Rural Health
Resources by Topic: Reimbursement and payment models
Rural Health: Pathway to Progress
Presents insights and perspectives from four rural healthcare leaders. Describes strategies for overcoming workforce challenges, increasing access to specialty care, and addressing cost pressures. Requires registration to download.
Date: 09/2023
Type: Document
Sponsoring organization: Reuters Events
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Presents insights and perspectives from four rural healthcare leaders. Describes strategies for overcoming workforce challenges, increasing access to specialty care, and addressing cost pressures. Requires registration to download.
Date: 09/2023
Type: Document
Sponsoring organization: Reuters Events
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Assessing the Impact of Medicaid Telehealth Policy Change on Equitable Access to Telehealth Services in North Carolina
Describes the evolution of North Carolina's Medicaid telehealth coverage and reimbursement policies in response to the COVID-19 pandemic. Discusses the impact of these policies on access to care. Compares data on telehealth claims by volume and as a percentage of total claims by race and rural-urban residence between March 2020 and December 2022.
Author(s): Shannon Dowler, Sam Thompson, Michelle Savuto, Jacqueline Marks-Smith, Jared Augenstein
Date: 09/2023
Type: Document
Sponsoring organization: Milbank Memorial Fund
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Describes the evolution of North Carolina's Medicaid telehealth coverage and reimbursement policies in response to the COVID-19 pandemic. Discusses the impact of these policies on access to care. Compares data on telehealth claims by volume and as a percentage of total claims by race and rural-urban residence between March 2020 and December 2022.
Author(s): Shannon Dowler, Sam Thompson, Michelle Savuto, Jacqueline Marks-Smith, Jared Augenstein
Date: 09/2023
Type: Document
Sponsoring organization: Milbank Memorial Fund
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Aging in Place: The Vital Role of Home Health in Access to Care
Recording of a September 19, 2023, U.S. Senate Committee on Finance Subcommittee on Health Care hearing on access to home health services and the role of home health in supporting aging in place. Features testimony from Carrie Edwards, Director of Home Care Services at Mary Lanning Healthcare in rural Nebraska, and Tracy Mroz, Associate Professor at the University of Washington and Investigator at the WWAMI Rural Health Research Center.
Additional links: Carrie Edwards, Mary Lanning Healthcare - Testimony, Tracy M. Mroz, University of Washington - Testimony
Date: 09/2023
Type: Video/Multimedia
Sponsoring organization: Senate Committee on Finance, Subcommittee on Health Care
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Recording of a September 19, 2023, U.S. Senate Committee on Finance Subcommittee on Health Care hearing on access to home health services and the role of home health in supporting aging in place. Features testimony from Carrie Edwards, Director of Home Care Services at Mary Lanning Healthcare in rural Nebraska, and Tracy Mroz, Associate Professor at the University of Washington and Investigator at the WWAMI Rural Health Research Center.
Additional links: Carrie Edwards, Mary Lanning Healthcare - Testimony, Tracy M. Mroz, University of Washington - Testimony
Date: 09/2023
Type: Video/Multimedia
Sponsoring organization: Senate Committee on Finance, Subcommittee on Health Care
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The Pennsylvania Rural Health Model (PARHM): Third Annual Evaluation Report
Evaluates the third performance year of the Pennsylvania Rural Health Model (PARHM), an initiative designed to test if global budgets can help rural hospitals improve their financial viability, provide flexibility to meet locally defined community health needs, and reduce overall healthcare spending. Provides an overview of the model and describes the implementation experience of participating hospitals and payers. Presents a descriptive quantitative assessment of financial performance, spending and utilization, access to care, and quality of care outcomes from 2016, the model's baseline, through 2021. Includes three case studies discussing three themes: the recruitment and retention of system-affiliated hospitals, engagement and coordination with community organizations and providers, and exploring service line changes.
Additional links: Appendix, Findings at a Glance
Date: 09/2023
Type: Document
Sponsoring organizations: Centers for Medicare and Medicaid Services, NORC at the University of Chicago
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Evaluates the third performance year of the Pennsylvania Rural Health Model (PARHM), an initiative designed to test if global budgets can help rural hospitals improve their financial viability, provide flexibility to meet locally defined community health needs, and reduce overall healthcare spending. Provides an overview of the model and describes the implementation experience of participating hospitals and payers. Presents a descriptive quantitative assessment of financial performance, spending and utilization, access to care, and quality of care outcomes from 2016, the model's baseline, through 2021. Includes three case studies discussing three themes: the recruitment and retention of system-affiliated hospitals, engagement and coordination with community organizations and providers, and exploring service line changes.
Additional links: Appendix, Findings at a Glance
Date: 09/2023
Type: Document
Sponsoring organizations: Centers for Medicare and Medicaid Services, NORC at the University of Chicago
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Evaluation of the Home Health Value-Based Purchasing (HHVBP) Model: Final Report
Evaluates the Home Health Value-Based Purchasing (HHVBP) Model, which tests the impact of providing financial incentives to home health agencies in nine states: Arizona, Florida, Iowa, Massachusetts, Maryland, Nebraska, North Carolina, Tennessee, and Washington. Examines how the financial incentives under the model influenced agency behavior. Describes impacts across key outcomes, including service utilization, quality of care, and patient experience, and examines the model's effects on access to care, health equity, and Medicare spending. Explores whether the model had unique impacts on access to home health care in rural areas.
Additional links: Appendices, Findings at a Glance
Date: 09/2023
Type: Document
Sponsoring organizations: Arbor Research Collaborative for Health, Centers for Medicare and Medicaid Services, L&M Policy Research
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Evaluates the Home Health Value-Based Purchasing (HHVBP) Model, which tests the impact of providing financial incentives to home health agencies in nine states: Arizona, Florida, Iowa, Massachusetts, Maryland, Nebraska, North Carolina, Tennessee, and Washington. Examines how the financial incentives under the model influenced agency behavior. Describes impacts across key outcomes, including service utilization, quality of care, and patient experience, and examines the model's effects on access to care, health equity, and Medicare spending. Explores whether the model had unique impacts on access to home health care in rural areas.
Additional links: Appendices, Findings at a Glance
Date: 09/2023
Type: Document
Sponsoring organizations: Arbor Research Collaborative for Health, Centers for Medicare and Medicaid Services, L&M Policy Research
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Health Panel Comment Letter - 2024 Physician Fee Schedule and Medicare Part B Proposed Rule
Comments offered in response to a July 13, 2023, Federal Register proposed rule revising the Medicare Physician Fee Schedule. Includes discussions on telehealth services, services addressing health-related social needs, advancing access to behavioral health services, Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs), and the Medicare Shared Savings Program.
Date: 09/2023
Type: Document
Sponsoring organization: Rural Policy Research Institute Rural Health Panel
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Comments offered in response to a July 13, 2023, Federal Register proposed rule revising the Medicare Physician Fee Schedule. Includes discussions on telehealth services, services addressing health-related social needs, advancing access to behavioral health services, Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs), and the Medicare Shared Savings Program.
Date: 09/2023
Type: Document
Sponsoring organization: Rural Policy Research Institute Rural Health Panel
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MedPAC Comment on CMS's Proposed Rule on the Outpatient Prospective Payment System for FY 2024
Comment on the July 31, 2023, Federal Register proposed rule revising the physician fee schedule to improve Medicare Hospital Outpatient Prospective Payment System (OPPS) and Medicare Ambulatory Surgical Center (ACS) payments for calendar year 2024. Includes discussions on extending the use of the hospital market basket to update ASC payment rates, a proposed quality measure for emergency department visits in Rural Emergency Hospitals (REHs), and more.
Date: 09/2023
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Comment on the July 31, 2023, Federal Register proposed rule revising the physician fee schedule to improve Medicare Hospital Outpatient Prospective Payment System (OPPS) and Medicare Ambulatory Surgical Center (ACS) payments for calendar year 2024. Includes discussions on extending the use of the hospital market basket to update ASC payment rates, a proposed quality measure for emergency department visits in Rural Emergency Hospitals (REHs), and more.
Date: 09/2023
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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MedPAC Comment on CMS's Proposed Rule on the Physician Prospective Payment System for FY 2024
Comment on the August 7, 2023, Federal Register proposed rule revising the physician fee schedule to improve payment systems for physicians and other Medicare Part B revisions. Includes discussions on payment rates for Medicare telehealth services; the Medicare Shared Savings Program, including regional adjustments; incorporating Medicare Advantage data into public reporting; and more.
Date: 09/2023
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Comment on the August 7, 2023, Federal Register proposed rule revising the physician fee schedule to improve payment systems for physicians and other Medicare Part B revisions. Includes discussions on payment rates for Medicare telehealth services; the Medicare Shared Savings Program, including regional adjustments; incorporating Medicare Advantage data into public reporting; and more.
Date: 09/2023
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Rural Health Value Summit: Driving Value Through Community-Based Partnerships
Provides an overview of a June 2023 summit regarding the intersection of rural providers and communities, value-based care and payment models, and social determinants of health (SDOH). Describes the efforts of Arkansas, Michigan, Oregon, and South Carolina communities that had representatives at the summit. Discusses opportunities for policymakers, payers, and health system leaders to build and support infrastructure to address social determinants of health in rural communities and offers possible next steps.
Date: 09/2023
Type: Document
Sponsoring organization: Rural Health Value
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Provides an overview of a June 2023 summit regarding the intersection of rural providers and communities, value-based care and payment models, and social determinants of health (SDOH). Describes the efforts of Arkansas, Michigan, Oregon, and South Carolina communities that had representatives at the summit. Discusses opportunities for policymakers, payers, and health system leaders to build and support infrastructure to address social determinants of health in rural communities and offers possible next steps.
Date: 09/2023
Type: Document
Sponsoring organization: Rural Health Value
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Further Extension of Grace Period Related to the "Four Walls" Requirement under 42 C.F.R. ยง 440.90 for Indian Health Service and Tribal Facilities to February 11, 2025
Guidance announcing the extension of a grace period permitting Indian Health Service (IHS) and tribal facilities to claim Medicaid reimbursement under the clinic services benefit for services provided outside of the "four walls" of the facility through February 11, 2025. Provides an overview of the history of this flexibility during the COVID-19 public health emergency (PHE) and previous guidance.
Date: 09/2023
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Guidance announcing the extension of a grace period permitting Indian Health Service (IHS) and tribal facilities to claim Medicaid reimbursement under the clinic services benefit for services provided outside of the "four walls" of the facility through February 11, 2025. Provides an overview of the history of this flexibility during the COVID-19 public health emergency (PHE) and previous guidance.
Date: 09/2023
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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