Rural Health
Resources by Topic: Health insurance
Medicare Claims Processing Manual Chapter 4 - Part B Hospital (Including Inpatient Hospital Part B and OPPS)
Outlines rules and regulations for processing Medicare Part B hospital claims. Covers special rules for Critical Access Hospital outpatient billing, hospital-based Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs) billing for non-RHC/FQHC services, and payment adjustments for Rural Emergency Hospitals (REHs).
Date: 06/2024
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Outlines rules and regulations for processing Medicare Part B hospital claims. Covers special rules for Critical Access Hospital outpatient billing, hospital-based Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs) billing for non-RHC/FQHC services, and payment adjustments for Rural Emergency Hospitals (REHs).
Date: 06/2024
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Leading the Way on the Journey to Health Equity and Wellness for American Indians/Alaska Natives
Recording of a May 30, 2024, conference session on addressing tribal health disparities as part of the Centers for Medicare & Medicaid Services (CMS) Health Equity Conference. Includes presentations from the National Indian Health Board on priorities for initiatives aimed at improving health equity for American Indians and Alaska Natives and CMS on improving and using demographic data to improve health equity, with a focus on Medicaid and CHIP data.
Additional links: Presentation Slides
Date: 05/2024
Type: Video/Multimedia
Sponsoring organization: Centers for Medicare and Medicaid Services
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Recording of a May 30, 2024, conference session on addressing tribal health disparities as part of the Centers for Medicare & Medicaid Services (CMS) Health Equity Conference. Includes presentations from the National Indian Health Board on priorities for initiatives aimed at improving health equity for American Indians and Alaska Natives and CMS on improving and using demographic data to improve health equity, with a focus on Medicaid and CHIP data.
Additional links: Presentation Slides
Date: 05/2024
Type: Video/Multimedia
Sponsoring organization: Centers for Medicare and Medicaid Services
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Association of Uninsured Status and Rurality with Risk of Financial Toxicity after Pediatric Trauma
Analyzes the risk of financial toxicity associated with pediatric traumatic injury for rural versus urban families. Utilizes 2016-2019 National Inpatient Sample patient data. Includes data on financial toxicity associated with uninsured status, rural versus urban insurance type, and rural versus urban demographic, clinical, and hospital characteristics.
Author(s): Amulya Vadlakonda, Nam Yong Cho, Nikhil Chervu, et al.
Citation: Surgery, 176(2), 455-461
Date: 05/2024
Type: Document
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Analyzes the risk of financial toxicity associated with pediatric traumatic injury for rural versus urban families. Utilizes 2016-2019 National Inpatient Sample patient data. Includes data on financial toxicity associated with uninsured status, rural versus urban insurance type, and rural versus urban demographic, clinical, and hospital characteristics.
Author(s): Amulya Vadlakonda, Nam Yong Cho, Nikhil Chervu, et al.
Citation: Surgery, 176(2), 455-461
Date: 05/2024
Type: Document
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Findings from the Quality of and Access to Health Care Supplement of the National Agricultural Workers Survey (NAWS) 2019–2020
Uses interviews with 2,172 crop farmworkers and their families to report on healthcare access, utilization, and insurance by various demographic, geographic, and citizenship factors.
Author(s): Wenson Fung, Amanda Gold, Jackie Copfer, Emily Finchum-Mason, Daniel Carroll
Date: 05/2024
Type: Document
Sponsoring organization: U.S. Department of Labor
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Uses interviews with 2,172 crop farmworkers and their families to report on healthcare access, utilization, and insurance by various demographic, geographic, and citizenship factors.
Author(s): Wenson Fung, Amanda Gold, Jackie Copfer, Emily Finchum-Mason, Daniel Carroll
Date: 05/2024
Type: Document
Sponsoring organization: U.S. Department of Labor
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Evaluation of the Maternal Opioid Misuse (MOM) Model: Third Annual Report (Implementation Year 2)
Provides an overview of the Maternal Opioid Misuse Model, which provides evidence-based integrated care and care coordination for pregnant and postpartum Medicaid beneficiaries with opioid use disorder (OUD). Describes activities MOM Model awardees undertook during the MOM Model's second implementation year, July 1, 2022–June 30, 2023. Discusses barriers pregnant and postpartum people with OUD face in accessing high-quality, continuous care, specifically in rural areas.
Additional links: Findings at a Glance
Date: 05/2024
Type: Document
Sponsoring organizations: Centers for Medicare and Medicaid Services, Insight Policy Research
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Provides an overview of the Maternal Opioid Misuse Model, which provides evidence-based integrated care and care coordination for pregnant and postpartum Medicaid beneficiaries with opioid use disorder (OUD). Describes activities MOM Model awardees undertook during the MOM Model's second implementation year, July 1, 2022–June 30, 2023. Discusses barriers pregnant and postpartum people with OUD face in accessing high-quality, continuous care, specifically in rural areas.
Additional links: Findings at a Glance
Date: 05/2024
Type: Document
Sponsoring organizations: Centers for Medicare and Medicaid Services, Insight Policy Research
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The Implications of Using Maternity Care Deserts to Measure Progress in Access to Obstetric Care: A Mixed-Integer Optimization Analysis
Compares geographic access to critical care obstetric (CCO) services in Georgia via a county-level maternal care desert model versus a model of census blocks further than 50 miles from CCO services. Uses each model to estimate how expansion of facilities would affect access to care, and also to estimate race and ethnicity, insurance status, age, and poverty rate of reproductive-aged women with limited access to care using 2017 American Community Survey data.
Author(s): Meghan E. Meredith, Lauren N. Steimle, Stephanie M. Radke
Citation: BMC Health Services Research, 24, 682
Date: 05/2024
Type: Document
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Compares geographic access to critical care obstetric (CCO) services in Georgia via a county-level maternal care desert model versus a model of census blocks further than 50 miles from CCO services. Uses each model to estimate how expansion of facilities would affect access to care, and also to estimate race and ethnicity, insurance status, age, and poverty rate of reproductive-aged women with limited access to care using 2017 American Community Survey data.
Author(s): Meghan E. Meredith, Lauren N. Steimle, Stephanie M. Radke
Citation: BMC Health Services Research, 24, 682
Date: 05/2024
Type: Document
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Pandemic-Era Trends in Telehealth Use among Americans with Private Health Insurance
Brief analyzing telehealth use between 2019 and 2021 for people younger than 65 with private health insurance. Discusses the impact of COVID-19 on telehealth use. Analyzes data by various factors such as age, rurality, access, broadband availability, and more. Discusses policy implications related to broadband access, mental healthcare provider shortages, costs, access, and equity. Includes both nationwide and state-by-state rural and urban comparisons.
Author(s): Beth Carter, Olivia Dean, Alex Hartzman, Luis Arzaluz, Aiden Wynia
Date: 05/2024
Type: Document
Sponsoring organization: AARP Public Policy Institute
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Brief analyzing telehealth use between 2019 and 2021 for people younger than 65 with private health insurance. Discusses the impact of COVID-19 on telehealth use. Analyzes data by various factors such as age, rurality, access, broadband availability, and more. Discusses policy implications related to broadband access, mental healthcare provider shortages, costs, access, and equity. Includes both nationwide and state-by-state rural and urban comparisons.
Author(s): Beth Carter, Olivia Dean, Alex Hartzman, Luis Arzaluz, Aiden Wynia
Date: 05/2024
Type: Document
Sponsoring organization: AARP Public Policy Institute
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CMS Bundled Payments for Care Improvement Advanced Model: Fifth Annual Evaluation Report
Fifth annual report of the Bundled Payments for Care Improvement Advanced (BPCI Advanced) Model, which tests whether linking payments for a clinical episode of care can reduce Medicare expenditures while maintaining or improving the quality of care. Explores the impact of BPCI Advanced on episode payments, utilization, and quality of care, as well as estimates of Medicare program savings in Model Year 4. Describes changes to the model that were implemented in Model Year 4 and how BPCI Advanced relates to Medicare Accountable Care Organizations (ACOs). Analyzes BPCI Advanced outcomes for beneficiaries from populations that have been historically underserved. Includes rural references throughout.
Additional links: Appendices, Executive Summary, Findings at a Glance
Author(s): The Lewin Group, Abt Associates, GDIT, Telligen
Date: 05/2024
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Fifth annual report of the Bundled Payments for Care Improvement Advanced (BPCI Advanced) Model, which tests whether linking payments for a clinical episode of care can reduce Medicare expenditures while maintaining or improving the quality of care. Explores the impact of BPCI Advanced on episode payments, utilization, and quality of care, as well as estimates of Medicare program savings in Model Year 4. Describes changes to the model that were implemented in Model Year 4 and how BPCI Advanced relates to Medicare Accountable Care Organizations (ACOs). Analyzes BPCI Advanced outcomes for beneficiaries from populations that have been historically underserved. Includes rural references throughout.
Additional links: Appendices, Executive Summary, Findings at a Glance
Author(s): The Lewin Group, Abt Associates, GDIT, Telligen
Date: 05/2024
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Senate Finance Committee Bipartisan Medicare GME Working Group Draft Proposal Outline and Questions for Consideration
Outlines draft policy proposals regarding the Medicare Graduate Medical Education (GME) program aimed at addressing healthcare workforce shortages. Proposals cover the distribution of Medicare GME slots to rural areas and key specialties, encouraging hospitals to train physicians in rural areas, the establishment of a Medicare GME Policy Council, GME data collection and transparency, and more. Includes questions for consideration on policies under consideration.
Date: 05/2024
Type: Document
Sponsoring organization: Senate Committee on Finance
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Outlines draft policy proposals regarding the Medicare Graduate Medical Education (GME) program aimed at addressing healthcare workforce shortages. Proposals cover the distribution of Medicare GME slots to rural areas and key specialties, encouraging hospitals to train physicians in rural areas, the establishment of a Medicare GME Policy Council, GME data collection and transparency, and more. Includes questions for consideration on policies under consideration.
Date: 05/2024
Type: Document
Sponsoring organization: Senate Committee on Finance
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MedPAC Comment on CMS's Proposed Rule on the Payment System for Inpatient Psychiatric Facilities for FY 2025
Comment on an April 3, 2024, Federal Register proposed rule revising the Inpatient Psychiatric Facility Prospective Payment System (IPF PPS) for fiscal year 2025. Includes a discussion of rural IPF PPS payment adjustments.
Date: 05/2024
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Comment on an April 3, 2024, Federal Register proposed rule revising the Inpatient Psychiatric Facility Prospective Payment System (IPF PPS) for fiscal year 2025. Includes a discussion of rural IPF PPS payment adjustments.
Date: 05/2024
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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