The Pennsylvania Rural Health Model (PARHM) is an innovative alternative payment model created by the Centers for Medicare and Medicaid Innovation (CMMI). It is the first of its kind, aimed at transforming healthcare, specifically in rural communities. This Model was created to address the financial challenges faced by rural hospitals, transitioning them from fee-for-service to global budget payments.
There have been several positive effects resulting from the PARHM:
1. Financial Stability: One of the core objectives has been to provide predictable revenue streams for rural hospitals. By stabilizing their finances, the PARHM has helped hospitals continue offering essential services without the constant threat of closure due to financial instability.
2. Healthcare Access: Ensuring that rural residents have consistent access to essential healthcare services has been a critical focal point of the PARHM. This includes maintaining emergency care, primary care, and specialized treatments that might otherwise be unavailable in rural areas. One of the most notable accomplishments of the PARHM is that no participant hospitals have closed during its implementation despite the impacts of the COVID-19 Pandemic.
3. Health Innovation: The Model has encouraged the adoption of innovative approaches to healthcare delivery. Since 2018, the RHRC team has provided technical assistance to participant hospitals, guiding them through a strategic transformation planning process to drive improvements to population health and access to care in their communities. Efforts have varied by the hospital and include goals such as telehealth implementation, service line expansions, and improved care management, but all can be attributed to three main transformation categories set forth by CMMI – (1) improving access to care, (2) improving population health, and (3) decreasing deaths due to substance use disorder.
4. Sustainable Healthcare Infrastructure: The PARHM has highlighted the importance of resilient and adaptable healthcare infrastructure that meets the evolving needs of rural communities. This infrastructure should include a robust clinical network and considerations for data exchange, quality reporting, and long-term sustainability planning to ensure the healthcare system can withstand future challenges.
5. Stakeholder Engagement: Last but certainly not least is fostering stakeholder relationships. Throughout its duration, cooperation between payers, hospitals, government bodies, and other key stakeholders has significantly contributed to the PARHM’s effectiveness. While all parties agree that the PARHM’s methodology is imperfect and requires changes for long-term stakeholder alignment, each has shown a dedication to its intended purpose and an openness to continue improving rural health sustainability.
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