Rural Health
Resources by Topic: Reimbursement and payment models
The Evolution of Annual Wellness Visits at Bellin Health Partners Next Generation Accountable Care Organization
Features a primarily rural Accountable Care Organization serving Michigan's upper peninsula and northeastern Wisconsin. Outlines their initiative to maximize the benefits of annual wellness visits using a care team and health information technology. Addresses provider incentives and efforts to improve care team communications, as well as the initiative's results and next steps.
Date: 05/2018
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Features a primarily rural Accountable Care Organization serving Michigan's upper peninsula and northeastern Wisconsin. Outlines their initiative to maximize the benefits of annual wellness visits using a care team and health information technology. Addresses provider incentives and efforts to improve care team communications, as well as the initiative's results and next steps.
Date: 05/2018
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Telemedicine Reimbursement
Policy position brief showing how telemedicine can help safety net providers care for people who live and work in rural and underserved areas. Lists types of programs, explores reimbursement issues, gives examples of innovative programs with telemedicine components, and offers recommendations for increasing access and improving outcomes.
Author(s): Becky Sanders, Zach Allen, Greg Maurer
Date: 05/2018
Type: Document
Sponsoring organization: National Rural Health Association
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Policy position brief showing how telemedicine can help safety net providers care for people who live and work in rural and underserved areas. Lists types of programs, explores reimbursement issues, gives examples of innovative programs with telemedicine components, and offers recommendations for increasing access and improving outcomes.
Author(s): Becky Sanders, Zach Allen, Greg Maurer
Date: 05/2018
Type: Document
Sponsoring organization: National Rural Health Association
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Demonstrations and Pilots: Rural Centric Transformation
Policy brief describing the need for an intentional increase in funding for rural centric innovation for demonstration projects and pilot programs. Analyzes current national policies and National Rural Health Association (NRHA) policy positions, and covers the need for rural specific demonstration project data. Includes policy recommendations.
Author(s): Kathy Whitmire, Sue Grafstrom, Erin Tanenbaum
Date: 05/2018
Type: Document
Sponsoring organization: National Rural Health Association
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Policy brief describing the need for an intentional increase in funding for rural centric innovation for demonstration projects and pilot programs. Analyzes current national policies and National Rural Health Association (NRHA) policy positions, and covers the need for rural specific demonstration project data. Includes policy recommendations.
Author(s): Kathy Whitmire, Sue Grafstrom, Erin Tanenbaum
Date: 05/2018
Type: Document
Sponsoring organization: National Rural Health Association
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Toward Hospital Global Budgeting: State Considerations
Overview of hospital global budgeting, using case studies from Maryland, Pennsylvania, and Vermont. Explores ways in which global budgets can offer some financial stability for rural hospitals.
Author(s): Robert Murray
Date: 05/2018
Type: Document
Sponsoring organization: State Health & Value Strategies
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Overview of hospital global budgeting, using case studies from Maryland, Pennsylvania, and Vermont. Explores ways in which global budgets can offer some financial stability for rural hospitals.
Author(s): Robert Murray
Date: 05/2018
Type: Document
Sponsoring organization: State Health & Value Strategies
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Toolkit: State Strategies to Develop Value-Based Payment Methodologies for Federally Qualified Health Centers
Designed to help policymakers implement Medicaid value-based payment (VBP) methodologies by providing background information, key considerations, and state strategies. Table 1 in the Payment Methodologies section gives an overview of select state VBP methodologies for Federally Qualified Health Centers (FQHCs). Addresses challenges for small and rural FQHCs.
Author(s): Rachel Donlon, Hannah Dorr, Kitty Purington
Date: 05/2018
Type: Document
Sponsoring organization: National Academy for State Health Policy
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Designed to help policymakers implement Medicaid value-based payment (VBP) methodologies by providing background information, key considerations, and state strategies. Table 1 in the Payment Methodologies section gives an overview of select state VBP methodologies for Federally Qualified Health Centers (FQHCs). Addresses challenges for small and rural FQHCs.
Author(s): Rachel Donlon, Hannah Dorr, Kitty Purington
Date: 05/2018
Type: Document
Sponsoring organization: National Academy for State Health Policy
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Medicaid Managed Care and the Rural Exception: A Review of Issues and Perspectives from the Field
Analyzes Medicaid waivers through September 2017 to examine how state Medicaid procedures affect rural populations. Covers information gathered from State Offices of Rural Health (SORHs), state Medicaid offices, and other stakeholders to describe the process of waiver development.
Author(s): Janice C. Probst, Amy B. Martin, Victor Kirksey
Date: 05/2018
Type: Document
Sponsoring organization: Rural and Minority Health Research Center (formerly the South Carolina Rural Health Research Center)
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Analyzes Medicaid waivers through September 2017 to examine how state Medicaid procedures affect rural populations. Covers information gathered from State Offices of Rural Health (SORHs), state Medicaid offices, and other stakeholders to describe the process of waiver development.
Author(s): Janice C. Probst, Amy B. Martin, Victor Kirksey
Date: 05/2018
Type: Document
Sponsoring organization: Rural and Minority Health Research Center (formerly the South Carolina Rural Health Research Center)
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Changes in Hospital Utilization Three Years into Maryland's Global Budget Program for Rural Hospitals
Examines the impact of Maryland's global budget program for acute care hospitals, with a focus on Medicare beneficiaries served by rural hospitals. Compares changes in hospital use and hospital spending between the rural hospitals participating in the global budget program and a control group during a 3-year period. Discusses the policy implications for other states considering alternate payment models.
Author(s): Eric T. Roberts, Laura A. Hatfield, J. Michael McWilliams, et al.
Citation: Health Affairs, 37(4), 644-653
Date: 04/2018
Type: Document
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Examines the impact of Maryland's global budget program for acute care hospitals, with a focus on Medicare beneficiaries served by rural hospitals. Compares changes in hospital use and hospital spending between the rural hospitals participating in the global budget program and a control group during a 3-year period. Discusses the policy implications for other states considering alternate payment models.
Author(s): Eric T. Roberts, Laura A. Hatfield, J. Michael McWilliams, et al.
Citation: Health Affairs, 37(4), 644-653
Date: 04/2018
Type: Document
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Market Characteristics Associated with Rural Hospitals' Provision of Post-Acute Care
Findings brief summarizing hospital- and market-level factors related to post-acute care (PAC) provided in rural hospitals from 2012-2015. Features statistics from 2012-2015 rural Medicare cost reports, PAC provision by census region in 2015, and percent of hospitals in frontier and remote areas in 2015 with breakdowns by type and PAC provision.
Author(s): Abby F. Hoffman, Randy K. Randolph, Alex R. Schulte, George H. Pink
Date: 04/2018
Type: Document
Sponsoring organization: North Carolina Rural Health Research Program
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Findings brief summarizing hospital- and market-level factors related to post-acute care (PAC) provided in rural hospitals from 2012-2015. Features statistics from 2012-2015 rural Medicare cost reports, PAC provision by census region in 2015, and percent of hospitals in frontier and remote areas in 2015 with breakdowns by type and PAC provision.
Author(s): Abby F. Hoffman, Randy K. Randolph, Alex R. Schulte, George H. Pink
Date: 04/2018
Type: Document
Sponsoring organization: North Carolina Rural Health Research Program
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CMS Innovation Center: Model Implementation and Center Performance
Examines the activities of the Centers for Medicare and Medicaid Services' Innovation Center. Discusses the Center's goals of identifying, testing, and improving payment and delivery models, while cutting healthcare costs and sharing best practices. Includes models tested in rural areas.
Additional links: Full Report
Date: 03/2018
Type: Document
Sponsoring organization: Government Accountability Office
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Examines the activities of the Centers for Medicare and Medicaid Services' Innovation Center. Discusses the Center's goals of identifying, testing, and improving payment and delivery models, while cutting healthcare costs and sharing best practices. Includes models tested in rural areas.
Additional links: Full Report
Date: 03/2018
Type: Document
Sponsoring organization: Government Accountability Office
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State Innovation Models (SIM) Initiative Evaluation: Model Test Year Four Annual Report
Fourth annual report on Round 1 of the CMS State Innovation Models (SIM) Initiative, which tests the ability of the governments in six states - Arkansas, Maine, Massachusetts, Minnesota, Oregon, and Vermont - to move providers to value-based payment models (VPMs). Describes the experiences of providers, health systems, consumers, payers, and state officials during the final full implementation year for most Round 1 states. Presents interim impacts on healthcare utilization, cost, and quality for individuals reached by SIM-supported VPMs during the SIM Initiative period. Includes information specific to rural areas.
Date: 03/2018
Type: Document
Sponsoring organizations: Centers for Medicare and Medicaid Services, RTI International
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Fourth annual report on Round 1 of the CMS State Innovation Models (SIM) Initiative, which tests the ability of the governments in six states - Arkansas, Maine, Massachusetts, Minnesota, Oregon, and Vermont - to move providers to value-based payment models (VPMs). Describes the experiences of providers, health systems, consumers, payers, and state officials during the final full implementation year for most Round 1 states. Presents interim impacts on healthcare utilization, cost, and quality for individuals reached by SIM-supported VPMs during the SIM Initiative period. Includes information specific to rural areas.
Date: 03/2018
Type: Document
Sponsoring organizations: Centers for Medicare and Medicaid Services, RTI International
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