Trends for Rural Health Clinics and Federally Qualified Health Centers Serving Rural Medicare Beneficiaries during the 1990's

摘要

The Health Care Financing Administration (HCFA) contracted with RAND to perform an analysis of Medicare spending for special payments to rural providers and their implications for access and costs of care for rural Medicare beneficiaries. Our goal was to provide a comprehensive overview of utilization and spending for these services over the last decade. Information from these trend analyses will guide our examination of future Medicare rural payment policy options. The special payment provisions examined include (1) bonus payments to physicians in rural HPSAs; (2) reimbursements to Rural Health Clinics and Federally Qualified Health Centers; (3) special payments for sole community hospitals, Medicare- dependent hospitals, rural referral centers, EACH/RPCH hospital networks, and Medical Assistance Facilities; and (4) capitation payments in rural counties, especially in underserved areas. This report presents the preliminary findings from our analysis of Rural Health Clinics (RHCs) and rural Federally Qualified Health Centers (FQHCs). We describe trends during the 1990's in the number, location, and utilization of these facilities by Medicare beneficiaries.