Rural Health
Resources by Topic: Reimbursement and payment models
Volume to Value Transition for Rural Health Systems
Policy position paper providing an overview of the transition from volume-based payment models to value-based payment models. Identifies opportunities and barriers to rural healthcare success in value-based payment models. Presents policy recommendations to promote rural healthcare facility participation in value-based payment models.
Author(s): Kim Breidenbach, Tammy Moore
Date: 10/2020
Type: Document
Sponsoring organization: National Rural Health Association
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Policy position paper providing an overview of the transition from volume-based payment models to value-based payment models. Identifies opportunities and barriers to rural healthcare success in value-based payment models. Presents policy recommendations to promote rural healthcare facility participation in value-based payment models.
Author(s): Kim Breidenbach, Tammy Moore
Date: 10/2020
Type: Document
Sponsoring organization: National Rural Health Association
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Health System Affiliation and Characteristics of Inpatient Stays at Rural and Metropolitan Hospitals, 2016
Presents statistics on inpatient stays at rural and metropolitan hospitals. Compares the number of inpatient hospitals stays by metropolitan status, health system affiliation, census region, and selected characteristics of the patients and hospital stays.
Author(s): Zeynal Karaca, Kathryn R. Fingar
Date: 10/2020
Type: Document
Sponsoring organization: Agency for Healthcare Research and Quality
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Presents statistics on inpatient stays at rural and metropolitan hospitals. Compares the number of inpatient hospitals stays by metropolitan status, health system affiliation, census region, and selected characteristics of the patients and hospital stays.
Author(s): Zeynal Karaca, Kathryn R. Fingar
Date: 10/2020
Type: Document
Sponsoring organization: Agency for Healthcare Research and Quality
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MedPAC Comment on CMS's Proposed Rule on Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems and Quality Reporting Programs for CY 2021
Comments on an August 12, 2020, Federal Register proposed rule revising the Medicare Hospital Outpatient Prospective Payment System (OPPS) and Medicare Ambulatory Surgical Center (ACS) payment system for calendar year 2021. Includes comments on payment rates for separately payable non–pass-through drugs obtained through the 340B Drug Pricing Program.
Date: 10/2020
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Comments on an August 12, 2020, Federal Register proposed rule revising the Medicare Hospital Outpatient Prospective Payment System (OPPS) and Medicare Ambulatory Surgical Center (ACS) payment system for calendar year 2021. Includes comments on payment rates for separately payable non–pass-through drugs obtained through the 340B Drug Pricing Program.
Date: 10/2020
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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MedPAC Comment on CMS's Proposed Rule on the Physician Fee Schedule and Other Revisions to Part B for CY 2021
Comment on an August 17, 2020 Federal Register proposed rule revising the physician fee schedule to improve payment systems for physicians and other Medicare Part B revisions. Includes a discussion of COVID-19-related telehealth expansion.
Date: 10/2020
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Comment on an August 17, 2020 Federal Register proposed rule revising the physician fee schedule to improve payment systems for physicians and other Medicare Part B revisions. Includes a discussion of COVID-19-related telehealth expansion.
Date: 10/2020
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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State Support to Rural Hospitals Fact Sheet
Overview of the Small Rural Hospital Improvement Program (SHIP) and the Medicare Rural Hospital Flexibility (Flex) program supporting rural hospitals and Critical Access Hospitals. Highlights with data the impact of these programs on a national level.
Date: 10/2020
Type: Document
Sponsoring organization: Health Resources and Services Administration
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Overview of the Small Rural Hospital Improvement Program (SHIP) and the Medicare Rural Hospital Flexibility (Flex) program supporting rural hospitals and Critical Access Hospitals. Highlights with data the impact of these programs on a national level.
Date: 10/2020
Type: Document
Sponsoring organization: Health Resources and Services Administration
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September 2020 MedPAC Meeting Transcript
Transcript from the Medicare Payment Advisory Commission's (MedPAC) September 2020 meeting. Covers the coronavirus pandemic and Medicare, the context for Medicare payment policy, a mandated report on the skilled nursing facility value-based purchasing program, a mandated report on the Protecting Access to Medicare Act of 2014's changes to the Medicare clinical laboratory fee schedule, and a Congressional request on private equity and Medicare. Includes rural references throughout.
Date: 09/2020
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Transcript from the Medicare Payment Advisory Commission's (MedPAC) September 2020 meeting. Covers the coronavirus pandemic and Medicare, the context for Medicare payment policy, a mandated report on the skilled nursing facility value-based purchasing program, a mandated report on the Protecting Access to Medicare Act of 2014's changes to the Medicare clinical laboratory fee schedule, and a Congressional request on private equity and Medicare. Includes rural references throughout.
Date: 09/2020
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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RHC Cost Reporting During COVID
Recording of a September 22, 2020, webinar covering cost reporting basics for Rural Health Clinics (RHCs), including telehealth reporting, FTE and visit calculations, productivity waiver requests, provider relief fund payments, and cost report filing deadlines. Part of the Rural Health Clinic Technical Assistance Series.
Additional links: Presentation Slides, Transcript
Date: 09/2020
Type: Video/Multimedia
Sponsoring organization: National Association of Rural Health Clinics
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Recording of a September 22, 2020, webinar covering cost reporting basics for Rural Health Clinics (RHCs), including telehealth reporting, FTE and visit calculations, productivity waiver requests, provider relief fund payments, and cost report filing deadlines. Part of the Rural Health Clinic Technical Assistance Series.
Additional links: Presentation Slides, Transcript
Date: 09/2020
Type: Video/Multimedia
Sponsoring organization: National Association of Rural Health Clinics
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Building Capacity for Value
Slides presented at the 2020 Nebraska Rural Health Conference describing the evolution of value-based care. Discusses different approaches to value-based care transformation, including the Medicare Shared Savings Program Accountable Care Organizations and global budgeting. Presents management and leadership strategies to navigate future changes while meeting community health needs.
Author(s): Karla Weng
Date: 09/2020
Type: Presentation Slides
Sponsoring organization: Rural Health Value
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Slides presented at the 2020 Nebraska Rural Health Conference describing the evolution of value-based care. Discusses different approaches to value-based care transformation, including the Medicare Shared Savings Program Accountable Care Organizations and global budgeting. Presents management and leadership strategies to navigate future changes while meeting community health needs.
Author(s): Karla Weng
Date: 09/2020
Type: Presentation Slides
Sponsoring organization: Rural Health Value
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Federal and State Policy Changes Since COVID-19
Video recording of a presentation on federal and state telehealth policy changes during the COVID-19 pandemic. Discusses Centers for Medicare and Medicaid (CMS) policies related to geographic and site location for the patient, provider location and type, and telehealth delivery modality. Addresses common issues related to reimbursement and payment codes, Medicare billing guidance for Federally Qualified Health Centers and Rural Health Clinics, and notes post-COVID policy questions and issues. Transcript available in the video description.
Date: 09/2020
Type: Video/Multimedia
Sponsoring organizations: Centers for Connected Health Policy, Northwest Regional Telehealth Resource Center
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Video recording of a presentation on federal and state telehealth policy changes during the COVID-19 pandemic. Discusses Centers for Medicare and Medicaid (CMS) policies related to geographic and site location for the patient, provider location and type, and telehealth delivery modality. Addresses common issues related to reimbursement and payment codes, Medicare billing guidance for Federally Qualified Health Centers and Rural Health Clinics, and notes post-COVID policy questions and issues. Transcript available in the video description.
Date: 09/2020
Type: Video/Multimedia
Sponsoring organizations: Centers for Connected Health Policy, Northwest Regional Telehealth Resource Center
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A Toolkit for Building and Growing a Sustainable Telehealth Program in Your Practice
Offers information for family practices to develop and implement telehealth strategies in light of the COVID-19 pandemic's impacts on regulatory and reimbursement policies. Topics include telehealth services, payment considerations, program sustainability, licensing and technology requirements, and workflow. Includes 10 telehealth scenarios with breakdowns of payer, technology, staff, coding, and other special considerations.
Date: 09/2020
Type: Document
Sponsoring organizations: American Academy of Family Physicians, Manatt Health
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Offers information for family practices to develop and implement telehealth strategies in light of the COVID-19 pandemic's impacts on regulatory and reimbursement policies. Topics include telehealth services, payment considerations, program sustainability, licensing and technology requirements, and workflow. Includes 10 telehealth scenarios with breakdowns of payer, technology, staff, coding, and other special considerations.
Date: 09/2020
Type: Document
Sponsoring organizations: American Academy of Family Physicians, Manatt Health
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