Rural Health
Resources by Topic: Accountable Care Organizations
Health Panel Comment Letter - 2024 Physician Fee Schedule and Medicare Part B Proposed Rule
Comments offered in response to a July 13, 2023, Federal Register proposed rule revising the Medicare Physician Fee Schedule. Includes discussions on telehealth services, services addressing health-related social needs, advancing access to behavioral health services, Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs), and the Medicare Shared Savings Program.
Date: 09/2023
Type: Document
Sponsoring organization: Rural Policy Research Institute Rural Health Panel
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Comments offered in response to a July 13, 2023, Federal Register proposed rule revising the Medicare Physician Fee Schedule. Includes discussions on telehealth services, services addressing health-related social needs, advancing access to behavioral health services, Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs), and the Medicare Shared Savings Program.
Date: 09/2023
Type: Document
Sponsoring organization: Rural Policy Research Institute Rural Health Panel
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MedPAC Comment on CMS's Proposed Rule on the Physician Prospective Payment System for FY 2024
Comment on the August 7, 2023, Federal Register proposed rule revising the physician fee schedule to improve payment systems for physicians and other Medicare Part B revisions. Includes discussions on payment rates for Medicare telehealth services; the Medicare Shared Savings Program, including regional adjustments; incorporating Medicare Advantage data into public reporting; and more.
Date: 09/2023
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Comment on the August 7, 2023, Federal Register proposed rule revising the physician fee schedule to improve payment systems for physicians and other Medicare Part B revisions. Includes discussions on payment rates for Medicare telehealth services; the Medicare Shared Savings Program, including regional adjustments; incorporating Medicare Advantage data into public reporting; and more.
Date: 09/2023
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Who's Accountable? Low-Value Care Received By Medicare Beneficiaries Outside Of Their Attributed Health Systems
Examines how much low-volume care and health system spending can be attributed to fee-for-service Medicare beneficiaries aged 65-years-old and older receiving care outside of the health system between 2017-2018. Explores beneficiary and health system factors associated with receiving the thirty most common low-value services, including beneficiaries' rurality and whether the low-value services originated from primary care physicians or specialists.
Author(s): Ishani Ganguli, Maia L. Crawford, Benjamin Usadi, et al.
Citation: Health Affairs, 42(8), 1128-1139
Date: 08/2023
Type: Document
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Examines how much low-volume care and health system spending can be attributed to fee-for-service Medicare beneficiaries aged 65-years-old and older receiving care outside of the health system between 2017-2018. Explores beneficiary and health system factors associated with receiving the thirty most common low-value services, including beneficiaries' rurality and whether the low-value services originated from primary care physicians or specialists.
Author(s): Ishani Ganguli, Maia L. Crawford, Benjamin Usadi, et al.
Citation: Health Affairs, 42(8), 1128-1139
Date: 08/2023
Type: Document
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Building On CMS's Accountable Care Vision To Improve Care For Medicare Beneficiaries
Describes progress the Centers for Medicare & Medicaid Services (CMS) has made to date in its accountable care strategy. Outlines areas that CMS is exploring to accelerate the growth of and access to accountable care organizations (ACOs) that can support improved care and quality for beneficiaries, especially those in rural and underserved areas. Covers aligning the testing of ACO models and features with the Shared Savings Program (SSP), growth in the SSP, and using ACOs to reach more underserved populations and promote health equity.
Author(s): Purva Rawal, Douglas Jacobs, Elizabeth Fowler, Meena Seshamani
Citation: Health Affairs Forefront
Date: 07/2023
Type: Document
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Describes progress the Centers for Medicare & Medicaid Services (CMS) has made to date in its accountable care strategy. Outlines areas that CMS is exploring to accelerate the growth of and access to accountable care organizations (ACOs) that can support improved care and quality for beneficiaries, especially those in rural and underserved areas. Covers aligning the testing of ACO models and features with the Shared Savings Program (SSP), growth in the SSP, and using ACOs to reach more underserved populations and promote health equity.
Author(s): Purva Rawal, Douglas Jacobs, Elizabeth Fowler, Meena Seshamani
Citation: Health Affairs Forefront
Date: 07/2023
Type: Document
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Rural Health Policy Landscape: Implications for Addressing Behavioral Health
Presentation slides from a July 22, 2023, presentation at the 48th Annual Rural Social Work Conference. Provides an overview of the federal, state, and commercial insurance policy landscapes regarding healthcare value and payment. Offers policy recommendations related to rural behavioral health.
Author(s): Keith J. Mueller
Date: 07/2023
Type: Document
Sponsoring organization: Rural Policy Research Institute
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Presentation slides from a July 22, 2023, presentation at the 48th Annual Rural Social Work Conference. Provides an overview of the federal, state, and commercial insurance policy landscapes regarding healthcare value and payment. Offers policy recommendations related to rural behavioral health.
Author(s): Keith J. Mueller
Date: 07/2023
Type: Document
Sponsoring organization: Rural Policy Research Institute
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Evaluation of the Vermont All-Payer Accountable Care Organization Model: Third Evaluation Report
Evaluates the first four and a half 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. Describes trends in substance use disorder diagnosis and treatment for Medicaid members. Outlines challenges and lessons learned, as well as areas for future research.
Additional links: Findings at a Glance, Technical Appendices
Date: 07/2023
Type: Document
Sponsoring organizations: Centers for Medicare and Medicaid Services, NORC at the University of Chicago
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Evaluates the first four and a half 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. Describes trends in substance use disorder diagnosis and treatment for Medicaid members. Outlines challenges and lessons learned, as well as areas for future research.
Additional links: Findings at a Glance, Technical Appendices
Date: 07/2023
Type: Document
Sponsoring organizations: Centers for Medicare and Medicaid Services, NORC at the University of Chicago
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A Rural Accountable Care Organization's Journey
Profiles South East Rural Physicians Alliance Accountable Care Organization (SERPA‐ACO), a physician‐led ACO consisting of 16 Nebraska clinics - 13 of which are rural. Describes various value-based payment models SERPA-ACO clinics participated in and activities the clinics use to succeed in these models. Includes recommendations for primary care clinics considering joining an ACO.
Date: 06/2023
Type: Document
Sponsoring organization: Rural Health Value
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Profiles South East Rural Physicians Alliance Accountable Care Organization (SERPA‐ACO), a physician‐led ACO consisting of 16 Nebraska clinics - 13 of which are rural. Describes various value-based payment models SERPA-ACO clinics participated in and activities the clinics use to succeed in these models. Includes recommendations for primary care clinics considering joining an ACO.
Date: 06/2023
Type: Document
Sponsoring organization: Rural Health Value
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A Path Forward: The Rural Healthcare System of the Future
Presentation slides that discuss federal and state healthcare policies, implementation of new models of care, and plans to transform patient modalities of care. Includes U.S. county-level map on the Medicare Shared Savings Program Accountable Care Organizations (ACO) assigned beneficiary population as well as county-level data on ACO attributed lives in Illinois and residents enrolled in Medicare advantage.
Author(s): Keith J. Mueller
Date: 06/2023
Type: Presentation Slides
Sponsoring organizations: Iowa Department of Health Management and Policy, Rural Policy Research Institute
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Presentation slides that discuss federal and state healthcare policies, implementation of new models of care, and plans to transform patient modalities of care. Includes U.S. county-level map on the Medicare Shared Savings Program Accountable Care Organizations (ACO) assigned beneficiary population as well as county-level data on ACO attributed lives in Illinois and residents enrolled in Medicare advantage.
Author(s): Keith J. Mueller
Date: 06/2023
Type: Presentation Slides
Sponsoring organizations: Iowa Department of Health Management and Policy, Rural Policy Research Institute
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Medicare Accountable Care Organizations: Presence in Rural America
Presentation slides from a June 6, 2023, webinar for the Rural Northern Border Healthcare Support Technical Assistance Center. Provides an overview of the Medicare Shared Savings Program, including the composition of program participants in 2023, the spread of Accountable Care Organizations (ACOs) in rural counties, and the federal and state policy landscape. Details changes to the Shared Savings Program for 2024.
Author(s): Keith J. Mueller
Date: 06/2023
Type: Presentation Slides
Sponsoring organization: Rural Policy Research Institute
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Presentation slides from a June 6, 2023, webinar for the Rural Northern Border Healthcare Support Technical Assistance Center. Provides an overview of the Medicare Shared Savings Program, including the composition of program participants in 2023, the spread of Accountable Care Organizations (ACOs) in rural counties, and the federal and state policy landscape. Details changes to the Shared Savings Program for 2024.
Author(s): Keith J. Mueller
Date: 06/2023
Type: Presentation Slides
Sponsoring organization: Rural Policy Research Institute
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RHCs & the Medicare Shared Savings Program - What You Need to Know
Recording of a March 7, 2023, webinar providing an overview of the transition to value-based care, Accountable Care Organizations, and the Medicare Shared Savings Program. Discusses considerations for Rural Health Clinic participation in the Shared Savings Program. Part of the Rural Health Clinic Technical Assistance Series.
Additional links: Presentation Slides, Transcript
Date: 03/2023
Type: Video/Multimedia
Sponsoring organization: National Association of Rural Health Clinics
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Recording of a March 7, 2023, webinar providing an overview of the transition to value-based care, Accountable Care Organizations, and the Medicare Shared Savings Program. Discusses considerations for Rural Health Clinic participation in the Shared Savings Program. Part of the Rural Health Clinic Technical Assistance Series.
Additional links: Presentation Slides, Transcript
Date: 03/2023
Type: Video/Multimedia
Sponsoring organization: National Association of Rural Health Clinics
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