Rural Health
Resources by Topic: Reimbursement and payment models
Innovation Center State-Based Initiatives: A Systematic Review of Lessons Learned
A synthesis of findings from 47 evaluation reports covering 12 Center for Medicare & Medicaid Innovation models with a state component. Includes information on the impact of models for rural areas and identifies barriers and challenges faced in rural areas.
Date: 08/2018
Type: Document
Sponsoring organizations: Centers for Medicare and Medicaid Services, L&M Policy Research
view details
A synthesis of findings from 47 evaluation reports covering 12 Center for Medicare & Medicaid Innovation models with a state component. Includes information on the impact of models for rural areas and identifies barriers and challenges faced in rural areas.
Date: 08/2018
Type: Document
Sponsoring organizations: Centers for Medicare and Medicaid Services, L&M Policy Research
view details
Advanced Primary Care: A Key Contributor to Successful ACOs
Reviews the literature on accountable care organizations (ACOs) regarding characteristics of successful ACOs and outcomes for cost, quality, and utilization, including literature on rural ACOs. Analyzes Medicare and National Committee for Quality Assurance (NCQA) data on ACO cost and quality outcomes to assess the role of advanced primary care models such as patient-centered medical homes on ACO success.
Additional links: Executive Summary, White Paper
Author(s): Yalda Jabbarpour, Megan Coffman, Andy Habib, et al.
Date: 08/2018
Type: Document
Sponsoring organizations: Primary Care Collaborative, Robert Graham Center
view details
Reviews the literature on accountable care organizations (ACOs) regarding characteristics of successful ACOs and outcomes for cost, quality, and utilization, including literature on rural ACOs. Analyzes Medicare and National Committee for Quality Assurance (NCQA) data on ACO cost and quality outcomes to assess the role of advanced primary care models such as patient-centered medical homes on ACO success.
Additional links: Executive Summary, White Paper
Author(s): Yalda Jabbarpour, Megan Coffman, Andy Habib, et al.
Date: 08/2018
Type: Document
Sponsoring organizations: Primary Care Collaborative, Robert Graham Center
view details
Spread of Medicare Accountable Care Organizations in Rural America
Analyzes data describing Medicare Accountable Care Organization (ACO) growth in non-metro U.S. counties from 2016 to 2017. Includes data on Medicare ACOs by metro and non-metro status and data on those Medicare ACOs participating in the ACO Investment Model (AIM) initiative by metro and non-metro status.
Author(s): Nora Kopping, Fred Ullrich, Keith Mueller
Date: 08/2018
Type: Document
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
view details
Analyzes data describing Medicare Accountable Care Organization (ACO) growth in non-metro U.S. counties from 2016 to 2017. Includes data on Medicare ACOs by metro and non-metro status and data on those Medicare ACOs participating in the ACO Investment Model (AIM) initiative by metro and non-metro status.
Author(s): Nora Kopping, Fred Ullrich, Keith Mueller
Date: 08/2018
Type: Document
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
view details
Evaluation of the Accountable Care Organization Investment Model: AIM Impacts in the First Performance Year
Evaluation examining the first year performance of the 47 Accountable Care Organizations (ACOs) participating in the ACO Investment Model (AIM), which tests the use of prepaid shared savings to encourage new ACOs to form in rural and underserved areas (Test 1) and to encourage current Medicare Shared Savings Program ACOs to transition to arrangements with greater financial risk (Test 2). Describes provider characteristics, beneficiary characteristics, and impacts of the 41 Test 1 AIM ACOs. Includes data on rurality for both Test 1 and Test 2 AIM ACOs.
Additional links: Appendices, Findings At-A-Glance
Date: 08/2018
Type: Document
Sponsoring organizations: Abt Associates, Centers for Medicare and Medicaid Services
view details
Evaluation examining the first year performance of the 47 Accountable Care Organizations (ACOs) participating in the ACO Investment Model (AIM), which tests the use of prepaid shared savings to encourage new ACOs to form in rural and underserved areas (Test 1) and to encourage current Medicare Shared Savings Program ACOs to transition to arrangements with greater financial risk (Test 2). Describes provider characteristics, beneficiary characteristics, and impacts of the 41 Test 1 AIM ACOs. Includes data on rurality for both Test 1 and Test 2 AIM ACOs.
Additional links: Appendices, Findings At-A-Glance
Date: 08/2018
Type: Document
Sponsoring organizations: Abt Associates, Centers for Medicare and Medicaid Services
view details
MedPAC Comment on CMS's Proposed Rule on the CY 2019 Home Health PPS Update and 2020 Case Mix Refinements
Comment on a July 12, 2018, Federal Register proposed rule revising payments for home health services. Includes a section addressing a proposed rural add-on payment policy.
Date: 08/2018
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
view details
Comment on a July 12, 2018, Federal Register proposed rule revising payments for home health services. Includes a section addressing a proposed rural add-on payment policy.
Date: 08/2018
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
view details
Medicare Fee-for-Service: Information on the First Year of Nationwide Reduced Payment Rates for Durable Medical Equipment
Examines the effects of reduced payment rates for certain durable medical equipment (DME) in non-bid areas. Reports on changes in the number of suppliers, utilization of rate-adjusted items, and beneficiaries' access to rate-adjusted items. Includes information on changes in rural and non-rural non-bid areas.
Additional links: Full Report
Date: 08/2018
Type: Document
Sponsoring organization: Government Accountability Office
view details
Examines the effects of reduced payment rates for certain durable medical equipment (DME) in non-bid areas. Reports on changes in the number of suppliers, utilization of rate-adjusted items, and beneficiaries' access to rate-adjusted items. Includes information on changes in rural and non-rural non-bid areas.
Additional links: Full Report
Date: 08/2018
Type: Document
Sponsoring organization: Government Accountability Office
view details
Rural Hospitals and Medicaid Payment Policy
Describes how rural hospitals serve Medicaid beneficiaries and the process through which Medicaid programs pay rural hospitals. Features statistics from 2015 with breakdowns by urban hospitals, Critical Access Hospitals (CAHs), and other rural hospitals.
Date: 08/2018
Type: Document
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
view details
Describes how rural hospitals serve Medicaid beneficiaries and the process through which Medicaid programs pay rural hospitals. Features statistics from 2015 with breakdowns by urban hospitals, Critical Access Hospitals (CAHs), and other rural hospitals.
Date: 08/2018
Type: Document
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
view details
Building a Community Health Worker Program: The Key to Better Care, Better Outcomes, & Lower Costs
A toolkit offering information and strategies to help hospitals and healthcare systems design and implement a community health worker (CHW) program targeted to the communities they serve. Highlights evidence-based best practices, sustainable financing of CHW activities, engaging stakeholders, and suggests outcome measures. Provides a chapter of case studies on rural, urban, and suburban settings.
Author(s): Beth A. Brooks, Sheila Davis, Loraine Frank-Lightfoot, et al.
Date: 07/2018
Type: Document
Sponsoring organizations: American Hospital Association, CommunityHealth Works
view details
A toolkit offering information and strategies to help hospitals and healthcare systems design and implement a community health worker (CHW) program targeted to the communities they serve. Highlights evidence-based best practices, sustainable financing of CHW activities, engaging stakeholders, and suggests outcome measures. Provides a chapter of case studies on rural, urban, and suburban settings.
Author(s): Beth A. Brooks, Sheila Davis, Loraine Frank-Lightfoot, et al.
Date: 07/2018
Type: Document
Sponsoring organizations: American Hospital Association, CommunityHealth Works
view details
2018 Rural Hospital and Clinic Financial Summit Report: Key Financial Success Indicators and Strategies
Identifies the indicators of financial success for hospitals and clinics, provides strategies to transition into value-based payment models, and includes success stories from Summit participants and resources necessary for hospitals and clinics. Includes a table showing Critical Access Hospital financial indicators medians for 2016.
Date: 07/2018
Type: Document
Sponsoring organization: National Rural Health Resource Center
view details
Identifies the indicators of financial success for hospitals and clinics, provides strategies to transition into value-based payment models, and includes success stories from Summit participants and resources necessary for hospitals and clinics. Includes a table showing Critical Access Hospital financial indicators medians for 2016.
Date: 07/2018
Type: Document
Sponsoring organization: National Rural Health Resource Center
view details
The Medicaid Fee-for-Service Provider Payment Process
Outlines Medicaid's fee-for-services (FFS) provider payment process. Details the claims-based submission payment process, as well as additional non-claims-based payment processes. Includes information targeted to Rural Health Clinics and Federally Qualified Health Centers throughout.
Date: 07/2018
Type: Document
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
view details
Outlines Medicaid's fee-for-services (FFS) provider payment process. Details the claims-based submission payment process, as well as additional non-claims-based payment processes. Includes information targeted to Rural Health Clinics and Federally Qualified Health Centers throughout.
Date: 07/2018
Type: Document
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
view details