CMS Seeks Rural Input on Unique Payment Model

04/26/16  Rockville, MD

The Federal Office of Rural Health Policy hopes that you will consider and share this RFI from the CMS Innovation Center with your colleagues and any entities that focus on rural health.

The ORHP is encouraged by the concepts CMS has laid out in this RFI and the opportunity it creates to think more creatively about how to focus on population health in a way that provides meaningful participation by rural providers. They encourage clinic experts to offer their perspectives on how a global budgeting approach could be developed that would offer a pathway for key rural safety net providers like Rural Health Clinics to focus on improving health in their communities through more creative and flexible financing.

In this RFI, CMS is explicitly asking for input from rural providers and experts on how one might build a global budgeting system that takes into account the historical financial protections for rural hospitals, Rural Health Clinics, and rural Community Health Centers as well as post-acute care providers.

ORHP would encourage commenters to see this as an opportunity to think beyond cost-based reimbursement or the traditional fee-for-service arrangements that have offered some protections to ensure access in rural areas, but which also create significant challenges in allowing rural providers to truly shape their delivery system to meet local need and improve the health of their service area.

In addition, ORHP would encourage rural providers to offer their thoughts to CMS on what sort of incentives could be created to encourage regional partnerships of providers and public and private payers that would ensure meaningful rural participation.

Comments on the Request for Information should be submitted electronically to by Friday, May 13, 2016. Additional details on the regional budget payment concept will be posted at as they become available. For more information, please contact .