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Rural Health
Resources by Topic: Reimbursement and payment models

Impact of Higher Payments for Rural Home Health Episodes on Rehospitalizations
Examines the impact of home health rural add-on payments on beneficiary outcomes, specifically on rehospitalizations. Uses Medicare data from 2007 to 2014 to compare rehospitalizations between rural and urban post-acute home health episodes before and after the implementation of the add-on payments in 2010. Discusses the implications of the findings on home health payment policy.
Author(s): Lacey Loomer, Momotazur Rahman, Tracy M. Mroz, Pedro L. Gozalo, Vincent Mor
Citation: Journal of Rural Health, 39(3), 604-610
Date: 06/2023
Type: Document
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A Rural Accountable Care Organization's Journey
Profiles South East Rural Physicians Alliance Accountable Care Organization (SERPA‐ACO), a physician‐led ACO consisting of 16 Nebraska clinics - 13 of which are rural. Describes various value-based payment models SERPA-ACO clinics participated in and activities the clinics use to succeed in these models. Includes recommendations for primary care clinics considering joining an ACO.
Date: 06/2023
Type: Document
Sponsoring organization: Rural Health Value
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A Path Forward: The Rural Healthcare System of the Future
Presentation slides that discuss federal and state healthcare policies, implementation of new models of care, and plans to transform patient modalities of care. Includes U.S. county-level map on the Medicare Shared Savings Program Accountable Care Organizations (ACO) assigned beneficiary population as well as county-level data on ACO attributed lives in Illinois and residents enrolled in Medicare advantage.
Author(s): Keith J. Mueller
Date: 06/2023
Type: Presentation Slides
Sponsoring organizations: Iowa Department of Health Management and Policy, Rural Policy Research Institute
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Health Care-Related Expiring Provisions of the 118th Congress, First Session
Outlines the healthcare-related funding and governmental authorities that will expire during the first session of the 118th Congress, calendar year 2023, if not extended through congressional action. Highlights similar provisions that expired during the 117th Congress (2021-2022). Includes rural references throughout.
Date: 06/2023
Type: Document
Sponsoring organization: Congressional Research Service
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Ambulance Deserts: Geographic Disparities in the Provision of Ambulance Services
Webinar recording presenting key findings from a chartbook that analyzes 41 states in 2021-2022 and identifies places and people in ambulance deserts, defined as locations that are more than 25 minutes from an ambulance station.
Additional links: Presentation Slides, Transcript
Author(s): Yvonne Jonk
Date: 06/2023
Type: Video/Multimedia
Sponsoring organizations: Maine Rural Health Research Center, Rural Health Research Gateway
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NHPCO Pediatric Facts and Figure, 2023 Edition
Provides an overview of pediatric hospice and palliative care in the United States. Includes information and data on patient characteristics, access to care, reimbursement, barriers and facilitators to care, and more. Section 3 compares the number and percentage of metropolitan and non-metropolitan counties with access to pediatric hospice and palliative care.
Date: 06/2023
Type: Document
Sponsoring organization: National Hospice and Palliative Care Organization
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Rural Health on Life Support - The State of America's Rural Health Systems
Podcast episode discussing the rural health landscape and how policies affect rural healthcare systems and service delivery. Covers rural hospital closures, payment policy, workforce concerns, emergency medical services (EMS), the Rural Emergency Hospital designation, and more.
Date: 06/2023
Type: Audio
Sponsoring organization: Impact! Communications, Inc.
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The EMS and Community Paramedic Workforces Respond to COVID-19
Results of a study in which 17 key informant experts shared their perspectives on how the emergency medical services (EMS) and community paramedicine (CP) workforces responded to COVID-19 during the first year of the pandemic. Also describes how the pandemic has affected EMS and CP. Features statistics on participant characteristics, with breakdowns by rural and urban locations.
Author(s): Davis G. Patterson, Marieke S. van Eijk, Samantha W. Pollack, Benjamin A. Stubbs, Christopher Hanson
Date: 06/2023
Type: Document
Sponsoring organization: Center for Health Workforce Studies
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Differences in the Merit-Based Incentive Payment System (MIPS) Performance of Clinicians in Metropolitan and Nonmetropolitan Counties in 2018
Provides a brief overview of the Merit-Based Incentive Payment System (MIPS) and describes rural clinician performance in MIPS in 2018. Compares rural and urban MIPS performance scores, payment adjustments, and risk-adjusted standardized Medicare Spending per Beneficiary (MSPB). Also compares rural and urban MIPS performance by practice size and the proportion of racial/ethnic minorities served. Presents the most frequently reported MIPS measures by urban and rural practices.
Date: 06/2023
Type: Document
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Critical Access Hospitals: Views on How Medicare Payment and Other Factors Affect Behavioral Health Services
Provides an overview of how Medicare payment policies for care provided by Critical Access Hospitals (CAHs). Explores how CAHs provide behavioral health services in their communities. Summarizes findings from interviews with officials from 10 CAHs, stakeholder organizations, the Centers for Medicare & Medicaid Services (CMS), and the Health Resources and Services Administration (HRSA) regarding how Medicare payment policies and other factors affect CAHs' ability to provide behavioral health services.
Additional links: Full Report
Date: 06/2023
Type: Document
Sponsoring organization: Government Accountability Office
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