Rural Health
Resources by Topic: Health insurance
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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Further Extension of Grace Period Related to the "Four Walls" Requirement under 42 C.F.R. § 440.90 for Indian Health Service and Tribal Facilities to February 11, 2025
Guidance announcing the extension of a grace period permitting Indian Health Service (IHS) and tribal facilities to claim Medicaid reimbursement under the clinic services benefit for services provided outside of the "four walls" of the facility through February 11, 2025. Provides an overview of the history of this flexibility during the COVID-19 public health emergency (PHE) and previous guidance.
Date: 09/2023
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Guidance announcing the extension of a grace period permitting Indian Health Service (IHS) and tribal facilities to claim Medicaid reimbursement under the clinic services benefit for services provided outside of the "four walls" of the facility through February 11, 2025. Provides an overview of the history of this flexibility during the COVID-19 public health emergency (PHE) and previous guidance.
Date: 09/2023
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Medicare Advantage Enrollment, Plan Availability and Premiums in Rural Areas
Research brief analyzing Medicare Advantage enrollment, availability, and premiums in rural areas to identify trends since 2010. Offers rural and urban comparisons.
Author(s): Jeannie Fuglesten Biniek, Gabrielle Clerveau, Anthony Damico, Tricia Neuman
Date: 09/2023
Type: Document
Sponsoring organization: KFF
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Research brief analyzing Medicare Advantage enrollment, availability, and premiums in rural areas to identify trends since 2010. Offers rural and urban comparisons.
Author(s): Jeannie Fuglesten Biniek, Gabrielle Clerveau, Anthony Damico, Tricia Neuman
Date: 09/2023
Type: Document
Sponsoring organization: KFF
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Meeting the Health and Social Needs of LGBTQ+ Older Adults Through Medicaid
Brief describing the unique healthcare needs for older LGBTQ+ adults. Discusses health outcome disparities, discrimination, intersectionality, barriers to care, and the challenges for rural residents. Offers recommendations for improving outcomes for older, Medicaid-enrolled LGBTQ+ adults in California.
Author(s): Matthew Phan, Carrie Graham, Torshira Moffet, Jason Flatt
Date: 09/2023
Type: Document
Sponsoring organization: Center for Health Care Strategies
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Brief describing the unique healthcare needs for older LGBTQ+ adults. Discusses health outcome disparities, discrimination, intersectionality, barriers to care, and the challenges for rural residents. Offers recommendations for improving outcomes for older, Medicaid-enrolled LGBTQ+ adults in California.
Author(s): Matthew Phan, Carrie Graham, Torshira Moffet, Jason Flatt
Date: 09/2023
Type: Document
Sponsoring organization: Center for Health Care Strategies
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Inflation Reduction Act Research Series: Medicare Enrollees' Use and Out-of-Pocket Expenditures for Drugs Selected for Negotiation under the Medicare Drug Price Negotiation Program
Provides an overview of the Medicare Drug Price Negotiation Program established by the Inflation Reduction Act. Examines prescription drug use and out-of-pocket spending by Medicare Part D enrollees in calendar year 2022 for each of the first 10 drugs selected for price negotiations, which will be applicable in 2026. Includes data on the demographic characteristics of Medicare Part D enrollees taking each drug, including urban-rural status, as well as the number of enrollees and mean out-of-pocket spending on each drug by state.
Date: 09/2023
Type: Document
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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Provides an overview of the Medicare Drug Price Negotiation Program established by the Inflation Reduction Act. Examines prescription drug use and out-of-pocket spending by Medicare Part D enrollees in calendar year 2022 for each of the first 10 drugs selected for price negotiations, which will be applicable in 2026. Includes data on the demographic characteristics of Medicare Part D enrollees taking each drug, including urban-rural status, as well as the number of enrollees and mean out-of-pocket spending on each drug by state.
Date: 09/2023
Type: Document
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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Missouri Rural Health Clinic Provider Manual
Provider manual identifying the conditions of participation providing services in Missouri state-funded healthcare programs, including MO HealthNet, Missouri's Medicaid program. Addresses enrollment, eligibility, claim filing, and billing requirements for Rural Health Clinics (RHCs) in Missouri. Includes information on covered telehealth services.
Date: 09/2023
Type: Document
Sponsoring organization: Missouri Department of Social Services
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Provider manual identifying the conditions of participation providing services in Missouri state-funded healthcare programs, including MO HealthNet, Missouri's Medicaid program. Addresses enrollment, eligibility, claim filing, and billing requirements for Rural Health Clinics (RHCs) in Missouri. Includes information on covered telehealth services.
Date: 09/2023
Type: Document
Sponsoring organization: Missouri Department of Social Services
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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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Evaluation of the Million Hearts® Cardiovascular Disease Risk Reduction Model: Final Evaluation Report
Describes the results of the Centers for Medicare & Medicaid Services (CMS) Million Hearts Cardiovascular Disease Risk Reduction Model, a five-year randomized trial that aimed to reduce the incidence of first-time heart attacks and strokes among Medicare beneficiaries. Covers participant characteristics, including rural or urban status and organization type; changes in cardiovascular disease risk scores; effects of the model on healthcare utilization; intermediate- and long-term impacts on beneficiaries; and the contribution of these findings to the broader literature on cardiovascular disease prevention and value-based care.
Additional links: Findings at a Glance
Date: 08/2023
Type: Document
Sponsoring organizations: Centers for Medicare and Medicaid Services, Mathematica, RAND Corporation
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Describes the results of the Centers for Medicare & Medicaid Services (CMS) Million Hearts Cardiovascular Disease Risk Reduction Model, a five-year randomized trial that aimed to reduce the incidence of first-time heart attacks and strokes among Medicare beneficiaries. Covers participant characteristics, including rural or urban status and organization type; changes in cardiovascular disease risk scores; effects of the model on healthcare utilization; intermediate- and long-term impacts on beneficiaries; and the contribution of these findings to the broader literature on cardiovascular disease prevention and value-based care.
Additional links: Findings at a Glance
Date: 08/2023
Type: Document
Sponsoring organizations: Centers for Medicare and Medicaid Services, Mathematica, RAND Corporation
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Iowa Community Health Centers and Value-Based Care
Describes how Iowa Primary Care Association (Iowa PCA) and two sister organizations, IowaHealth+ and INConcertCare, pursued value-based care opportunities before joining the Medicare Shared Savings Program. Discusses the network's Medicaid value-based care contract; a partnership with Main Street Health to expand value-based contracting and provide more comprehensive, integrated primary care to patients with Medicare Advantage; data analytics; strategic planning and roadmaps; and next steps.
Date: 08/2023
Type: Document
Sponsoring organization: Rural Health Value
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Describes how Iowa Primary Care Association (Iowa PCA) and two sister organizations, IowaHealth+ and INConcertCare, pursued value-based care opportunities before joining the Medicare Shared Savings Program. Discusses the network's Medicaid value-based care contract; a partnership with Main Street Health to expand value-based contracting and provide more comprehensive, integrated primary care to patients with Medicare Advantage; data analytics; strategic planning and roadmaps; and next steps.
Date: 08/2023
Type: Document
Sponsoring organization: Rural Health Value
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Medicaid and CHIP Renewals Webinar Focused on Reaching Special Populations: Reaching Out to People Who Live in Rural Areas
A recorded webinar with strategies and resources to use in communicating with rural people enrolled in Medicaid and CHIP about how to maintain health insurance coverage. Transcript provided, along with the link and password to access the webinar recording.
Date: 08/2023
Type: Video/Multimedia
Sponsoring organization: Centers for Medicare and Medicaid Services
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A recorded webinar with strategies and resources to use in communicating with rural people enrolled in Medicaid and CHIP about how to maintain health insurance coverage. Transcript provided, along with the link and password to access the webinar recording.
Date: 08/2023
Type: Video/Multimedia
Sponsoring organization: Centers for Medicare and Medicaid Services
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