Rural Health
Resources by Topic: Reimbursement and payment models
Medicare Hospice Care: Modifications to Payment Methodology May Be Warranted
Discusses proposed adjustments to Medicare payments for hospice services. Includes some information on rural aspects of hospice and Medicare reimbursement.
Additional links: Full Report
Date: 10/2004
Sponsoring organization: Government Accountability Office
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Discusses proposed adjustments to Medicare payments for hospice services. Includes some information on rural aspects of hospice and Medicare reimbursement.
Additional links: Full Report
Date: 10/2004
Sponsoring organization: Government Accountability Office
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Medicare: Information Needed to Assess Adequacy of Rate-Setting Methodology for Payments for Hospital Outpatient Services
Examines whether the outpatient prospective payment system (OPPS) rate-setting methodology results in payment rates that uniformly reflect hospitals' costs for providing drugs and devices. Includes information specific to rural hospitals and the OPPS.
Additional links: Full Report
Date: 09/2004
Sponsoring organization: Government Accountability Office
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Examines whether the outpatient prospective payment system (OPPS) rate-setting methodology results in payment rates that uniformly reflect hospitals' costs for providing drugs and devices. Includes information specific to rural hospitals and the OPPS.
Additional links: Full Report
Date: 09/2004
Sponsoring organization: Government Accountability Office
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Exploring the Impact of Medicare's Post-Acute Care Transfer Payment Policy on Rural Hospitals
Describes a change in Medicare post-acute transfer payment policy and its impact on rural and urban hospitals. Includes data on the financial impact and hospital discharge behavior before and after the change.
Author(s): Julie A. Schoenman
Date: 07/2004
Sponsoring organization: NORC Walsh Center for Rural Health Analysis
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Describes a change in Medicare post-acute transfer payment policy and its impact on rural and urban hospitals. Includes data on the financial impact and hospital discharge behavior before and after the change.
Author(s): Julie A. Schoenman
Date: 07/2004
Sponsoring organization: NORC Walsh Center for Rural Health Analysis
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Rural Implications of Medicare's Post-Acute Care Transfer Payment Policy
Reports results of a study that examines the behavioral and financial impacts of a change in Medicare payment to pay acute-care hospital cases in 10 DRGs as transfers instead of discharges when the patient is discharged to a targeted post-acute care (PAC) provider after a short inpatient stay. Also projects the likely financial impact of extending the policy to cover additional DRGs or discharges to swing beds.
Author(s): Julie A. Schoenman
Date: 06/2004
Sponsoring organization: NORC Walsh Center for Rural Health Analysis
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Reports results of a study that examines the behavioral and financial impacts of a change in Medicare payment to pay acute-care hospital cases in 10 DRGs as transfers instead of discharges when the patient is discharged to a targeted post-acute care (PAC) provider after a short inpatient stay. Also projects the likely financial impact of extending the policy to cover additional DRGs or discharges to swing beds.
Author(s): Julie A. Schoenman
Date: 06/2004
Sponsoring organization: NORC Walsh Center for Rural Health Analysis
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MedPAC Report to the Congress: Medicare Payment Policy, 2004
Annual review of Medicare payment policies, with recommendations to Congress. Discussion of rural aspects of Medicare payment policies are included throughout the report. Includes discussion of the growth of Medicare spending and quality of care Medicare recipients receive.
Date: 03/2004
Sponsoring organization: Medicare Payment Advisory Commission
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Annual review of Medicare payment policies, with recommendations to Congress. Discussion of rural aspects of Medicare payment policies are included throughout the report. Includes discussion of the growth of Medicare spending and quality of care Medicare recipients receive.
Date: 03/2004
Sponsoring organization: Medicare Payment Advisory Commission
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Modeling the Frontier Extended Stay Clinic Conditions of Participation and Reimbursement Methodologies
Discusses the financial feasibility of the Frontier Extended Stay Clinic (FESC), a proposed provider type to expand services in remote and isolated primary care clinics. Compares Medicare reimbursement for FESC status with Federally Qualified Health Center (FQHC), Rural Health Clinic (RHC), and Critical Access Hospital (CAH) reimbursement. Includes detailed examples of financial impact for seven clinics in rural Alaska, Nevada, Washington, and Wyoming.
Date: 2004
Sponsoring organization: Federal Office of Rural Health Policy
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Discusses the financial feasibility of the Frontier Extended Stay Clinic (FESC), a proposed provider type to expand services in remote and isolated primary care clinics. Compares Medicare reimbursement for FESC status with Federally Qualified Health Center (FQHC), Rural Health Clinic (RHC), and Critical Access Hospital (CAH) reimbursement. Includes detailed examples of financial impact for seven clinics in rural Alaska, Nevada, Washington, and Wyoming.
Date: 2004
Sponsoring organization: Federal Office of Rural Health Policy
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Rural-Urban Issues in the Wage Index Adjustment for Prospective Payment in Skilled Nursing Facilities
Discusses the use of the hospital wage index for the skilled nursing facility prospective payment system (SNF PPS) and how a change to an SNF wage index would impact rural and urban skilled nursing facilities. Also identifies some related issues that impact reimbursement to SNFs in both urban and rural areas.
Additional links: Findings Brief, January 2004
Author(s): Kathleen Dalton, Rebecca Slifkin
Date: 11/2003
Sponsoring organization: North Carolina Rural Health Research Program
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Discusses the use of the hospital wage index for the skilled nursing facility prospective payment system (SNF PPS) and how a change to an SNF wage index would impact rural and urban skilled nursing facilities. Also identifies some related issues that impact reimbursement to SNFs in both urban and rural areas.
Additional links: Findings Brief, January 2004
Author(s): Kathleen Dalton, Rebecca Slifkin
Date: 11/2003
Sponsoring organization: North Carolina Rural Health Research Program
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Ambulance Services: Medicare Payments Can be Better Targeted to Trips in Less Densely Populated Rural Areas
Covers factors that affect ambulance costs per trip, how these factors vary across geographic areas, and how well Medicare payments account for geographic cost differences.
Additional links: Full Report
Date: 09/2003
Sponsoring organization: Government Accountability Office
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Covers factors that affect ambulance costs per trip, how these factors vary across geographic areas, and how well Medicare payments account for geographic cost differences.
Additional links: Full Report
Date: 09/2003
Sponsoring organization: Government Accountability Office
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MedPAC Report to the Congress: Variation and Innovation in Medicare
Analyzes variation within the Medicare program and explores a variety of possible payment innovations. Includes some rural-specific information. Geographic, market, quality, hospital financial performance, and use of physician services variations are covered. Also examines Medicare's reimbursement for Part B drugs. Recommendations include quality incentives and competitive pricing.
Date: 06/2003
Sponsoring organization: Medicare Payment Advisory Commission
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Analyzes variation within the Medicare program and explores a variety of possible payment innovations. Includes some rural-specific information. Geographic, market, quality, hospital financial performance, and use of physician services variations are covered. Also examines Medicare's reimbursement for Part B drugs. Recommendations include quality incentives and competitive pricing.
Date: 06/2003
Sponsoring organization: Medicare Payment Advisory Commission
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MedPAC Report to the Congress: Medicare Payment Policy, 2003
Report to the Congress. Reviews the Medicare prospective payment systems (PPSs) for seven sectors: hospital inpatient, hospital outpatient, physician, skilled nursing, home health, outpatient dialysis, and ambulatory surgical center services. Also discusses broader issues related to Medicare payments. Includes recommendations. Appendix with data on hospital financial performance for 1991-2000.
Date: 03/2003
Sponsoring organization: Medicare Payment Advisory Commission
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Report to the Congress. Reviews the Medicare prospective payment systems (PPSs) for seven sectors: hospital inpatient, hospital outpatient, physician, skilled nursing, home health, outpatient dialysis, and ambulatory surgical center services. Also discusses broader issues related to Medicare payments. Includes recommendations. Appendix with data on hospital financial performance for 1991-2000.
Date: 03/2003
Sponsoring organization: Medicare Payment Advisory Commission
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