Under one draft legislative proposal developed by the National Rural Health Association to give CAHs an on-ramp to move into value-based payments, participating CAHs would receive a 2 percent increase in Medicare reimbursement for submitting quality data and would be required to join an accountable care organization (ACO) within three to five years.
On the regulatory front, the Centers for Medicare & Medicaid Services’ Center for Medicare & Medicaid Innovation (CMMI) has significant authority and funding to test (and expand, if successful), innovative models to improve health care quality and value. CMMI launched Pennsylvania’s Rural Health Model in 2017 to test global budgeting and community-specific transformation plans in rural Pennsylvania.
Legislative and federal-agency efforts are supported by the work of outside organizations, in some cases under contracts with federal agencies. For example, The National Quality Forum is developing rural-specific quality performance measures that can be used as a basis for value-based reimbursement in rural areas.