Rural Health
Resources by Topic: Reimbursement and payment models
Statement by Julie Petersen, PMH Medical Center, before the Committee on Appropriations Subcommittee on Labor, Health and Human Services, Education and Related Agencies
Testimony presented at a May 7, 2015 Labor-HHS Subcommittee hearing on rural health. Provides an overview of rural healthcare innovations in Washington State. Discusses challenges facing the state's Critical Access Hospitals and other small rural hospitals.
Author(s): Julie Petersen
Date: 05/2015
Type: Document
Sponsoring organization: Senate Committee on Appropriations
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Testimony presented at a May 7, 2015 Labor-HHS Subcommittee hearing on rural health. Provides an overview of rural healthcare innovations in Washington State. Discusses challenges facing the state's Critical Access Hospitals and other small rural hospitals.
Author(s): Julie Petersen
Date: 05/2015
Type: Document
Sponsoring organization: Senate Committee on Appropriations
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Statement by Tim Wolters, Citizens Memorial Hospital and Lake Regional Health System, before the Committee on Appropriations Subcommittee on Labor, Health and Human Services, and Education and Related Agencies
Testimony presented at a May 7, 2015 Labor-HHS Subcommittee hearing on rural health. Discusses the impact rural hospitals have on their communities and the challenges rural Prospective Payment System (PPS) hospitals face that make them vulnerable to cuts in Medicare reimbursement.
Author(s): Tim Wolters
Date: 05/2015
Type: Document
Sponsoring organization: Senate Committee on Appropriations
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Testimony presented at a May 7, 2015 Labor-HHS Subcommittee hearing on rural health. Discusses the impact rural hospitals have on their communities and the challenges rural Prospective Payment System (PPS) hospitals face that make them vulnerable to cuts in Medicare reimbursement.
Author(s): Tim Wolters
Date: 05/2015
Type: Document
Sponsoring organization: Senate Committee on Appropriations
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Public Law 114-10: Medicare Access and CHIP Reauthorization Act of 2015
Full text of the Medicare Access and CHIP Reauthorization Act of 2015, commonly referred to as MACRA. MACRA seeks to transition healthcare from fee-for-service to value-based care by repealing the Sustainable Growth Rate (SGR) formula and replacing it with the Quality Payment Program (QPP). The QPP streamlines data collection efforts and rewards providers based on value instead of volume through the Merit-Based Incentive Payment System (MIPS) and Advanced Alternative Payment Models (Advanced APMs).
Date: 04/2015
Type: Document
Sponsoring organization: U.S. Congress
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Full text of the Medicare Access and CHIP Reauthorization Act of 2015, commonly referred to as MACRA. MACRA seeks to transition healthcare from fee-for-service to value-based care by repealing the Sustainable Growth Rate (SGR) formula and replacing it with the Quality Payment Program (QPP). The QPP streamlines data collection efforts and rewards providers based on value instead of volume through the Merit-Based Incentive Payment System (MIPS) and Advanced Alternative Payment Models (Advanced APMs).
Date: 04/2015
Type: Document
Sponsoring organization: U.S. Congress
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Sole Community Hospitals: Early Indications Show That TRICARE's Revised Reimbursement Rules Have Not Affected Access to Care
Reports on the impact of a January 2014 revision to TRICARE's reimbursement for Sole Community Hospitals (SCHs), which serve primarily rural areas. The new TRICARE reimbursement rules approximate Medicare's for these hospitals. Looks at the impact of revised SCH reimbursement on healthcare access for servicemembers and their dependents. Findings based on claims data, as well as interviews with 10 SCHs and with national stakeholders. Appendices include information on SCHs with a high number of TRICARE admissions.
Additional links: Full Report
Date: 04/2015
Type: Document
Sponsoring organization: Government Accountability Office
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Reports on the impact of a January 2014 revision to TRICARE's reimbursement for Sole Community Hospitals (SCHs), which serve primarily rural areas. The new TRICARE reimbursement rules approximate Medicare's for these hospitals. Looks at the impact of revised SCH reimbursement on healthcare access for servicemembers and their dependents. Findings based on claims data, as well as interviews with 10 SCHs and with national stakeholders. Appendices include information on SCHs with a high number of TRICARE admissions.
Additional links: Full Report
Date: 04/2015
Type: Document
Sponsoring organization: Government Accountability Office
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A Critique of the Office of the Inspector General's Report on Swing Beds in Critical Access Hospitals
Evaluates the methods and data of a March 2015 report from the Office of the Inspector General (OIG), U.S. Department of Health and Human Services, commenting on Medicare reimbursement policy for swing bed services in Critical Access Hospitals (CAHs).
Author(s): Kristin L. Reiter, G. Mark Holmes
Date: 03/2015
Type: Document
Sponsoring organization: North Carolina Rural Health Research Program
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Evaluates the methods and data of a March 2015 report from the Office of the Inspector General (OIG), U.S. Department of Health and Human Services, commenting on Medicare reimbursement policy for swing bed services in Critical Access Hospitals (CAHs).
Author(s): Kristin L. Reiter, G. Mark Holmes
Date: 03/2015
Type: Document
Sponsoring organization: North Carolina Rural Health Research Program
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MedPAC Report to the Congress: Medicare Payment Policy, 2015
Annual review of Medicare payment policies, with recommendations to Congress. Discussions of rural aspects of Medicare payment policies are included throughout the report.
Date: 03/2015
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Annual review of Medicare payment policies, with recommendations to Congress. Discussions of rural aspects of Medicare payment policies are included throughout the report.
Date: 03/2015
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Medicare Could Have Saved Billions at Critical Access Hospitals If Swing-Bed Services Were Reimbursed Using the Skilled Nursing Facility Prospective Payment System Rates
Reports the Inspector General's findings from a study of swing bed services and reimbursement at Critical Access Hospitals (CAHs). Addresses changes in swing bed usage over time and examines the potential impact to Medicare of reimbursing swing bed services at skilled nursing facility (SNF) prospective payment system (PPS) rates.
Date: 03/2015
Type: Document
Sponsoring organization: Office of Inspector General (HHS)
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Reports the Inspector General's findings from a study of swing bed services and reimbursement at Critical Access Hospitals (CAHs). Addresses changes in swing bed usage over time and examines the potential impact to Medicare of reimbursing swing bed services at skilled nursing facility (SNF) prospective payment system (PPS) rates.
Date: 03/2015
Type: Document
Sponsoring organization: Office of Inspector General (HHS)
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The Future of Rural Behavioral Health
Policy paper discussing the unique challenges of providing behavioral healthcare services in rural areas. Includes policy recommendations and interventions related to workforce development, reimbursement and financing, integration of care, and the use of technology in delivering behavioral healthcare.
Author(s): Will Wilson, Angela Bangs, Tammy Hatting
Date: 02/2015
Type: Document
Sponsoring organization: National Rural Health Association
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Policy paper discussing the unique challenges of providing behavioral healthcare services in rural areas. Includes policy recommendations and interventions related to workforce development, reimbursement and financing, integration of care, and the use of technology in delivering behavioral healthcare.
Author(s): Will Wilson, Angela Bangs, Tammy Hatting
Date: 02/2015
Type: Document
Sponsoring organization: National Rural Health Association
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Developmental Strategies and Challenges of Rural Accountable Care Organizations
Reports information gathered from 4 Accountable Care Organizations (ACOs) serving rural Medicare beneficiaries in 2013. Highlights lessons learned, opportunities for success, and challenges observed by the ACOs.
Author(s): Jure Baloh, A. Clinton MacKinney, Keith Mueller, et al.
Date: 02/2015
Type: Document
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Reports information gathered from 4 Accountable Care Organizations (ACOs) serving rural Medicare beneficiaries in 2013. Highlights lessons learned, opportunities for success, and challenges observed by the ACOs.
Author(s): Jure Baloh, A. Clinton MacKinney, Keith Mueller, et al.
Date: 02/2015
Type: Document
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Do Current Medicare Rural Hospital Payment Systems Align with Cost Determinants?
Discusses various payment models that may affect the financial performance of rural hospitals and the variables (geographic, community, market, and hospital) that affect rural hospital costs.
Author(s): Kristin Moss, G. Mark Holmes, George H. Pink,
Date: 02/2015
Type: Document
Sponsoring organization: North Carolina Rural Health Research Program
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Discusses various payment models that may affect the financial performance of rural hospitals and the variables (geographic, community, market, and hospital) that affect rural hospital costs.
Author(s): Kristin Moss, G. Mark Holmes, George H. Pink,
Date: 02/2015
Type: Document
Sponsoring organization: North Carolina Rural Health Research Program
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