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Rural Health
Resources by Topic: Reimbursement and payment models

Rural Hospitals: Community Cornerstones Facing Perilous Threats to Care
Infographic presenting data regarding the importance of rural hospitals to their communities. Includes information on workforce and financial challenges experienced by rural hospitals, as well as the impact of hospital closures on access to care. Provides recommendations on actions to support rural hospitals and communities.
Date: 02/2023
Type: Document
Sponsoring organization: American Hospital Association
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State-Based Recommendations to Support Rural Ambulance Agencies
Discusses challenges faced by rural ambulance agencies and emergency medical services (EMS) agencies. Identifies state-based policy opportunities to support rural ambulance agencies. Covers EMS as an essential service, professional management, EMS zones, and standby costs.
Author(s): A. Clinton MacKinney, Keith J. Mueller, Alva O. Ferdinand, et al.
Date: 02/2023
Type: Document
Sponsoring organization: Rural Policy Research Institute Rural Health Panel
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Chartis Center for Rural Health Research & Resources for the 2023 National Rural Health Association's Rural Health Policy Institute Conference
Offers research and analysis of the stability of the rural healthcare safety net. Includes Rural Health Safety Net Under Renewed Pressure as Pandemic Fades and presentation slides on this report from the 2023 National Rural Health Association Policy Institute. Provides links to national and state data tables showing the financial impact of federal policies on rural hospitals.
Date: 02/2023
Type: Website
Sponsoring organization: Chartis Center for Rural Health
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Rural Health Safety Net Under Renewed Pressure as Pandemic Fades
Examines financial and operational metrics for rural hospitals, comparing hospitals in states that did and did not expand Medicaid, as well as the discontinuation of obstetrics and chemotherapy services. Discusses how the Rural Emergency Hospital (REH) designation can provide a path forward for some rural facilities and explores seven characteristics that may have the greatest impact on a facility's consideration to convert to an REH.
Date: 02/2023
Type: Document
Sponsoring organization: Chartis Center for Rural Health
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2023 Stability of the Rural Health Safety Net: State and National Data Tables
Provides links to national and state data tables showing the financial impact of federal policies such as sequestration and bad debt reimbursement on rural hospital revenues, jobs, and gross domestic product. Presented at the February 2023 National Rural Health Association Policy Institute.
Date: 02/2023
Type: Website
Sponsoring organization: Chartis Center for Rural Health
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The State of Rural Healthcare: Research Report and Outlook for 2023
Presents results of a survey of 110 rural healthcare organizations across 25 states regarding their financial health and strategic priorities. Identifies the top challenges identified by the surveyed organizations. Discusses how providers are addressing four strategic priorities, including workforce management, patient experience, financial performance, and digital transformation.
Date: 02/2023
Type: Document
Sponsoring organization: Wipfli, LLP
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January 2023 MACPAC Meeting Transcript
Transcript from the Medicaid and CHIP Payment and Access Commission's (MACPAC) January 2023 meeting. Covers Medicaid race and ethnicity data collection and reporting, nursing facility provider payment principles, challenges for states administering Medicaid home- and community-based services and access barriers for Medicaid beneficiaries, Medicaid managed care quality oversight, the unwinding of the Public Health Emergency, and more. Includes rural references and considerations throughout.
Date: 01/2023
Type: Document
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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Community Health Centers And Medicaid: A Deeper Dive Into FQHC Alternative Payment Reform
An overview of the development of the Medicaid FQHC policy, since 1965, between Medicare and Medicaid, providing third-party financing, and CHCs, offering primary healthcare to underserved rural and urban areas. Discusses the discrepancies in Medicaid payment policies affecting CHCs, and federal legislative actions and amendments to reconcile budgets. Describes the alternative payment methodology (APM) and its effect on the prospective payment system.
Author(s): Sara Rosenbaum, Peter Shin, Jessica Shara, Colleen Bedenbaugh
Citation: Health Affairs
Date: 01/2023
Type: Document
Sponsoring organization: Health Affairs
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State Policies for Expanding Medicaid Coverage of Community Health Worker (CHW) Services
Discusses state Medicaid coverage policies regarding Community Health Workers (CHWs) in place as of July 1, 2022, and planned for fiscal year 2023. Covers CHW coverage initiatives implemented or planned through Medicaid state plan amendments, Section 1115 demonstration authority, and as part of a Center for Medicare and Medicaid Innovation (CMMI) model.
Date: 01/2023
Type: Document
Sponsoring organization: KFF
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Orientation to Rural Emergency Hospital Conversion and Technical Assistance
Recording of a January 18, 2023, webinar discussing the Rural Emergency Hospital (REH) program. Provides an overview of the REH designation, policy and regulatory requirements, and REH Technical Assistance Center (TAC) services. Transcript available by clicking the dots above the video description, then selecting Show transcript.
Additional links: Presentation Slides
Date: 01/2023
Type: Document
Sponsoring organizations: Mathematica, Rural Health Redesign Center
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