Department of Health and Human Services (HHS) Rural Health Innovation and Transformation Technical Assistance Grant

In an effort to control health care costs and improve the quality of care, public and private payers have increasingly implemented initiatives to encourage value-based care. Value-based care programs reward health care providers for the quality of care through the realignment of financial incentives towards value over volume. Because of the unique economic factors affecting rural providers, the implementation and effects of value-based care initiatives may look different in rural, low-volume settings. For example, low patient volumes, along with low margins, in rural settings can make it more difficult to absorb the financial risks associated with value-based care. Start-up costs for value-based care may seem prohibitive for some, while small volumes may make it more difficult to measure value and may increase the risk of skewed outcomes. At the same time, value-based care initiatives are evolving towards risk-based models, and there is a need to help stakeholders and the public understand how these changes affect rural health care. Therefore, a major goal of this funding opportunity is to support the ability of rural providers to participate and succeed in current and emerging payment and delivery system models designed to provide value-based care.

Value-based care is one of the four priorities of the United States Department of Health and Human Services (HHS). Through the prioritization of value-based care, HHS is working to transform our healthcare system from one that pays for procedures and sickness to one that pays for outcomes and health, focusing on four areas:1

1 U.S. Department of Health and Human Services. Secretary Priorities. Available at: https://www.hhs.gov/about/leadership/secretary/priorities/index.html#value-based-healthcare

2 Centers for Medicare and Medicaid Services. Rural Health Strategy. May 2018. Available at: https://www.cms.gov/About-CMS/Agency-Information/OMH/Downloads/Rural-Strategy-2018.pdf

1. Maximizing the promise of health information technology (IT), including through promoting interoperability.

2. Boosting transparency around price and quality.

3. Pioneering bold new models in Medicare and Medicaid.

4. Removing government burdens and barriers, especially those impeding care coordination.

In 2018, the Centers for Medicare and Medicaid Services (CMS) issued its CMS Rural Health Strategy to elevate rural health as an important focus of its provider payment policies, including delivery system reform and innovation opportunities.2 In alignment with the HHS priorities and the CMS Rural Health Strategy, this funding opportunity seeks to provide a mechanism for the federal government to work collaboratively with rural health care stakeholders on TA to achieve the following goals: HRSA-19-022

1. Raise awareness of the unique considerations facing rural providers and communities in implementing value-based care in the current and emerging environments, with a particular focus on the four strategic areas identified above.

2. Engage stakeholders with strategies to help rural providers and communities participate in value-based care models.