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Rural Health
Resources by Topic: Reimbursement and payment models

MedPAC Comment on CMS's Proposed Rule on the Hospital Inpatient PPS and the Long-term Care Hospital PPS for FY 2025
Comments on a May 2, 2024, Federal Register proposed rule revising the hospital inpatient and long-term care hospital (LTCH) prospective payment systems (PPS). Discusses proposals on rate-setting in both the inpatient prospective payment systems (IPPS) and LTCH PPS; the Transforming Episode Accountability Model (TEAM), including the definition of rural hospitals eligible to participate in a lower-risk track; new payments to small, independent hospitals that establish and maintain a 6-month buffer supply of essential medicines; updates to wage index values and policies; and updates to outlier reconciliation thresholds.
Date: 06/2024
Sponsoring organization: Medicare Payment Advisory Commission
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Sources of Federal Funding for Health Care Facilities: Frequently Asked Questions
Provides an overview of how the federal government supports healthcare facilities, with a focus on hospitals. Discusses how Medicare and Medicaid pay acute care hospitals and for services rendered to beneficiaries and enrollees, as well as other payments these programs make. Identifies federal grants, loans, and technical assistance programs that can support health facilities. Describes how federal agencies, including the Health Resources and Services Administration (HRSA) and the U.S. Department of Agriculture (USDA), have supported healthcare facilities during emergencies.
Date: 06/2024
Sponsoring organization: Congressional Research Service
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CMS Bundled Payments for Care Improvement Advanced Model: Fifth Annual Evaluation Report
Fifth annual report of the Bundled Payments for Care Improvement Advanced (BPCI Advanced) Model, which tests whether linking payments for a clinical episode of care can reduce Medicare expenditures while maintaining or improving the quality of care. Explores the impact of BPCI Advanced on episode payments, utilization, and quality of care, as well as estimates of Medicare program savings in Model Year 4. Describes changes to the model that were implemented in Model Year 4 and how BPCI Advanced relates to Medicare Accountable Care Organizations (ACOs). Includes rural references throughout.
Additional links: Appendices, Executive Summary, Findings at a Glance
Author(s): The Lewin Group, Abt Associates, GDIT, Telligen
Date: 05/2024
Sponsoring organization: Centers for Medicare & Medicaid Services
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MedPAC Comment on CMS's Proposed Rule on the Payment System for Inpatient Psychiatric Facilities for FY 2025
Comment on an April 3, 2024, Federal Register proposed rule revising the Inpatient Psychiatric Facility Prospective Payment System (IPF PPS) for fiscal year 2025. Includes a discussion of rural IPF PPS payment adjustments.
Date: 05/2024
Sponsoring organization: Medicare Payment Advisory Commission
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Converting to Rural Emergency Hospitals
Podcast episode featuring a discussion with Rural Emergency Hospital (REH) Chief Executive Officers in New Mexico and Oklahoma regarding the conversion to REH status. Discusses the conversion process of each REH; how they built trust and buy-in from patients and communities, including state and federal policymakers; and financial considerations of conversion.
Date: 05/2024
Sponsoring organization: American Hospital Association
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Time for Action: Securing A Strong Nursing Workforce for North Carolina
Offers 8 recommendations for developing the nursing workforce in North Carolina. Discusses the workforce pipeline, professional education, well-being and safety in the workplace, leadership, retention, advocacy, staffing standards, billing, and more. Discusses rural throughout.
Date: 05/2024
Sponsoring organization: North Carolina Institute of Medicine
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Telehealth Policies and Federally Qualified Health Centers, Spring 2024
Provides an overview of telehealth policies for Federally Qualified Health Centers (FQHCs). Covers originating and distance sites, reimbursement, services outside the four walls of the FQHC, and more. Includes a chart of FQHC Medicaid telehealth reimbursement eligibility policies by state.
Date: 05/2024
Sponsoring organization: Center for Connected Health Policy: The National Telehealth Policy Resource Center
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New Medicare Behavioral Health Providers: Incorporating MHCs and MFTs Into Your RHC
Recording of a May 9, 2024, webinar discussing Medicare coverage of marriage and family therapists (MFTs) and mental health counselors (MHCs) effective January 1, 2024, and the implications for Rural Health Clinics. Describes skills and attributes of MFTs and MHCs and provides an overview of common mental health concerns for older adults. Part of the Rural Health Clinic Technical Assistance Series.
Additional links: Presentation Slides
Date: 05/2024
Sponsoring organization: National Association of Rural Health Clinics
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Markup of H.R. 8261, H.R. 7931, H.R. 8245, H.R. 8244, H.R. 8235, and H.R. 8246
Recording of a May 8, 2024, House Ways and Means Committee markup of six bills regarding rural health. Legislation covers the extension of telehealth flexibilities, location requirements for Critical Access Hospitals in mountainous areas, the rural nursing home and physician workforce, and Rural Emergency Hospital eligibility.
Date: 05/2024
Sponsoring organization: House Ways and Means Committee
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Quality Payment Program (QPP) 2022: Participation and Payment Results At-a-Glance
Provides an overview of the results of the Quality Payment Program (QPP) for the 2022 performance year. Highlights the percentage of small and rural providers receiving negative, neutral, and positive payment adjustments for 2024.
Date: 05/2024
Sponsoring organization: Centers for Medicare & Medicaid Services
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