Rural Health
Resources by Topic: Reimbursement and payment models
Implementing High-Quality Primary Care: Rebuilding the Foundation of Health Care
Examines the current state of primary care in the United States, and describes an implementation plan to strengthen high-quality primary care. Discusses value-based care and reimbursement, access to care, primary care workforce recruitment and training, and the role of health information technology. Includes rural references throughout.
Additional links: Read Online
Author(s): Board on Health Care Services
Date: 2021
Type: Document
Sponsoring organization: Health and Medicine Division (HMD), National Academies of Sciences, Engineering, and Medicine
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Examines the current state of primary care in the United States, and describes an implementation plan to strengthen high-quality primary care. Discusses value-based care and reimbursement, access to care, primary care workforce recruitment and training, and the role of health information technology. Includes rural references throughout.
Additional links: Read Online
Author(s): Board on Health Care Services
Date: 2021
Type: Document
Sponsoring organization: Health and Medicine Division (HMD), National Academies of Sciences, Engineering, and Medicine
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Rural Federally Qualified Health Centers Financial and Operational Performance Analysis 2016-2019
Examines financial and operational characteristics of rural Federally Qualified Health Centers (FQHCs). Explores FQHC 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.
Date: 2021
Type: Document
Sponsoring organization: Capital Link
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Examines financial and operational characteristics of rural Federally Qualified Health Centers (FQHCs). Explores FQHC 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.
Date: 2021
Type: Document
Sponsoring organization: Capital Link
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Public Law 116–260: Consolidated Appropriations Act, 2021
Text of the Consolidated Appropriations Act, 2021, Public Law 116-260 (December 27, 2020). Section 125 establishes the Rural Emergency Hospital designation. Section 127 makes changes to direct graduate medical education (GME) and indirect GME payments to teaching hospitals that train residents in Rural Training Programs.
Date: 12/2020
Type: Document
Sponsoring organization: U.S. Congress
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Text of the Consolidated Appropriations Act, 2021, Public Law 116-260 (December 27, 2020). Section 125 establishes the Rural Emergency Hospital designation. Section 127 makes changes to direct graduate medical education (GME) and indirect GME payments to teaching hospitals that train residents in Rural Training Programs.
Date: 12/2020
Type: Document
Sponsoring organization: U.S. Congress
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December 2020 MedPAC Meeting Transcript
Transcript from the Medicare Payment Advisory Commission's (MedPAC) December 2020 meeting. Covers payment adequacy and updates for hospital inpatient and outpatient services and the mandated report on expanding the post-acute care transfer policy to hospice, ambulatory surgical center services, outpatient dialysis services, physician and other health professional services, hospice services, and a status report and benchmark policy option on the Medicare Advantage program. Includes rural references throughout.
Date: 12/2020
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Transcript from the Medicare Payment Advisory Commission's (MedPAC) December 2020 meeting. Covers payment adequacy and updates for hospital inpatient and outpatient services and the mandated report on expanding the post-acute care transfer policy to hospice, ambulatory surgical center services, outpatient dialysis services, physician and other health professional services, hospice services, and a status report and benchmark policy option on the Medicare Advantage program. Includes rural references throughout.
Date: 12/2020
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Rural Health Clinics Modernization Policy Explained
Recording of a webinar (updated December 31, 2020) providing an overview of statutory revisions to the Rural Health Clinic (RHC) payment methodology. Explains the impact of the changes on both capped and uncapped RHCs. Includes information on telehealth reimbursement for RHCs. Part of the Rural Health Clinic Technical Assistance Series.
Additional links: Presentation Slides
Author(s): Bill Finerfrock, Nathan Baugh
Date: 12/2020
Type: Video/Multimedia
Sponsoring organization: National Association of Rural Health Clinics
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Recording of a webinar (updated December 31, 2020) providing an overview of statutory revisions to the Rural Health Clinic (RHC) payment methodology. Explains the impact of the changes on both capped and uncapped RHCs. Includes information on telehealth reimbursement for RHCs. Part of the Rural Health Clinic Technical Assistance Series.
Additional links: Presentation Slides
Author(s): Bill Finerfrock, Nathan Baugh
Date: 12/2020
Type: Video/Multimedia
Sponsoring organization: National Association of Rural Health Clinics
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The Centers for Medicare & Medicaid Services Could Improve Its Wage Index Adjustment for Hospitals in Areas With the Lowest Wages
Analyzes characteristics of hospitals with area wage indexes (AWI) in the bottom quartile in 2020, including rurality, geography, Medicaid expansion status, and hourly wages. Provides an overview of the hospital wage index system and AWI, circularity, and the impact of these policies on prospective payment system (PPS) hospitals. Offers policy recommendations to the Centers for Medicare and Medicaid Services regarding future adjustments.
Additional links: Full Data Brief
Date: 12/2020
Type: Document
Sponsoring organization: Office of Inspector General (HHS)
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Analyzes characteristics of hospitals with area wage indexes (AWI) in the bottom quartile in 2020, including rurality, geography, Medicaid expansion status, and hourly wages. Provides an overview of the hospital wage index system and AWI, circularity, and the impact of these policies on prospective payment system (PPS) hospitals. Offers policy recommendations to the Centers for Medicare and Medicaid Services regarding future adjustments.
Additional links: Full Data Brief
Date: 12/2020
Type: Document
Sponsoring organization: Office of Inspector General (HHS)
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NRHA Rapid Response Policy Brief: Telehealth
Policy position brief outlining the National Rural Health Association's policy statements and recommendations to encourage the adoption of telehealth services in rural America. Discusses reimbursement, healthcare quality, broadband access, and other telehealth policy topics.
Author(s): Pat Schou, Sarah Huling, Brady Beecham, Leslie Marsh, Rachael Sherard
Date: 12/2020
Type: Document
Sponsoring organization: National Rural Health Association
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Policy position brief outlining the National Rural Health Association's policy statements and recommendations to encourage the adoption of telehealth services in rural America. Discusses reimbursement, healthcare quality, broadband access, and other telehealth policy topics.
Author(s): Pat Schou, Sarah Huling, Brady Beecham, Leslie Marsh, Rachael Sherard
Date: 12/2020
Type: Document
Sponsoring organization: National Rural Health Association
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How to Design Value‐based Care Models for Rural Participant Success: A Summit Findings Report
Summarizes a July 2020 virtual summit of rural participants in value‐based care (VBC) models and programs. Details six themes on VBC model design, implementation, and operation that can influence rural organization participation in VBC models. Provides recommendations for VBC model designers to improve rural healthcare provider participation and success in VBC models.
Author(s): Keith Mueller, Clint MacKinney, Jennifer Lundblad, Karla Weng
Date: 12/2020
Type: Document
Sponsoring organization: Rural Health Value
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Summarizes a July 2020 virtual summit of rural participants in value‐based care (VBC) models and programs. Details six themes on VBC model design, implementation, and operation that can influence rural organization participation in VBC models. Provides recommendations for VBC model designers to improve rural healthcare provider participation and success in VBC models.
Author(s): Keith Mueller, Clint MacKinney, Jennifer Lundblad, Karla Weng
Date: 12/2020
Type: Document
Sponsoring organization: Rural Health Value
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Case Study: Exploring Options to Deploy Capitated Payments to Enhance Primary Care in Rural Settings
Discusses the need for primary care services in rural areas. Provides an overview of healthcare delivery models that utilize capitated payments. Presents examples of capitated payment agreements aimed at increasing the use and quality of primary care services in rural communities, and offers lessons learned.
Date: 12/2020
Type: Document
Sponsoring organization: American Hospital Association
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Discusses the need for primary care services in rural areas. Provides an overview of healthcare delivery models that utilize capitated payments. Presents examples of capitated payment agreements aimed at increasing the use and quality of primary care services in rural communities, and offers lessons learned.
Date: 12/2020
Type: Document
Sponsoring organization: American Hospital Association
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An Observational Study of Telemental Care Delivery and the Context for Involuntary Commitment for Mental Health Patients in a Group of Rural Emergency Departments
Examines telemental healthcare delivery in Critical Access Hospital (CAH) emergency departments (ED) in 4 Indiana counties, with a focus on the context surrounding subsequent psychiatric involuntary commitment (IC) or noninvoluntary commitment (non-IC) of mental health patients who presented to the participating EDs. Provides information on patient demographics, ED wait time and length of stay, ED costs and reimbursement, and telehealth parity laws.
Author(s): Roseanne Fairchild, Shiaw-Fen Ferng-Kuo, Hicham Rahmouni, Daniel Hardesty
Citation: Telemedicine Reports, 1(1), 22-35
Date: 11/2020
Type: Document
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Examines telemental healthcare delivery in Critical Access Hospital (CAH) emergency departments (ED) in 4 Indiana counties, with a focus on the context surrounding subsequent psychiatric involuntary commitment (IC) or noninvoluntary commitment (non-IC) of mental health patients who presented to the participating EDs. Provides information on patient demographics, ED wait time and length of stay, ED costs and reimbursement, and telehealth parity laws.
Author(s): Roseanne Fairchild, Shiaw-Fen Ferng-Kuo, Hicham Rahmouni, Daniel Hardesty
Citation: Telemedicine Reports, 1(1), 22-35
Date: 11/2020
Type: Document
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