Rural Health Clinics
 

Document Type

Policy Brief

Publication Date

11-2019

Keywords

MRHRC, Rural Health Clinica, Medicare, costs, rural, healthcare delivery, Cutler

Abstract

The Rural Health Clinic (RHC) Program is one of the nation’s oldest rural primary care programs. A key feature of the RHC Program is Medicare and Medicaid volume-appropriate, cost-based reimbursement, which is designed to sustain these vulnerable rural primary care providers. Medicare currently pays RHCs for the lesser of reasonable costs (expressed as an adjusted cost per visit) for a defined package of RHC services or a per-visit reimbursement cap, from which provider-based RHCs owned by hospitals with fewer than 50 beds are exempt. Although the per-visit cap is updated periodically, RHC administrators, policymakers, and stakeholders question whether the updates have allowed RHCs to keep pace with increases in staffing and other costs. This brief explores this issue by examining the costs of RHCs relative to Medicare payment limits for different types and sizes of RHC providers.

Comments

For more information on this study, please contact John Gale at john.gale@maine.edu

Funding Organization or Grant

Federal Office of Rural Health Policy

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