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Rural Health Information Hub

Rural Health
Resources by Topic: Reimbursement and payment models

The Effectiveness of Policies to Improve Primary Care Access for Underserved Populations: An Assessment of the Literature
Review of research literature to assess whether policy initiatives targeting primary care access for rural and underserved populations has been effective in reducing healthcare disparities. Initiatives considered include availability, accessibility, accommodation, affordability, and acceptability.
Additional links: Fact Sheet: Alleviating Structural Barriers to Obtaining Primary Care Services, Fact Sheet: Bringing Outpatient Clinics into Communities, Fact Sheet: Ensuring Comfort and Communication in the Delivery of Primary Care Services, Fact Sheet: Increasing the Availability of Primary Care Clinicians, Fact Sheet: Removing Financial Barriers to Primary Care
Author(s): Maanasa Kona, Megan Houston, Nia Gooding
Date: 01/2022
Sponsoring organization: Milbank Memorial Fund
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CARES Act Telehealth Expansion: Trends in Post-Discharge Follow-Up and Association with 30-Day Readmissions for Hospital Readmissions Reduction Program Health Conditions
Provides an overview of the Hospital Readmissions Reduction Program (HRRP) and examines the impact of expanded Medicare payment for telehealth services on post-discharge follow-up and hospital readmissions for HRRP conditions. Describes trends in post-discharge follow-up before and after the telehealth expansion and compares trends by health condition, sociodemographic characteristics, rurality, and follow-up method.
Date: 01/2022
Sponsoring organization: Centers for Medicare and Medicaid Services
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U.S. Health Care Expenditures: Costs, Lessons, and Opportunities
Summarizes a March 15-16, 2021, workshop exploring issues related to increasing healthcare spending in the United States. Provides an overview of the scope of healthcare spending in the United States, innovations implemented to address spending, and the role of research in policy change. Includes information on rural payment models.
Additional links: Read Online
Date: 2022
Sponsoring organization: Health and Medicine Division (HMD), National Academies of Sciences, Engineering, and Medicine
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Early Patient-Centered Outcomes Research Experience With the Use of Telehealth to Address Disparities: Scoping Review
Provides an overview of Patient-Centered Outcomes Research Institute (PCORI)-funded research on using telehealth to address health disparities. Describes barriers and facilitators to implementing telehealth in populations at risk for disparities, including people in rural areas, and identifies themes across studies.
Citation: Journal of Medical Internet Research, 23(12), e28503
Date: 12/2021
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State Policy Changes Could Increase Access to Opioid Treatment via Telehealth
Issue brief discussing barriers to opioid use disorder (OUD) treatment via telehealth and policy recommendations to support telehealth, including reimbursement and regulatory policies. Discusses issues of broadband access, infrastructure, and data collection in relation to telehealth implementation.
Date: 12/2021
Sponsoring organization: Pew
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Medicare and Beneficiaries Pay More for Preadmission Services at Affiliated Hospitals Than at Wholly Owned Settings
Provides an overview of the Medicare diagnosis-related group (DRG) window policy. Examines how much Medicare and Medicare beneficiaries paid affiliated settings, including Critical Access Hospitals, for admission-related outpatient services in 2019 that would have otherwise been covered by the DRG policy at wholly-owned hospitals. Offers recommendations to the Centers for Medicare & Medicaid Services (CMS) for updating the DRG policy.
Date: 12/2021
Sponsoring organization: Office of Inspector General (HHS)
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COVID-19 National Emergency: Early Trends in Hospitalizations for Hospital Readmissions Reduction Program Health Conditions and 30-Day Readmission Rates
Provides an overview of the Hospital Readmissions Reduction Program (HRRP). Describes monthly trends in hospitalizations of Medicare beneficiaries for HRRP conditions before and after the implementation of COVID-19 emergency measures through September 30, 2020. Examines how monthly trends in unadjusted 30-day readmission rates before and after implementation of COVID-19 emergency measures and how these rates differ by sociodemographic characteristics, including rurality. Discusses policy opportunities and interventions to enhance post-discharge follow-up and reduce readmission rates.
Date: 12/2021
Sponsoring organization: Centers for Medicare and Medicaid Services
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December 2021 MedPAC Meeting Transcript
Transcript from the Medicare Payment Advisory Commission's (MedPAC) December 2021 meeting. Covers payment adequacy and updates for hospital inpatient and outpatient services and the mandated report on changes to the low-volume hospital payment adjustment, physician and other health professional services, ambulatory surgical center services, outpatient dialysis services, and hospice services. Highlights the effect of COVID-19 relief funding on rural hospital margins, rural hospital bypass, and rural hospice payment utilization, among other rural references.
Date: 12/2021
Sponsoring organization: Medicare Payment Advisory Commission
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Understanding the "Tool-ish-ness" of Telehealth: Q&A with Dr. Jonathan Neufeld
An interview with clinical psychologist and program director for the Great Plains Telehealth Resource & Assistance Center, Dr. Jonathan Neufeld. Discusses the role of telehealth in healthcare delivery. Describes how telecommunications tools can be used by providers to bring quality care to rural areas.
Author(s): Kay Miller Temple
Citation: Rural Monitor
Date: 12/2021
Sponsoring organization: Rural Health Information Hub
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Final CY 2022 Physician Fee Schedule
Fact sheet addressing the Centers for Medicare and Medicaid Services policies for Medicare beginning on January 1, 2022. Includes sections on telehealth services, the Consolidated Appropriations Act, audio-only services, communications technology based services, Federally Qualified Health Centers and Rural Health Clinics, and additional policies.
Date: 11/2021
Sponsoring organization: Center for Connected Health Policy: The National Telehealth Policy Resource Center
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