Rural Health
Resources by Topic: Health insurance
Primary Care Collaborative 2024 Evidence Report: An Evaluation of Primary Care in Medicare Accountable Care Organizations
Examines the role of primary care in Accountable Care Organizations (ACOs) in the Medicare Shared Savings Program (MSSP), and includes 3 case studies of MSSP ACOs that are primary care centric. Explores how the performance of ACOs may be affected by serving beneficiaries with high economic and social need. Mentions rural throughout.
Author(s): Ann Greiner, David Muhlestein, Ann Kempski, Melissa K. Fillippi, Alison N. Huffstetler
Date: 11/2024
Sponsoring organizations: Primary Care Collaborative, Robert Graham Center, Simple Healthcare
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Examines the role of primary care in Accountable Care Organizations (ACOs) in the Medicare Shared Savings Program (MSSP), and includes 3 case studies of MSSP ACOs that are primary care centric. Explores how the performance of ACOs may be affected by serving beneficiaries with high economic and social need. Mentions rural throughout.
Author(s): Ann Greiner, David Muhlestein, Ann Kempski, Melissa K. Fillippi, Alison N. Huffstetler
Date: 11/2024
Sponsoring organizations: Primary Care Collaborative, Robert Graham Center, Simple Healthcare
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Nurse Practitioner Race and Ethnicity and Interest in Independent Primary Care Practice and Serving Medicaid Enrollees
Surveyed California nurse practitioners (NPs) to determine the current practice and practice intentions following scope of practice regulation changes in California. Presents 2023 data showing rurality of NPs by amount of primary care offered and Medicaid patient caseload currently and those considering independent primary care practice, among other characteristics.
Author(s): Ulrike Muench, Amy Quan, Rosalind de Lisser, Timothy Bates, Joanne Spetz
Citation: Health Affairs Scholar, 2(12)
Date: 11/2024
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Surveyed California nurse practitioners (NPs) to determine the current practice and practice intentions following scope of practice regulation changes in California. Presents 2023 data showing rurality of NPs by amount of primary care offered and Medicaid patient caseload currently and those considering independent primary care practice, among other characteristics.
Author(s): Ulrike Muench, Amy Quan, Rosalind de Lisser, Timothy Bates, Joanne Spetz
Citation: Health Affairs Scholar, 2(12)
Date: 11/2024
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Dashboard: Arkansas Healthcare Expenditures
Interactive dashboard providing data on medical, pharmacy, and dental expenditures in Arkansas, utilizing the Arkansas Healthcare Transparency Initiative's All-Payer Claims Database for the years 2021-2023. Allows sorting by year, type of coverage, and type of service for individuals, total expenditures, or average annualized expenditures. Breaks down data at the county level by sex, age, payer type, and race/ethnicity.
Date: 11/2024
Sponsoring organization: Arkansas Center for Health Improvement
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Interactive dashboard providing data on medical, pharmacy, and dental expenditures in Arkansas, utilizing the Arkansas Healthcare Transparency Initiative's All-Payer Claims Database for the years 2021-2023. Allows sorting by year, type of coverage, and type of service for individuals, total expenditures, or average annualized expenditures. Breaks down data at the county level by sex, age, payer type, and race/ethnicity.
Date: 11/2024
Sponsoring organization: Arkansas Center for Health Improvement
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Evaluation of the Impact of the No Surprises Act on Health Care Market Outcomes: Exploring Pre-Implementation Trends - Second Annual Report
Provides an overview of the No Surprises Act, which aims to protect participants, beneficiaries, and enrollees in group health plans and group and individual health insurance coverage from surprise medical bills. Updates key trends in factors that will be important to evaluate the effects of the No Surprises Act identified in the First Annual Report, including market consolidation and concentration, out-of-network billing, and potential surprise bills. Describes discussions with healthcare providers, private health plans and issuers, and patients regarding implementation and understanding of the No Surprises Act.
Date: 11/2024
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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Provides an overview of the No Surprises Act, which aims to protect participants, beneficiaries, and enrollees in group health plans and group and individual health insurance coverage from surprise medical bills. Updates key trends in factors that will be important to evaluate the effects of the No Surprises Act identified in the First Annual Report, including market consolidation and concentration, out-of-network billing, and potential surprise bills. Describes discussions with healthcare providers, private health plans and issuers, and patients regarding implementation and understanding of the No Surprises Act.
Date: 11/2024
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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Federally Qualified Health Centers and Performance of Medicare Accountable Care Organizations
Explores the association between participation of Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs) in Medicare Shared Savings Program Accountable Care Organizations (ACOs) with ACOs' beneficiary characteristics, utilization, expenditure, and quality. Features statistics including estimated changes in Medicare Shared Savings Program ACO-assigned beneficiaries, utilization, and expenditure, with breakdowns by FQHC and RHC visits and other types of visits.
Author(s): Kun Li, Yucheng Hou, Frank McStay, Jonathan Gonzalez-Smith, Robert S. Saunders
Citation: JAMA Network Open, 7(11), e2445536
Date: 11/2024
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Explores the association between participation of Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs) in Medicare Shared Savings Program Accountable Care Organizations (ACOs) with ACOs' beneficiary characteristics, utilization, expenditure, and quality. Features statistics including estimated changes in Medicare Shared Savings Program ACO-assigned beneficiaries, utilization, and expenditure, with breakdowns by FQHC and RHC visits and other types of visits.
Author(s): Kun Li, Yucheng Hou, Frank McStay, Jonathan Gonzalez-Smith, Robert S. Saunders
Citation: JAMA Network Open, 7(11), e2445536
Date: 11/2024
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RHC Regulatory Changes in 2025 - Medicare Physician Fee Schedule Updates You Need to Know!
Recording of a November 18, 2024, webinar providing an overview of telehealth payment rates for Rural Health Clinics (RHCs) and other regulatory updates and potential changes for 2025. Covers Medicare vaccine reimbursement changes, the elimination of productivity standards, lab requirement changes, intensive outpatient program (IOP) services, telehealth regulations, and more. Part of the Rural Health Clinic Technical Assistance Series.
Additional links: Presentation Slides
Date: 11/2024
Sponsoring organization: National Association of Rural Health Clinics
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Recording of a November 18, 2024, webinar providing an overview of telehealth payment rates for Rural Health Clinics (RHCs) and other regulatory updates and potential changes for 2025. Covers Medicare vaccine reimbursement changes, the elimination of productivity standards, lab requirement changes, intensive outpatient program (IOP) services, telehealth regulations, and more. Part of the Rural Health Clinic Technical Assistance Series.
Additional links: Presentation Slides
Date: 11/2024
Sponsoring organization: National Association of Rural Health Clinics
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State Telehealth Laws and Reimbursement Policies Report, Fall 2024
Provides an overview of state telehealth policies as of early September 2024. Covers Medicaid reimbursement, private payer laws, and professional requirements.
Additional links: Executive Summary, Infographic, State Summary Chart
Date: 11/2024
Sponsoring organization: Center for Connected Health Policy: The National Telehealth Policy Resource Center
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Provides an overview of state telehealth policies as of early September 2024. Covers Medicaid reimbursement, private payer laws, and professional requirements.
Additional links: Executive Summary, Infographic, State Summary Chart
Date: 11/2024
Sponsoring organization: Center for Connected Health Policy: The National Telehealth Policy Resource Center
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Advancing Health Care in Rural, Tribal, and Geographically Isolated Communities: FY2024 Year in Review
Summarizes Centers for Medicare & Medicaid Services (CMS) activities in fiscal year 2024 to advance health and ensure affordable healthcare for people living in rural, tribal, and geographically isolated communities. Covers 6 priority focus areas: applying a community-informed geographic lens; increasing the collection and use of standardized data; strengthening and supporting healthcare professionals; optimizing medical and communication technology; expanding access to comprehensive healthcare coverage, benefits, and services and supports; and driving innovation and value-based care.
Date: 11/2024
Sponsoring organization: Centers for Medicare and Medicaid Services
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Summarizes Centers for Medicare & Medicaid Services (CMS) activities in fiscal year 2024 to advance health and ensure affordable healthcare for people living in rural, tribal, and geographically isolated communities. Covers 6 priority focus areas: applying a community-informed geographic lens; increasing the collection and use of standardized data; strengthening and supporting healthcare professionals; optimizing medical and communication technology; expanding access to comprehensive healthcare coverage, benefits, and services and supports; and driving innovation and value-based care.
Date: 11/2024
Sponsoring organization: Centers for Medicare and Medicaid Services
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Calendar Year (CY) 2025 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 2025. Summarizes provisions related to telehealth services; advanced primary care management services; behavioral health services; opioid treatment programs; dental and oral health services; Rural Health Clinic (RHC) and Federally Qualified Health Center (FQHC) care coordination services, telecommunication services, intensive outpatient program (IOP) services, and payment for vaccine costs; and more.
Date: 11/2024
Sponsoring organization: Centers for Medicare and Medicaid Services
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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 2025. Summarizes provisions related to telehealth services; advanced primary care management services; behavioral health services; opioid treatment programs; dental and oral health services; Rural Health Clinic (RHC) and Federally Qualified Health Center (FQHC) care coordination services, telecommunication services, intensive outpatient program (IOP) services, and payment for vaccine costs; and more.
Date: 11/2024
Sponsoring organization: Centers for Medicare and Medicaid Services
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CY 2025 Medicare Hospital Outpatient Prospective Payment System and Ambulatory Surgical Center Payment System Final Rule (CMS 1809-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 2025. Summarizes provisions regarding changes to Intensive Outpatient Program (IOP) and partial hospital program rate setting; incorporating an add-on payment to the Medicare outpatient hospital all-inclusive rate (AIR) for certain high-cost drugs for people with Medicare who receive care at Indian Health Service (IHS) or tribal hospitals; updates to the Hospital Outpatient Quality Reporting (OQR), Ambulatory Surgical Center Quality Reporting (ASCQR), and Rural Emergency Hospital Quality Reporting (REHQR) Programs; a new Conditions of Participation (CoPs) for hospitals and Critical Access Hospitals (CAHs) for obstetrical services; Medicaid and CHIP continuous eligibility; Medicaid clinic services "four walls" exceptions; and more.
Date: 11/2024
Sponsoring organization: Centers for Medicare and Medicaid Services
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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 2025. Summarizes provisions regarding changes to Intensive Outpatient Program (IOP) and partial hospital program rate setting; incorporating an add-on payment to the Medicare outpatient hospital all-inclusive rate (AIR) for certain high-cost drugs for people with Medicare who receive care at Indian Health Service (IHS) or tribal hospitals; updates to the Hospital Outpatient Quality Reporting (OQR), Ambulatory Surgical Center Quality Reporting (ASCQR), and Rural Emergency Hospital Quality Reporting (REHQR) Programs; a new Conditions of Participation (CoPs) for hospitals and Critical Access Hospitals (CAHs) for obstetrical services; Medicaid and CHIP continuous eligibility; Medicaid clinic services "four walls" exceptions; and more.
Date: 11/2024
Sponsoring organization: Centers for Medicare and Medicaid Services
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