Rural Health
Resources by Topic: Reimbursement and payment models
Impact of New Rural Health Clinic (RHC) Reimbursement Methodology
Webinar discussing changes to the Rural Health Clinic (RHC) reimbursement methodology, covering upper payment limits and Oklahoma-specific implications of the changes, as well as RHC reimbursement impacts. Part a series of webinars directed toward rural hospital CEOs and CFOs.
Date: 03/2022
Type: Video/Multimedia
Sponsoring organizations: Oklahoma Office of Rural Health, Stroudwater Associates
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Webinar discussing changes to the Rural Health Clinic (RHC) reimbursement methodology, covering upper payment limits and Oklahoma-specific implications of the changes, as well as RHC reimbursement impacts. Part a series of webinars directed toward rural hospital CEOs and CFOs.
Date: 03/2022
Type: Video/Multimedia
Sponsoring organizations: Oklahoma Office of Rural Health, Stroudwater Associates
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Environmental Scan on Issues Related to the Development of Population-Based Total Cost of Care (TCOC) Models in the Broader Context of Alternative Payment Models (APMs) and Physician-Focused Payment Models (PFPMs)
Presents results of an environmental scan regarding population-based total cost of care (TCOC) payment models and the role these models can play in optimizing health care delivery and value-based transformation in the context of alternative payment models (APMs) and physician-focused payment models (PFPMs). Provides an overview of TCOC payment models, relevant performance and outcome measures used in reporting and evaluation, findings from research related to population-based models and programs that seek to reduce TCOC, barriers and challenges related to implementing population-based TCOC models, and opportunities for improving and optimizing efforts to develop and implement these models. Highlights rural considerations and examples throughout.
Date: 03/2022
Type: Document
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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Presents results of an environmental scan regarding population-based total cost of care (TCOC) payment models and the role these models can play in optimizing health care delivery and value-based transformation in the context of alternative payment models (APMs) and physician-focused payment models (PFPMs). Provides an overview of TCOC payment models, relevant performance and outcome measures used in reporting and evaluation, findings from research related to population-based models and programs that seek to reduce TCOC, barriers and challenges related to implementing population-based TCOC models, and opportunities for improving and optimizing efforts to develop and implement these models. Highlights rural considerations and examples throughout.
Date: 03/2022
Type: Document
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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Telehealth for FQHCs/RHCs: School-Based Telehealth
Offers a 3-part video series on school-based telehealth for Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs). Topics covered in part 1 include school-based telehealth resources and opportunities; part 2 offers information on school-based health clinic benefits, program development, payment, and technology considerations; and part 3 covers school based primary care, integrated behavioral health, virtual learning, and evolution of telehealth services. If viewed through YouTube, transcripts are available by clicking the three dots and selecting "show transcript."
Additional links: Telehealth for FQHCs/RHCs: School-Based Telehealth Part 2, Telehealth for FQHCs/RHCs: School-Based Telehealth Part 3
Date: 03/2022
Type: Video/Multimedia
Sponsoring organization: National Consortium of Telehealth Resource Centers
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Offers a 3-part video series on school-based telehealth for Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs). Topics covered in part 1 include school-based telehealth resources and opportunities; part 2 offers information on school-based health clinic benefits, program development, payment, and technology considerations; and part 3 covers school based primary care, integrated behavioral health, virtual learning, and evolution of telehealth services. If viewed through YouTube, transcripts are available by clicking the three dots and selecting "show transcript."
Additional links: Telehealth for FQHCs/RHCs: School-Based Telehealth Part 2, Telehealth for FQHCs/RHCs: School-Based Telehealth Part 3
Date: 03/2022
Type: Video/Multimedia
Sponsoring organization: National Consortium of Telehealth Resource Centers
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MedPAC Report to the Congress: Medicare Payment Policy, 2022
Annual review of Medicare payment policies, with recommendations to Congress. Includes discussion on Medicare payment policies directly affecting rural providers and beneficiaries. Addresses payment adequacy for healthcare facilities and services, improving Medicare payment for post-acute care, Medicare Advantage, Medicare Part D, and the impact of healthcare provider consolidation.
Date: 03/2022
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Annual review of Medicare payment policies, with recommendations to Congress. Includes discussion on Medicare payment policies directly affecting rural providers and beneficiaries. Addresses payment adequacy for healthcare facilities and services, improving Medicare payment for post-acute care, Medicare Advantage, Medicare Part D, and the impact of healthcare provider consolidation.
Date: 03/2022
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Vermont's All-Payer Accountable Care Organization Model: Mt. Ascutney Hospital and Health Center's Experience
Profiles Mt. Ascutney Hospital and Health Center (MAHHC), a Critical Access Hospital and health center partnership in central Vermont. Describes how MAHHC provides care differently as a participant in the OneCare Vermont accountable care organization (ACO). Discusses how MAHHC adapted healthcare delivery during the COVID-19 pandemic. Highlights challenges and financial implications of MAHHC's participation in OneCare Vermont.
Date: 03/2022
Type: Document
Sponsoring organization: Rural Health Value
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Profiles Mt. Ascutney Hospital and Health Center (MAHHC), a Critical Access Hospital and health center partnership in central Vermont. Describes how MAHHC provides care differently as a participant in the OneCare Vermont accountable care organization (ACO). Discusses how MAHHC adapted healthcare delivery during the COVID-19 pandemic. Highlights challenges and financial implications of MAHHC's participation in OneCare Vermont.
Date: 03/2022
Type: Document
Sponsoring organization: Rural Health Value
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Report to Congress on Medicaid and CHIP, March 2022
Reports on five aspects of Medicaid: 1) transitioning Medicaid beneficiaries out of institutions and back into the community under the Money Follows the Person (MFP) demonstration program, 2) improving access to vaccines and vaccination rates for adults enrolled in Medicaid, and 3) reviewing hospital payment policy for the nation's safety-net hospitals. Chapter 3 examines the relationship between disproportionate share hospital (DSH) allotments to states and the number of uninsured individuals, the amounts and sources of hospitals' uncompensated care costs, and the amounts and sources of hospitals' uncompensated care costs. Table 3-1 details DSH spending for urban and rural hospitals and for Critical Access Hospitals.
Date: 03/2022
Type: Document
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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Reports on five aspects of Medicaid: 1) transitioning Medicaid beneficiaries out of institutions and back into the community under the Money Follows the Person (MFP) demonstration program, 2) improving access to vaccines and vaccination rates for adults enrolled in Medicaid, and 3) reviewing hospital payment policy for the nation's safety-net hospitals. Chapter 3 examines the relationship between disproportionate share hospital (DSH) allotments to states and the number of uninsured individuals, the amounts and sources of hospitals' uncompensated care costs, and the amounts and sources of hospitals' uncompensated care costs. Table 3-1 details DSH spending for urban and rural hospitals and for Critical Access Hospitals.
Date: 03/2022
Type: Document
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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Indian Health Service: Information on Third-Party Collections and Processes to Procure Supplies and Services
Reviews the Indian Health Service (IHS) oversight of collections received from third-party payers such as Medicare, Medicaid, and private insurance for care provided to patients. Examines recent trends in third-party collections; describes IHS's processes to procure medical supplies, pharmaceuticals, and health care services; and discusses the extent to which IHS has entered into procurement contracts under the Buy Indian Act.
Additional links: Full Report
Date: 03/2022
Type: Document
Sponsoring organization: Government Accountability Office
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Reviews the Indian Health Service (IHS) oversight of collections received from third-party payers such as Medicare, Medicaid, and private insurance for care provided to patients. Examines recent trends in third-party collections; describes IHS's processes to procure medical supplies, pharmaceuticals, and health care services; and discusses the extent to which IHS has entered into procurement contracts under the Buy Indian Act.
Additional links: Full Report
Date: 03/2022
Type: Document
Sponsoring organization: Government Accountability Office
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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 2022 National Rural Health Association Policy Institute.
Date: 02/2022
Type: Website
Sponsoring organization: Chartis Center for Rural Health
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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 2022 National Rural Health Association Policy Institute.
Date: 02/2022
Type: Website
Sponsoring organization: Chartis Center for Rural Health
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Medicare: Information on Geographic Adjustments to Physician Payments for Physicians' Time, Skills, and Effort
Provides an overview of the work geographic practice cost indices (GPCI), which the Centers for Medicare & Medicaid Services uses to adjust Medicare physician payments to account for differences in the costs of providing care across various geographic locations. Examines the extent to which the work GPCI accounts for geographic variation in physician earnings and how Medicare payments could change under potential modifications to the work GPCI.
Additional links: Full Report
Date: 02/2022
Type: Document
Sponsoring organization: Government Accountability Office
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Provides an overview of the work geographic practice cost indices (GPCI), which the Centers for Medicare & Medicaid Services uses to adjust Medicare physician payments to account for differences in the costs of providing care across various geographic locations. Examines the extent to which the work GPCI accounts for geographic variation in physician earnings and how Medicare payments could change under potential modifications to the work GPCI.
Additional links: Full Report
Date: 02/2022
Type: Document
Sponsoring organization: Government Accountability Office
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Structural Factors That Impact Rural Life Expectancy
Policy position paper focused on challenges to improving life expectancy in rural areas. Offers policy recommendations to address health outcomes in rural populations.
Author(s): Bryan Price, Elizabeth Ruen, Wade Swenson
Date: 02/2022
Type: Document
Sponsoring organization: National Rural Health Association
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Policy position paper focused on challenges to improving life expectancy in rural areas. Offers policy recommendations to address health outcomes in rural populations.
Author(s): Bryan Price, Elizabeth Ruen, Wade Swenson
Date: 02/2022
Type: Document
Sponsoring organization: National Rural Health Association
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