Rural Health
Resources by Topic: Reimbursement and payment models
Congress Establishes New Medicare Provider Category and Reimbursement for Rural Emergency Hospitals
Provides an overview of the Rural Emergency Hospital (REH) provider designation established in the Consolidated Appropriations Act, 2021. Discusses provider eligibility criteria, REH requirements and permitted services, and Medicare reimbursement. Highlights key questions that need to be addressed by the Centers for Medicare and Medicaid Services.
Author(s): Emily J. Cook, Sandra M. DiVarco, Caroline Reigart
Citation: National Law Review, XI(5)
Date: 01/2021
Type: Document
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Provides an overview of the Rural Emergency Hospital (REH) provider designation established in the Consolidated Appropriations Act, 2021. Discusses provider eligibility criteria, REH requirements and permitted services, and Medicare reimbursement. Highlights key questions that need to be addressed by the Centers for Medicare and Medicaid Services.
Author(s): Emily J. Cook, Sandra M. DiVarco, Caroline Reigart
Citation: National Law Review, XI(5)
Date: 01/2021
Type: Document
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Continuing on the Road to Value
Slides presented at the Indiana Rural Health Association's Annual Public Policy Forum in 2021. Discusses management methods and policy initiatives for transitioning hospitals to value-based care. Includes information on the Community Health Access and Rural Transformation (CHART) Model, Accountable Care Organization (ACO) Pathways to Success, and global budgeting.
Author(s): Keith J. Mueller
Date: 01/2021
Type: Presentation Slides
Sponsoring organization: Rural Policy Research Institute
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Slides presented at the Indiana Rural Health Association's Annual Public Policy Forum in 2021. Discusses management methods and policy initiatives for transitioning hospitals to value-based care. Includes information on the Community Health Access and Rural Transformation (CHART) Model, Accountable Care Organization (ACO) Pathways to Success, and global budgeting.
Author(s): Keith J. Mueller
Date: 01/2021
Type: Presentation Slides
Sponsoring organization: Rural Policy Research Institute
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Telehealth After COVID-19: Clarifying Policy Goals for a Way Forward
Examines how telehealth may be used to improve healthcare quality, reduce costs, improve access to care, and meet other policy objections. Presents recommendations for telehealth policy after the COVID-19 pandemic.
Author(s): Lori Uscher-Pines, Monique Martineau
Date: 01/2021
Type: Document
Sponsoring organization: RAND Corporation
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Examines how telehealth may be used to improve healthcare quality, reduce costs, improve access to care, and meet other policy objections. Presents recommendations for telehealth policy after the COVID-19 pandemic.
Author(s): Lori Uscher-Pines, Monique Martineau
Date: 01/2021
Type: Document
Sponsoring organization: RAND Corporation
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Independent Evaluation of Comprehensive Primary Care Plus (CPC+): Third Annual Report
Reports on the first three program years of the Comprehensive Primary Care Plus (CPC+) model, a CMS primary care payment and delivery reform effort. Discusses CPC+ participating practices, payer partners, and health information technology (HIT) vendors supporting the program. Describes practice changes and outcomes for Medicare fee-for-service beneficiaries.
Additional links: Appendices, Findings at a Glance
Date: 01/2021
Type: Document
Sponsoring organizations: Centers for Medicare and Medicaid Services, Mathematica
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Reports on the first three program years of the Comprehensive Primary Care Plus (CPC+) model, a CMS primary care payment and delivery reform effort. Discusses CPC+ participating practices, payer partners, and health information technology (HIT) vendors supporting the program. Describes practice changes and outcomes for Medicare fee-for-service beneficiaries.
Additional links: Appendices, Findings at a Glance
Date: 01/2021
Type: Document
Sponsoring organizations: Centers for Medicare and Medicaid Services, Mathematica
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Mental Health Systems Solutions Explorer
Interactive tool offering evidence-based solutions to increase mental healthcare utilization, increase access to care, and establish a continuum of care. Contains examples of each solution in practice. Solutions can be filtered to view those specifically of interest to rural communities.
Date: 01/2021
Type: Tool
Sponsoring organization: RAND Corporation
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Interactive tool offering evidence-based solutions to increase mental healthcare utilization, increase access to care, and establish a continuum of care. Contains examples of each solution in practice. Solutions can be filtered to view those specifically of interest to rural communities.
Date: 01/2021
Type: Tool
Sponsoring organization: RAND Corporation
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How to Transform the U.S. Mental Health System: Evidence-based Recommendations
Discusses evidence-based strategies to promote mental healthcare utilization, improve access to care, and establish a continuum of care. Offers 15 recommendations to improve mental healthcare, including policies regarding reimbursement, workforce growth, and digital and telehealth services, among other topics. Includes rural references throughout.
Additional links: Full Report, Research Brief: Transforming Mental Health Care in the United States
Author(s): Ryan K. McBain, Nicole K. Eberhart, Joshua Breslau, et al.
Date: 01/2021
Type: Document
Sponsoring organization: RAND Corporation
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Discusses evidence-based strategies to promote mental healthcare utilization, improve access to care, and establish a continuum of care. Offers 15 recommendations to improve mental healthcare, including policies regarding reimbursement, workforce growth, and digital and telehealth services, among other topics. Includes rural references throughout.
Additional links: Full Report, Research Brief: Transforming Mental Health Care in the United States
Author(s): Ryan K. McBain, Nicole K. Eberhart, Joshua Breslau, et al.
Date: 01/2021
Type: Document
Sponsoring organization: RAND Corporation
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Medicare Severe Wound Care: Spending Declines May Reflect Site of Care Changes; Limited Information Is Available on Quality
Reports on an analysis of where Medicare beneficiaries received care for severe wounds in 2018 and Medicare payment for these services. Provides an overview of the implementation of a dual payment system for long-term care hospitals in 2016, and examines how the dual payment system affected the availability and quality of severe wound care for Medicare beneficiaries. Includes data on severe wound care by facility type in addition to Medicare spending by urban and rural location.
Additional links: Full Report
Date: 01/2021
Type: Document
Sponsoring organization: Government Accountability Office
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Reports on an analysis of where Medicare beneficiaries received care for severe wounds in 2018 and Medicare payment for these services. Provides an overview of the implementation of a dual payment system for long-term care hospitals in 2016, and examines how the dual payment system affected the availability and quality of severe wound care for Medicare beneficiaries. Includes data on severe wound care by facility type in addition to Medicare spending by urban and rural location.
Additional links: Full Report
Date: 01/2021
Type: Document
Sponsoring organization: Government Accountability Office
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Telehealth Policies Impacting Federally Qualified Health Centers in Face of COVID‐19
Provides an overview of changes to federal, California Medicaid, and private insurer telehealth policies in response to COVID-19. Discusses opportunities and limitations Federally Qualified Health Centers and Rural Health Clinics may face in expanding telehealth services. Offers recommendations for removing barriers for providers in rural and underserved areas.
Author(s): Miku Sodhi
Citation: Journal of Rural Health, 37(1), 158-160
Date: 01/2021
Type: Document
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Provides an overview of changes to federal, California Medicaid, and private insurer telehealth policies in response to COVID-19. Discusses opportunities and limitations Federally Qualified Health Centers and Rural Health Clinics may face in expanding telehealth services. Offers recommendations for removing barriers for providers in rural and underserved areas.
Author(s): Miku Sodhi
Citation: Journal of Rural Health, 37(1), 158-160
Date: 01/2021
Type: Document
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Economics of Using Telemedicine to Supplement Hospice Care in Rural Areas
Describes a tele-hospice program implemented in 2015 by Hospice Services, Inc., a community-based hospice provider that serves rural and frontier counties in northwest and north central Kansas, in partnership with the University of Kansas Medical Center. Explores the financial impact of the tele-hospice intervention, comparing tele-hospice costs with costs of in-person services. Also identifies cost savings related to the use of virtual technology to conduct administrative meetings.
Author(s): Adam F. Lomenick, Sandy J. Kuhlman, Joe L. Barnes, et al.
Citation: Journal of Palliative Medicine, 24(10), 1461–1466
Date: 2021
Type: Document
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Describes a tele-hospice program implemented in 2015 by Hospice Services, Inc., a community-based hospice provider that serves rural and frontier counties in northwest and north central Kansas, in partnership with the University of Kansas Medical Center. Explores the financial impact of the tele-hospice intervention, comparing tele-hospice costs with costs of in-person services. Also identifies cost savings related to the use of virtual technology to conduct administrative meetings.
Author(s): Adam F. Lomenick, Sandy J. Kuhlman, Joe L. Barnes, et al.
Citation: Journal of Palliative Medicine, 24(10), 1461–1466
Date: 2021
Type: Document
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Rural Federally Qualified Health Centers Financial and Operational Performance Analysis 2017-2020
Examines financial and operational characteristics of rural Federally Qualified Health Centers (FQHCs) from 2017-2020. 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: 2021
Type: Document
Sponsoring organization: Capital Link
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Examines financial and operational characteristics of rural Federally Qualified Health Centers (FQHCs) from 2017-2020. 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: 2021
Type: Document
Sponsoring organization: Capital Link
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