Rural Health
Resources by Topic: Reimbursement and payment models
Rural/Urban and Regional Variation in the 2019 CMS Hospital Wage Index
Findings brief describing the geographic variation in the 2019 Centers for Medicare and Medicaid Services (CMS) hospital wage index by rural and urban definitions. Includes data comparisons for rural and urban definitions by Census region, frontier and remote (FAR) codes, and state.
Author(s): Kristie W. Thompson, Ann Howard, George H. Pink
Date: 05/2019
Sponsoring organization: North Carolina Rural Health Research Program
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Findings brief describing the geographic variation in the 2019 Centers for Medicare and Medicaid Services (CMS) hospital wage index by rural and urban definitions. Includes data comparisons for rural and urban definitions by Census region, frontier and remote (FAR) codes, and state.
Author(s): Kristie W. Thompson, Ann Howard, George H. Pink
Date: 05/2019
Sponsoring organization: North Carolina Rural Health Research Program
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Opportunities to Advance Complex Care in Rural and Frontier Areas
Examines obstacles rural and frontier healthcare organizations face in providing complex care based on interviews with experts around the U.S. Focuses on rural social determinants of health, workforce shortages, and rural community relationships. Includes examples of models related to community collaboration, care coordination, social determinants of health, the health workforce, technology, and payment.
Author(s): Jim Lloyd
Date: 05/2019
Sponsoring organization: Center for Health Care Strategies
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Examines obstacles rural and frontier healthcare organizations face in providing complex care based on interviews with experts around the U.S. Focuses on rural social determinants of health, workforce shortages, and rural community relationships. Includes examples of models related to community collaboration, care coordination, social determinants of health, the health workforce, technology, and payment.
Author(s): Jim Lloyd
Date: 05/2019
Sponsoring organization: Center for Health Care Strategies
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Medicare Physician Payment Reform After Two Years: Examining MACRA Implementation and the Road Ahead
Provides a recording of a U.S. Senate Committee on Finance hearing on physician payment reforms under the Medicare Access and CHIP Reauthorization Act (MACRA). Features testimonies about what is working well and challenges faced, including provisions and challenges for small and rural practices. Contains testimonies from the American Medical Association, American Academy of Family Physicians, American College of Surgeons, American Medical Group Association, and Brookings Institution.
Additional links: American Medical Association Testimony, John Cullen Testimony, Scott Hines Testimony
Date: 05/2019
Sponsoring organization: Senate Committee on Finance
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Provides a recording of a U.S. Senate Committee on Finance hearing on physician payment reforms under the Medicare Access and CHIP Reauthorization Act (MACRA). Features testimonies about what is working well and challenges faced, including provisions and challenges for small and rural practices. Contains testimonies from the American Medical Association, American Academy of Family Physicians, American College of Surgeons, American Medical Group Association, and Brookings Institution.
Additional links: American Medical Association Testimony, John Cullen Testimony, Scott Hines Testimony
Date: 05/2019
Sponsoring organization: Senate Committee on Finance
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The Center for Medicare and Medicaid Innovation 2018 Report to Congress
Reports to Congress on payment and service delivery models and initiatives tested or announced by the Center for Medicare and Medicaid Innovation between October 2016 and 2018. Addresses Accountable Care Organization (ACO) models, population-based payment models, bundled payment models, and models that integrated Medicaid and Medicare beneficiary care. Identifies model adaptations for rural health organizations, such as the ACO Investment model, and includes a section on the Pennsylvania Rural Health Model.
Date: 04/2019
Sponsoring organization: Centers for Medicare and Medicaid Services
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Reports to Congress on payment and service delivery models and initiatives tested or announced by the Center for Medicare and Medicaid Innovation between October 2016 and 2018. Addresses Accountable Care Organization (ACO) models, population-based payment models, bundled payment models, and models that integrated Medicaid and Medicare beneficiary care. Identifies model adaptations for rural health organizations, such as the ACO Investment model, and includes a section on the Pennsylvania Rural Health Model.
Date: 04/2019
Sponsoring organization: Centers for Medicare and Medicaid Services
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Independent Evaluation of Comprehensive Primary Care Plus (CPC+): First Annual Report
Provides an overview of first-year findings for CPC+, including who participated, the supports practices received, how practices implemented CPC+, and the impacts on cost, service use, and outcomes for Medicare beneficiaries. Features statistics with breakdowns by rural, suburban, or urban location.
Additional links: Appendices to the Supplemental Volume, Findings at a Glance, Supplemental Volume
Author(s): Deborah Peikes, Grace Anglin, Mary Harrington, et al.
Date: 04/2019
Sponsoring organizations: Centers for Medicare and Medicaid Services, Mathematica Policy Research
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Provides an overview of first-year findings for CPC+, including who participated, the supports practices received, how practices implemented CPC+, and the impacts on cost, service use, and outcomes for Medicare beneficiaries. Features statistics with breakdowns by rural, suburban, or urban location.
Additional links: Appendices to the Supplemental Volume, Findings at a Glance, Supplemental Volume
Author(s): Deborah Peikes, Grace Anglin, Mary Harrington, et al.
Date: 04/2019
Sponsoring organizations: Centers for Medicare and Medicaid Services, Mathematica Policy Research
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Oral Health: Targeting Rural Areas
Compiles articles from a special issue of the Texas Public Health Journal focusing on rural oral health in Texas, Louisiana, and Oklahoma. Covers emergency department use in Texas for oral health needs in rural versus urban counties, geriatric oral health and workforce options such as teledentistry, a Delivery System Reform Incentive Payment project under a state waiver targeting rural communities, partnerships to reach underserved areas and pregnant women, and oral health initiatives in Louisiana and Oklahoma.
Citation: Texas Public Health Journal, 71(2), 2-16
Date: 04/2019
Sponsoring organization: Texas Public Health Association
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Compiles articles from a special issue of the Texas Public Health Journal focusing on rural oral health in Texas, Louisiana, and Oklahoma. Covers emergency department use in Texas for oral health needs in rural versus urban counties, geriatric oral health and workforce options such as teledentistry, a Delivery System Reform Incentive Payment project under a state waiver targeting rural communities, partnerships to reach underserved areas and pregnant women, and oral health initiatives in Louisiana and Oklahoma.
Citation: Texas Public Health Journal, 71(2), 2-16
Date: 04/2019
Sponsoring organization: Texas Public Health Association
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MedPAC Report to the Congress: Medicare Payment Policy: Hospital Inpatient and Outpatient Services: Chapter 3
Examines the adequacy of Medicare payments to hospitals in 2017 and offers recommendations for changes. Includes a discussion of rural hospital closures and provides rural/urban breakdowns for hospital occupancy rates, Medicare inpatient discharges, and Medicare margins.
Date: 03/2019
Sponsoring organization: Medicare Payment Advisory Commission
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Examines the adequacy of Medicare payments to hospitals in 2017 and offers recommendations for changes. Includes a discussion of rural hospital closures and provides rural/urban breakdowns for hospital occupancy rates, Medicare inpatient discharges, and Medicare margins.
Date: 03/2019
Sponsoring organization: Medicare Payment Advisory Commission
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MedPAC Report to the Congress: Medicare Payment Policy, 2019
Annual review of Medicare payment policies, with recommendations to Congress. Includes discussion on Medicare payment policies directly affecting rural providers and beneficiaries. Addresses opioids, Medicare Part D, Medicare Advantage, Medicare's quality incentive program for hospitals, and payment adequacy for healthcare facilities and services.
Date: 03/2019
Sponsoring organization: Medicare Payment Advisory Commission
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Annual review of Medicare payment policies, with recommendations to Congress. Includes discussion on Medicare payment policies directly affecting rural providers and beneficiaries. Addresses opioids, Medicare Part D, Medicare Advantage, Medicare's quality incentive program for hospitals, and payment adequacy for healthcare facilities and services.
Date: 03/2019
Sponsoring organization: Medicare Payment Advisory Commission
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Report to Congress on Medicaid and CHIP, March 2019
Reports on three aspects of Medicaid: improving the structure of Disproportionate Share Hospital (DSH) payment reductions, oversight of upper payment limits for supplemental payments to hospitals, and Disproportionate Share Hospital (DSH) payments to states. Chapter 3 includes the annual report on DSH payments, which provide support to safety-net hospitals to help offset uncompensated care costs for Medicaid and uninsured patients. Table 3-1 identifies DSH spending for urban and rural hospitals and for Critical Access Hospitals.
Date: 03/2019
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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Reports on three aspects of Medicaid: improving the structure of Disproportionate Share Hospital (DSH) payment reductions, oversight of upper payment limits for supplemental payments to hospitals, and Disproportionate Share Hospital (DSH) payments to states. Chapter 3 includes the annual report on DSH payments, which provide support to safety-net hospitals to help offset uncompensated care costs for Medicaid and uninsured patients. Table 3-1 identifies DSH spending for urban and rural hospitals and for Critical Access Hospitals.
Date: 03/2019
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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2019 Telehealth Reimbursement
Provides an overview of Medicare reimbursement for telehealth services and discusses factors, policies, and legislation affecting reimbursement including: geographic and originating site restrictions; provider restrictions; service restrictions; payment for remote communication technology; chronic care management and remote monitoring; Medicare Advantage; Accountable Care Organizations, bundled care, and telehealth. Covers Medicaid and private payer telehealth reimbursement policies.
Date: 02/2019
Sponsoring organization: Center for Connected Health Policy: The National Telehealth Policy Resource Center
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Provides an overview of Medicare reimbursement for telehealth services and discusses factors, policies, and legislation affecting reimbursement including: geographic and originating site restrictions; provider restrictions; service restrictions; payment for remote communication technology; chronic care management and remote monitoring; Medicare Advantage; Accountable Care Organizations, bundled care, and telehealth. Covers Medicaid and private payer telehealth reimbursement policies.
Date: 02/2019
Sponsoring organization: Center for Connected Health Policy: The National Telehealth Policy Resource Center
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