Rural Health
Resources by Topic: Reimbursement and payment models
MedPAC Report to the Congress: Medicare Payment Policy, 2018
Annual review of Medicare payment policies, with recommendations to Congress. Includes discussion on Medicare payment policies directly affecting rural providers and beneficiaries. Addresses Medicare Part D, Medicare Advantage, telehealth, payment incentive programs, and payment adequacy for healthcare facilities and services.
Additional links: Chapter 14 Online-Only Appendixes: The Medicare Prescription Drug Program (Part D): Status Report (March 2018 Report, Revised June 25, 2018), Chapter 16 Online-Only Appendixes: Mandated Report: Telehealth Services and the Medicare Program (March 2018 report), Errata Sheet: Table 9-7, Page 255 (March 2018 Report, Revised May 30, 2018)
Date: 03/2018
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
view details
Annual review of Medicare payment policies, with recommendations to Congress. Includes discussion on Medicare payment policies directly affecting rural providers and beneficiaries. Addresses Medicare Part D, Medicare Advantage, telehealth, payment incentive programs, and payment adequacy for healthcare facilities and services.
Additional links: Chapter 14 Online-Only Appendixes: The Medicare Prescription Drug Program (Part D): Status Report (March 2018 Report, Revised June 25, 2018), Chapter 16 Online-Only Appendixes: Mandated Report: Telehealth Services and the Medicare Program (March 2018 report), Errata Sheet: Table 9-7, Page 255 (March 2018 Report, Revised May 30, 2018)
Date: 03/2018
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
view details
Report to Congress on Medicaid and CHIP, March 2018
Reports on three aspects of Medicaid: managed care, telehealth, and Disproportionate Share Hospital (DSH) payments. Chapter 2 discusses how the use of telehealth services can help patients access healthcare services in rural and frontier areas. Chapter 3 includes the third annual report on DSH payments, which provide support to safety-net hospitals to help offset uncompensated care costs for Medicaid and uninsured patients. Table 3-2 identifies DSH spending for urban and rural hospitals and for Critical Access Hospitals.
Date: 03/2018
Type: Document
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
view details
Reports on three aspects of Medicaid: managed care, telehealth, and Disproportionate Share Hospital (DSH) payments. Chapter 2 discusses how the use of telehealth services can help patients access healthcare services in rural and frontier areas. Chapter 3 includes the third annual report on DSH payments, which provide support to safety-net hospitals to help offset uncompensated care costs for Medicaid and uninsured patients. Table 3-2 identifies DSH spending for urban and rural hospitals and for Critical Access Hospitals.
Date: 03/2018
Type: Document
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
view details
Behavioral Health Integration into Primary Care
Profile of a rural health system, Western Wisconsin Health (WWH), and its work to deliver behavioral health services. Provides an overview of how behavioral health providers and services were integrated with primary care, with a cultural change to focus on whole-person care. Includes information on Medicare and Medicaid reimbursement for the behavioral health services provided at WWH's Rural Health Clinic. Discusses how WWH behavioral health providers offer telehealth services to other rural areas of Wisconsin.
Date: 03/2018
Type: Document
Sponsoring organization: Rural Health Value
view details
Profile of a rural health system, Western Wisconsin Health (WWH), and its work to deliver behavioral health services. Provides an overview of how behavioral health providers and services were integrated with primary care, with a cultural change to focus on whole-person care. Includes information on Medicare and Medicaid reimbursement for the behavioral health services provided at WWH's Rural Health Clinic. Discusses how WWH behavioral health providers offer telehealth services to other rural areas of Wisconsin.
Date: 03/2018
Type: Document
Sponsoring organization: Rural Health Value
view details
Rural Health Care Costs: Are They Higher and Why Might They Differ from Urban Health Care Costs?
Explores issues surrounding healthcare costs and investigates differences between rural and urban expenditures. Includes statistics on Medicare fee-for-service expenditures in 2014 with breakdowns by metropolitan and non-metropolitan status.
Author(s): Dunc Williams, Mark Holmes
Citation: North Carolina Medical Journal, 79(1), 51-55
Date: 01/2018
Type: Document
view details
Explores issues surrounding healthcare costs and investigates differences between rural and urban expenditures. Includes statistics on Medicare fee-for-service expenditures in 2014 with breakdowns by metropolitan and non-metropolitan status.
Author(s): Dunc Williams, Mark Holmes
Citation: North Carolina Medical Journal, 79(1), 51-55
Date: 01/2018
Type: Document
view details
2018 OPPS Medicare Part B Payment Impact Analysis
Examines how changes to the CY 2018 Medicare Outpatient Prospective Payment System (OPPS) will impact hospitals' net Part B payments. Discusses the payment reduction for drugs purchased through the 340B Program and how the reduction will affect rural and urban hospitals. Includes a state-by-state analysis of aggregate impacts.
Additional links: Full Report
Date: 01/2018
Type: Document
Sponsoring organization: Avalere
view details
Examines how changes to the CY 2018 Medicare Outpatient Prospective Payment System (OPPS) will impact hospitals' net Part B payments. Discusses the payment reduction for drugs purchased through the 340B Program and how the reduction will affect rural and urban hospitals. Includes a state-by-state analysis of aggregate impacts.
Additional links: Full Report
Date: 01/2018
Type: Document
Sponsoring organization: Avalere
view details
Affiliation Partners Sought to Prepare Small Hospital for Value-Based Care
Details how Grinnell Regional Medical Center (GRMC) in Grinnell, Iowa, followed a robust due diligence process to identify affiliation partners and prepare for participation in risk-based reimbursement models. GRMC is a 49-bed private, nonprofit medical center that serves 6 rural counties in Iowa.
Date: 01/2018
Type: Document
Sponsoring organization: Rural Health Value
view details
Details how Grinnell Regional Medical Center (GRMC) in Grinnell, Iowa, followed a robust due diligence process to identify affiliation partners and prepare for participation in risk-based reimbursement models. GRMC is a 49-bed private, nonprofit medical center that serves 6 rural counties in Iowa.
Date: 01/2018
Type: Document
Sponsoring organization: Rural Health Value
view details
Taking Stock: Policy Opportunities for Advancing Rural Health
Examines the progress of health system transformation and discusses the challenges that remain for rural people, places, and providers. Organized around seven main topics: Medicare, Medicaid and CHIP, insurance coverage and affordability, quality, healthcare finance and system transformation, workforce, and population health. Provides background information on each topic and shares policy suggestions for addressing each topic's most pressing issues.
Author(s): Keith J. Mueller, Charles Alfero, Andrew F. Coburn, et al.
Date: 01/2018
Type: Document
Sponsoring organization: Rural Policy Research Institute Rural Health Panel
view details
Examines the progress of health system transformation and discusses the challenges that remain for rural people, places, and providers. Organized around seven main topics: Medicare, Medicaid and CHIP, insurance coverage and affordability, quality, healthcare finance and system transformation, workforce, and population health. Provides background information on each topic and shares policy suggestions for addressing each topic's most pressing issues.
Author(s): Keith J. Mueller, Charles Alfero, Andrew F. Coburn, et al.
Date: 01/2018
Type: Document
Sponsoring organization: Rural Policy Research Institute Rural Health Panel
view details
Reinventing Rural Health Care: A Case Study of Seven Upper Midwest States
Examines the state of rural healthcare in seven states - Iowa, Minnesota, Montana, Nebraska, North Dakota, South Dakota, and Wyoming - and uses the findings to determine the impact of existing federal policies, understand ongoing healthcare challenges, and identify opportunities for improvement in rural healthcare access and delivery. Addresses rightsizing healthcare services to fit community needs, creating rural funding mechanisms, building and supporting the primary care physician workforce, and expanding telemedicine services. Analysis is based on interviews with over 90 national thought leaders and key stakeholders.
Additional links: Infographic, Summary – Rural Health Care: Lessons Learned
Date: 01/2018
Type: Document
Sponsoring organization: Bipartisan Policy Center
view details
Examines the state of rural healthcare in seven states - Iowa, Minnesota, Montana, Nebraska, North Dakota, South Dakota, and Wyoming - and uses the findings to determine the impact of existing federal policies, understand ongoing healthcare challenges, and identify opportunities for improvement in rural healthcare access and delivery. Addresses rightsizing healthcare services to fit community needs, creating rural funding mechanisms, building and supporting the primary care physician workforce, and expanding telemedicine services. Analysis is based on interviews with over 90 national thought leaders and key stakeholders.
Additional links: Infographic, Summary – Rural Health Care: Lessons Learned
Date: 01/2018
Type: Document
Sponsoring organization: Bipartisan Policy Center
view details
Integrating Department of Defense and Department of Veterans Affairs Purchased Care: Preliminary Feasibility Assessment
Examines the feasibility of integrating the Department of Defense and Department of Veterans Affairs healthcare systems. Explores the potential impact on healthcare access, quality, and costs for beneficiaries, addressing implications for rural areas throughout. Discusses changes that would need to be made at a legislative, policy, and contractual level if an integrated purchased care program was implemented.
Author(s): Carrie M. Farmer, Terri Tanielian, Christine Buttorff, et al.
Date: 2018
Type: Document
Sponsoring organization: RAND Corporation
view details
Examines the feasibility of integrating the Department of Defense and Department of Veterans Affairs healthcare systems. Explores the potential impact on healthcare access, quality, and costs for beneficiaries, addressing implications for rural areas throughout. Discusses changes that would need to be made at a legislative, policy, and contractual level if an integrated purchased care program was implemented.
Author(s): Carrie M. Farmer, Terri Tanielian, Christine Buttorff, et al.
Date: 2018
Type: Document
Sponsoring organization: RAND Corporation
view details
Availability of Healthcare Providers for Rural Veterans Eligible for Purchased Care under the Veterans Choice Act
Highlights a study on the utilization of the Veterans Choice Act, specifically rurality of veterans eligible to purchase non-VHA healthcare. Details the role VHA facilities continue to play in providing healthcare to veterans who qualify for Veterans Choice.
Author(s): Michael E. Ohl, Margaret Carrell, Andrew Thurman, et al.
Citation: BMC Health Services Research, 18(1)
Date: 2018
Type: Document
view details
Highlights a study on the utilization of the Veterans Choice Act, specifically rurality of veterans eligible to purchase non-VHA healthcare. Details the role VHA facilities continue to play in providing healthcare to veterans who qualify for Veterans Choice.
Author(s): Michael E. Ohl, Margaret Carrell, Andrew Thurman, et al.
Citation: BMC Health Services Research, 18(1)
Date: 2018
Type: Document
view details