Rural Health
Resources by Topic: Reimbursement and payment models
Medicare Payment Basics: Inpatient Psychiatric Facilities Services Payment System
Overview of Medicare's payment system for inpatient psychiatric services provided in freestanding hospitals or specialized hospital-based units. Demonstrates how payments for these services are adjusted to reflect geographic differences in labor costs, and cost of care by facility and patient characteristics.
Date: 10/2024
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Overview of Medicare's payment system for inpatient psychiatric services provided in freestanding hospitals or specialized hospital-based units. Demonstrates how payments for these services are adjusted to reflect geographic differences in labor costs, and cost of care by facility and patient characteristics.
Date: 10/2024
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Medicare Payment Basics: Hospital Acute Inpatient Services Payment System
Overview of Medicare payments to hospitals for acute inpatient care. Includes information on rate setting, Medicare payments for medical education, payments to Medicare Disproportionate Share Hospitals (DSH), new technology payments special payments for rural hospitals, quality incentive payments and penalties, and payment rate updates.
Date: 10/2024
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Overview of Medicare payments to hospitals for acute inpatient care. Includes information on rate setting, Medicare payments for medical education, payments to Medicare Disproportionate Share Hospitals (DSH), new technology payments special payments for rural hospitals, quality incentive payments and penalties, and payment rate updates.
Date: 10/2024
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Medicare Payment Basics: Hospice Services Payment System
Overview of the Medicare hospice benefit and Medicare payments to hospice providers. Describes the four levels of care of the hospice prospective payment system and payment rates.
Date: 10/2024
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Overview of the Medicare hospice benefit and Medicare payments to hospice providers. Describes the four levels of care of the hospice prospective payment system and payment rates.
Date: 10/2024
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Medicare Payment Basics: Home Health Care Services Payment System
Overview of Medicare payments for home health care services. Includes information on rate-setting and payments for quality reporting and performance. Describes the Patient-Driven Groupings Model (PDGM) and the home health resource groups (HHRGs) based on clinical and functional status.
Date: 10/2024
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Overview of Medicare payments for home health care services. Includes information on rate-setting and payments for quality reporting and performance. Describes the Patient-Driven Groupings Model (PDGM) and the home health resource groups (HHRGs) based on clinical and functional status.
Date: 10/2024
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Medicare Payment Basics: Durable Medical Equipment Payment System
Overview of Medicare payments for medical equipment used to treat beneficiaries at home. Defines durable medical equipment (DME), details the DME fee schedule, and discusses the competitive bidding program (CBP) for DME. Includes information on adjustments to fee schedule payment rates outside of competitive bidding areas (CBAs).
Date: 10/2024
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Overview of Medicare payments for medical equipment used to treat beneficiaries at home. Defines durable medical equipment (DME), details the DME fee schedule, and discusses the competitive bidding program (CBP) for DME. Includes information on adjustments to fee schedule payment rates outside of competitive bidding areas (CBAs).
Date: 10/2024
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Medicare Payment Basics: Ambulance Services Payment System
Provides an overview of Medicare payments for ambulance services. Discusses rural add-on payment policies, geographic categories determining payment rates, super-rural ZIP codes, and ambulance fee schedules.
Date: 10/2024
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Provides an overview of Medicare payments for ambulance services. Discusses rural add-on payment policies, geographic categories determining payment rates, super-rural ZIP codes, and ambulance fee schedules.
Date: 10/2024
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Medicare Payment Basics: Accountable Care Organizations Payment Systems
Provides an overview of Medicare's Accountable Care Organization (ACO) programs. Discusses the payment mechanics of ACOs, including the maximum shared savings and losses of Medicare Shared Savings Program ACOs by track and level.
Date: 10/2024
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Provides an overview of Medicare's Accountable Care Organization (ACO) programs. Discusses the payment mechanics of ACOs, including the maximum shared savings and losses of Medicare Shared Savings Program ACOs by track and level.
Date: 10/2024
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Medicare Payment Basics: Critical Access Hospitals Payment System
Presents an overview of Medicare payments for Critical Access Hospitals (CAHs). Compares differences in Medicare payments for CAHs, Sole Community Hospitals, and Medicare-Dependent Hospitals.
Date: 10/2024
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Presents an overview of Medicare payments for Critical Access Hospitals (CAHs). Compares differences in Medicare payments for CAHs, Sole Community Hospitals, and Medicare-Dependent Hospitals.
Date: 10/2024
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Final Report of the Rural Texas Obstetrics Study
Uses data analysis, interviews, and surveys to report on rural obstetrics access issues in Texas. Discusses facility closures, distance to care, provider shortages, reimbursements, and healthcare quality. Offers an analysis of 15 facilities that closed OB departments to understand potential drivers of closures. Email address required to access report.
Date: 09/2024
Type: Document
Sponsoring organization: Stroudwater Associates
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Uses data analysis, interviews, and surveys to report on rural obstetrics access issues in Texas. Discusses facility closures, distance to care, provider shortages, reimbursements, and healthcare quality. Offers an analysis of 15 facilities that closed OB departments to understand potential drivers of closures. Email address required to access report.
Date: 09/2024
Type: Document
Sponsoring organization: Stroudwater Associates
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September 2024 MedPAC Meeting Transcript
Transcript from the Medicare Payment Advisory Commission's (MedPAC) September 2024 meeting. Covers Medicare's overall financial situation, cost-sharing for outpatient services at Critical Access Hospitals, and experiences and challenges of measuring the quality of care provided by rural providers.
Additional links: Cost Sharing for Outpatient Services at Critical Access Hospitals - Presentation Slides, Medicare's Measurement of Rural Provider Quality - Presentation Slides
Date: 09/2024
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Transcript from the Medicare Payment Advisory Commission's (MedPAC) September 2024 meeting. Covers Medicare's overall financial situation, cost-sharing for outpatient services at Critical Access Hospitals, and experiences and challenges of measuring the quality of care provided by rural providers.
Additional links: Cost Sharing for Outpatient Services at Critical Access Hospitals - Presentation Slides, Medicare's Measurement of Rural Provider Quality - Presentation Slides
Date: 09/2024
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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