Rural Health
Resources by Topic: Reimbursement and payment models
Community Health Centers And Medicaid: A Deeper Dive Into FQHC Alternative Payment Reform
An overview of the development of the Medicaid FQHC policy, since 1965, between Medicare and Medicaid, providing third-party financing, and CHCs, offering primary healthcare to underserved rural and urban areas. Discusses the discrepancies in Medicaid payment policies affecting CHCs, and federal legislative actions and amendments to reconcile budgets. Describes the alternative payment methodology (APM) and its effect on the prospective payment system.
Author(s): Sara Rosenbaum, Peter Shin, Jessica Sharac, Colleen Bedenbaugh
Citation: Health Affairs
Date: 01/2023
Sponsoring organization: Health Affairs
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An overview of the development of the Medicaid FQHC policy, since 1965, between Medicare and Medicaid, providing third-party financing, and CHCs, offering primary healthcare to underserved rural and urban areas. Discusses the discrepancies in Medicaid payment policies affecting CHCs, and federal legislative actions and amendments to reconcile budgets. Describes the alternative payment methodology (APM) and its effect on the prospective payment system.
Author(s): Sara Rosenbaum, Peter Shin, Jessica Sharac, Colleen Bedenbaugh
Citation: Health Affairs
Date: 01/2023
Sponsoring organization: Health Affairs
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State Policies for Expanding Medicaid Coverage of Community Health Worker (CHW) Services
Discusses state Medicaid coverage policies regarding Community Health Workers (CHWs) in place as of July 1, 2022, and planned for fiscal year 2023. Covers CHW coverage initiatives implemented or planned through Medicaid state plan amendments, Section 1115 demonstration authority, and as part of a Center for Medicare and Medicaid Innovation (CMMI) model.
Date: 01/2023
Sponsoring organization: KFF
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Discusses state Medicaid coverage policies regarding Community Health Workers (CHWs) in place as of July 1, 2022, and planned for fiscal year 2023. Covers CHW coverage initiatives implemented or planned through Medicaid state plan amendments, Section 1115 demonstration authority, and as part of a Center for Medicare and Medicaid Innovation (CMMI) model.
Date: 01/2023
Sponsoring organization: KFF
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Orientation to Rural Emergency Hospital Conversion and Technical Assistance
Recording of a January 18, 2023, webinar discussing the Rural Emergency Hospital (REH) program. Provides an overview of the REH designation, policy and regulatory requirements, and REH Technical Assistance Center (TAC) services. Transcript available by clicking the dots above the video description, then selecting Show transcript.
Date: 01/2023
Sponsoring organizations: Mathematica, Rural Health Redesign Center
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Recording of a January 18, 2023, webinar discussing the Rural Emergency Hospital (REH) program. Provides an overview of the REH designation, policy and regulatory requirements, and REH Technical Assistance Center (TAC) services. Transcript available by clicking the dots above the video description, then selecting Show transcript.
Date: 01/2023
Sponsoring organizations: Mathematica, Rural Health Redesign Center
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Rural Hospitals Must Keep up with Innovation to Remain Viable
Describes changes to the healthcare market environment, including technology, telehealth, services offered by retailers and large corporations, and declining patient volume. Outlines priorities for Critical Access Hospitals to remain viable, including the transition to population-based payment. Details a transition framework to guide hospitals as they move to a population-based payment system and navigate a changing environment.
Date: 01/2023
Sponsoring organization: Stroudwater Associates
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Describes changes to the healthcare market environment, including technology, telehealth, services offered by retailers and large corporations, and declining patient volume. Outlines priorities for Critical Access Hospitals to remain viable, including the transition to population-based payment. Details a transition framework to guide hospitals as they move to a population-based payment system and navigate a changing environment.
Date: 01/2023
Sponsoring organization: Stroudwater Associates
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Rural Federally Qualified Health Centers Financial and Operational Performance Analysis 2018-2021
Examines financial and operational characteristics of rural Federally Qualified Health Centers (FQHCs) from 2018-2021. Explores FQHC growth and expansion, patient and payer mix, revenue and growth mix, financial performance, quality of care, and more. Compares data on rural FQHCs to urban and national FQHC data. Requires name, email address, and organization information to download.
Date: 01/2023
Sponsoring organization: Capital Link
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Examines financial and operational characteristics of rural Federally Qualified Health Centers (FQHCs) from 2018-2021. Explores FQHC growth and expansion, patient and payer mix, revenue and growth mix, financial performance, quality of care, and more. Compares data on rural FQHCs to urban and national FQHC data. Requires name, email address, and organization information to download.
Date: 01/2023
Sponsoring organization: Capital Link
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Examining Rural Telehealth During the Public Health Emergency
Examines the use of telehealth visits for rural and urban fee-for-service Medicare enrollees between January 2018 and June 2021. Compares telehealth utilization before the COVID-19 pandemic (2018-2019) with telehealth utilization from January 2020 to June 2021. Describes the demographic, geographical, and technological characteristics of telehealth services that were associated with increased telehealth use. Explores the extent to which the increased implementation and utilization of telehealth during the PHE impacted the cost of patient care and provider utilization.
Date: 01/2023
Sponsoring organizations: Centers for Medicare and Medicaid Services, CMS Alliance to Modernize Healthcare
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Examines the use of telehealth visits for rural and urban fee-for-service Medicare enrollees between January 2018 and June 2021. Compares telehealth utilization before the COVID-19 pandemic (2018-2019) with telehealth utilization from January 2020 to June 2021. Describes the demographic, geographical, and technological characteristics of telehealth services that were associated with increased telehealth use. Explores the extent to which the increased implementation and utilization of telehealth during the PHE impacted the cost of patient care and provider utilization.
Date: 01/2023
Sponsoring organizations: Centers for Medicare and Medicaid Services, CMS Alliance to Modernize Healthcare
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The Future Pediatric Subspecialty Physician Workforce: Meeting the Needs of Infants, Children, and Adolescents
Reports on barriers to increasing the pediatric subspecialist workforce and discusses the impact on research to improve health outcomes for children. Discusses access to care, education of the workforce, reimbursement rates, and more. Highlights rural specific challenges throughout.
Additional links: Read Online
Author(s): Board on Children, Youth, and Families
Date: 2023
Sponsoring organization: Health and Medicine Division (HMD), National Academies of Sciences, Engineering, and Medicine
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Reports on barriers to increasing the pediatric subspecialist workforce and discusses the impact on research to improve health outcomes for children. Discusses access to care, education of the workforce, reimbursement rates, and more. Highlights rural specific challenges throughout.
Additional links: Read Online
Author(s): Board on Children, Youth, and Families
Date: 2023
Sponsoring organization: Health and Medicine Division (HMD), National Academies of Sciences, Engineering, and Medicine
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School-Based Telehealth Playbook
Guides health centers through the design, implementation, and operation of a telehealth program that meets the needs of children and adolescents. Covers assessing needs and readiness, program models, business models, technology and equipment, program evaluation, partnerships, and implementation. Highlights examples from rural areas throughout.
Date: 2023
Sponsoring organization: School-Based Health Alliance
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Guides health centers through the design, implementation, and operation of a telehealth program that meets the needs of children and adolescents. Covers assessing needs and readiness, program models, business models, technology and equipment, program evaluation, partnerships, and implementation. Highlights examples from rural areas throughout.
Date: 2023
Sponsoring organization: School-Based Health Alliance
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Rural Community Engagement Resource Guide
Describes the importance of community engagement in developing and implementing strategies to improve health, increase value, and drive equitable care delivery. Outlines a variety of toolkits, strategies, and resources to help initiate, improve, and inspire community engagement strategies that support value-based care.
Additional links: Community Engagement and Value Based Care Infographic
Date: 2023
Sponsoring organization: Rural Health Value
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Describes the importance of community engagement in developing and implementing strategies to improve health, increase value, and drive equitable care delivery. Outlines a variety of toolkits, strategies, and resources to help initiate, improve, and inspire community engagement strategies that support value-based care.
Additional links: Community Engagement and Value Based Care Infographic
Date: 2023
Sponsoring organization: Rural Health Value
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Virginia Community Services Boards Behavioral Health Services: 2022
Report on activities of Virginia's Community Services Boards (CSBs), the state's primary mechanism for providing publicly funded behavioral health services in local communities. Includes a section on CSBs' role in providing services to rural areas. Features statistics on numbers of substance use disorder and mental health consumers, with breakdowns by urban and rural CSBs.
Date: 12/2022
Sponsoring organization: Joint Legislative Audit and Review Commission
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Report on activities of Virginia's Community Services Boards (CSBs), the state's primary mechanism for providing publicly funded behavioral health services in local communities. Includes a section on CSBs' role in providing services to rural areas. Features statistics on numbers of substance use disorder and mental health consumers, with breakdowns by urban and rural CSBs.
Date: 12/2022
Sponsoring organization: Joint Legislative Audit and Review Commission
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