Rural Health
Resources by Topic: Reimbursement and payment models
Rethinking Rural Health: FY 2020 Year in Review
Provides an overview of Centers for Medicaid and Medicare Services (CMS) programs and activities that have affected rural health and healthcare in fiscal year 2020. Focuses on nine priority areas: COVID-19, maternal health, Medicare Advantage (MA) and the Federally-facilitated Marketplace (FFM), quality improvement, practitioner engagement, patient empowerment and person-centered care, Medicare and Medicaid payment and policy, models and demonstrations, and telehealth.
Date: 11/2020
Sponsoring organization: Centers for Medicare and Medicaid Services
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Provides an overview of Centers for Medicaid and Medicare Services (CMS) programs and activities that have affected rural health and healthcare in fiscal year 2020. Focuses on nine priority areas: COVID-19, maternal health, Medicare Advantage (MA) and the Federally-facilitated Marketplace (FFM), quality improvement, practitioner engagement, patient empowerment and person-centered care, Medicare and Medicaid payment and policy, models and demonstrations, and telehealth.
Date: 11/2020
Sponsoring organization: Centers for Medicare and Medicaid Services
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Overview of Emergency Department Visits Related to Injuries, by Cause of Injury, 2017
Presents statistics on emergency department (ED) visits related to injuries in 2017. Includes the number of ED visits related to each cause of injury; the percentage of visits that resulted in the patient being admitted or transferred to another hospital; rate of ED visit due to injuries by different population characteristics including age, sex, income, and rural status; and the distribution of primary expected payer for ED visits related to injuries.
Author(s): Audrey J. Weiss, Lawrence D. Reid, Marguerite L. Barrett
Date: 11/2020
Sponsoring organization: Agency for Healthcare Research and Quality
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Presents statistics on emergency department (ED) visits related to injuries in 2017. Includes the number of ED visits related to each cause of injury; the percentage of visits that resulted in the patient being admitted or transferred to another hospital; rate of ED visit due to injuries by different population characteristics including age, sex, income, and rural status; and the distribution of primary expected payer for ED visits related to injuries.
Author(s): Audrey J. Weiss, Lawrence D. Reid, Marguerite L. Barrett
Date: 11/2020
Sponsoring organization: Agency for Healthcare Research and Quality
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October 2020 MedPAC Meeting Transcript
Transcript from the Medicare Payment Advisory Commission's (MedPAC) October 2020 meeting. Covers an alternative value incentive program that corrects current shortcomings for the skilled nursing facility value-based purchasing program; future research directions in hospice payment policy; balancing financial pressure and equity in Medicare Advantage benchmark policy; and current Medicare indirect medical education policy, concerns, and principles for revising. Includes rural references throughout.
Date: 10/2020
Sponsoring organization: Medicare Payment Advisory Commission
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Transcript from the Medicare Payment Advisory Commission's (MedPAC) October 2020 meeting. Covers an alternative value incentive program that corrects current shortcomings for the skilled nursing facility value-based purchasing program; future research directions in hospice payment policy; balancing financial pressure and equity in Medicare Advantage benchmark policy; and current Medicare indirect medical education policy, concerns, and principles for revising. Includes rural references throughout.
Date: 10/2020
Sponsoring organization: Medicare Payment Advisory Commission
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Billing & Coding Telehealth
Recording of a webinar presented in October at the NARHC 2020 Virtual Fall Institute covering telehealth billing requirements relevant during the COVID-19 pandemic. Discusses changes that may occur once the public health emergency end, and the posting and coding of telehealth services on a cost report.
Additional links: Presentation Slides
Date: 10/2020
Sponsoring organization: National Association of Rural Health Clinics
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Recording of a webinar presented in October at the NARHC 2020 Virtual Fall Institute covering telehealth billing requirements relevant during the COVID-19 pandemic. Discusses changes that may occur once the public health emergency end, and the posting and coding of telehealth services on a cost report.
Additional links: Presentation Slides
Date: 10/2020
Sponsoring organization: National Association of Rural Health Clinics
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Navigating RHC COVID-19 Testing Fund Reporting Requirements
Recording of an October 7, 2020, webinar providing detailed information about the reporting requirements for the Rural Health Clinic (RHC) COVID-19 Testing Relief Fund. Discusses the importance of reporting data and the type of data that should be documented. Part of the Rural Health Clinic Technical Assistance Series.
Additional links: Presentation Slides, Transcript
Date: 10/2020
Sponsoring organization: National Association of Rural Health Clinics
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Recording of an October 7, 2020, webinar providing detailed information about the reporting requirements for the Rural Health Clinic (RHC) COVID-19 Testing Relief Fund. Discusses the importance of reporting data and the type of data that should be documented. Part of the Rural Health Clinic Technical Assistance Series.
Additional links: Presentation Slides, Transcript
Date: 10/2020
Sponsoring organization: National Association of Rural Health Clinics
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Anesthesia Services: Differences between Private and Medicare Payments Likely Due to Providers' Strong Negotiating Position
Examines trends in differences between Medicare and private payments for anesthesia services, as well as the the supply of anesthesia providers for Medicare beneficiaries. Includes a discussion on the availability of anesthesia providers in rural areas.
Additional links: Full Report
Date: 10/2020
Sponsoring organization: Government Accountability Office
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Examines trends in differences between Medicare and private payments for anesthesia services, as well as the the supply of anesthesia providers for Medicare beneficiaries. Includes a discussion on the availability of anesthesia providers in rural areas.
Additional links: Full Report
Date: 10/2020
Sponsoring organization: Government Accountability Office
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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
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
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
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
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
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
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
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
Sponsoring organization: Medicare Payment Advisory Commission
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