Rural Health
Resources by Topic: Reimbursement and payment models
Ambulance Deserts: Geographic Disparities in the Provision of Ambulance Services
Chartbook presenting data on ambulance deserts from 41 states in 2021-2022, and identifying places and people that are more than 25 minutes from an ambulance station. Include maps of ambulance desert locations and health care facility locations for every state with available data, and documents coverage gaps in the provision of ambulance services across geographic areas across the United States.
Author(s): Yvonne Jonk, Carly Milkowski, Zachariah Croll, Karen Pearson
Date: 05/2023
Sponsoring organization: Maine Rural Health Research Center
view details
Chartbook presenting data on ambulance deserts from 41 states in 2021-2022, and identifying places and people that are more than 25 minutes from an ambulance station. Include maps of ambulance desert locations and health care facility locations for every state with available data, and documents coverage gaps in the provision of ambulance services across geographic areas across the United States.
Author(s): Yvonne Jonk, Carly Milkowski, Zachariah Croll, Karen Pearson
Date: 05/2023
Sponsoring organization: Maine Rural Health Research Center
view details
Barriers to Rural Health Care From the Provider Perspective
Results of a study using data from interviews with 20 healthcare providers in rural areas of western Pennsylvania. Explores barriers to care, including cost and insurance, geographic dispersion, and provider shortage and burnout. Offers strategies for improvement, including use of telehealth, mobile clinics, and increased use of advanced practice providers.
Author(s): Avinash Maganty, Mary E. Byrnes, Megan Hamm, et al.
Citation: Rural and Remote Health, 23(2), 7769
Date: 05/2023
view details
Results of a study using data from interviews with 20 healthcare providers in rural areas of western Pennsylvania. Explores barriers to care, including cost and insurance, geographic dispersion, and provider shortage and burnout. Offers strategies for improvement, including use of telehealth, mobile clinics, and increased use of advanced practice providers.
Author(s): Avinash Maganty, Mary E. Byrnes, Megan Hamm, et al.
Citation: Rural and Remote Health, 23(2), 7769
Date: 05/2023
view details
Improving Health Care Access in Rural Communities: Obstacles and Opportunities
Presents the U.S. Senate Committee on Finance, Subcommittee on Health Care hearing on improving access to high-quality, affordable healthcare in rural communities. Discusses workforce issues, education pipeline, transportation, broadband, school-based health centers, payment models and value-based care, and rural-friendly policies. Features testimonies from representatives of Frances Mahon Deaconess Hospital, Choptank Community Health System, Essentia Health, and the Sheps Center For Health Services Research.
Additional links: Testimony by David Herman, Testimony by Erin Aune, Testimony by Mark Holmes, Testimony by Sara Rich
Date: 05/2023
Sponsoring organization: Senate Committee on Finance, Subcommittee on Health Care
view details
Presents the U.S. Senate Committee on Finance, Subcommittee on Health Care hearing on improving access to high-quality, affordable healthcare in rural communities. Discusses workforce issues, education pipeline, transportation, broadband, school-based health centers, payment models and value-based care, and rural-friendly policies. Features testimonies from representatives of Frances Mahon Deaconess Hospital, Choptank Community Health System, Essentia Health, and the Sheps Center For Health Services Research.
Additional links: Testimony by David Herman, Testimony by Erin Aune, Testimony by Mark Holmes, Testimony by Sara Rich
Date: 05/2023
Sponsoring organization: Senate Committee on Finance, Subcommittee on Health Care
view details
How Regional Partnerships Bolster Rural Hospitals
Explores how Critical Access Hospitals (CAHs) and other rural providers partner to overcome challenges. Profiles six regional partnerships that address staffing, quality improvement, contracts with payers, value-based payment, and community development. Offers lessons learned that could inform policy changes to strengthen rural providers.
Author(s): Martha Hostetter, Sarah Klein
Date: 05/2023
Sponsoring organization: Commonwealth Fund
view details
Explores how Critical Access Hospitals (CAHs) and other rural providers partner to overcome challenges. Profiles six regional partnerships that address staffing, quality improvement, contracts with payers, value-based payment, and community development. Offers lessons learned that could inform policy changes to strengthen rural providers.
Author(s): Martha Hostetter, Sarah Klein
Date: 05/2023
Sponsoring organization: Commonwealth Fund
view details
340B Drug Discount Program: Information about Hospitals That Received an Eligibility Exception as a Result of COVID-19
Provides an overview of a provision of the Consolidated Appropriations Act, 2022, that allowed hospitals to request an exception to the disproportionate share hospital (DSH) percentage eligibility requirement if they were unable to meet it due to the COVID-19 pandemic. Explores the exception process and provides information on hospitals that received the exception. Discusses the amount of 340B drug purchases and discounts that excepted hospitals indicated they had in 2020 and 2021; the extent to which excepted hospitals indicated providing discounts on 340B drugs to low-income, uninsured patients; and results of the Health Resources and Services Administration's audits and oversight activities to assess program compliance.
Additional links: Full Report
Date: 05/2023
Sponsoring organization: Government Accountability Office
view details
Provides an overview of a provision of the Consolidated Appropriations Act, 2022, that allowed hospitals to request an exception to the disproportionate share hospital (DSH) percentage eligibility requirement if they were unable to meet it due to the COVID-19 pandemic. Explores the exception process and provides information on hospitals that received the exception. Discusses the amount of 340B drug purchases and discounts that excepted hospitals indicated they had in 2020 and 2021; the extent to which excepted hospitals indicated providing discounts on 340B drugs to low-income, uninsured patients; and results of the Health Resources and Services Administration's audits and oversight activities to assess program compliance.
Additional links: Full Report
Date: 05/2023
Sponsoring organization: Government Accountability Office
view details
Access to Maternity Providers: Midwives and Birth Centers
Provides an overview of the role of certified nurse-midwives and birth centers in Medicaid and how beneficiaries use these services. Describes policy issues and barriers to expanding access to midwives and birth centers, including payment policies; contracting with managed care organizations; licensure, certification, and accreditation; scope of practice; and limited supply. Includes rural considerations throughout.
Date: 05/2023
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
view details
Provides an overview of the role of certified nurse-midwives and birth centers in Medicaid and how beneficiaries use these services. Describes policy issues and barriers to expanding access to midwives and birth centers, including payment policies; contracting with managed care organizations; licensure, certification, and accreditation; scope of practice; and limited supply. Includes rural considerations throughout.
Date: 05/2023
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
view details
Closed, Converted, Merged, and New Hospitals with Medicare Rural Designations: January 2018-November 2022
Provides an overview of four Medicare rural hospital designations - Critical Access Hospital, Low-Volume Hospital, Medicare Dependent Hospital, and Sole Community Hospital - and factors related to financial distress that these designations are intended to address. Explores the number of rural-designated hospitals that have closed, merged, converted, or opened between January 2018-November 2022 and compares the number of rural-designated hospitals with the number of non-designated hospitals. Outlines considerations for Congress regarding policy options for rural hospitals and access to healthcare services in rural areas.
Date: 04/2023
Sponsoring organization: Congressional Research Service
view details
Provides an overview of four Medicare rural hospital designations - Critical Access Hospital, Low-Volume Hospital, Medicare Dependent Hospital, and Sole Community Hospital - and factors related to financial distress that these designations are intended to address. Explores the number of rural-designated hospitals that have closed, merged, converted, or opened between January 2018-November 2022 and compares the number of rural-designated hospitals with the number of non-designated hospitals. Outlines considerations for Congress regarding policy options for rural hospitals and access to healthcare services in rural areas.
Date: 04/2023
Sponsoring organization: Congressional Research Service
view details
April 2023 MACPAC Meeting Transcript
Transcript from the Medicaid and CHIP Payment and Access Commission's (MACPAC) April 2023 meeting. Covers automatic adjustments to Disproportionate Share Hospital (DSH) allotments, DSH third-party payer policy, integrating care for dually eligible beneficiaries, access to Medicaid coverage and care for adults leaving incarceration, adult access to covered dental benefits, access to home- and community-based services, and an update on the COVID-19 public health emergency (PHE) unwinding. Includes rural references and considerations throughout.
Date: 04/2023
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
view details
Transcript from the Medicaid and CHIP Payment and Access Commission's (MACPAC) April 2023 meeting. Covers automatic adjustments to Disproportionate Share Hospital (DSH) allotments, DSH third-party payer policy, integrating care for dually eligible beneficiaries, access to Medicaid coverage and care for adults leaving incarceration, adult access to covered dental benefits, access to home- and community-based services, and an update on the COVID-19 public health emergency (PHE) unwinding. Includes rural references and considerations throughout.
Date: 04/2023
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
view details
April 2023 MedPAC Meeting Transcript
Transcript from the Medicare Payment Advisory Commission's (MedPAC) April 2023 meeting. Covers high prices of drugs covered under Medicare Part B, draft recommendations for reforming Medicare's wage index systems, aligning fee-for-service payment rates across ambulatory settings, leveraging Medicare policies to address social determinants of health, assessing post-sale rebates for prescription drugs in Medicare Part D, and assessing the need for Medicare safety net payments for skilled nursing facilities and home health agencies. Features discussions on draft reports regarding a prototype design for a post-acute care prospective payment system, telehealth in Medicare, and behavioral health in Medicare. Includes rural references throughout.
Date: 04/2023
Sponsoring organization: Medicare Payment Advisory Commission
view details
Transcript from the Medicare Payment Advisory Commission's (MedPAC) April 2023 meeting. Covers high prices of drugs covered under Medicare Part B, draft recommendations for reforming Medicare's wage index systems, aligning fee-for-service payment rates across ambulatory settings, leveraging Medicare policies to address social determinants of health, assessing post-sale rebates for prescription drugs in Medicare Part D, and assessing the need for Medicare safety net payments for skilled nursing facilities and home health agencies. Features discussions on draft reports regarding a prototype design for a post-acute care prospective payment system, telehealth in Medicare, and behavioral health in Medicare. Includes rural references throughout.
Date: 04/2023
Sponsoring organization: Medicare Payment Advisory Commission
view details
Big Changes with the New Rural Emergency Hospital Model
Podcast episode providing an overview of the Rural Emergency Hospital designation. Discusses the role of the Rural Emergency Hospital Technical Assistance Center and the types of support it provides.
Date: 04/2023
Sponsoring organization: American Hospital Association
view details
Podcast episode providing an overview of the Rural Emergency Hospital designation. Discusses the role of the Rural Emergency Hospital Technical Assistance Center and the types of support it provides.
Date: 04/2023
Sponsoring organization: American Hospital Association
view details