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Rural Health
Resources by Topic: Reimbursement and payment models

State Innovation Model Testing Awards from the Centers for Medicare & Medicaid Services Innovation Center: Highlighting Rural Focus
Summarizes the activities and accomplishments of rural-specific State Innovation Models (SIM) in 11 states: Arkansas, Colorado, Idaho, Iowa, Maine, Michigan, Minnesota, New York, Ohio, Oregon, and Vermont. Describes the SIM initiative, which began in 2012 to support states committed to designing and testing strategies for payment model and delivery system reform.
Date: 06/2022
Type: Document
Sponsoring organization: Rural Health Value
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Convergence of Service Providers and Managers' Perspectives on Strengths, Gaps, and Priorities for Rural Health System Redesign: A Whole-Systems Qualitative Study in Washington County, Maine
Presents themes from interviews with 46 direct healthcare service providers between September - November 2020 in Washington County, Maine. Explores existing clinical service strengths, local and state gaps in services and the impact of those gaps on quality and safety, and priorities and strategies for sustaining or restoring essential healthcare services.
Author(s): Rebecca L. West, Judy Margo, Jeff Brown, Amy Dowley, Susan Haas
Citation: Journal of Primary Care & Community Health, 13
Date: 05/2022
Type: Document
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Trends in Revenue Sources among Rural Hospitals
Examines outpatient care as a revenue source for rural hospitals between 2011 and 2019 by analyzing Healthcare Cost Report Information System data from 1,866 rural hospitals. Includes data broken down by rural versus urban, inpatient/outpatient revenue, and hospital payment classification, such as Critical Access Hospital, Medicare-Dependent Hospital, Prospective Payment System, Rural Referral Center, and Sole Community Hospital, among other things.
Author(s): Randall John, Tyler Malone, George Pink
Date: 05/2022
Type: Document
Sponsoring organization: North Carolina Rural Health Research Program
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MedPAC Comment on CMS's Proposed Rule on the Inpatient Rehabilitation Facility PPS for FY 2023
Comments on an April 6, 2022, Federal Register proposed rule addressing updates to the prospective payment system for inpatient rehabilitation facilities (IRFs) for fiscal year 2023. Includes comments on the IRF teaching and rural payment adjustments.
Date: 05/2022
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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MedPAC Comment on CMS's Proposed Rule on the Inpatient Psychiatric Facility PPS for FY 2023
Comment on an April 4, 2022, Federal Register proposed rule revising the Inpatient Psychiatric Facility Prospective Payment System (IPF PPS) for fiscal year 2023. Includes a discussion of rural and Disproportionate Share Hospital (DSH) IPF PPS payment adjustments.
Date: 05/2022
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Let's Get a Good Deal on Health Care
Explains the challenges rural hospitals face with current payment systems and the potential that value-based payment holds for meeting rural communities' needs.
Author(s): A. Clinton MacKinney
Citation: Rural Monitor
Date: 05/2022
Type: Document
Sponsoring organization: Rural Health Information Hub
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Independent Evaluation of Comprehensive Primary Care Plus (CPC+): Fourth Annual Report
Reports on the first four program years of the Comprehensive Primary Care Plus (CPC+) model, a CMS primary care payment and delivery reform effort. Discusses CPC+ participating practices, payer partners, and health information technology (HIT) vendors supporting the program. Describes practice changes regarding care delivery and outcomes for Medicare fee-for-service beneficiaries.
Additional links: Appendices, Findings at a Glance
Date: 05/2022
Type: Document
Sponsoring organizations: Centers for Medicare and Medicaid Services, Mathematica
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The Future of Telehealth Roundtable: The Potential Impact of Emerging Technologies on Health Equity
Presents insights and key ideas from a roundtable on the future of telehealth following the COVID-19 pandemic, covering barriers to telehealth delivery, opportunities for equitable care, and policy and regulatory issues impacting telehealth access. Includes rural mentions throughout.
Date: 05/2022
Type: Document
Sponsoring organization: National Committee for Quality Assurance
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The Impact of COVID-19 on the Rural Health Care Landscape: Challenges and Opportunities
Presents an overview of key findings from interviews with stakeholders in eight states - Iowa, Minnesota, Montana, Nebraska, Nevada, North Dakota, South Dakota, and Wyoming - regarding the rural healthcare landscape. Discusses rural hospital financial health, rural hospital transformation models, challenges facing the rural healthcare workforce, and the role of telehealth in increasing access to care. Provides recommendations aimed at further advancing the use of virtual care in all communities, including rural and frontier areas, beyond the temporary federal COVID-19 public health emergency flexibilities.
Author(s): Sabah Bhatnagar, Julia Harris, Tara Hartnett, et al.
Date: 05/2022
Type: Document
Sponsoring organization: Bipartisan Policy Center
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The Role of Social Determinants of Health in Value-Based Payment Models During COVID-19: An Evolving Rural Perspective
Recording of an April 2022 webinar discussing how some rural health providers address social determinants of health in their communities and mitigate hardships associated with COVID-19. Highlights strategies using value-based payment models and collaboration with community partners. Transcript is available in the video description.
Additional links: Presentation Slides
Author(s): Alana Knudson
Date: 04/2022
Type: Video/Multimedia
Sponsoring organizations: National Rural Health Resource Center, NORC Walsh Center for Rural Health Analysis
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