Rural Healthcare Payment and Reimbursement – Resources
Selected recent or important resources focusing on Rural Healthcare Payment and Reimbursement.
Making Care Primary (MCP) Model
Provides information on the Centers for Medicare & Medicaid Services (CMS) Innovation Center's Making Care Primary (MCP) Model, which offers a pathway for primary care clinicians in eight states to gradually adopt prospective, population-based payments while building infrastructure to improve behavioral health and specialty care integration and enhance equitable access to care.
Type: Website
Sponsoring organization: Centers for Medicare and Medicaid Services
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Provides information on the Centers for Medicare & Medicaid Services (CMS) Innovation Center's Making Care Primary (MCP) Model, which offers a pathway for primary care clinicians in eight states to gradually adopt prospective, population-based payments while building infrastructure to improve behavioral health and specialty care integration and enhance equitable access to care.
Type: Website
Sponsoring organization: Centers for Medicare and Medicaid Services
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Accountable Care Organization Realizing Equity, Access, and Community Health (ACO REACH) Model
Provides information on the Centers for Medicare & Medicaid Services (CMS) Innovation Center's ACO Realizing Equity, Access, and Community Health (ACO REACH) Model, which is intended to encourage healthcare coordination to improve care for people with Medicare, especially those from underserved communities.
Type: Website
Sponsoring organization: Centers for Medicare and Medicaid Services
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Provides information on the Centers for Medicare & Medicaid Services (CMS) Innovation Center's ACO Realizing Equity, Access, and Community Health (ACO REACH) Model, which is intended to encourage healthcare coordination to improve care for people with Medicare, especially those from underserved communities.
Type: Website
Sponsoring organization: Centers for Medicare and Medicaid Services
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Health Costs, Coverage and Delivery State Legislation Database
Identifies enacted state legislation addressing healthcare costs, access, and health system efficiencies. Topics covered include alternative payment methods, health insurance marketplaces, health system consolidation and competition, Medicaid reforms, price transparency, surprise billing, and telehealth. Searchable by state, topic, keyword, year, status, and primary sponsor. Updated every two weeks, with information on legislation starting in 2022.
Type: Database
Sponsoring organization: National Conference of State Legislatures
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Identifies enacted state legislation addressing healthcare costs, access, and health system efficiencies. Topics covered include alternative payment methods, health insurance marketplaces, health system consolidation and competition, Medicaid reforms, price transparency, surprise billing, and telehealth. Searchable by state, topic, keyword, year, status, and primary sponsor. Updated every two weeks, with information on legislation starting in 2022.
Type: Database
Sponsoring organization: National Conference of State Legislatures
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PubMed Search: Rural Payment and Reimbursement
Searches PubMed's collection of journal article citations on the topic of rural healthcare payment and reimbursement.
Type: Literature Search
Sponsoring organization: U.S. National Library of Medicine
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Searches PubMed's collection of journal article citations on the topic of rural healthcare payment and reimbursement.
Type: Literature Search
Sponsoring organization: U.S. National Library of Medicine
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Medicare Learning Network: Medicare Payment Systems
Provides general information about Medicare payment systems, including the DMEPOS Fee Schedule, Inpatient Psychiatric Facility Prospective Payment System (IPF PPS), Inpatient Rehabilitation Facility Prospective Payment System (IRF PPS), and more. Includes links to additional resources for each provider type.
Type: Website
Sponsoring organization: Centers for Medicare and Medicaid Services
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Provides general information about Medicare payment systems, including the DMEPOS Fee Schedule, Inpatient Psychiatric Facility Prospective Payment System (IPF PPS), Inpatient Rehabilitation Facility Prospective Payment System (IRF PPS), and more. Includes links to additional resources for each provider type.
Type: Website
Sponsoring organization: Centers for Medicare and Medicaid Services
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Code of Federal Regulations: Title 42 Public Health, Chapter 4, Subchapter B, Part 425: Medicare Shared Savings Program
Details and describes the regulations for Accountable Care Organizations (ACOs) to participate in the Medicare Shared Savings Program. Provides information on eligibility, application procedures, reporting requirements, and special assignment conditions for Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs).
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Details and describes the regulations for Accountable Care Organizations (ACOs) to participate in the Medicare Shared Savings Program. Provides information on eligibility, application procedures, reporting requirements, and special assignment conditions for Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs).
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Rural Community Hospital Demonstration
An overview of a CMS demonstration project which provides cost-based reimbursement for small rural hospitals too large to be Critical Access Hospitals. Examines the community benefits and financial impact for participating hospitals.
Type: Website
Sponsoring organization: Centers for Medicare and Medicaid Services
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An overview of a CMS demonstration project which provides cost-based reimbursement for small rural hospitals too large to be Critical Access Hospitals. Examines the community benefits and financial impact for participating hospitals.
Type: Website
Sponsoring organization: Centers for Medicare and Medicaid Services
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Profiles of Value Based Care in Action
Profiles of rural healthcare organizations that are taking innovative approaches to healthcare delivery and finance.
Type: Website
Sponsoring organization: Rural Health Value
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Profiles of rural healthcare organizations that are taking innovative approaches to healthcare delivery and finance.
Type: Website
Sponsoring organization: Rural Health Value
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CMS Innovation Center
Supports the development, testing and sharing of innovative healthcare payment and service delivery models. Includes data, reports, webinars and forums for sharing knowledge among healthcare innovators, data researchers and policy analysts.
Type: Website
Sponsoring organization: Centers for Medicare and Medicaid Services
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Supports the development, testing and sharing of innovative healthcare payment and service delivery models. Includes data, reports, webinars and forums for sharing knowledge among healthcare innovators, data researchers and policy analysts.
Type: Website
Sponsoring organization: Centers for Medicare and Medicaid Services
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Health.mil Rates and Reimbursement: Hospital Classifications
Identifies TRICARE reimbursement methodologies for Sole Community Hospitals (SCH) and Critical Access Hospitals (CAHs). Also lists CAH inpatient and outpatient cost-to-charge ratios (CCRs).
Type: Website
Sponsoring organization: Military Health System
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Identifies TRICARE reimbursement methodologies for Sole Community Hospitals (SCH) and Critical Access Hospitals (CAHs). Also lists CAH inpatient and outpatient cost-to-charge ratios (CCRs).
Type: Website
Sponsoring organization: Military Health System
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Additional resources are available related to this guide. See the full list of resources by topic for:
- Accountable Care Organizations
- Care coordination
- Health insurance
- Healthcare business and finance
- Medicaid
- Medicare
- Policy
- Reimbursement and payment models
- Service delivery models
Last Updated: 10/17/2024