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Rural Health Information Hub

Rural Health
Resources by Topic: Healthcare business and finance

Calendar Year (CY) 2015 Rural Health Clinic (RHC) and Federally Qualified Health Centers (FQHC) Updates: Payment Rate Increases for RHCs and FQHCs Billing Under the All-Inclusive Rate System (AIR), and Urban and Rural Designations for FQHCs Billing Under the AIR
Provides updates for RHCs and FQHCs that are submitting claims to Medicare Administrative Contractors (MACs) for services to Medicare beneficiaries.
Date: 12/2024
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Reconsidering and Measuring Patient Access in Medicaid
Discusses ways to measure patient access and coverage of those enrolled in Medicaid, focusing on their insurance plan quality, reimbursement rates, and clinician networks. Considers policy impacts on rural areas.
Author(s): Benjamin D. Sommers, Renuka Tipirnen
Citation: JAMA Health Forum, 5(4)
Date: 04/2024
Type: Document
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April 2024 MedPAC Meeting Transcript
Transcript from the Medicare Payment Advisory Commission's (MedPAC) April 2024 meeting. Covers telehealth in Medicare, alternative approaches to lowering Medicare payments for select conditions in inpatient rehabilitation facilities, approaches for updating the Medicare physician fee schedule, initial findings from an analysis of Medicare Part B payment rates and 340B ceiling prices, and more. Includes discussion of telehealth in rural areas and data on telehealth use in Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs) between 2020 and 2022.
Additional links: Telehealth in Medicare: Status Report - Presentation Slides
Date: 04/2024
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Using the Updated Financial Distress Index to Describe Relative Risk of Hospital Financial Distress
Describes the relative risk of rural hospitals and selected urban hospitals experiencing financial distress in 2023. Provides an overview of an updated Financial Distress Index (FDI), which incorporates variables reflecting changes to operational environments since the publication of the 2017 FDI to predict and analyze financial distress and risk of rural hospital closure. Presents data on the characteristics of hospitals by relative risk of financial distress in 2023 and the number of hospitals in each state across in category of relative risk of financial distress.
Author(s): Tyler Malone, George Pink, Kristie Thompson, Mark Holmes
Date: 04/2024
Type: Document
Sponsoring organization: North Carolina Rural Health Research Program
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Survey Emphasizes Scale and Significance of the RHC Program
Summarizes results of a 2024 national survey of 930 Rural Health Clinics. Presents data on the average payer mix, use and attitude toward telehealth services, Medicare Advantage (MA) contract structures, and MA reimbursement relative to traditional Medicare reimbursement, and more.
Additional links: NARHC 2024 Policy Survey Results
Date: 04/2024
Type: Document
Sponsoring organization: National Association of Rural Health Clinics
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Transforming Oral Health Care in North Carolina
Makes recommendations for improving oral health access, supporting oral care workforce and providers, and promoting oral health quality and equity in North Carolina. Discusses oral health in rural and underserved areas throughout, including coverage of workforce distribution, dental safety net, and access barriers.
Date: 04/2024
Type: Document
Sponsoring organization: North Carolina Institute of Medicine
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Rural Hospitals' Perspectives On Health System Affiliation
Brief exploring hospital affiliation with consideration for rural contexts. Discusses impacts on costs of services, quality of care, and system finances. Offers recommended steps when choosing to affiliate and metrics for evaluating success.
Author(s): Joel M. James, Keith J. Mueller, Dan M. Shane
Date: 04/2024
Type: Document
Sponsoring organization: Rural Policy Research Institute Rural Health Panel
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Medicare and Medicaid Programs: Minimum Staffing Standards for Long-Term Care Facilities and Medicaid Institutional Payment Transparency Reporting Final Rule (CMS 3442-F)
Fact sheet providing an overview of the Centers for Medicare & Medicaid Services (CMS) final rule for minimum staffing standards for long-term care facilities. Details three core staffing proposals: 1) minimum nurse staffing standards; 2) a requirement to have an RN onsite 24 hours a day, seven days a week; and 3) enhanced facility assessment requirements. Outlines a staggered implementation approach, including a later implementation date for rural facilities, and hardship exemption qualification requirements. Also describes Medicaid payment transparency reporting provisions for nursing and intermediate care facilities related to the percentage of Medicaid funds spent on compensation to direct care workers and support staff.
Additional links: External FAQs
Date: 04/2024
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Meeting Essential Health Services And Reimagining Obstetrics In A Rural Community
Case study profiling Kittitas Valley Healthcare (KVH) in rural Washington. Describes how KVH implemented a new staffing model to maintain essential obstetrics and gynecological care.
Date: 04/2024
Type: Document
Sponsoring organization: American Hospital Association
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Ten Things to Know About Consolidation in Health Care Provider Markets
Discusses consolidation in healthcare provider markets, including different types of consolidation, trends, benefits and harms for patients and other consumers, key research findings, policy options for increasing competition, and more. Highlights impacts on rural and underserved communities throughout.
Author(s): Zachary Levinson, Jamie Godwin, Scott Hulver, Tricia Neuman
Date: 04/2024
Type: Document
Sponsoring organization: KFF
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