type: Document
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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Provides an overview of the role of certified nurse-midwives and birth centers in Medicaid and how beneficiaries use these services. Describes policy issues and barriers to expanding access to midwives and birth centers, including payment policies; contracting with managed care organizations; licensure, certification, and accreditation; scope of practice; and limited supply. Includes rural considerations throughout.
Date: 05/2023
Type: Document
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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