Rural Health
Resources by Topic: Reimbursement and payment models
Medicare: Information on the Transition to Alternative Payment Models by Providers in Rural, Health Professional Shortage, or Underserved Areas
Describes the participation of providers in rural and health professional shortage areas in Advanced APMs from 2017 through 2019. Discusses challenges providers in rural, shortage, and underserved areas face in transitioning to APMs, as well as actions CMS takes to help these providers transition to APMs. Includes data by practice and provider type.
Additional links: Full Report
Date: 11/2021
Sponsoring organization: Government Accountability Office
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Describes the participation of providers in rural and health professional shortage areas in Advanced APMs from 2017 through 2019. Discusses challenges providers in rural, shortage, and underserved areas face in transitioning to APMs, as well as actions CMS takes to help these providers transition to APMs. Includes data by practice and provider type.
Additional links: Full Report
Date: 11/2021
Sponsoring organization: Government Accountability Office
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Rural Emergency Hospital: Policy Brief and Recommendations to the Secretary
Describes the development of the Rural Emergency Hospital (REH) designation in response to rural hospital closures and issues accessing emergency care. Lists statutory requirements for hospitals wishing to become an REH, and offers policy recommendations related to participation conditions, quality reporting, reimbursement, and emergency medical transfer agreement.
Date: 10/2021
Sponsoring organization: National Advisory Committee on Rural Health and Human Services
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Describes the development of the Rural Emergency Hospital (REH) designation in response to rural hospital closures and issues accessing emergency care. Lists statutory requirements for hospitals wishing to become an REH, and offers policy recommendations related to participation conditions, quality reporting, reimbursement, and emergency medical transfer agreement.
Date: 10/2021
Sponsoring organization: National Advisory Committee on Rural Health and Human Services
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Driving Health System Transformation - A Strategy for the CMS Innovation Center's Second Decade
White paper describing the new vision and strategic objectives for the Center for Medicare and Medicaid Innovation (CMS Innovation Center) for the next 10 years that seeks to achieve equitable health outcomes through the provision of high-quality, affordable, person-centered care. Shares beneficiary and healthcare provider goals for each strategic objective in Table 2. Strategic objectives include: driving accountable care, advancing health equity, supporting innovation, addressing affordability, and partnering to achieve healthcare system transformation. Includes discussion on models focused on improving rural health and ways of increasing participation in those models in rural and underserved areas.
Additional links: At a Glance
Date: 10/2021
Sponsoring organization: Centers for Medicare & Medicaid Services
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White paper describing the new vision and strategic objectives for the Center for Medicare and Medicaid Innovation (CMS Innovation Center) for the next 10 years that seeks to achieve equitable health outcomes through the provision of high-quality, affordable, person-centered care. Shares beneficiary and healthcare provider goals for each strategic objective in Table 2. Strategic objectives include: driving accountable care, advancing health equity, supporting innovation, addressing affordability, and partnering to achieve healthcare system transformation. Includes discussion on models focused on improving rural health and ways of increasing participation in those models in rural and underserved areas.
Additional links: At a Glance
Date: 10/2021
Sponsoring organization: Centers for Medicare & Medicaid Services
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Medicare: Provider Performance and Experiences Under the Merit-Based Incentive Payment System
Examines Centers for Medicare and Medicaid Services (CMS) data on Merit-Based Incentive Payment System (MIPS) performance category scores, final scores, and payment adjustments from performance years 2017 through 2019. Summarizes interviews with 11 stakeholder groups and identifies strengths and challenges of the MIPS program. Presents data on MIPS performance scores and related payment adjustments by practice size, geographic location, method of participation, and specialty.
Additional links: Full Report
Date: 10/2021
Sponsoring organization: Government Accountability Office
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Examines Centers for Medicare and Medicaid Services (CMS) data on Merit-Based Incentive Payment System (MIPS) performance category scores, final scores, and payment adjustments from performance years 2017 through 2019. Summarizes interviews with 11 stakeholder groups and identifies strengths and challenges of the MIPS program. Presents data on MIPS performance scores and related payment adjustments by practice size, geographic location, method of participation, and specialty.
Additional links: Full Report
Date: 10/2021
Sponsoring organization: Government Accountability Office
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Who Will Answer the Call? An Abstract of Challenges Facing Michigan's Rural EMS Agencies
Provides an overview of challenges experienced by Michigan's rural emergency medical services (EMS) agencies, such as reimbursement, access to care, recruitment and retention, workforce shortages and training, and more.
Date: 09/2021
Sponsoring organization: Rural Subcommittee of the EMS Coordinating Committee
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Provides an overview of challenges experienced by Michigan's rural emergency medical services (EMS) agencies, such as reimbursement, access to care, recruitment and retention, workforce shortages and training, and more.
Date: 09/2021
Sponsoring organization: Rural Subcommittee of the EMS Coordinating Committee
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Addressing Health-Related Social Needs to Improve Rural Health: Ideas to Action
Identifies strategies for building community and regional systems of care to better address the social needs of patients and inform the design of community-level rural health transformation initiatives, pilots, or demonstrations in rural Maine. Examines existing literature and evidence from similar initiatives in Vermont, Idaho, and Oregon, and highlights key observations. Describes key components of a demonstration designed to build, implement, and test strategies for aligning health, social service, and other systems in order to advance whole-person care.
Author(s): Andrew F. Coburn, Deborah A. Deatrick
Date: 09/2021
Sponsoring organizations: Maine Rural Health Action Network, New England Rural Health Association
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Identifies strategies for building community and regional systems of care to better address the social needs of patients and inform the design of community-level rural health transformation initiatives, pilots, or demonstrations in rural Maine. Examines existing literature and evidence from similar initiatives in Vermont, Idaho, and Oregon, and highlights key observations. Describes key components of a demonstration designed to build, implement, and test strategies for aligning health, social service, and other systems in order to advance whole-person care.
Author(s): Andrew F. Coburn, Deborah A. Deatrick
Date: 09/2021
Sponsoring organizations: Maine Rural Health Action Network, New England Rural Health Association
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Health Panel Comment Letter – Rural Emergency Hospitals (REH)
Offers comments in response to the Centers for Medicare and Medicaid Services (CMS) Request for Information on Rural Emergency Hospitals (REH). Addresses the type and scope of services REHs could offer, conditions of participation, collaboration and care coordination, quality measurement, payment, and more.
Date: 09/2021
Sponsoring organization: Rural Policy Research Institute Rural Health Panel
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Offers comments in response to the Centers for Medicare and Medicaid Services (CMS) Request for Information on Rural Emergency Hospitals (REH). Addresses the type and scope of services REHs could offer, conditions of participation, collaboration and care coordination, quality measurement, payment, and more.
Date: 09/2021
Sponsoring organization: Rural Policy Research Institute Rural Health Panel
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Identifying Allowable Expenses for COVID-19 Programs
Recording of a September 23, 2021, webinar on the Rural Health Clinic (RHC) COVID-19 Testing Program and RHC COVID-19 Testing and Mitigation Program. Discusses allowable and unallowable expenses for these programs, as well as reimbursable and unreimbursable expenses.
Additional links: Presentation Slides, Transcript
Date: 09/2021
Sponsoring organization: National Association of Rural Health Clinics
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Recording of a September 23, 2021, webinar on the Rural Health Clinic (RHC) COVID-19 Testing Program and RHC COVID-19 Testing and Mitigation Program. Discusses allowable and unallowable expenses for these programs, as well as reimbursable and unreimbursable expenses.
Additional links: Presentation Slides, Transcript
Date: 09/2021
Sponsoring organization: National Association of Rural Health Clinics
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Evaluation of the Rural Community Hospital Demonstration: Report Covering 2005-2017 (Interim Report 1)
Provides an overview of the Rural Community Hospital Demonstration (RCHD). Describes the characteristics of RCHD participants that entered the demonstration between 2005-2012, the Medicare payments received under program, and the impact of the RCHD on hospital finances between 2005-2017.
Additional links: Findings at a Glance
Date: 09/2021
Sponsoring organization: Centers for Medicare & Medicaid Services
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Provides an overview of the Rural Community Hospital Demonstration (RCHD). Describes the characteristics of RCHD participants that entered the demonstration between 2005-2012, the Medicare payments received under program, and the impact of the RCHD on hospital finances between 2005-2017.
Additional links: Findings at a Glance
Date: 09/2021
Sponsoring organization: Centers for Medicare & Medicaid Services
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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 2022
Comments on an August 4, 2021, Federal Register proposed rule revising the Medicare Hospital Outpatient Prospective Payment System (OPPS) and Medicare Ambulatory Surgical Center (ACS) payment system for calendar year 2022. Includes considerations for Rural Emergency Hospital payments and emergency department staffing requirements.
Date: 09/2021
Sponsoring organization: Medicare Payment Advisory Commission
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Comments on an August 4, 2021, Federal Register proposed rule revising the Medicare Hospital Outpatient Prospective Payment System (OPPS) and Medicare Ambulatory Surgical Center (ACS) payment system for calendar year 2022. Includes considerations for Rural Emergency Hospital payments and emergency department staffing requirements.
Date: 09/2021
Sponsoring organization: Medicare Payment Advisory Commission
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