The Pennsylvania Rural Health Model: Hospitals' Early Experiences With Global Payment for Rural Communities

Area of Science:

• Healthcare policy and reform
• Rural health services research
• Health economics

Background:

• The Pennsylvania Rural Health Model was implemented in January 2019 for all-payer prospective global budget reimbursement.
• This demonstration project, funded by the Center for Medicare and Medicaid Innovation, aimed to support rural hospitals.

Purpose of the Study:

• To identify challenges and lessons learned during the design, development, and early implementation of the Pennsylvania Rural Health Model.
• To provide insights for other states seeking to reform rural healthcare payment models.

Main Methods:

• Qualitative research approach utilizing primary source documents.
• Semistructured interviews with 20 key stakeholders, including state officials, hospitals, and technical assistance providers.

Main Results:

• Four critical attributes for innovative healthcare projects were identified: strong leadership and inter-agency cooperation, stakeholder education on rural health disparities and challenges, realistic timelines for relationship building, and multistakeholder collaboration to foster a rural health movement.

Conclusions:

• The Pennsylvania model offers a promising approach for other states to address rural population needs and support vital community hospitals.
• Lessons learned can guide the transition from volume-based to value-based care in rural healthcare settings.