Rural Health
Resources by Topic: Reimbursement and payment models
Out‐of‐Network Air Ambulance Bills: Prevalence, Magnitude, and Policy Solutions
Examines the prevalence and cost of surprise air ambulance bills among privately insured patients. Describes air ambulance rates for commercial payers in relation to Medicare rates. Compares the number of air ambulance claims from urban and rural locations. Offers policy solutions to address surprise and out-of-network bills for these services.
Author(s): Erin C. Fuse Brown, Erin Trish, Bich Ly, Mark Hall, Loren Adler
Citation: Milbank Quarterly, 98(3), 747-774
Date: 06/2020
view details
Examines the prevalence and cost of surprise air ambulance bills among privately insured patients. Describes air ambulance rates for commercial payers in relation to Medicare rates. Compares the number of air ambulance claims from urban and rural locations. Offers policy solutions to address surprise and out-of-network bills for these services.
Author(s): Erin C. Fuse Brown, Erin Trish, Bich Ly, Mark Hall, Loren Adler
Citation: Milbank Quarterly, 98(3), 747-774
Date: 06/2020
view details
How Telehealth Policy is Structured in the United States
June 23, 2020, webinar recording provides an overview of the telehealth policy landscape on the federal and state levels. Discusses telehealth reimbursement policies. Outlines federal and state telehealth policy changes as a result of the COVID-19 pandemic.
Additional links: Presentation Slides
Date: 06/2020
Sponsoring organization: Center for Connected Health Policy: The National Telehealth Policy Resource Center
view details
June 23, 2020, webinar recording provides an overview of the telehealth policy landscape on the federal and state levels. Discusses telehealth reimbursement policies. Outlines federal and state telehealth policy changes as a result of the COVID-19 pandemic.
Additional links: Presentation Slides
Date: 06/2020
Sponsoring organization: Center for Connected Health Policy: The National Telehealth Policy Resource Center
view details
Provision of Mental Health Services by Critical Access Hospital-Based Rural Health Clinics
Examines the extent to which Critical Access Hospital (CAH)-based Rural Health Clinics (RHCs) provide mental health services. Describes the characteristics and staffing patterns of CAH-based RHCs that offer these services. Explores challenges of providing mental health services at RHCs and strategies for integrating mental health and primary care services.
Author(s): John Gale, Zachariah Croll, Nathan First, Sara Kahn-Troster
Date: 06/2020
Sponsoring organization: Flex Monitoring Team
view details
Examines the extent to which Critical Access Hospital (CAH)-based Rural Health Clinics (RHCs) provide mental health services. Describes the characteristics and staffing patterns of CAH-based RHCs that offer these services. Explores challenges of providing mental health services at RHCs and strategies for integrating mental health and primary care services.
Author(s): John Gale, Zachariah Croll, Nathan First, Sara Kahn-Troster
Date: 06/2020
Sponsoring organization: Flex Monitoring Team
view details
CMS Bundled Payments for Care Improvement Advanced Model: Year 1 Evaluation Annual Report
A formative evaluation of the Bundled Payments for Care Improvement Advanced (BPCI Advanced) Model, which tests whether linking payments for a clinical episode of care can reduce Medicare expenditures while maintaining or improving quality of care. Covers the period from October 1, 2018 through March 31, 2019. Describes participants in the model, clinical episodes included, and the reach of the model. Includes information on rural hospital participation in the model.
Additional links: Appendices, Findings at a Glance
Author(s): The Lewin Group, Abt Associates, GDIT, Telligen
Date: 06/2020
Sponsoring organization: Centers for Medicare and Medicaid Services
view details
A formative evaluation of the Bundled Payments for Care Improvement Advanced (BPCI Advanced) Model, which tests whether linking payments for a clinical episode of care can reduce Medicare expenditures while maintaining or improving quality of care. Covers the period from October 1, 2018 through March 31, 2019. Describes participants in the model, clinical episodes included, and the reach of the model. Includes information on rural hospital participation in the model.
Additional links: Appendices, Findings at a Glance
Author(s): The Lewin Group, Abt Associates, GDIT, Telligen
Date: 06/2020
Sponsoring organization: Centers for Medicare and Medicaid Services
view details
MedPAC Report to the Congress: Medicare and the Health Care Delivery System, June 2020
Evaluates Medicare payment issues and offers recommendations to the U.S. Congress. Includes chapters on value-based payment in Medicare, Accountable Care Organizations (ACOs), the Medicare Advantage quality bonus program, the impact of changes in the 21st Century Cures Act to risk adjustment for Medicare Advantage enrollees, Medicare Part D, separately payable drugs in the hospital outpatient prospective payment system, and the Medicare end-stage renal disease prospective payment system. Examines the current payment policy for low-volume and rural dialysis facilities and proposes changes.
Additional links: Executive Summary
Date: 06/2020
Sponsoring organization: Medicare Payment Advisory Commission
view details
Evaluates Medicare payment issues and offers recommendations to the U.S. Congress. Includes chapters on value-based payment in Medicare, Accountable Care Organizations (ACOs), the Medicare Advantage quality bonus program, the impact of changes in the 21st Century Cures Act to risk adjustment for Medicare Advantage enrollees, Medicare Part D, separately payable drugs in the hospital outpatient prospective payment system, and the Medicare end-stage renal disease prospective payment system. Examines the current payment policy for low-volume and rural dialysis facilities and proposes changes.
Additional links: Executive Summary
Date: 06/2020
Sponsoring organization: Medicare Payment Advisory Commission
view details
Report to Congress on Medicaid and CHIP, June 2020
Semi-annual report to Congress from the Medicaid and CHIP Payment and Access Commission (MACPAC). Discusses care integration for beneficiaries dually eligible for Medicaid and Medicare, recommendations for increasing enrollment in Medicare Shared Savings Programs, the role of Medicaid in relation to TRICARE, how to address increasing mortality and morbidity among pregnant and postpartum women, and the effects of substance use disorder on pregnant and postpartum women and their infants. Includes rural references throughout.
Date: 06/2020
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
view details
Semi-annual report to Congress from the Medicaid and CHIP Payment and Access Commission (MACPAC). Discusses care integration for beneficiaries dually eligible for Medicaid and Medicare, recommendations for increasing enrollment in Medicare Shared Savings Programs, the role of Medicaid in relation to TRICARE, how to address increasing mortality and morbidity among pregnant and postpartum women, and the effects of substance use disorder on pregnant and postpartum women and their infants. Includes rural references throughout.
Date: 06/2020
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
view details
Telehealth and Telemedicine in Missouri
Discusses telehealth programs in Missouri, including the early contributions of the Missouri Telehealth Network to the growth of telehealth and the MO HealthNet program. Discusses telehealth's impact on rural healthcare access and state-level approaches to reimbursement, licensing, restrictions, and telemedicine delivery.
Author(s): Mirna Becevic, Lincoln R. Sheets, Emmanuelle Wallach, et al.
Citation: Missouri Medicine, 117(3), 228-234
Date: 05/2020
view details
Discusses telehealth programs in Missouri, including the early contributions of the Missouri Telehealth Network to the growth of telehealth and the MO HealthNet program. Discusses telehealth's impact on rural healthcare access and state-level approaches to reimbursement, licensing, restrictions, and telemedicine delivery.
Author(s): Mirna Becevic, Lincoln R. Sheets, Emmanuelle Wallach, et al.
Citation: Missouri Medicine, 117(3), 228-234
Date: 05/2020
view details
RHC COVID-19 Testing Funds: What You Need to Know
Recording of a May 26, 2020, webinar providing information about the funding appropriated by the Congress as part of the Coronavirus Aid, Relief, and Economic Security (CARES) Act for Rural Health Clinics (RHCs) to support COVID-19 testing and related activities. Discusses the specific terms and conditions RHCs will have to meet when spending the money to defeat the pandemic. Part of the Rural Health Clinic Technical Assistance Series.
Additional links: Presentation Slides, Transcript
Date: 05/2020
Sponsoring organization: National Association of Rural Health Clinics
view details
Recording of a May 26, 2020, webinar providing information about the funding appropriated by the Congress as part of the Coronavirus Aid, Relief, and Economic Security (CARES) Act for Rural Health Clinics (RHCs) to support COVID-19 testing and related activities. Discusses the specific terms and conditions RHCs will have to meet when spending the money to defeat the pandemic. Part of the Rural Health Clinic Technical Assistance Series.
Additional links: Presentation Slides, Transcript
Date: 05/2020
Sponsoring organization: National Association of Rural Health Clinics
view details
Health Panel Comment Letter – Maternal and Infant Health Care in Rural Communities
Offers comments in response to the CMS Maternal and Infant Health Care in Rural Communities Request for Information. Describes Medicare cost reporting challenges for obstetric services at Critical Access Hospitals and possible changes to maternal health coverage under Medicaid.
Date: 05/2020
Sponsoring organization: Rural Policy Research Institute Rural Health Panel
view details
Offers comments in response to the CMS Maternal and Infant Health Care in Rural Communities Request for Information. Describes Medicare cost reporting challenges for obstetric services at Critical Access Hospitals and possible changes to maternal health coverage under Medicaid.
Date: 05/2020
Sponsoring organization: Rural Policy Research Institute Rural Health Panel
view details
Fact Sheet: Rural Community Hospital (RCH) Demonstration
Provides an overview of the Rural Community Hospital demonstration program. Describes reimbursement challenges that rural hospitals face and the early results of the program.
Date: 05/2020
Sponsoring organization: American Hospital Association
view details
Provides an overview of the Rural Community Hospital demonstration program. Describes reimbursement challenges that rural hospitals face and the early results of the program.
Date: 05/2020
Sponsoring organization: American Hospital Association
view details