Projects

Transforming Rural Health in Pennsylvania with Global Budgets

2019–2021

Project Overview

Objective

To increase rural Pennsylvanians’ access to high quality care and improve their health, while reducing the growth of hospital expenditures and increasing the financial viability of rural hospitals using an all-payer global budget. 

Project Motivation

Rural hospitals are under increasing pressure to provide high quality care and access while maintaining financial viability. The Pennsylvania Rural Health Model aims to address these challenges for Pennsylvania’s rural hospitals. 

Prepared For

The Rural Health Redesign Center Authority

All-payer global budgets aim to increase access to care and improve health in rural communities.
The Pennsylvania Rural Health Model is a payment innovation model jointly administered by the Pennsylvania Department of Health and the Centers for Medicare & Medicaid Services (CMS) Innovation Center. Under this model, participating rural hospitals are paid based on all-payer global budgets—a fixed amount that is set in advance for inpatient and outpatient hospital-based services. Our experts are working with the Pennsylvania Department of Health to support recruitment efforts and participation of eligible hospitals, develop necessary data requests, produce global budget outputs, and conduct data aggregation and analytics for payers and providers. In addition, in concert with the Department of Health, Mathematica is collaborating with the CMS Innovation Center to foster innovation and partnering.
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We have witnessed an increase in rural hospital closures nationwide. Our current method of paying for each individual service does not provide the right incentives or resources to rural communities to meet their high burden of disease. Global budgets implemented together with major payers might provide solutions to a fundamental misalignment in our health care.
- Sule Gerovich, Director of State Health

Related Staff

Sule Gerovich

Sule Gerovich

Senior Director, Business Development

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Evelyn Li

Evelyn Li

Senior Researcher

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Eric Schone

Eric Schone

Principal Researcher

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