Rural Health
Resources by Topic: Reimbursement and payment models
Simulation and Analysis of an Alternative Medicare Home Health Payment System Not Based on Number of Therapy Visits
Outlines a possible approach to redesigning the Medicare home health payment system and describes the likely impacts of such a change. Includes statistics with breakdowns by number of therapy and non-therapy visits, payment-to-cost ratios, medical procedure or chronic illness, and type of health facility.
Author(s): Doug Wissoker, Bowen Garrett
Date: 08/2015
Type: Document
Sponsoring organization: Urban Institute
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Outlines a possible approach to redesigning the Medicare home health payment system and describes the likely impacts of such a change. Includes statistics with breakdowns by number of therapy and non-therapy visits, payment-to-cost ratios, medical procedure or chronic illness, and type of health facility.
Author(s): Doug Wissoker, Bowen Garrett
Date: 08/2015
Type: Document
Sponsoring organization: Urban Institute
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Hospital Policy Issues: Statement by Mark Miller, Medicare Payment Advisory Commission before Subcommittee on Health, Committee on Ways and Means, U.S. House of Representatives
Testimony from the Medicare Payment Advisory Commission's executive director presented at a July 22nd, 2015, Ways and Means subcommittee hearing concerning Medicare hospital payment issues, rural health issues, and beneficiary access to care. Discusses Medicare's rural hospital payment adjustments, how they impact access to care, and principles to consider in evaluating rural add-on payments. Also discusses MedPAC recommendations related to graduate medical education (GME), including some related to rural training.
Author(s): Mark E. Miller
Date: 07/2015
Type: Document
Sponsoring organizations: House Ways and Means Committee, Subcommittee on Health, Medicare Payment Advisory Commission
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Testimony from the Medicare Payment Advisory Commission's executive director presented at a July 22nd, 2015, Ways and Means subcommittee hearing concerning Medicare hospital payment issues, rural health issues, and beneficiary access to care. Discusses Medicare's rural hospital payment adjustments, how they impact access to care, and principles to consider in evaluating rural add-on payments. Also discusses MedPAC recommendations related to graduate medical education (GME), including some related to rural training.
Author(s): Mark E. Miller
Date: 07/2015
Type: Document
Sponsoring organizations: House Ways and Means Committee, Subcommittee on Health, Medicare Payment Advisory Commission
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Characteristics of Children in Medicaid Managed Care and Medicaid Fee-for-service, 2003-2005
Examines how children enrolled in Medicaid fee-for-service programs compare to those in comprehensive managed care programs. Includes information on sociodemographic, health, and geographic characteristics. Table 5 provides figures by type of Medicaid program for urban and rural enrollees.
Author(s): Patricia C. Lloyd, Alan E. Simon, Jennifer D. Parker
Date: 06/2015
Type: Document
Sponsoring organization: National Center for Health Statistics
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Examines how children enrolled in Medicaid fee-for-service programs compare to those in comprehensive managed care programs. Includes information on sociodemographic, health, and geographic characteristics. Table 5 provides figures by type of Medicaid program for urban and rural enrollees.
Author(s): Patricia C. Lloyd, Alan E. Simon, Jennifer D. Parker
Date: 06/2015
Type: Document
Sponsoring organization: National Center for Health Statistics
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Statement by George Stover, Rice County Hospital District 1, before the Committee on Appropriations Subcommittee on Labor, Health and Human Services, Education and Related Agencies
Covers testimony presented at a May 7, 2015 Labor-Health and Human Services subcommittee hearing on rural health from George Stover, the chief executive officer for the Hospital District #1 of Rice County in Lyons, Kansas. Discusses regulatory and reimbursement challenges facing Critical Access Hospitals (CAHs).
Author(s): George Stover
Date: 05/2015
Type: Document
Sponsoring organization: Senate Committee on Appropriations
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Covers testimony presented at a May 7, 2015 Labor-Health and Human Services subcommittee hearing on rural health from George Stover, the chief executive officer for the Hospital District #1 of Rice County in Lyons, Kansas. Discusses regulatory and reimbursement challenges facing Critical Access Hospitals (CAHs).
Author(s): George Stover
Date: 05/2015
Type: Document
Sponsoring organization: Senate Committee on Appropriations
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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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