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Rural Health
Resources by Topic: Reimbursement and payment models

Medicare Physician Payments: Trends in Service Utilization, Spending, and Fees Prompt Consideration of Alternative Payment Approaches
Statement discussing the sustainable growth rate (SGR) system, which Medicare uses to determine annual changes to physician fees. Includes some rural-specific information.
Additional links: Full Report
Author(s): A. Bruce Steinwald
Date: 07/2006
Type: Document
Sponsoring organization: Government Accountability Office
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Comparison of the Rural Health Clinic and Federally Qualified Health Center Programs
Provides a general comparison of the financial components of the Rural Health Clinic (RHC) and Federally Qualified Health Center (FQHC) programs under Medicare and Medicaid.
Date: 06/2006
Type: Document
Sponsoring organization: Health Resources and Services Administration
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MedPAC Report to the Congress: Medicare Payment Policy, 2006
Annual review of Medicare payment policies, with recommendations to Congress. Discussions of rural aspects of Medicare payment policies are included throughout the report.
Date: 03/2006
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Trends in Skilled Nursing and Swing-bed Use in Rural Areas, 1996-2003
Examines trends in the delivery of skilled nursing facility (SNF) services in rural areas during a period of dramatic change in Medicare payments. Focuses on the role of rural hospitals in providing SNF services, as a number of regulatory changes occurred between 1998 and 2002 that could potentially influence hospital provision of skilled nursing care.
Author(s): Kathleen Dalton, Jeongyoung Park, Ann Howard, Rebecca Slifkin
Date: 12/2005
Type: Document
Sponsoring organization: North Carolina Rural Health Research Program
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Revisions to Medicare's Disproportionate Share Payment Policy to Incorporate Bad Debt and Charity Care
Investigates the impact of possible changes to the Medicare disproportionate share (DSH) payment policy, designed to incorporate information on the hospital's uncompensated care burden as well as to improve the payment formula. These analyses are intended to help policymakers evaluate the likely impact of revising the DSH payment methodology.
Author(s): Julie A. Schoenman, Janet P. Sutton, Lan Zhao
Date: 09/2005
Type: Document
Sponsoring organization: NORC Walsh Center for Rural Health Analysis
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Utilization of Home Health Services Among Rural Medicare Beneficiaries Before and After the PPS: Final Report
Describes the results of a study on the rural effects of the Medicare prospective payment system (PPS), including whether the PPS contributed to changes in the demographic and clinical characteristics of home care users; the likelihood of using each of six home care disciplines; and the intensity of services.
Author(s): Janet P. Sutton
Date: 08/2005
Type: Document
Sponsoring organization: NORC Walsh Center for Rural Health Analysis
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Health Centers and Rural Clinics: State and Federal Implementation Issues for Medicaid's New Payment System
Reviews states' implementation of the prospective payment system (PPS) for Medicaid payments to Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs). Includes recommendations for CMS on guidance and oversight for states.
Additional links: Full Report
Date: 06/2005
Type: Document
Sponsoring organization: Government Accountability Office
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MedPAC Report to the Congress: Medicare Payment Policy, 2005
Annual review of Medicare payment policies, with recommendations to Congress. Discussions of rural aspects of Medicare payment policies are included throughout the report. Includes discussion of strategies to improve care, including pay for performance and information technology.
Date: 03/2005
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Home Health Payment Reform: Trends in the Supply of Rural Agencies and Availability of Home-Based Skilled Services
Reports on changes in the supply of home health agencies in rural and urban areas before and after the Balanced Budget Act (BBA) of 1997, which changed reimbursement for home health. Also looks at provision of physical therapy, occupational therapy, speech therapy, and medical social work by rural and urban home health agencies.
Author(s): Janet P. Sutton
Date: 03/2005
Type: Document
Sponsoring organization: NORC Walsh Center for Rural Health Analysis
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Medicare Physician Fees: Geographic Adjustment Indices Are Valid in Design, but Data and Methods Need Refinement
Discusses Medicare's geographic practice cost indices (GPCI). Includes discussion of how these indices impact rural physicians, physician incomes, location, recruitment, and retention.
Additional links: Full Report
Date: 03/2005
Type: Document
Sponsoring organization: Government Accountability Office
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