Rural Health
Resources by Topic: Reimbursement and payment models
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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CPC Practice Spotlights
A collection of short features on primary care practices that participated in the CMS Comprehensive Primary Care (CPC) initiative, a multi-payer initiative that offered population-based care management fees and shared savings opportunities to participating practices. Includes examples of practices serving rural areas.
Date: 01/2015
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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A collection of short features on primary care practices that participated in the CMS Comprehensive Primary Care (CPC) initiative, a multi-payer initiative that offered population-based care management fees and shared savings opportunities to participating practices. Includes examples of practices serving rural areas.
Date: 01/2015
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Rural Health Care: Redefining Access
Discusses collaboration, recruitment and retention, providing specialty services and quality of care as methods to strengthen the health of North Carolina's rural communities.
Author(s): Chris Collins
Citation: North Carolina Medical Journal, 76(1), 20-23
Date: 01/2015
Type: Document
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Discusses collaboration, recruitment and retention, providing specialty services and quality of care as methods to strengthen the health of North Carolina's rural communities.
Author(s): Chris Collins
Citation: North Carolina Medical Journal, 76(1), 20-23
Date: 01/2015
Type: Document
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International Classification of Disease: CMS's Efforts to Prepare for the New Version of the Disease and Procedure Codes
Review of the efforts undertaken by the Centers for Medicare and Medicaid Services (CMS) to prepare for the transition to the 10th revision of the International Classification of Diseases (ICD-10) codes. Evaluates the materials developed and activities undertaken by CMS to help providers' transition and describes concerns of stakeholder organizations, including rural-specific considerations.
Additional links: Full Report
Date: 01/2015
Type: Document
Sponsoring organization: Government Accountability Office
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Review of the efforts undertaken by the Centers for Medicare and Medicaid Services (CMS) to prepare for the transition to the 10th revision of the International Classification of Diseases (ICD-10) codes. Evaluates the materials developed and activities undertaken by CMS to help providers' transition and describes concerns of stakeholder organizations, including rural-specific considerations.
Additional links: Full Report
Date: 01/2015
Type: Document
Sponsoring organization: Government Accountability Office
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The Need to Reform Medicare's Payments to Skilled Nursing Facilities Is as Strong as Ever
Compares payments made to skilled nursing facilities (SNFs) and costs over time to see if changes made by the Centers for Medicare and Medicaid Services (CMS) to the payment system have improved payment accuracy. Table 3 and Table 4 compare healthcare facility characteristics, including rural location.
Author(s): Carol Carter, Bowen Garrett, Doug Wissoker
Date: 01/2015
Type: Document
Sponsoring organizations: Medicare Payment Advisory Commission, Urban Institute
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Compares payments made to skilled nursing facilities (SNFs) and costs over time to see if changes made by the Centers for Medicare and Medicaid Services (CMS) to the payment system have improved payment accuracy. Table 3 and Table 4 compare healthcare facility characteristics, including rural location.
Author(s): Carol Carter, Bowen Garrett, Doug Wissoker
Date: 01/2015
Type: Document
Sponsoring organizations: Medicare Payment Advisory Commission, Urban Institute
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Authorities and Mechanisms for Purchased Care at the Department of Veterans Affairs
Presents an independent assessment of the Purchased Care component from the Veterans Access, Choice, and Accountability Act of 2014. Discusses the system used to fill in gaps in care for veterans that live in rural areas or far from a VA Medical Center (VAMC). Compares the VA's system to other payer models in the federal government.
Author(s): Michael D. Greenberg, Caroline Batka, Christine Buttorff, et al.
Date: 2015
Type: Document
Sponsoring organization: RAND Corporation
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Presents an independent assessment of the Purchased Care component from the Veterans Access, Choice, and Accountability Act of 2014. Discusses the system used to fill in gaps in care for veterans that live in rural areas or far from a VA Medical Center (VAMC). Compares the VA's system to other payer models in the federal government.
Author(s): Michael D. Greenberg, Caroline Batka, Christine Buttorff, et al.
Date: 2015
Type: Document
Sponsoring organization: RAND Corporation
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Critical Access Hospital Financial Pro Forma
Financial modeling resource used to assist rural hospitals in projecting long-term finances under the Fee-For-Service (FFS)/cost-based reimbursement systems.
Date: 2015
Type: Tool
Sponsoring organization: Rural Health Value
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Financial modeling resource used to assist rural hospitals in projecting long-term finances under the Fee-For-Service (FFS)/cost-based reimbursement systems.
Date: 2015
Type: Tool
Sponsoring organization: Rural Health Value
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