Rural Health
Resources by Topic: Reimbursement and payment models
Case Study: Exploring Options to Deploy Capitated Payments to Enhance Primary Care in Rural Settings
Discusses the need for primary care services in rural areas. Provides an overview of healthcare delivery models that utilize capitated payments. Presents examples of capitated payment agreements aimed at increasing the use and quality of primary care services in rural communities, and offers lessons learned.
Date: 12/2020
Sponsoring organization: American Hospital Association
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Discusses the need for primary care services in rural areas. Provides an overview of healthcare delivery models that utilize capitated payments. Presents examples of capitated payment agreements aimed at increasing the use and quality of primary care services in rural communities, and offers lessons learned.
Date: 12/2020
Sponsoring organization: American Hospital Association
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An Observational Study of Telemental Care Delivery and the Context for Involuntary Commitment for Mental Health Patients in a Group of Rural Emergency Departments
Examines telemental healthcare delivery in Critical Access Hospital (CAH) emergency departments (ED) in 4 Indiana counties, with a focus on the context surrounding subsequent psychiatric involuntary commitment (IC) or noninvoluntary commitment (non-IC) of mental health patients who presented to the participating EDs. Provides information on patient demographics, ED wait time and length of stay, ED costs and reimbursement, and telehealth parity laws.
Author(s): Roseanne Fairchild, Shiaw-Fen Ferng-Kuo, Hicham Rahmouni, Daniel Hardesty
Citation: Telemedicine Reports, 1(1), 22-35
Date: 11/2020
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Examines telemental healthcare delivery in Critical Access Hospital (CAH) emergency departments (ED) in 4 Indiana counties, with a focus on the context surrounding subsequent psychiatric involuntary commitment (IC) or noninvoluntary commitment (non-IC) of mental health patients who presented to the participating EDs. Provides information on patient demographics, ED wait time and length of stay, ED costs and reimbursement, and telehealth parity laws.
Author(s): Roseanne Fairchild, Shiaw-Fen Ferng-Kuo, Hicham Rahmouni, Daniel Hardesty
Citation: Telemedicine Reports, 1(1), 22-35
Date: 11/2020
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Rural Challenges, Strategies, and Recommendations to Advance Value-Based Payment and Care During and Beyond the COVID-19 Crisis
Describes the key challenges rural primary care and behavioral health providers have faced in delivering care since COVID-19, in addition to the policy changes implemented in response to those challenges. Offers state-level policy recommendations for improving rural primary care and behavioral health services.
Author(s): Angel Bourgoin, Jim Maxwell, Yvette Cho, Rachel Tobey
Date: 11/2020
Sponsoring organization: Delta Center for a Thriving Safety Net
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Describes the key challenges rural primary care and behavioral health providers have faced in delivering care since COVID-19, in addition to the policy changes implemented in response to those challenges. Offers state-level policy recommendations for improving rural primary care and behavioral health services.
Author(s): Angel Bourgoin, Jim Maxwell, Yvette Cho, Rachel Tobey
Date: 11/2020
Sponsoring organization: Delta Center for a Thriving Safety Net
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The Future of State Telehealth Policy
Provides an overview of state and federal telehealth flexibilities implemented during the COVID-19 pandemic. Discusses long-term considerations for governors regarding the impact of these flexibilities on healthcare delivery and payment and the appropriateness of these policies in the future.
Date: 11/2020
Sponsoring organization: National Governors Association
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Provides an overview of state and federal telehealth flexibilities implemented during the COVID-19 pandemic. Discusses long-term considerations for governors regarding the impact of these flexibilities on healthcare delivery and payment and the appropriateness of these policies in the future.
Date: 11/2020
Sponsoring organization: National Governors Association
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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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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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