Health Policy Commons^™

Community Characteristics And Financial And Operational Performance Of Rural Health Clinics In The United States: A Chartbook, John Gale Ms, Zachariah Croll Mph, Jamar Croom Ms, Louisa Munk Mph, Yvonne Jonk Phd

Rural Health Clinics

This chartbook provides an overview of Rural Health Clinic (RHC) characteristics and issues using data from CMS’s Provider of Services file, Medicare Cost Reports, and the Robert Wood Johnson Foundation’s’ County Health Ranking and will be useful to policymakers and others interested in the performance of RHCs nationally. It can also be useful to RHC administrators to benchmark staffing patterns, productivity, and efficiency. Finally, it provides a discussion of the challenges related to collection and reporting of RHC quality data.

For more information, please contact John Gale, john.gale@maine.edu

Rural Health Clinic Costs And Medicare Reimbursement, John A. Gale Ms, Zachariah T. Croll Mph, Andrew F. Coburn Phd

Rural Health Clinics

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 …