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Rural Health Information Hub

Rural Health
Resources by Topic: Reimbursement and payment models

Experience in the Pennsylvania Rural Health Model: Barnes-Kasson County Hospital
Profiles Barnes-Kasson County Hospital, a Critical Access Hospital with three hospital-based Rural Health Clinics and a skilled nursing facility in Pennsylvania. Discusses the CAH's experience participating in the Pennsylvania Rural Health Model (PARHM). Describes the Barnes-Kasson transformation plan, challenges of the global budget model, peer learning and networking opportunities, and next steps.
Date: 08/2022
Sponsoring organization: Rural Health Value
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Health Panel Comment Letter – Medicare Advantage Program
Offers comments in response to the Centers for Medicare & Medicaid Services (CMS) Request for Information on various aspects of the Medicare Advantage (MA) program. Presents a rural perspective on the MA program and discusses health equity in the MA program, expanding access to care, and value-based contracting. Includes data on the proportion of MA plans offering supplemental benefits in noncore, micropolitan, and metropolitan counties in 2020.
Date: 08/2022
Sponsoring organization: Rural Policy Research Institute Rural Health Panel
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What Happens When a Hospital Closes?
Podcast episode discussing the impact of rural hospital closures and obstetrics units on their communities. Explores why facilities and units close and the impact of closures on mortality, prenatal care, maternal and infant health outcomes, and access to quality care.
Date: 08/2022
Sponsoring organization: Freakonomics
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MedPAC Comment on CMS's Proposed Rule on the ESRD PPS Update for CY 2023
Comments on a June 28, 2022, 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: 08/2022
Sponsoring organization: Medicare Payment Advisory Commission
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Changes in the Provision of Health Care Services by Rural Critical Access Hospitals and Prospective Payment System Hospitals in 2009 compared to 2017
Findings brief exploring changes in the availability and provision of different health care services among rural Critical Access Hospitals and Prospective Payment System hospitals from 2009 to 2017, using data from the American Hospital Association Annual Survey Database. Features statistics with breakdowns by types of services offered, type of hospital, and percentage-point change from 2009 to 2017.
Author(s): Randall John, Kathleen Knocke, Sharita Thomas, et al.
Date: 08/2022
Sponsoring organization: North Carolina Rural Health Research Program
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MedPAC Comment on CMS's Proposed Rule on the Home Health Prospective Payment System for CY 2023
Comments on a June 23, 2022, Federal Register proposed rule related to Medicare payment policies for home health agencies. Includes comments regarding the collection of data on the use of telecommunications technology under the Medicare home health benefit and quality measure stratification as a tool to address healthcare disparities and advance health equity.
Date: 08/2022
Sponsoring organization: Medicare Payment Advisory Commission
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2020 Quality Payment Program Experience Report
Reports on the clinician experience for those participating in the Quality Payment Program in 2020. Presents data on Merit-based Incentive Payment System (MIPS) eligibility and participation rates for clinicians in small practices and rural areas, as well as their mean payment adjustment scores.
Date: 08/2022
Sponsoring organization: Centers for Medicare and Medicaid Services
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Integrating Behavioral Health into Your RHC
Recording of a July 19, 2022, webinar regarding Rural Health Clinic (RHC) billing for behavioral health services. Part of the Rural Health Clinic Technical Assistance Series.
Additional links: Presentation Slides, Transcript
Date: 07/2022
Sponsoring organization: National Association of Rural Health Clinics
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Synthesis of Evaluation Results across 21 Medicare Models, 2012-2020
Summarizes results from evaluations of 21 Centers for Medicare & Medicaid (CMS) Innovation Center models. Examines measures related to gross and net Medicare spending, utilization, and quality of care. Identifies themes among models with similar participant types and interventions used. Offers considerations for acute or specialty care and targeted populations models and prevention and population management models.
Additional links: Findings at a Glance, Synthesis of Evaluation Results Across 21 Medicare Models Slides, Transcript, Webinar Recording
Date: 07/2022
Sponsoring organization: Centers for Medicare and Medicaid Services
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Engaging Your Board and Community in Value-Based Care Conversations
Provides starting points for healthcare organizations to engage in value-based care conversations with their board and community members to support strategic planning and informed decision-making.
Date: 07/2022
Sponsoring organization: Rural Health Value
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