Rural Health
Resources by Topic: Reimbursement and payment models
The Pennsylvania Rural Health Model (PARHM): First Annual Report
Evaluates the first year of the Pennsylvania Rural Health Model (PARHM), an initiative designed to test if global budgets can help rural hospitals improve their financial viability, provide flexibility to meet locally defined community health needs, and reduce overall health care spending. Provides an overview of the model and describes the implementation experience of the first cohort of participating hospitals. Presents preliminary, descriptive data on the financial performance and utilization outcomes of Cohort 1 participants.
Additional links: Appendix, Findings at a Glance
Date: 08/2021
Type: Document
Sponsoring organizations: Centers for Medicare and Medicaid Services, NORC at the University of Chicago
view details
Evaluates the first year of the Pennsylvania Rural Health Model (PARHM), an initiative designed to test if global budgets can help rural hospitals improve their financial viability, provide flexibility to meet locally defined community health needs, and reduce overall health care spending. Provides an overview of the model and describes the implementation experience of the first cohort of participating hospitals. Presents preliminary, descriptive data on the financial performance and utilization outcomes of Cohort 1 participants.
Additional links: Appendix, Findings at a Glance
Date: 08/2021
Type: Document
Sponsoring organizations: Centers for Medicare and Medicaid Services, NORC at the University of Chicago
view details
Paying for Telemedicine in Smaller Rural Hospitals: Extending the Technology to Those Who Benefit Most
Viewpoint article discussing the positive financial impacts of telemedicine in emergency departments (EDs) and barriers to using telemedicine in small rural hospitals related to patient volume, high upfront costs, and reimbursement issues. Outlines policy interventions to support rural telemedicine.
Author(s): Kori S. Zachrison, Jessica V. Richard, Ateev Mehrotra
Citation: JAMA Health Forum, 2(8), e211570
Date: 08/2021
Type: Document
view details
Viewpoint article discussing the positive financial impacts of telemedicine in emergency departments (EDs) and barriers to using telemedicine in small rural hospitals related to patient volume, high upfront costs, and reimbursement issues. Outlines policy interventions to support rural telemedicine.
Author(s): Kori S. Zachrison, Jessica V. Richard, Ateev Mehrotra
Citation: JAMA Health Forum, 2(8), e211570
Date: 08/2021
Type: Document
view details
Primary Care Case Management in Medicaid: A Strategy for Supporting Primary Care in Rural Areas
Describes how Medicaid agencies in five states - Alabama, Colorado, Maine, Idaho, and Oklahoma - utilize primary care case management (PCCM) programs to strengthen primary care, particularly in rural areas. Identifies three strategies implemented by some or all of these states to support primary care providers, and highlights lessons learned for state Medicaid programs that want to strengthen primary care in rural areas.
Author(s): Neva Kaye
Date: 08/2021
Type: Document
Sponsoring organization: National Academy for State Health Policy
view details
Describes how Medicaid agencies in five states - Alabama, Colorado, Maine, Idaho, and Oklahoma - utilize primary care case management (PCCM) programs to strengthen primary care, particularly in rural areas. Identifies three strategies implemented by some or all of these states to support primary care providers, and highlights lessons learned for state Medicaid programs that want to strengthen primary care in rural areas.
Author(s): Neva Kaye
Date: 08/2021
Type: Document
Sponsoring organization: National Academy for State Health Policy
view details
MedPAC Comment on CMS's Proposed Rule on the ESRD PPS for CY 2022
Comments on a July 9, 2021, Federal Register proposed rule related to Medicare payment policies for end-stage renal disease (ESRD). Includes comments addressing the low-volume payment adjustment (LVPA) and the rural adjustment.
Date: 08/2021
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
view details
Comments on a July 9, 2021, Federal Register proposed rule related to Medicare payment policies for end-stage renal disease (ESRD). Includes comments addressing the low-volume payment adjustment (LVPA) and the rural adjustment.
Date: 08/2021
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
view details
The Swing Bed Program: Impacting Patients, Providers, and Community
Brief video overview of the swing bed program, which helps rural hospitals provide patient- and community-centric post-acute healthcare. Describes the history, related policy issues, early implementation, and evolution of the program.
Date: 08/2021
Type: Video/Multimedia
Sponsoring organization: Rural Health Information Hub
view details
Brief video overview of the swing bed program, which helps rural hospitals provide patient- and community-centric post-acute healthcare. Describes the history, related policy issues, early implementation, and evolution of the program.
Date: 08/2021
Type: Video/Multimedia
Sponsoring organization: Rural Health Information Hub
view details
History of the Swing Bed: A Look Through the Rural Rearview Mirror
Reviews the history of the swing bed program, which helps rural hospitals serve patients and the community through provision of post-acute care. Shares insights from experts who describe early implementation and key program elements that have contributed to the program's success.
Author(s): Kay Miller Temple
Citation: Rural Monitor
Date: 08/2021
Type: Document
Sponsoring organization: Rural Health Information Hub
view details
Reviews the history of the swing bed program, which helps rural hospitals serve patients and the community through provision of post-acute care. Shares insights from experts who describe early implementation and key program elements that have contributed to the program's success.
Author(s): Kay Miller Temple
Citation: Rural Monitor
Date: 08/2021
Type: Document
Sponsoring organization: Rural Health Information Hub
view details
Understanding the Rural Swing Bed: More than Just a Reimbursement Policy
Provides an overview of the swing bed program and its role as a patient-centric post-acute care solution that helps rural hospitals serve their communities. Discusses the impact of the program, reimbursement, quality measures, and more.
Author(s): Kay Miller Temple
Citation: Rural Monitor
Date: 08/2021
Type: Document
Sponsoring organization: Rural Health Information Hub
view details
Provides an overview of the swing bed program and its role as a patient-centric post-acute care solution that helps rural hospitals serve their communities. Discusses the impact of the program, reimbursement, quality measures, and more.
Author(s): Kay Miller Temple
Citation: Rural Monitor
Date: 08/2021
Type: Document
Sponsoring organization: Rural Health Information Hub
view details
Diabetes-Related Inpatient Stays, 2018
Brief examining nonmaternal inpatient stays related to type 1 and type 2 diabetes based on 2018 National Inpatient Sample (NIS) data. Presents distribution of inpatient stays by age, gender, insurance status, income, race and ethnicity, and metro and rural location.
Author(s): Kathryn R. Fingar, Lawrence D. Reid
Date: 07/2021
Type: Document
Sponsoring organizations: Agency for Healthcare Research and Quality, Healthcare Cost and Utilization Project
view details
Brief examining nonmaternal inpatient stays related to type 1 and type 2 diabetes based on 2018 National Inpatient Sample (NIS) data. Presents distribution of inpatient stays by age, gender, insurance status, income, race and ethnicity, and metro and rural location.
Author(s): Kathryn R. Fingar, Lawrence D. Reid
Date: 07/2021
Type: Document
Sponsoring organizations: Agency for Healthcare Research and Quality, Healthcare Cost and Utilization Project
view details
Evaluation of the State Innovation Models (SIM) Initiative Round 2: Model Test Final Report
Final report on the Round 2 State Innovation Models (SIM) program across eleven participating states - Colorado, Connecticut, Delaware, Idaho, Iowa, Michigan, New York, Ohio, Rhode Island, Tennessee, and Washington. Discusses the adoption of delivery models and payment reforms related to value-based payment (VBP) and alternative payment models (APMs). Examines whether the implementation efforts and healthcare delivery system reforms impacted the quality of care, health outcomes, population health, and spending.
Additional links: Appendix, Findings at a Glance
Date: 06/2021
Type: Document
Sponsoring organizations: Centers for Medicare and Medicaid Services, RTI International
view details
Final report on the Round 2 State Innovation Models (SIM) program across eleven participating states - Colorado, Connecticut, Delaware, Idaho, Iowa, Michigan, New York, Ohio, Rhode Island, Tennessee, and Washington. Discusses the adoption of delivery models and payment reforms related to value-based payment (VBP) and alternative payment models (APMs). Examines whether the implementation efforts and healthcare delivery system reforms impacted the quality of care, health outcomes, population health, and spending.
Additional links: Appendix, Findings at a Glance
Date: 06/2021
Type: Document
Sponsoring organizations: Centers for Medicare and Medicaid Services, RTI International
view details
Basics of Value-based Care and Payment
Slides presented to the Rural Healthcare Provider Transition Project (RHPTP) providing an overview of value-based care and payment models. Includes examples of rural providers addressing patient social needs, tackling local health issues, and aligning services with community needs.
Author(s): Jennifer P. Lundblad
Date: 06/2021
Type: Presentation Slides
Sponsoring organization: Rural Health Value
view details
Slides presented to the Rural Healthcare Provider Transition Project (RHPTP) providing an overview of value-based care and payment models. Includes examples of rural providers addressing patient social needs, tackling local health issues, and aligning services with community needs.
Author(s): Jennifer P. Lundblad
Date: 06/2021
Type: Presentation Slides
Sponsoring organization: Rural Health Value
view details