Healthcare Revenue Cycle Management, ICD-10, Claims Reimbursement, Medicare, Medicaid

Rural Hospitals

5 Rural Hospitals Take on All-Payer Global Budgets to Boost Care

March 8, 2019 - Pennsylvania Governor Tom Wolf recently tapped the first five hospitals and five payers to participate in a new alternative payment model from the CMS Innovation Center that uses all-payer global budgets to support rural hospital transformation. Barnes-Kasson Hospital, Endless Mountains Health System, Geisinger Jersey Shore Hospital, University of Pittsburgh Medical Center (UPMC) Kane...


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21% of Rural Hospitals at High Financial Risk of Closing

by Jacqueline LaPointe

A new analysis from consulting firm Navigant revealed that one-in-five rural hospitals is at high risk of closing based on their current financial position. The analysis of publicly available data explored the financial viability and...

AHA Wants More Alternative Payment Models for Rural Hospitals

by Jacqueline LaPointe

In its 2019 Rural Advocacy Agenda, the American Hospital Association (AHA) called for more opportunities for rural hospitals to successfully participate in bundled payment models, the Quality Payment Program, and other alternative payment...

Hospital Bankruptcies Are On the Rise, Hitting Rural Areas Hard

by Jacqueline LaPointe

The healthcare industry experience more than 20 hospital bankruptcies since 2016, and about three-quarters of the distressed hospitals operated in rural areas, law firm Polsinelli recently reported. The Am Law 100 firm tracks Chapter 11...

GAO Finds Uptick in Rural Hospital Closures as Inpatient Use Falls

by Jacqueline LaPointe

Sixty-four rural hospitals closed between 2013 and 2017, more than double the number of rural hospitals closures in the prior five-year period, the Government Accountability Office (GAO) recently reported. Rural hospital closures are not...

Rural Hospitals Get Low-Volume, Medicare-Dependent Funds Extended

by Jacqueline LaPointe

While the recent 2019 Medicare Inpatient Prospective Payment System (IPPS) rule brought major changes to healthcare price transparency and meaningful use, the rule also extended two key payment programs for small and rural hospitals. Those...

Flexibility, Value-Based Payment Key to Rural Hospital Success

by Jacqueline LaPointe

Health policies should provide rural hospitals with the flexibility to develop healthcare services that meet community needs and the value-based payment and funding structures to support tailored services, the Bipartisan Policy Center...

Over 1,300 Hospitals Urge CMS to Withdraw 340B Drug Payment Cuts

by Jacqueline LaPointe

Over 1,300 rural hospitals and other healthcare organizations that serve low-income communities added their voices to the growing list of stakeholders opposing proposed payment cuts to the 340B Drug Pricing program. CMS proposed in July...

In IRS First, Non-Profit Hospital Loses Status Under ACA Rules

by Jacqueline LaPointe

The IRS recently revoked a rural hospital’s non-profit status for failure to meet new community health needs assessment requirements under the Affordable Care Act. According to an IRS letter dated Feb. 14, 2017, the unnamed hospital...

Post-Acute Care Payment Reform Threatens Rural Hospitals

by Jacqueline LaPointe

A proposed unified Medicare reimbursement for post-acute care services and value-based care payment models, such as accountable care organizations (ACOs) and bundled payments, may propel rural hospital closures as the reforms lower their...

Top 4 Rural Hospital Challenges with Revenue Cycle Management

by Jacqueline LaPointe

Rural hospitals may be the only healthcare option for individuals living in sparsely populated areas, but revenue cycle management challenges have forced many of these facilities to permanently close their doors. The healthcare industry...

41% of Rural Hospitals Operating with Negative Margins

by Jacqueline LaPointe

Approximately 41 percent of rural hospitals faced negative operating margins in 2016, a recent Chartis Group and iVantage Health Analytics study of over 2,100 rural hospitals revealed. Researchers added that rural hospitals located in...

AHA Urges Rural, Post-Acute Care Medicare Reimbursement Reform

by Jacqueline LaPointe

In a Congressional hearing on the current status of Medicare reimbursement systems, the American Hospital Association (AHA) urged lawmakers to focus on rural hospital and post-acute care payments. MACRA extended a number of key Medicare...

MIPS Requirements for Clinicians in Small, Rural Hospitals

by Jacqueline LaPointe

In light of the unique challenges eligible clinicians in small and rural hospitals face, CMS developed special Merit-Based Incentive Payment System (MIPS) eligibility and reporting requirements for the clinician group. Through MIPS, CMS...

CMS Calls On Rural Hospitals to Join Alternative Payment Model

by Jacqueline LaPointe

CMS is seeking applicants to participate in a new round of the Rural Community Hospital Demonstration Program that tests a cost-based alternative payment model among small rural hospitals. Lawmakers authorized a five-year extension of the...

Senators Push Bill to Address Physician Shortage in Rural Areas

by Jacqueline LaPointe

Three senators recently introduced a rural healthcare bill that would extend the Conrad State 30 Program until 2021 to help alleviate the physician shortage in designated Health Professions Shortage Areas or Medically Underserved...

CMS Awards $100M for Small, Rural Clinician MACRA Help

by Jacqueline LaPointe

ORLANDO - CMS recently selected 11 healthcare organizations to receive a total of $100 million in funding to help small and rural eligible clinicians participate in the newly-launched MACRA. Each organization received $20 million to...

How a Rural Hospital Used Health IT, EHR to Stay Independent

by Jacqueline LaPointe

In a time of declining claims reimbursement rates and value-based care, rural hospitals are struggling more than ever to improve their healthcare revenue cycle management strategies. For many rural hospitals, the decision oftentimes comes...

All-Payer Alternative Payment Model Targets PA Rural Hospitals

by Jacqueline LaPointe

A new six-year all-payer alternative payment model will focus on improving care quality and reducing healthcare costs at rural hospitals in Pennsylvania, CMS announced in a recent fact sheet. The CMS Innovation Center’s latest...

URAC Calls for Virtual Group Rules in Quality Payment Program

by Jacqueline LaPointe

URAC, a non-profit healthcare accreditation company, recently called on CMS to implement virtual group standards under the Quality Payment Program in 2018 that promote economies of scale for more activities than just reporting...

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