Rural Health
Resources by Topic: Accountable Care Organizations
Federally Qualified Health Centers and Performance of Medicare Accountable Care Organizations
Explores the association between participation of Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs) in Medicare Shared Savings Program Accountable Care Organizations (ACOs) with ACOs' beneficiary characteristics, utilization, expenditure, and quality. Features statistics including estimated changes in Medicare Shared Savings Program ACO-assigned beneficiaries, utilization, and expenditure, with breakdowns by FQHC and RHC visits and other types of visits.
Author(s): Kun Li, Yucheng Hou, Frank McStay, Jonathan Gonzalez-Smith, Robert S. Saunders
Citation: JAMA Network Open, 7(11), e2445536
Date: 11/2024
Type: Document
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Explores the association between participation of Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs) in Medicare Shared Savings Program Accountable Care Organizations (ACOs) with ACOs' beneficiary characteristics, utilization, expenditure, and quality. Features statistics including estimated changes in Medicare Shared Savings Program ACO-assigned beneficiaries, utilization, and expenditure, with breakdowns by FQHC and RHC visits and other types of visits.
Author(s): Kun Li, Yucheng Hou, Frank McStay, Jonathan Gonzalez-Smith, Robert S. Saunders
Citation: JAMA Network Open, 7(11), e2445536
Date: 11/2024
Type: Document
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Re-Imagining Rural Health: Themes, Concepts, and Next Steps from the CMS Innovation Center "Hackathon" Series
Summarizes themes that emerged from Centers for Medicare & Medicaid Services (CMS) Innovation Center's August 2024 Rural Health Hackathons, which aimed to inform potential payment and service delivery model development and to identify innovative solutions to address the access, care delivery, and workforce needs of rural, Tribal, frontier, and geographically isolated areas communities. Describes lessons learned from previous Innovation Center models focused on rural health and how these lessons were applied during the development of new models. Outlines potential areas for the Innovation Center to explore to advance health in rural, Tribal, frontier, and geographically isolated areas.
Date: 11/2024
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Summarizes themes that emerged from Centers for Medicare & Medicaid Services (CMS) Innovation Center's August 2024 Rural Health Hackathons, which aimed to inform potential payment and service delivery model development and to identify innovative solutions to address the access, care delivery, and workforce needs of rural, Tribal, frontier, and geographically isolated areas communities. Describes lessons learned from previous Innovation Center models focused on rural health and how these lessons were applied during the development of new models. Outlines potential areas for the Innovation Center to explore to advance health in rural, Tribal, frontier, and geographically isolated areas.
Date: 11/2024
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Beneficiary and Clinician Perspectives on Medicare and Other Issues: Findings from 2024 Focus Groups in Select States
Summarizes findings from 24 focus groups of Medicare beneficiaries, Medicare and Medicaid (dual eligible) beneficiaries, and clinicians conducted between May and June 2024, including three virtual focus groups of rural Medicare beneficiaries. Highlights themes that emerged across the focus groups covering Medicare coverage options, access to care, telehealth, organization of care, and prescription drugs.
Date: 10/2024
Type: Document
Sponsoring organizations: Medicare Payment Advisory Commission, NORC at the University of Chicago
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Summarizes findings from 24 focus groups of Medicare beneficiaries, Medicare and Medicaid (dual eligible) beneficiaries, and clinicians conducted between May and June 2024, including three virtual focus groups of rural Medicare beneficiaries. Highlights themes that emerged across the focus groups covering Medicare coverage options, access to care, telehealth, organization of care, and prescription drugs.
Date: 10/2024
Type: Document
Sponsoring organizations: Medicare Payment Advisory Commission, NORC at the University of Chicago
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Medicare Payment Basics: Accountable Care Organizations Payment Systems
Provides an overview of Medicare's Accountable Care Organization (ACO) programs. Discusses the payment mechanics of ACOs, including the maximum shared savings and losses of Medicare Shared Savings Program ACOs by track and level.
Date: 10/2024
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Provides an overview of Medicare's Accountable Care Organization (ACO) programs. Discusses the payment mechanics of ACOs, including the maximum shared savings and losses of Medicare Shared Savings Program ACOs by track and level.
Date: 10/2024
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Financial Performance of Rural and Urban Hospitals in the Medicare Shared Savings Program
Presents financial performance trends of hospitals that participated in Medicare's Shared Savings Program (SSP) from 2011-2018. Compares trends in 6 financial outcomes between SSP and non-SSP hospitals, and differences in these trends among rural and urban hospitals.
Author(s): Huang Huang, Xi Zhu, Fred Ullrich, A. Clinton MacKinney, Keith Mueller
Date: 09/2024
Type: Document
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Presents financial performance trends of hospitals that participated in Medicare's Shared Savings Program (SSP) from 2011-2018. Compares trends in 6 financial outcomes between SSP and non-SSP hospitals, and differences in these trends among rural and urban hospitals.
Author(s): Huang Huang, Xi Zhu, Fred Ullrich, A. Clinton MacKinney, Keith Mueller
Date: 09/2024
Type: Document
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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MedPAC Data Book: Health Care Spending and the Medicare Program, 2024
Provides an overview of Medicare spending and highlights data on Medicare beneficiary demographics, dual-eligible beneficiaries, quality of care provided through the Medicare program, and other payer liability. Examines settings of care, including rural-specific provider sites, as they relate to spending, access to care, and profit margins. Compares rural and urban beneficiaries and providers throughout. Chart 6-2 addresses rural hospital closures.
Date: 07/2024
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Provides an overview of Medicare spending and highlights data on Medicare beneficiary demographics, dual-eligible beneficiaries, quality of care provided through the Medicare program, and other payer liability. Examines settings of care, including rural-specific provider sites, as they relate to spending, access to care, and profit margins. Compares rural and urban beneficiaries and providers throughout. Chart 6-2 addresses rural hospital closures.
Date: 07/2024
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Evaluation of the Vermont All-Payer Accountable Care Organization Model: 2018-2022 - Fourth Evaluation Report
Evaluates the first five performance years of the Vermont All-Payer Accountable Care Organization Model (VTAPM), which aims to assess whether scaling an Accountable Care Organization (ACO) across all payers in the state can reduce program expenditures while preserving or improving care quality. Discusses the implementation of the model, provider engagement, efforts to address population health goals; characteristics of participating hospitals, practitioners, and beneficiaries; and the model's impacts on Medicare spending, utilization, and quality of care. Includes analyses of Medicare ACO subgroups and Medicaid spending, utilization, and quality of care trends. Outlines challenges and lessons learned.
Additional links: Findings at a Glance, Technical Appendices
Date: 06/2024
Type: Document
Sponsoring organizations: Centers for Medicare and Medicaid Services, NORC at the University of Chicago
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Evaluates the first five performance years of the Vermont All-Payer Accountable Care Organization Model (VTAPM), which aims to assess whether scaling an Accountable Care Organization (ACO) across all payers in the state can reduce program expenditures while preserving or improving care quality. Discusses the implementation of the model, provider engagement, efforts to address population health goals; characteristics of participating hospitals, practitioners, and beneficiaries; and the model's impacts on Medicare spending, utilization, and quality of care. Includes analyses of Medicare ACO subgroups and Medicaid spending, utilization, and quality of care trends. Outlines challenges and lessons learned.
Additional links: Findings at a Glance, Technical Appendices
Date: 06/2024
Type: Document
Sponsoring organizations: Centers for Medicare and Medicaid Services, NORC at the University of Chicago
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Health Subcommittee Hearing on Improving Value-Based Care for Patients and Providers
Recording of a June 26, 2024, House Committee on Ways and Means Subcommittee on Health hearing on the challenges and opportunities associated with delivering better health outcomes and Medicare savings through value-based care. Features testimony from Sarah Chouinard, Chief Medical Officer of Main Street Health, regarding value-based care delivery in rural areas.
Additional links: Sarah Chouinard, Main Street Health - Testimony
Date: 06/2024
Type: Video/Multimedia
Sponsoring organization: House Ways and Means Committee, Subcommittee on Health
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Recording of a June 26, 2024, House Committee on Ways and Means Subcommittee on Health hearing on the challenges and opportunities associated with delivering better health outcomes and Medicare savings through value-based care. Features testimony from Sarah Chouinard, Chief Medical Officer of Main Street Health, regarding value-based care delivery in rural areas.
Additional links: Sarah Chouinard, Main Street Health - Testimony
Date: 06/2024
Type: Video/Multimedia
Sponsoring organization: House Ways and Means Committee, Subcommittee on Health
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Medicare Accountable Care Organizations: Past Performance and Future Directions
Summarizes research findings about Medicare accountable care organizations (ACOs) from recent peer-reviewed journals, official evaluations of Medicare ACOs, and research organization reports. Describes characteristics of certain ACOs associated with greater savings and factors that limit ACOs' ability to achieve net budgetary savings for the Medicare program. Identifies policy approaches that could increase savings for Medicare through ACOs and the Medicare Shared Savings Program. Includes a brief discussion of challenges facing ACOs in rural and underserved areas.
Date: 04/2024
Type: Document
Sponsoring organization: Congressional Budget Office
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Summarizes research findings about Medicare accountable care organizations (ACOs) from recent peer-reviewed journals, official evaluations of Medicare ACOs, and research organization reports. Describes characteristics of certain ACOs associated with greater savings and factors that limit ACOs' ability to achieve net budgetary savings for the Medicare program. Identifies policy approaches that could increase savings for Medicare through ACOs and the Medicare Shared Savings Program. Includes a brief discussion of challenges facing ACOs in rural and underserved areas.
Date: 04/2024
Type: Document
Sponsoring organization: Congressional Budget Office
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2023 National CAH Quality Inventory & Assessment National Report
Presents a high-level summary of key data points from the October-December 2023 National Critical Access Hospital (CAH) Quality Inventory and Assessment. Includes data on CAH system affiliation; median average daily census and emergency department volume; hospital inpatient, behavioral health and specialty care, and outpatient and other service lines; and CAH quality payment model participation.
Author(s): Megan Lahr, Robert Barclay, Madeleine Pick
Date: 04/2024
Type: Document
Sponsoring organization: Flex Monitoring Team
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Presents a high-level summary of key data points from the October-December 2023 National Critical Access Hospital (CAH) Quality Inventory and Assessment. Includes data on CAH system affiliation; median average daily census and emergency department volume; hospital inpatient, behavioral health and specialty care, and outpatient and other service lines; and CAH quality payment model participation.
Author(s): Megan Lahr, Robert Barclay, Madeleine Pick
Date: 04/2024
Type: Document
Sponsoring organization: Flex Monitoring Team
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