Rural Health
Resources by Topic: Reimbursement and payment models
New and Expanded Flexibilities for Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs)
Provides an overview of changes to Rural Health Clinic (RHC) and Federally Qualified Health Centers (FQHCs) requirements and payment policies in response to the COVID-19 public health emergency (PHE) and subsequent changes at the end of the PHE on May 11, 2023. Includes information on telehealth flexibilities that have continued through 2024.
Date: 05/2023
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Provides an overview of changes to Rural Health Clinic (RHC) and Federally Qualified Health Centers (FQHCs) requirements and payment policies in response to the COVID-19 public health emergency (PHE) and subsequent changes at the end of the PHE on May 11, 2023. Includes information on telehealth flexibilities that have continued through 2024.
Date: 05/2023
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Closed, Converted, Merged, and New Hospitals with Medicare Rural Designations: January 2018-November 2022
Provides an overview of four Medicare rural hospital designations - Critical Access Hospital, Low-Volume Hospital, Medicare Dependent Hospital, and Sole Community Hospital - and factors related to financial distress that these designations are intended to address. Explores the number of rural-designated hospitals that have closed, merged, converted, or opened between January 2018-November 2022 and compares the number of rural-designated hospitals with the number of non-designated hospitals. Outlines considerations for Congress regarding policy options for rural hospitals and access to healthcare services in rural areas.
Date: 04/2023
Type: Document
Sponsoring organization: Congressional Research Service
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Provides an overview of four Medicare rural hospital designations - Critical Access Hospital, Low-Volume Hospital, Medicare Dependent Hospital, and Sole Community Hospital - and factors related to financial distress that these designations are intended to address. Explores the number of rural-designated hospitals that have closed, merged, converted, or opened between January 2018-November 2022 and compares the number of rural-designated hospitals with the number of non-designated hospitals. Outlines considerations for Congress regarding policy options for rural hospitals and access to healthcare services in rural areas.
Date: 04/2023
Type: Document
Sponsoring organization: Congressional Research Service
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April 2023 MACPAC Meeting Transcript
Transcript from the Medicaid and CHIP Payment and Access Commission's (MACPAC) April 2023 meeting. Covers automatic adjustments to Disproportionate Share Hospital (DSH) allotments, DSH third-party payer policy, integrating care for dually eligible beneficiaries, access to Medicaid coverage and care for adults leaving incarceration, adult access to covered dental benefits, access to home- and community-based services, and an update on the COVID-19 public health emergency (PHE) unwinding. Includes rural references and considerations throughout.
Date: 04/2023
Type: Document
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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Transcript from the Medicaid and CHIP Payment and Access Commission's (MACPAC) April 2023 meeting. Covers automatic adjustments to Disproportionate Share Hospital (DSH) allotments, DSH third-party payer policy, integrating care for dually eligible beneficiaries, access to Medicaid coverage and care for adults leaving incarceration, adult access to covered dental benefits, access to home- and community-based services, and an update on the COVID-19 public health emergency (PHE) unwinding. Includes rural references and considerations throughout.
Date: 04/2023
Type: Document
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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April 2023 MedPAC Meeting Transcript
Transcript from the Medicare Payment Advisory Commission's (MedPAC) April 2023 meeting. Covers high prices of drugs covered under Medicare Part B, draft recommendations for reforming Medicare's wage index systems, aligning fee-for-service payment rates across ambulatory settings, leveraging Medicare policies to address social determinants of health, assessing post-sale rebates for prescription drugs in Medicare Part D, and assessing the need for Medicare safety net payments for skilled nursing facilities and home health agencies. Features discussions on draft reports regarding a prototype design for a post-acute care prospective payment system, telehealth in Medicare, and behavioral health in Medicare. Includes rural references throughout.
Date: 04/2023
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Transcript from the Medicare Payment Advisory Commission's (MedPAC) April 2023 meeting. Covers high prices of drugs covered under Medicare Part B, draft recommendations for reforming Medicare's wage index systems, aligning fee-for-service payment rates across ambulatory settings, leveraging Medicare policies to address social determinants of health, assessing post-sale rebates for prescription drugs in Medicare Part D, and assessing the need for Medicare safety net payments for skilled nursing facilities and home health agencies. Features discussions on draft reports regarding a prototype design for a post-acute care prospective payment system, telehealth in Medicare, and behavioral health in Medicare. Includes rural references throughout.
Date: 04/2023
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Big Changes with the New Rural Emergency Hospital Model
Podcast episode providing an overview of the Rural Emergency Hospital designation. Discusses the role of the Rural Emergency Hospital Technical Assistance Center and the types of support it provides.
Date: 04/2023
Type: Audio
Sponsoring organization: American Hospital Association
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Podcast episode providing an overview of the Rural Emergency Hospital designation. Discusses the role of the Rural Emergency Hospital Technical Assistance Center and the types of support it provides.
Date: 04/2023
Type: Audio
Sponsoring organization: American Hospital Association
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Analysis of Hospital Operating Margins and Provision of Safety Net Services
Explores the association between five hospital safety net services - undercompensated care measured using the Disproportionate Share Hospital index, uncompensated care, essential community services, neighborhood disadvantage, and Sole Community Hospital and Critical Access Hospital status - and hospital operating margins. Includes information on the relationship between bed count, Census region, urban/rural location, ownership status, and having a Graduate Medical Education residency program with operating margins.
Author(s): Lukas K. Gaffney, Kenneth A. Michelson
Citation: JAMA Network Open, 6(4), e238785
Date: 04/2023
Type: Document
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Explores the association between five hospital safety net services - undercompensated care measured using the Disproportionate Share Hospital index, uncompensated care, essential community services, neighborhood disadvantage, and Sole Community Hospital and Critical Access Hospital status - and hospital operating margins. Includes information on the relationship between bed count, Census region, urban/rural location, ownership status, and having a Graduate Medical Education residency program with operating margins.
Author(s): Lukas K. Gaffney, Kenneth A. Michelson
Citation: JAMA Network Open, 6(4), e238785
Date: 04/2023
Type: Document
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Better Together: Rural Hospital High-Value Networks
Examines how rural hospital high-value networks can create economies of scale and value-based care capacity in order to enter into value-based payment contracts.
Author(s): Clint MacKinney, Nate White, Brett Norell
Citation: Rural Monitor
Date: 04/2023
Type: Document
Sponsoring organization: Rural Health Information Hub
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Examines how rural hospital high-value networks can create economies of scale and value-based care capacity in order to enter into value-based payment contracts.
Author(s): Clint MacKinney, Nate White, Brett Norell
Citation: Rural Monitor
Date: 04/2023
Type: Document
Sponsoring organization: Rural Health Information Hub
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Engaging Primary Care in Value-Based Payment: New Findings from the 2022 Commonwealth Fund Survey of Primary Care Physicians
Describes the results of the 2022 Commonwealth Fund International Health Policy Survey of Primary Care Physicians regarding fee-for-service and value-based payment models. Highlights trends between smaller, rural practices and larger, urban ones and discusses implications on quality of care.
Author(s): Celli Horstman, Corinne Lewis
Date: 04/2023
Type: Document
Sponsoring organization: Commonwealth Fund
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Describes the results of the 2022 Commonwealth Fund International Health Policy Survey of Primary Care Physicians regarding fee-for-service and value-based payment models. Highlights trends between smaller, rural practices and larger, urban ones and discusses implications on quality of care.
Author(s): Celli Horstman, Corinne Lewis
Date: 04/2023
Type: Document
Sponsoring organization: Commonwealth Fund
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Rural Healthcare Disparities in the United States: Can Our Payer Structures Help Us Get Upstream?
Describes a care model utilizing community health workers (CHWs) to engage patients by screening for diseases, and offering education and information to help them manage their chronic conditions in an accessible, non-traditional settings such as a food bank distribution centers, county fairs, livestock auctions, and educational events in rural Idaho. Discusses the value of CHWs, along with a primary care team, in improving outcomes for populations at risk, and the absence of payment models to support this model.
Author(s): Kelly McGrath
Citation: Journal of General Internal Medicine, 38 (Suppl 1), 16-17
Date: 03/2023
Type: Document
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Describes a care model utilizing community health workers (CHWs) to engage patients by screening for diseases, and offering education and information to help them manage their chronic conditions in an accessible, non-traditional settings such as a food bank distribution centers, county fairs, livestock auctions, and educational events in rural Idaho. Discusses the value of CHWs, along with a primary care team, in improving outcomes for populations at risk, and the absence of payment models to support this model.
Author(s): Kelly McGrath
Citation: Journal of General Internal Medicine, 38 (Suppl 1), 16-17
Date: 03/2023
Type: Document
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Programs of All-Inclusive Care for the Elderly in Rural America: Policy Brief and Recommendations to the Secretary
Provides an overview of Programs of All-Inclusive Care for the Elderly (PACE). Discusses barriers to implementing PACE programs in rural areas and offers policy recommendations and considerations to facilitate the expansion of these programs in rural communities.
Date: 03/2023
Type: Document
Sponsoring organization: National Advisory Committee on Rural Health and Human Services
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Provides an overview of Programs of All-Inclusive Care for the Elderly (PACE). Discusses barriers to implementing PACE programs in rural areas and offers policy recommendations and considerations to facilitate the expansion of these programs in rural communities.
Date: 03/2023
Type: Document
Sponsoring organization: National Advisory Committee on Rural Health and Human Services
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