PA – New Global Capitation Model for Rural Hospitals

January 2017 ~

CMS has announced a new seven-year global capitation model for rural hospitals in Pennsylvania (PA).

The news model, dubbed Pennsylvania Rural Health Model, will use global budgets to incentivize hospitals toward improve quality of care, access to appropriate care, and patient outcomes while reducing Medicare spending.

Under PA’s Rural Health Model, participating critical access hospitals and acute care hospitals will receive all-payer global budgets for a fixed amount of money that is set in advance and funded by all participating insurers, to cover inpatient and outpatient services. PA will prospectively set the all-payer global budget for each participating rural hospital, based primarily on historical net revenue for inpatient and outpatient hospital-based services from all participating payers.

According to CMS, “The Model will test whether the predictable nature of the global budgets will enable participating rural hospitals to invest in quality and preventive care, and to tailor the services they deliver to better meet the needs of their local communities.”

For more information, visit the Pennsylvania Rural Health Model page located in CMS’ Innovation Center.


Source(s): HealthcareFinance News; RevCycleIntelligence; CMS; AHA News;