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Resources by Topic: Health insurance

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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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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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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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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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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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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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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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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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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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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