Rural Health
Resources by Topic: Health insurance
Five Things to Know About Medicare Site-Neutral Payment Reforms
Discusses site-neutral payment reforms that seek to align Medicare payments with outpatient services in different settings. Examines benefits and drawbacks of the policy and discusses how the policy would impact rural hospitals.
Author(s): Zachary Levinson, Tricia Neuman, Scott Hulver
Date: 06/2024
Type: Document
Sponsoring organization: KFF
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Discusses site-neutral payment reforms that seek to align Medicare payments with outpatient services in different settings. Examines benefits and drawbacks of the policy and discusses how the policy would impact rural hospitals.
Author(s): Zachary Levinson, Tricia Neuman, Scott Hulver
Date: 06/2024
Type: Document
Sponsoring organization: KFF
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Updated Analysis: Using Population-Based Outcome Measures to Assess the Impact of Telehealth Expansion on Medicare Beneficiaries' Access to Care and Quality of Care
Explores the association between telehealth use, quality of care, and access to care when both telehealth and in-person visits are available to fee-for-service (FFS) Medicare beneficiaries. Compares data from the second half of 2018 and 2019 to the second half of 2022 by the level of telehealth utilization in Hospital Service Areas (HSAs). Describes the effects of telehealth for urban and rural beneficiaries and differentiates between telehealth utilization for behavioral and non-behavioral health services. Updates a June 2023 report that analyzed data from 2021.
Author(s): Tanvi Rao, Angshuman Gooptu, Karin Johnson, Guido Cataife, Steven Susana-Castillo
Date: 06/2024
Type: Document
Sponsoring organizations: American Institutes for Research, Medicare Payment Advisory Commission
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Explores the association between telehealth use, quality of care, and access to care when both telehealth and in-person visits are available to fee-for-service (FFS) Medicare beneficiaries. Compares data from the second half of 2018 and 2019 to the second half of 2022 by the level of telehealth utilization in Hospital Service Areas (HSAs). Describes the effects of telehealth for urban and rural beneficiaries and differentiates between telehealth utilization for behavioral and non-behavioral health services. Updates a June 2023 report that analyzed data from 2021.
Author(s): Tanvi Rao, Angshuman Gooptu, Karin Johnson, Guido Cataife, Steven Susana-Castillo
Date: 06/2024
Type: Document
Sponsoring organizations: American Institutes for Research, Medicare Payment Advisory Commission
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MedPAC Report to the Congress: Medicare and the Health Care Delivery System, June 2024
Evaluates Medicare payment issues and provides recommendations to the U.S. Congress. Covers approaches for updating fee-for-service (FFS) Medicare's physician fee schedule (PFS) payments and incentivizing participation in alternative payment models; provider networks and prior authorization in Medicare Advantage (MA) plans; an assessment of the relative completeness of MA encounter data and other data sources; Medicare coverage and payments for medical software; alternate approaches to lower Medicare payment rates for select conditions in inpatient rehabilitation facilities; and Medicare's Acute Hospital Care at Home program. Includes rural references throughout.
Additional links: Executive Summary
Date: 06/2024
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Evaluates Medicare payment issues and provides recommendations to the U.S. Congress. Covers approaches for updating fee-for-service (FFS) Medicare's physician fee schedule (PFS) payments and incentivizing participation in alternative payment models; provider networks and prior authorization in Medicare Advantage (MA) plans; an assessment of the relative completeness of MA encounter data and other data sources; Medicare coverage and payments for medical software; alternate approaches to lower Medicare payment rates for select conditions in inpatient rehabilitation facilities; and Medicare's Acute Hospital Care at Home program. Includes rural references throughout.
Additional links: Executive Summary
Date: 06/2024
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Effort Required and Lessons Learned from Recruiting Health Plans and Rural Primary Care Practices for a Cancer Screening Outreach Study
Explores factors influencing recruitment and enrollment of primary care practices for SMARTER CRC, a rural colorectal cancer (CRC) screening trial in Oregon. Discusses outreach strategies, relationship-building, messaging, reasons for participation among clinical practices and Medicare health plans, and more. Highlights rural-specific factors throughout.
Author(s): Brittany Badicke, Jennifer Coury, Emily Myers, et al.
Citation: Journal of Primary Care & Community Health, 15
Date: 06/2024
Type: Document
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Explores factors influencing recruitment and enrollment of primary care practices for SMARTER CRC, a rural colorectal cancer (CRC) screening trial in Oregon. Discusses outreach strategies, relationship-building, messaging, reasons for participation among clinical practices and Medicare health plans, and more. Highlights rural-specific factors throughout.
Author(s): Brittany Badicke, Jennifer Coury, Emily Myers, et al.
Citation: Journal of Primary Care & Community Health, 15
Date: 06/2024
Type: Document
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Report to Congress on Medicaid and CHIP, June 2024
Semi-annual report to Congress from the Medicaid and CHIP Payment and Access Commission (MACPAC). Covers recommendations for increased transparency in Medicaid and CHIP financing, tools for optimizing state Medicaid agency contracts (SMACs), enrollment trends in Medicare Savings Programs (MSPs), and demographic data collection in Medicaid. Includes rural references throughout.
Date: 06/2024
Type: Document
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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Semi-annual report to Congress from the Medicaid and CHIP Payment and Access Commission (MACPAC). Covers recommendations for increased transparency in Medicaid and CHIP financing, tools for optimizing state Medicaid agency contracts (SMACs), enrollment trends in Medicare Savings Programs (MSPs), and demographic data collection in Medicaid. Includes rural references throughout.
Date: 06/2024
Type: Document
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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Health Insurance Coverage and Access to Care among American Indians and Alaska Natives: Recent Trends and Key Challenges
Issue brief presenting data on rates of insurance coverage, Medicaid coverage, and access to healthcare for American Indians and Alaska Natives (AI/AN) using American Community Survey data. Discusses the impacts of health disparities, coverage expansions under the Affordable Care Act, and state Medicaid expansions on AI/AN populations.
Date: 06/2024
Type: Document
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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Issue brief presenting data on rates of insurance coverage, Medicaid coverage, and access to healthcare for American Indians and Alaska Natives (AI/AN) using American Community Survey data. Discusses the impacts of health disparities, coverage expansions under the Affordable Care Act, and state Medicaid expansions on AI/AN populations.
Date: 06/2024
Type: Document
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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Improving Access to Affordable and Equitable Health Coverage: A Review from 2010 to 2024
An issue brief that provides commentary and data on how the Affordable Care Act (ACA) has impacted access to health insurance coverage. Provides uninsurance rates by demographic groups and discusses the effect of the ACA on rural areas.
Author(s): Thomas Buchmueller, Amelia Whitman, Christie Peters, Nancy De Lew
Date: 06/2024
Type: Document
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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An issue brief that provides commentary and data on how the Affordable Care Act (ACA) has impacted access to health insurance coverage. Provides uninsurance rates by demographic groups and discusses the effect of the ACA on rural areas.
Author(s): Thomas Buchmueller, Amelia Whitman, Christie Peters, Nancy De Lew
Date: 06/2024
Type: Document
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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MedPAC Comment on CMS's Proposed Rule on the Hospital Inpatient PPS and the Long-term Care Hospital PPS for FY 2025
Comments on a May 2, 2024, Federal Register proposed rule revising the hospital inpatient and long-term care hospital (LTCH) prospective payment systems (PPS). Discusses proposals on rate-setting in both the inpatient prospective payment systems (IPPS) and LTCH PPS; the Transforming Episode Accountability Model (TEAM), including the definition of rural hospitals eligible to participate in a lower-risk track; new payments to small, independent hospitals that establish and maintain a 6-month buffer supply of essential medicines; updates to wage index values and policies; and updates to outlier reconciliation thresholds.
Date: 06/2024
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Comments on a May 2, 2024, Federal Register proposed rule revising the hospital inpatient and long-term care hospital (LTCH) prospective payment systems (PPS). Discusses proposals on rate-setting in both the inpatient prospective payment systems (IPPS) and LTCH PPS; the Transforming Episode Accountability Model (TEAM), including the definition of rural hospitals eligible to participate in a lower-risk track; new payments to small, independent hospitals that establish and maintain a 6-month buffer supply of essential medicines; updates to wage index values and policies; and updates to outlier reconciliation thresholds.
Date: 06/2024
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Sources of Federal Funding for Health Care Facilities: Frequently Asked Questions
Provides an overview of how the federal government supports healthcare facilities, with a focus on hospitals. Discusses how Medicare and Medicaid pay acute care hospitals and for services rendered to beneficiaries and enrollees, as well as other payments these programs make. Identifies federal grants, loans, and technical assistance programs that can support health facilities. Describes how federal agencies, including the Health Resources and Services Administration (HRSA) and the U.S. Department of Agriculture (USDA), have supported healthcare facilities during emergencies.
Date: 06/2024
Type: Document
Sponsoring organization: Congressional Research Service
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Provides an overview of how the federal government supports healthcare facilities, with a focus on hospitals. Discusses how Medicare and Medicaid pay acute care hospitals and for services rendered to beneficiaries and enrollees, as well as other payments these programs make. Identifies federal grants, loans, and technical assistance programs that can support health facilities. Describes how federal agencies, including the Health Resources and Services Administration (HRSA) and the U.S. Department of Agriculture (USDA), have supported healthcare facilities during emergencies.
Date: 06/2024
Type: Document
Sponsoring organization: Congressional Research Service
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Merit-Based Incentive Payment System (MIPS): Traditional MIPS Scoring Guide for the 2024 Performance Year
Provides details on how scores are calculated for the Merit-Based Incentive Payment System (MIPS), one of two tracks under the Medicare Quality Payment Program. Explains the four performance categories that affect Medicare Physician Fee Schedule payments: quality, cost, improvement activities, and promoting interoperability. Includes information for small practices.
Date: 06/2024
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Provides details on how scores are calculated for the Merit-Based Incentive Payment System (MIPS), one of two tracks under the Medicare Quality Payment Program. Explains the four performance categories that affect Medicare Physician Fee Schedule payments: quality, cost, improvement activities, and promoting interoperability. Includes information for small practices.
Date: 06/2024
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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