Rural Health
Resources by Topic: Reimbursement and payment models
How Alaska Supports Rural and Frontier Behavioral Health Services
Describes Alaska's Behavioral Health Aide (BHA) program, a non-licensed provider type designed to promote behavioral health and wellness in Alaska Native individuals, families, and communities through culturally relevant training and education. Discusses qualifications for the BHA certification, payment, and next steps for other states seeking to develop similar programs.
Date: 10/2022
Type: Document
Sponsoring organization: National Academy for State Health Policy
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Describes Alaska's Behavioral Health Aide (BHA) program, a non-licensed provider type designed to promote behavioral health and wellness in Alaska Native individuals, families, and communities through culturally relevant training and education. Discusses qualifications for the BHA certification, payment, and next steps for other states seeking to develop similar programs.
Date: 10/2022
Type: Document
Sponsoring organization: National Academy for State Health Policy
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National Advisory Committee on Rural Health and Human Services Meeting Summary, Lawrence, Kansas, September 14-16, 2022
Summarizes the 90th meeting of the National Advisory Committee on Rural Health and Human Services (NACRHHS), which was held in Lawrence, Kansas. Presents an overview of national and state perspectives on Programs of All-Inclusive Care for the Elderly (PACE).
Date: 09/2022
Type: Document
Sponsoring organization: National Advisory Committee on Rural Health and Human Services
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Summarizes the 90th meeting of the National Advisory Committee on Rural Health and Human Services (NACRHHS), which was held in Lawrence, Kansas. Presents an overview of national and state perspectives on Programs of All-Inclusive Care for the Elderly (PACE).
Date: 09/2022
Type: Document
Sponsoring organization: National Advisory Committee on Rural Health and Human Services
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Configuration and Delivery of Primary Care in Rural and Urban Settings
Compares structure, capabilities, and payment reform participation of isolated, small town, micropolitan, and metropolitan physician practices. Features statistics on characteristics of physician practices, Medicare beneficiaries, and beneficiary utilization in 2017, with breakdowns by rurality.
Author(s): Taressa K. Fraze, Valerie A. Lewis, Andrew Wood, Helen Newton, Carrie H. Colla
Citation: Journal of General Internal Medicine, 37(12), 3045-3053
Date: 09/2022
Type: Document
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Compares structure, capabilities, and payment reform participation of isolated, small town, micropolitan, and metropolitan physician practices. Features statistics on characteristics of physician practices, Medicare beneficiaries, and beneficiary utilization in 2017, with breakdowns by rurality.
Author(s): Taressa K. Fraze, Valerie A. Lewis, Andrew Wood, Helen Newton, Carrie H. Colla
Citation: Journal of General Internal Medicine, 37(12), 3045-3053
Date: 09/2022
Type: Document
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September 2022 MedPAC Meeting Transcript
Transcript from the Medicare Payment Advisory Commission's (MedPAC) September 2022 meeting. Covers Medicare payments to safety-net clinicians, the development of a prototype post-acute care prospective payment system, nursing facility staffing requirements and data, the expansion of telehealth during the COVID-19 public health emergency (PHE) and payment for telehealth services after the PHE, inpatient psychiatric facility care, and Part D data on drug rebates and discounts. Includes rural references and considerations throughout.
Date: 09/2022
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Transcript from the Medicare Payment Advisory Commission's (MedPAC) September 2022 meeting. Covers Medicare payments to safety-net clinicians, the development of a prototype post-acute care prospective payment system, nursing facility staffing requirements and data, the expansion of telehealth during the COVID-19 public health emergency (PHE) and payment for telehealth services after the PHE, inpatient psychiatric facility care, and Part D data on drug rebates and discounts. Includes rural references and considerations throughout.
Date: 09/2022
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Health Panel Comment Letter – Medicare Shared Savings Program Requirements
Comments offered in response to a July 29, 2022, proposed rule regarding changes to the Medicare Shared Savings Program (SSP) to facilitate more widespread participation in Accountable Care Organizations (ACOs). Discusses how changes will impact rural Medicare beneficiaries, as well as challenges to extending ACOs to all rural counties. Covers advanced interest payments, extended time in one-sided risk, changes to calculating benchmarks, proposals to allow low revenue ACOs to realize shared savings at a lower minimum, a health equity adjustment, and social determinants of health measures.
Date: 09/2022
Type: Document
Sponsoring organization: Rural Policy Research Institute Rural Health Panel
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Comments offered in response to a July 29, 2022, proposed rule regarding changes to the Medicare Shared Savings Program (SSP) to facilitate more widespread participation in Accountable Care Organizations (ACOs). Discusses how changes will impact rural Medicare beneficiaries, as well as challenges to extending ACOs to all rural counties. Covers advanced interest payments, extended time in one-sided risk, changes to calculating benchmarks, proposals to allow low revenue ACOs to realize shared savings at a lower minimum, a health equity adjustment, and social determinants of health measures.
Date: 09/2022
Type: Document
Sponsoring organization: Rural Policy Research Institute Rural Health Panel
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Rural Health Equity and Quality Summit Report
Summarizes a June 2022 summit with experts in rural healthcare policy, health equity, value-based care, and clinical quality to explore the roles of small rural hospitals and Rural Health Clinics in achieving health equity. Discusses barriers and challenges to achieving rural health equity. Presents best practices and innovative models in promoting health equity in rural areas.
Date: 09/2022
Type: Document
Sponsoring organization: National Rural Health Resource Center
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Summarizes a June 2022 summit with experts in rural healthcare policy, health equity, value-based care, and clinical quality to explore the roles of small rural hospitals and Rural Health Clinics in achieving health equity. Discusses barriers and challenges to achieving rural health equity. Presents best practices and innovative models in promoting health equity in rural areas.
Date: 09/2022
Type: Document
Sponsoring organization: National Rural Health Resource Center
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Landscape of Area-Level Deprivation Measures and Other Approaches to Account for Social Risk and Social Determinants of Health in Health Care Payments
Examines social determinants of health (SDOH) at the community level and their impact on health-related social needs (HRSNs) of the individual. Discusses how policies related to federal payment systems can incentivize screening for HRSNs as well as referrals to appropriate social and behavioral services. Provides an environmental scan of what measures can be used to provide accountability for funding and policy efforts targeted at SDOH. Includes an appendix that defines and describes indices of social risk, such as the social vulnerability index (SVI) and area deprivation index (ADI), as well as payment models that include measures of social risk.
Author(s): Joshua Breslau, Laurie Martin, Justin Timbie, Nabeel Qureshi, Deborah Zajdman
Date: 09/2022
Type: Document
Sponsoring organizations: HHS Office of the Assistant Secretary for Planning and Evaluation, RAND Corporation
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Examines social determinants of health (SDOH) at the community level and their impact on health-related social needs (HRSNs) of the individual. Discusses how policies related to federal payment systems can incentivize screening for HRSNs as well as referrals to appropriate social and behavioral services. Provides an environmental scan of what measures can be used to provide accountability for funding and policy efforts targeted at SDOH. Includes an appendix that defines and describes indices of social risk, such as the social vulnerability index (SVI) and area deprivation index (ADI), as well as payment models that include measures of social risk.
Author(s): Joshua Breslau, Laurie Martin, Justin Timbie, Nabeel Qureshi, Deborah Zajdman
Date: 09/2022
Type: Document
Sponsoring organizations: HHS Office of the Assistant Secretary for Planning and Evaluation, RAND Corporation
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Next Steps for the Rural Emergency Hospital Model
Blog post discussing rural hospital closures and how the Rural Emergency Hospital (REH) model can help financially vulnerable hospitals align their services to the needs of the community. Highlights recommendations to the U.S. Department of Health and Human Services regarding REH Conditions of Participation and payment.
Date: 09/2022
Type: Document
Sponsoring organization: Bipartisan Policy Center
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Blog post discussing rural hospital closures and how the Rural Emergency Hospital (REH) model can help financially vulnerable hospitals align their services to the needs of the community. Highlights recommendations to the U.S. Department of Health and Human Services regarding REH Conditions of Participation and payment.
Date: 09/2022
Type: Document
Sponsoring organization: Bipartisan Policy Center
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September 2022 MACPAC Meeting Transcript
Transcript from the Medicaid and CHIP Payment and Access Commission's (MACPAC) September 2022 meeting. Covers Medicaid race and ethnicity data collection and reporting, state processes and stakeholder engagement for unwinding continuous coverage requirement, countercyclical disproportionate share hospital policies, and integrating care for dually eligible beneficiaries in Medicaid fee-for-services, among other things. Includes rural references throughout.
Date: 09/2022
Type: Document
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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Transcript from the Medicaid and CHIP Payment and Access Commission's (MACPAC) September 2022 meeting. Covers Medicaid race and ethnicity data collection and reporting, state processes and stakeholder engagement for unwinding continuous coverage requirement, countercyclical disproportionate share hospital policies, and integrating care for dually eligible beneficiaries in Medicaid fee-for-services, among other things. Includes rural references throughout.
Date: 09/2022
Type: Document
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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Health Panel Comment Letter – Hospital Outpatient Prospective Payment System and Rural Emergency Hospitals
Comments offered in response to a July 26, 2022, Federal Register proposed rule revising the Medicare Hospital Outpatient Prospective Payment System (OPPS) and Medicare Ambulatory Surgical Center (ACS) payment system for calendar year 2023 and establishing Rural Emergency Hospital (REH) payment policy, quality measures, and enrollment policy. Discusses telehealth services for mental healthcare; REH quality measures, telehealth, and Conditions of Participation; and the use of Centers for Medicare & Medicaid Services (CMS) data on hospital and skilled nursing facilities changes in ownership.
Date: 09/2022
Type: Document
Sponsoring organization: Rural Policy Research Institute Rural Health Panel
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Comments offered in response to a July 26, 2022, Federal Register proposed rule revising the Medicare Hospital Outpatient Prospective Payment System (OPPS) and Medicare Ambulatory Surgical Center (ACS) payment system for calendar year 2023 and establishing Rural Emergency Hospital (REH) payment policy, quality measures, and enrollment policy. Discusses telehealth services for mental healthcare; REH quality measures, telehealth, and Conditions of Participation; and the use of Centers for Medicare & Medicaid Services (CMS) data on hospital and skilled nursing facilities changes in ownership.
Date: 09/2022
Type: Document
Sponsoring organization: Rural Policy Research Institute Rural Health Panel
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