Rural Health
Resources by Topic: Reimbursement and payment models
Rural Health Clinic All-Inclusive Rate: CY 2023 Update
Provides an overview of Rural Health Clinic (RHC) payment limits and cost report data requirements for calendar year 2023.
Date: 11/2022
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
view details
Provides an overview of Rural Health Clinic (RHC) payment limits and cost report data requirements for calendar year 2023.
Date: 11/2022
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
view details
New Mexico Primary Care Alternative Payment Model Provider Readiness Assessment
Examines facilitators and barriers related to primary care stakeholders' readiness to implement an alternative payment model (APM) in New Mexico. Analyzes 2022 survey and focus group data from providers to gain feedback from Federally Qualified Health Centers (FQHCs), small- and medium-sized practices, hospitals, and interprofessional teams. Discusses issues such as care delivery, health information technology (HIT), financial and organizational readiness, and more, with information specific to small and rural facilities.
Date: 11/2022
Type: Document
Sponsoring organizations: Health Management Associates, New Mexico Human Services Department
view details
Examines facilitators and barriers related to primary care stakeholders' readiness to implement an alternative payment model (APM) in New Mexico. Analyzes 2022 survey and focus group data from providers to gain feedback from Federally Qualified Health Centers (FQHCs), small- and medium-sized practices, hospitals, and interprofessional teams. Discusses issues such as care delivery, health information technology (HIT), financial and organizational readiness, and more, with information specific to small and rural facilities.
Date: 11/2022
Type: Document
Sponsoring organizations: Health Management Associates, New Mexico Human Services Department
view details
Access to Emergency Medical Services in Rural Communities: Policy Brief and Recommendations to the Secretary
Provides an overview of issues related to the provision of emergency medical services (EMS) in rural areas. Discusses rural EMS access, financing, and workforce challenges, as well as promising telehealth innovations. Outlines federal programs and resources that support EMS programs. Offers policy recommendations related to access to EMS, workforce, and reimbursement.
Date: 11/2022
Type: Document
Sponsoring organization: National Advisory Committee on Rural Health and Human Services
view details
Provides an overview of issues related to the provision of emergency medical services (EMS) in rural areas. Discusses rural EMS access, financing, and workforce challenges, as well as promising telehealth innovations. Outlines federal programs and resources that support EMS programs. Offers policy recommendations related to access to EMS, workforce, and reimbursement.
Date: 11/2022
Type: Document
Sponsoring organization: National Advisory Committee on Rural Health and Human Services
view details
Medicaid Population-Based Payment: The Current Landscape, Early Insights, and Considerations for Policymakers
Provides an overview of population-based payment (PBP) models and the Medicaid PBP landscape. Identifies promising strategies for designing and implementing PBPs in Medicaid and considerations for state and federal policymakers who want to support these programs. Highlights state PBP approaches, including the Pennsylvania Rural Health Model.
Author(s): Rob Houston, Anne Smithey, Kelsey Brykman
Date: 11/2022
Type: Document
Sponsoring organization: Center for Health Care Strategies
view details
Provides an overview of population-based payment (PBP) models and the Medicaid PBP landscape. Identifies promising strategies for designing and implementing PBPs in Medicaid and considerations for state and federal policymakers who want to support these programs. Highlights state PBP approaches, including the Pennsylvania Rural Health Model.
Author(s): Rob Houston, Anne Smithey, Kelsey Brykman
Date: 11/2022
Type: Document
Sponsoring organization: Center for Health Care Strategies
view details
National Rural Health Day Webinar: CMS Framework for Advancing Health Care
Recording of a November 15, 2022, webinar providing an overview of the Centers for Medicare & Medicaid (CMS) Framework for Advancing Health Care in Rural, Tribal and Geographically Isolated Communities. Discusses the CMS Framework for Health Equity and identifies other rural health resources, including other recent CMS rural health reports.
Additional links: Presentation Slides, Transcript
Date: 11/2022
Type: Video/Multimedia
Sponsoring organization: Centers for Medicare and Medicaid Services
view details
Recording of a November 15, 2022, webinar providing an overview of the Centers for Medicare & Medicaid (CMS) Framework for Advancing Health Care in Rural, Tribal and Geographically Isolated Communities. Discusses the CMS Framework for Health Equity and identifies other rural health resources, including other recent CMS rural health reports.
Additional links: Presentation Slides, Transcript
Date: 11/2022
Type: Video/Multimedia
Sponsoring organization: Centers for Medicare and Medicaid Services
view details
Clarity for Rural Emergency Hospitals and Changes for Critical Access Hospitals: CMS Finalizes Conditions of Participation and Payment and Enrollment Policies But Pauses Stark Law Flexibilities
Provides an overview of the Rural Emergency Hospitals (REHs) provisions of the Calendar Year 2023 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System Final Rule. Discusses REH reimbursement, Conditions of Participation (CoPs), enrollment provisions, and Stark Law regulatory modifications to accommodate REHs. Highlights changes to the definition of "primary roads" related to Critical Access Hospital (CAH) CoPs.
Author(s): Emily Jane Cook, Caroline Reignley, Amber Arnold, Sandra M. DiVarco
Date: 11/2022
Type: Document
Sponsoring organization: McDermott Will & Emery
view details
Provides an overview of the Rural Emergency Hospitals (REHs) provisions of the Calendar Year 2023 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System Final Rule. Discusses REH reimbursement, Conditions of Participation (CoPs), enrollment provisions, and Stark Law regulatory modifications to accommodate REHs. Highlights changes to the definition of "primary roads" related to Critical Access Hospital (CAH) CoPs.
Author(s): Emily Jane Cook, Caroline Reignley, Amber Arnold, Sandra M. DiVarco
Date: 11/2022
Type: Document
Sponsoring organization: McDermott Will & Emery
view details
Certified Community Behavioral Health Clinics Demonstration Program: Report to Congress, 2021
Provides an overview of the Certified Community Behavioral Health Clinic (CCBHC) demonstration. Offers a summary of the findings from the prior annual reports on the CCBHC demonstration, a comparison of cost and quality in the first two demonstration years, and the results of impact analyses. This is the fifth annual report to Congress on the CCBHC demonstration.
Date: 11/2022
Type: Document
Sponsoring organizations: HHS Office of the Assistant Secretary for Planning and Evaluation, Mathematica
view details
Provides an overview of the Certified Community Behavioral Health Clinic (CCBHC) demonstration. Offers a summary of the findings from the prior annual reports on the CCBHC demonstration, a comparison of cost and quality in the first two demonstration years, and the results of impact analyses. This is the fifth annual report to Congress on the CCBHC demonstration.
Date: 11/2022
Type: Document
Sponsoring organizations: HHS Office of the Assistant Secretary for Planning and Evaluation, Mathematica
view details
Medicare Shared Savings Program: Rule Changes and Implications for Rural Health Care Organizations
Summarizes changes to the Centers for Medicare & Medicaid Services (CMS) Medicare Shared Savings Program (SSP) that take effect in January 2023 for current participants, and in January 2024 for organizations applying for a January 1, 2024 start. Discusses the potential impact of these changes on rural health and participation considerations.
Date: 11/2022
Type: Document
Sponsoring organization: Rural Health Value
view details
Summarizes changes to the Centers for Medicare & Medicaid Services (CMS) Medicare Shared Savings Program (SSP) that take effect in January 2023 for current participants, and in January 2024 for organizations applying for a January 1, 2024 start. Discusses the potential impact of these changes on rural health and participation considerations.
Date: 11/2022
Type: Document
Sponsoring organization: Rural Health Value
view details
CMS Framework for Advancing Health Care in Rural, Tribal, and Geographically Isolated Communities
Report outlines the Centers for Medicare & Medicaid Services (CMS) plan for improving health equity and health outcomes across the U.S. for rural, tribal, and geographically isolated communities. Details a 6 priority framework emphasizing the application of a community-informed geographic lens; the collection and use of standardized data; support for healthcare professionals; the optimization of medical and communication technology; the expansion of access to comprehensive healthcare coverage, benefits, and services and supports; and innovation and value-based care. Highlights examples of activities CMS is undertaking in support of each priority and recent CMS efforts that align with each priority.
Date: 11/2022
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
view details
Report outlines the Centers for Medicare & Medicaid Services (CMS) plan for improving health equity and health outcomes across the U.S. for rural, tribal, and geographically isolated communities. Details a 6 priority framework emphasizing the application of a community-informed geographic lens; the collection and use of standardized data; support for healthcare professionals; the optimization of medical and communication technology; the expansion of access to comprehensive healthcare coverage, benefits, and services and supports; and innovation and value-based care. Highlights examples of activities CMS is undertaking in support of each priority and recent CMS efforts that align with each priority.
Date: 11/2022
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
view details
Advancing Rural Health Equity: Fiscal Year 2022 Year in Review
Summarizes Centers for Medicare & Medicaid Services (CMS) activities in fiscal year 2022 to advance health equity for people living in rural, tribal, and geographically isolated communities. Covers 10 priority focus areas: Medicaid and the Children's Health Insurance Program (CHIP), Medicare, Marketplace, the rural health workforce, payment and delivery system models and demonstrations, long-term services and supports, maternal health, mental health and substance use disorders, quality, and COVID-19.
Date: 11/2022
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
view details
Summarizes Centers for Medicare & Medicaid Services (CMS) activities in fiscal year 2022 to advance health equity for people living in rural, tribal, and geographically isolated communities. Covers 10 priority focus areas: Medicaid and the Children's Health Insurance Program (CHIP), Medicare, Marketplace, the rural health workforce, payment and delivery system models and demonstrations, long-term services and supports, maternal health, mental health and substance use disorders, quality, and COVID-19.
Date: 11/2022
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
view details