Skip to main content
Rural Health Information Hub

Rural Health
Resources by Topic: Reimbursement and payment models

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
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
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
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
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
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
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
Cost of Practice Transformation in Primary Care: Joining an Accountable Care Organization
Examines the cost of becoming part of an Accountable Care Organization (ACO) for Rural Health Clinics (RHCs) using data from over 800 RHCs in nine states. Compares the cost per patient of RHCs that were part of the Medicare Shared Savings Program to a similar group of RHCs that were not part of the program.
Author(s): Richard Hofler, Judith Ortiz, Brian Cote
Citation: Journal of Health Care Finance, 44(3), 1-16
Date: 2018
Type: Document
view details
Connected Care Toolkit: Chronic Care Management Resources for Health Care Professionals and Communities
A guide for healthcare professionals to support them in offering chronic care management (CCM) services. Provides links to CMS resources, including guides targeted to Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs). Also includes educational materials to help patients understand CCM services.
Date: 2018
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
view details
What Are Rural Health Leaders Asking about Value-Based Care and Payment?
Brief highlights a survey of 60 rural healthcare leaders on value-based care and payment priorities. Details the survey questions, results, and the number of priorities ranked in top five by the participants.
Date: 2018
Type: Document
Sponsoring organization: Rural Health Value
view details