PARHM
Pennsylvania Rural Health Model
The Pennsylvania Rural Health Model (PARHM) pays participating rural hospitals a fixed amount upfront, regardless of patient volume. This global budget empowers hospitals to invest in high-quality primary and specialty care tailored to their communities. The model aims to improve the financial viability of rural hospitals, enhance health outcomes, and maintain access to care for rural residents.
Innovation
The Model tests whether the predictable nature of global budgets enables participating rural hospitals to invest in quality and preventive care, and tailor their services to better meet the needs of their local communities.
The Problem
Pennsylvania hospitals in rural areas often do not have the financial resources or workforce necessary to maintain and expand access to care needed in the community, or to make investments that may improve quality of care and patient experience. As a result of these challenges, many rural Pennsylvanians have seen their local hospital close.
The Solution
PARHM pays participating hospitals a fixed amount upfront, regardless of patient volume, empowering these hospitals to invest in high-quality primary and specialty care that addressed the specific needs of the communities they serve.
Expected Outcomes
Rural Pennsylvania residents may experience greater access to high-quality care and live healthier lives. The model aims to improve both the financial viability of rural Pennsylvania hospitals and improve health outcomes, while maintaining continued access to care.
Strategy
CMS believes this Model furthers CMS' goals of improving the health of beneficiaries in rural areas, maintaining access to health care for rural populations, and determining the impact of an alternative payment model on rural providers, who have generally had lower rates of participation in alternative payment models.
Model Goals
- Improve overall health of rural Pennsylvania residents
- Reduce the growth of hospital expenditures across payers, including Medicare
- Improve the financial viability of rural Pennsylvania hospitals
- Maintain continued access to care for Pennsylvania's rural residents
Patient Eligibility
Beneficiaries must be Pennsylvania residents who reside in a rural area served by a participating rural hospital and receive coverage from a participating payer.
- Pennsylvania resident
- Resides in a rural area of Pennsylvania served by a participating rural hospital
- Receives coverage from a participating payer
Provider Eligibility
The Model is open to critical access hospitals and acute care hospitals in rural Pennsylvania that prepare an approved Rural Hospital Transformation Plan.
- Must be a critical access hospital or acute care hospital
- Must be located in rural Pennsylvania
- Must prepare a Rural Hospital Transformation Plan approved by Pennsylvania and CMS
Care Categories
Chronic Disease Management
Preventive Care
Behavioral Health
Primary and Specialty Care
CMS Benchmarks & Thresholds
financial
operational
population
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