Rural Health
Resources by Topic: Reimbursement and payment models
Medicare Value-Based Payment Models: Participation Challenges and Available Assistance for Small and Rural Practices
Identifies challenges faced by small and rural physician practices when participating in Medicare's new value-based payment models, and groups them into five key areas: financial resources and risk management, health IT and data, population health management care delivery, quality and efficiency performance measurement and reporting, and effects of model participation and managing compliance with requirements. Also identifies two types of organizations, partner and non-partner, along with the services they provide, that can help small and rural practices overcome these challenges.
Additional links: Full Report
Date: 12/2016
Type: Document
Sponsoring organization: Government Accountability Office
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Identifies challenges faced by small and rural physician practices when participating in Medicare's new value-based payment models, and groups them into five key areas: financial resources and risk management, health IT and data, population health management care delivery, quality and efficiency performance measurement and reporting, and effects of model participation and managing compliance with requirements. Also identifies two types of organizations, partner and non-partner, along with the services they provide, that can help small and rural practices overcome these challenges.
Additional links: Full Report
Date: 12/2016
Type: Document
Sponsoring organization: Government Accountability Office
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Freestanding Emergency Departments: An Alternative Model for Rural Communities
Describes the freestanding emergency department (FSED) model as an option for rural communities that can no longer support inpatient services. Looks at both hospital-based and independent FSEDs, examines financial viability of the model, and features rural FSEDs in Illinois and Arizona.
Author(s): Jenn Lukens
Citation: Rural Monitor
Date: 11/2016
Type: Document
Sponsoring organization: Rural Health Information Hub
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Describes the freestanding emergency department (FSED) model as an option for rural communities that can no longer support inpatient services. Looks at both hospital-based and independent FSEDs, examines financial viability of the model, and features rural FSEDs in Illinois and Arizona.
Author(s): Jenn Lukens
Citation: Rural Monitor
Date: 11/2016
Type: Document
Sponsoring organization: Rural Health Information Hub
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The Financial Importance of the Sole Community Hospital Payment Designation
Investigates the economic importance of the Sole Community Hospital (SCH) program by reviewing data between 2006 and 2015 regarding the proportion of SCHs reimbursed at the hospital-specific rate, and their profitability of providing services to Medicare patients. Also, discusses the economic consequences that would occur if the SCH program was not in operation in 2015.
Author(s): Sharita R. Thomas, Randy Randolph, G. Mark Holmes, George H. Pink
Date: 11/2016
Type: Document
Sponsoring organization: North Carolina Rural Health Research Program
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Investigates the economic importance of the Sole Community Hospital (SCH) program by reviewing data between 2006 and 2015 regarding the proportion of SCHs reimbursed at the hospital-specific rate, and their profitability of providing services to Medicare patients. Also, discusses the economic consequences that would occur if the SCH program was not in operation in 2015.
Author(s): Sharita R. Thomas, Randy Randolph, G. Mark Holmes, George H. Pink
Date: 11/2016
Type: Document
Sponsoring organization: North Carolina Rural Health Research Program
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Innovations in Rural Health System Development: Moving Rural Health Systems to Value-Based Payment
Offers examples of rural health system transformation models and strategies from Maine and other regions of the U.S. to assist rural communities in moving forward with value-based payment systems.
Author(s): Sara Kahn-Troster, Andrew Coburn
Date: 10/2016
Type: Document
Sponsoring organizations: Maine Health Access Foundation, Maine Rural Health Research Center
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Offers examples of rural health system transformation models and strategies from Maine and other regions of the U.S. to assist rural communities in moving forward with value-based payment systems.
Author(s): Sara Kahn-Troster, Andrew Coburn
Date: 10/2016
Type: Document
Sponsoring organizations: Maine Health Access Foundation, Maine Rural Health Research Center
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Impact of Race/Ethnicity and Socioeconomic Status on Risk-Adjusted Readmission Rates: Implications for the Hospital Readmissions Reduction Program
Examines what would happen to hospitals' excess readmission ratios and potential penalties if socioeconomic status and race/ethnicity were added to the Centers for Medicare & Medicaid Services risk-adjustment algorithm. Includes information on potential change in penalties for metropolitan, micropolitan, and nonmetro hospitals.
Author(s): Grant R. Martsolf, Marguerite L. Barrett, Audrey J. Weiss, et al.
Citation: Inquiry, 53
Date: 10/2016
Type: Document
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Examines what would happen to hospitals' excess readmission ratios and potential penalties if socioeconomic status and race/ethnicity were added to the Centers for Medicare & Medicaid Services risk-adjustment algorithm. Includes information on potential change in penalties for metropolitan, micropolitan, and nonmetro hospitals.
Author(s): Grant R. Martsolf, Marguerite L. Barrett, Audrey J. Weiss, et al.
Citation: Inquiry, 53
Date: 10/2016
Type: Document
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The Impact of the Low Volume Hospital (LVH) Program on the Viability of Small, Rural Hospitals
Compares rural low volume hospitals (LVH) with non-LVH (Inpatient Prospective Payment System) hospitals. Discusses the financial impact of removing the LVH program and returning to the 2005 LVH classification and payment adjustment, and the effect this will have on Medicare beneficiaries.
Author(s): Rebecca G. Whitaker, G. Mark Holmes, George H. Pink
Date: 10/2016
Type: Document
Sponsoring organization: North Carolina Rural Health Research Program
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Compares rural low volume hospitals (LVH) with non-LVH (Inpatient Prospective Payment System) hospitals. Discusses the financial impact of removing the LVH program and returning to the 2005 LVH classification and payment adjustment, and the effect this will have on Medicare beneficiaries.
Author(s): Rebecca G. Whitaker, G. Mark Holmes, George H. Pink
Date: 10/2016
Type: Document
Sponsoring organization: North Carolina Rural Health Research Program
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Rural Hospital Participation and Performance in Value-Based Purchasing and Other Delivery System Reform Initiatives
Reports on the participation of delivery system reform initiatives by rural hospitals, and discusses the supporting factors and challenges for successful participation. Includes data comparing rural and urban Hospital Value-Based Payment (HVBP) performance.
Author(s): Karen E. Joynt, Nguyen Nguyen, Lok Wong Samson, et al.
Date: 10/2016
Type: Document
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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Reports on the participation of delivery system reform initiatives by rural hospitals, and discusses the supporting factors and challenges for successful participation. Includes data comparing rural and urban Hospital Value-Based Payment (HVBP) performance.
Author(s): Karen E. Joynt, Nguyen Nguyen, Lok Wong Samson, et al.
Date: 10/2016
Type: Document
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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Aging in Rural and Frontier Oregon: Challenges Facing Rural and Frontier Home Health Agencies
Provides an overview of the services and challenges affecting home health agencies offering assistance to the aging population in rural Oregon by county. Includes discussion on healthcare access, home health agency regulation and reimbursement, recruitment and retention of healthcare providers, and physician compliance.
Author(s): Callie Walsh-Bailey, Jamie Horst
Date: 09/2016
Type: Document
Sponsoring organization: Oregon Office of Rural Health
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Provides an overview of the services and challenges affecting home health agencies offering assistance to the aging population in rural Oregon by county. Includes discussion on healthcare access, home health agency regulation and reimbursement, recruitment and retention of healthcare providers, and physician compliance.
Author(s): Callie Walsh-Bailey, Jamie Horst
Date: 09/2016
Type: Document
Sponsoring organization: Oregon Office of Rural Health
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State Innovation Models (SIM) Initiative Evaluation: Model Test Year Two Annual Report
Second annual report detailing the findings of CMS's State Innovation Models (SIM) Initiative, which tests the ability of the governments in six states - Arkansas, Maine, Massachusetts, Minnesota, Vermont, and Oregon - to accelerate health system transformation in the areas of delivery systems, payment models, information technology, workforce development, and more. Presents results from the second of three planned site visits to the states, including interviews, focus groups, and surveys. Connections made throughout to issues specifically affecting rural healthcare.
Date: 08/2016
Type: Document
Sponsoring organizations: Centers for Medicare and Medicaid Services, RTI International
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Second annual report detailing the findings of CMS's State Innovation Models (SIM) Initiative, which tests the ability of the governments in six states - Arkansas, Maine, Massachusetts, Minnesota, Vermont, and Oregon - to accelerate health system transformation in the areas of delivery systems, payment models, information technology, workforce development, and more. Presents results from the second of three planned site visits to the states, including interviews, focus groups, and surveys. Connections made throughout to issues specifically affecting rural healthcare.
Date: 08/2016
Type: Document
Sponsoring organizations: Centers for Medicare and Medicaid Services, RTI International
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Report to Congress: E-health and Telemedicine
Reports the state of e-health and telemedicine after the implementation of the Affordable Care Act (ACA). Includes current policy challenges, discussion of federal level telehealth activity, and a legislative proposal for FY17.
Date: 08/2016
Type: Document
Sponsoring organization: U.S. Department of Health and Human Services
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Reports the state of e-health and telemedicine after the implementation of the Affordable Care Act (ACA). Includes current policy challenges, discussion of federal level telehealth activity, and a legislative proposal for FY17.
Date: 08/2016
Type: Document
Sponsoring organization: U.S. Department of Health and Human Services
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