Rural Health
Resources by Topic: Health insurance
Evaluation of the Medicare Care Choices Model: Fifth and Final Annual Evaluation Report
Evaluates the Medicare Care Choice Model (MCCM), which tests whether offering eligible Medicare beneficiaries the option to receive supportive services without forgoing payment for treatment of their terminal conditions improved their quality of life and care, increased patient and family satisfaction, and reduced Medicare expenditures. Describes the characteristics of participating hospices and withdrawal of providers over time; beneficiaries who were referred to, eligible for, and enrolled in MCCM; services provided and the quality of service delivery; transitions from MCCM to the Medicare hospice benefit; beneficiary outcomes and effects across subgroups; and key findings. Includes information on rural provider and beneficiary participation in the model and compares rural and urban beneficiary outcomes.
Additional links: Findings at a Glance, Participant Experience & Evaluation Results Video
Date: 11/2023
Type: Document
Sponsoring organizations: Centers for Medicare and Medicaid Services, Mathematica
view details
Evaluates the Medicare Care Choice Model (MCCM), which tests whether offering eligible Medicare beneficiaries the option to receive supportive services without forgoing payment for treatment of their terminal conditions improved their quality of life and care, increased patient and family satisfaction, and reduced Medicare expenditures. Describes the characteristics of participating hospices and withdrawal of providers over time; beneficiaries who were referred to, eligible for, and enrolled in MCCM; services provided and the quality of service delivery; transitions from MCCM to the Medicare hospice benefit; beneficiary outcomes and effects across subgroups; and key findings. Includes information on rural provider and beneficiary participation in the model and compares rural and urban beneficiary outcomes.
Additional links: Findings at a Glance, Participant Experience & Evaluation Results Video
Date: 11/2023
Type: Document
Sponsoring organizations: Centers for Medicare and Medicaid Services, Mathematica
view details
Medicare Advantage Enrollment Update 2023
Reports on the percentage of rural Medicare beneficiaries enrolled in Medicare Advantage (MA) plans by metropolitan and nonmetropolitan location and plan type, from 2014-2023.
Author(s): Edmer Lazaro, Fred Ullrich, Keith Mueller
Date: 11/2023
Type: Document
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
view details
Reports on the percentage of rural Medicare beneficiaries enrolled in Medicare Advantage (MA) plans by metropolitan and nonmetropolitan location and plan type, from 2014-2023.
Author(s): Edmer Lazaro, Fred Ullrich, Keith Mueller
Date: 11/2023
Type: Document
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
view details
National and State Level Estimates of WIC Eligibility and Program Reach in 2021, Final Report, Volume 1
Compares eligibility versus participation in Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) benefits in 2021 using Community Population Survey Annual Social and Economic Supplement (CPS-ASEC), American Community Survey (ACS), and National Vital Statistics data. Discusses trends over time for infants and pregnant women as well as by breastfeeding status, race and ethnicity, Medicaid participation, urbanicity. Includes state and regional comparisons.
Additional links: Appendices, Volume 2, Summary
Author(s): Courtenay Kessler, Andrew Bryant, Kate Munkacsy, Kelsey Farson Gray
Date: 11/2023
Type: Document
Sponsoring organization: USDA Food and Nutrition Service
view details
Compares eligibility versus participation in Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) benefits in 2021 using Community Population Survey Annual Social and Economic Supplement (CPS-ASEC), American Community Survey (ACS), and National Vital Statistics data. Discusses trends over time for infants and pregnant women as well as by breastfeeding status, race and ethnicity, Medicaid participation, urbanicity. Includes state and regional comparisons.
Additional links: Appendices, Volume 2, Summary
Author(s): Courtenay Kessler, Andrew Bryant, Kate Munkacsy, Kelsey Farson Gray
Date: 11/2023
Type: Document
Sponsoring organization: USDA Food and Nutrition Service
view details
Hospital Outpatient Prospective Payment System (OPPS): Remedy for the 340B-Acquired Drug Payment Policy for Calendar Years 2018-2022 Final Rule (CMS 1793-F)
Fact sheet providing an overview of the Centers for Medicare & Medicaid Services (CMS) final rule describing the agency's actions to remedy payment cuts to certain hospitals that participate in the 340B Drug Pricing Program from 2018-2022 that were declared unlawful by the Supreme Court's decision in American Hospital Association v. Becerra, 142 S. Ct. 1896 (2022). Details the one-time lump sum payments to affected 340B covered entities to what they would have been paid had the 340B payment cuts not been applied, as well as a 0.5% payment reduction on future non-drug item and service payments to maintain budget neutrality beginning in calendar year 2026.
Date: 11/2023
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
view details
Fact sheet providing an overview of the Centers for Medicare & Medicaid Services (CMS) final rule describing the agency's actions to remedy payment cuts to certain hospitals that participate in the 340B Drug Pricing Program from 2018-2022 that were declared unlawful by the Supreme Court's decision in American Hospital Association v. Becerra, 142 S. Ct. 1896 (2022). Details the one-time lump sum payments to affected 340B covered entities to what they would have been paid had the 340B payment cuts not been applied, as well as a 0.5% payment reduction on future non-drug item and service payments to maintain budget neutrality beginning in calendar year 2026.
Date: 11/2023
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
view details
CY 2024 Medicare Hospital Outpatient Prospective Payment System and Ambulatory Surgical Center Payment System Final Rule (CMS 1786-FC)
Fact sheet providing an overview of the Centers for Medicare & Medicaid Services (CMS) final rule regarding updates and changes to the Medicare payments for hospital outpatient and Ambulatory Surgical Center (ASC) services for calendar year 2024. Summarizes provisions regarding changes to the community mental health centers (CMHC) Conditions of Participation (CoPs); payment for intensive outpatient program (IOP) services; payment methodology for Indian Health Service (IHS) and tribal facilities that convert to Rural Emergency Hospital (REH) status; the Hospital Outpatient Quality Reporting (OQR), Ambulatory Surgical Center Quality Reporting (ASCQR), and Rural Emergency Hospital Quality Reporting (REHQR) Programs; and more.
Date: 11/2023
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
view details
Fact sheet providing an overview of the Centers for Medicare & Medicaid Services (CMS) final rule regarding updates and changes to the Medicare payments for hospital outpatient and Ambulatory Surgical Center (ASC) services for calendar year 2024. Summarizes provisions regarding changes to the community mental health centers (CMHC) Conditions of Participation (CoPs); payment for intensive outpatient program (IOP) services; payment methodology for Indian Health Service (IHS) and tribal facilities that convert to Rural Emergency Hospital (REH) status; the Hospital Outpatient Quality Reporting (OQR), Ambulatory Surgical Center Quality Reporting (ASCQR), and Rural Emergency Hospital Quality Reporting (REHQR) Programs; and more.
Date: 11/2023
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
view details
Calendar Year (CY) 2024 Medicare Physician Fee Schedule Final Rule
Fact sheet providing an overview of the Centers for Medicare & Medicaid Services (CMS) final rule regarding updates and changes to the Medicare payments under the Physician Fee Schedule (PFS) and other Medicare Part B issues for calendar year 2024. Summarizes provisions related to paying separately for Community Health Integration, Social Determinants of Health (SDOH) Risk Assessment, and Principal Illness Navigation services; telehealth services; mental health visits furnished by Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs); including marriage and family therapists and mental health counselors as eligible for payment at RHCs and FQHCs; and more.
Date: 11/2023
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
view details
Fact sheet providing an overview of the Centers for Medicare & Medicaid Services (CMS) final rule regarding updates and changes to the Medicare payments under the Physician Fee Schedule (PFS) and other Medicare Part B issues for calendar year 2024. Summarizes provisions related to paying separately for Community Health Integration, Social Determinants of Health (SDOH) Risk Assessment, and Principal Illness Navigation services; telehealth services; mental health visits furnished by Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs); including marriage and family therapists and mental health counselors as eligible for payment at RHCs and FQHCs; and more.
Date: 11/2023
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
view details
Medicare Learning Network: Rural Emergency Hospitals
Details the regulatory requirements for providers to become a Rural Emergency Hospital (REH). Provides information on REH billing for Medicare services, Medicare payments for REH services, and the additional monthly facility payment.
Date: 11/2023
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
view details
Details the regulatory requirements for providers to become a Rural Emergency Hospital (REH). Provides information on REH billing for Medicare services, Medicare payments for REH services, and the additional monthly facility payment.
Date: 11/2023
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
view details
County by County Plan Year 2024 Insurer Participation in Health Insurance Exchanges
County-level map of the United States showing the projected number of health insurance carriers that will participate in the Health Insurance Exchanges during 2024.
Date: 10/2023
Type: Map/Mapping System
Sponsoring organization: Centers for Medicare and Medicaid Services
view details
County-level map of the United States showing the projected number of health insurance carriers that will participate in the Health Insurance Exchanges during 2024.
Date: 10/2023
Type: Map/Mapping System
Sponsoring organization: Centers for Medicare and Medicaid Services
view details
Assisting Rural Consumers
Offers information and guidance for Navigators and certified application counselors helping rural healthcare consumers. Covers rural-relevant considerations and policy updates regarding Federally-facilitated and State-based Marketplaces, Medicaid/CHIP, and Medicare. Outlines tips for assisters to address barriers to care and conducting outreach in rural areas.
Date: 10/2023
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
view details
Offers information and guidance for Navigators and certified application counselors helping rural healthcare consumers. Covers rural-relevant considerations and policy updates regarding Federally-facilitated and State-based Marketplaces, Medicaid/CHIP, and Medicare. Outlines tips for assisters to address barriers to care and conducting outreach in rural areas.
Date: 10/2023
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
view details
Rural Hospital Experiences in the Colorado Hospital Transformation Program
Provides an overview of the Colorado Hospital Transformation Program (CO HTP), a 5-year program that ties Medicaid supplemental payments to hospitals' ability to meet performance targets through September 2026. Describes the experiences of three Critical Access Hospitals (CAHs) and explores how CO HTP impacts rural hospitals. Covers planning and community engagement, quality of care, and healthcare costs.
Date: 10/2023
Type: Document
Sponsoring organization: Rural Health Value
view details
Provides an overview of the Colorado Hospital Transformation Program (CO HTP), a 5-year program that ties Medicaid supplemental payments to hospitals' ability to meet performance targets through September 2026. Describes the experiences of three Critical Access Hospitals (CAHs) and explores how CO HTP impacts rural hospitals. Covers planning and community engagement, quality of care, and healthcare costs.
Date: 10/2023
Type: Document
Sponsoring organization: Rural Health Value
view details