Rural Health
Resources by Topic: Reimbursement and payment models
Medicaid and CHIP in the Commonwealth of the Northern Mariana Islands
Summarizes key requirements and design features of Medicaid and the State Children's Health Insurance Program (CHIP) in the Northern Mariana Islands. Features statistics on program costs from fiscal years 2011-2019, with breakdowns by federal spending and Northern Mariana Islands spending.
Date: 02/2021
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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Summarizes key requirements and design features of Medicaid and the State Children's Health Insurance Program (CHIP) in the Northern Mariana Islands. Features statistics on program costs from fiscal years 2011-2019, with breakdowns by federal spending and Northern Mariana Islands spending.
Date: 02/2021
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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January 2021 MACPAC Meeting Transcript
Transcript from the Medicaid and CHIP Payment and Access Commission's (MACPAC) January 2021 meeting. Covers the review of draft chapters and recommendations regarding postpartum coverage, estate recovery, automatic countercyclical financing adjustment, design considerations for creating a new unified program for dually eligible beneficiaries, and housing supports for individuals with substance use disorder, among other things. Also details a MACPAC study on non-emergency medical transportation (NEMT), which includes a discussion of NEMT in rural areas.
Date: 01/2021
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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Transcript from the Medicaid and CHIP Payment and Access Commission's (MACPAC) January 2021 meeting. Covers the review of draft chapters and recommendations regarding postpartum coverage, estate recovery, automatic countercyclical financing adjustment, design considerations for creating a new unified program for dually eligible beneficiaries, and housing supports for individuals with substance use disorder, among other things. Also details a MACPAC study on non-emergency medical transportation (NEMT), which includes a discussion of NEMT in rural areas.
Date: 01/2021
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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January 2021 MedPAC Meeting Transcript
Transcript from the Medicare Payment Advisory Commission's (MedPAC) January 2021 meeting. Features a discussion on the expansion of telehealth in Medicare. Also covers payment adequacy and updates for hospital inpatient and outpatient services and the mandated report expanding the post-acute care transfer policy to hospice, physician and other health professional services, ambulatory surgical center services, outpatient dialysis services, hospice services, skilled nursing facility services, home health agency services, inpatient rehabilitation facility services, long-term care hospital services, and CMMI's development and implementation of alternative payment models.
Date: 01/2021
Sponsoring organization: Medicare Payment Advisory Commission
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Transcript from the Medicare Payment Advisory Commission's (MedPAC) January 2021 meeting. Features a discussion on the expansion of telehealth in Medicare. Also covers payment adequacy and updates for hospital inpatient and outpatient services and the mandated report expanding the post-acute care transfer policy to hospice, physician and other health professional services, ambulatory surgical center services, outpatient dialysis services, hospice services, skilled nursing facility services, home health agency services, inpatient rehabilitation facility services, long-term care hospital services, and CMMI's development and implementation of alternative payment models.
Date: 01/2021
Sponsoring organization: Medicare Payment Advisory Commission
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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 & Medicaid Services.
Author(s): Emily J. Cook, Sandra M. DiVarco, Caroline Reigart
Citation: National Law Review, XI(5)
Date: 01/2021
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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 & Medicaid Services.
Author(s): Emily J. Cook, Sandra M. DiVarco, Caroline Reigart
Citation: National Law Review, XI(5)
Date: 01/2021
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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
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
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
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
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
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
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
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
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
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
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
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
Sponsoring organization: Government Accountability Office
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