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Rural Health
Resources by Topic: Reimbursement and payment models

Impacts of the Medicare Modernization Act on Rural Health Systems and Beneficiaries
Offers an analysis of rural-pertinent provisions of the Medicare Modernization Act of 2003. Summarizes legislative and regulatory provisions of special significance to rural beneficiaries and health care systems.
Author(s): Keith Mueller, Andrew Coburn, Charles Fluharty, et al.
Date: 02/2005
Type: Document
Sponsoring organization: Rural Policy Research Institute Rural Health Panel
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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
Type: Document
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
Type: Document
Sponsoring organization: Government Accountability Office
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Rural Physicians' Acceptance of New Medicare Patients
Describes trends for urban and rural physicians who no longer accept new Medicare patients. Discusses the impact of Medicare payment policy changes on rural physicians' decisions to accept Medicare patients.
Author(s): Keith J. Mueller, A. Clinton MacKinney, Timothy D. McBride, Jane L. Meza, Liyan Xu
Citation: RUPRI Rural Policy Brief, 9(5)
Date: 08/2004
Type: Document
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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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
Type: Document
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
Type: Document
Sponsoring organization: NORC Walsh Center for Rural Health Analysis
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An Analysis of the Agreement of Financial Data Between the Medicare Cost Report and the Audited Hospital Financial Statement
Describes the results of a study of rural hospital financial measures, comparing Medicare Cost Reports with audited hospital financial statements.
Author(s): Li-Wu Chen, Julie Stoner, Catherine Makhanu, Kathy Minikus, Keith J. Mueller
Date: 05/2004
Type: Document
Sponsoring organization: RUPRI Center for Rural Health Policy 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
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (P.L. 108-173): A Summary of Provisions Important to Rural Health Care Delivery
Overview of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (P.L. 108-173) as it relates to rural healthcare. Includes information on how this Act impacts beneficiaries, healthcare access, and payments to rural healthcare providers.
Author(s): Keith J. Mueller
Date: 01/2004
Type: Document
Sponsoring organizations: RUPRI Center for Rural Health Policy Analysis, Rural Policy Research Institute
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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
Type: Document
Sponsoring organization: Federal Office of Rural Health Policy
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