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Rural Health Information Hub

Rural Health
Resources by Topic: Health insurance

Medicare Payment for Rural or Geographically Isolated Hospitals
Displays data on Medicare payment adjustments for Sole Community Hospitals, Medicare-Dependent Hospitals, Low-Volume Hospitals, and Critical Access Hospitals. Includes information on the number of qualifying hospitals by state and eligibility criteria.
Date: 04/2024
Sponsoring organization: Congressional Research Service
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Protecting, Connecting and Thriving: Rural Public Health and Healthcare
Webinar recording of a panel discussing rural public health topics including rural health disparities, mortality, COVID-19, Medicaid coverage, primary care, graduate medical education, and services for veterans. Transcript is available in the video description.
Date: 04/2024
Sponsoring organizations: The RURAL Study, University of Texas Health Science Center at San Antonio
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KanCare Unwinding Data by Age and County as of Feb. 29, 2024
An interactive data table that depicts Medicaid unwinding in Kansas related to the end of the COVID-19 federal Public Health Emergency in March 2023. Allows user to select for rurality, age group, and county, showing corresponding approved, discontinued, or reinstatement window insurance coverage counts and rates.
Author(s): Alex Ferguson, Wen-Chieh Lin
Date: 04/2024
Sponsoring organization: Kansas Health Institute
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Report on Prevention of Out-Of-Network Ground Ambulance Emergency Service Balance Billing
Recommendations from the Ground Ambulance and Patient Billing Advisory Committee, convened between May and November, 2023, to protect consumers from balance billing and protect their access to emergency services. Features sections on rural ambulance services and community paramedicine.
Date: 03/2024
Sponsoring organization: Ground Ambulance and Patient Billing Advisory Committee
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Primary Care Spending in Medicare Fee-for-Service: An Illustrative Analysis Using Alternative Definitions of Primary Care
Discusses the importance of primary care to promote positive health outcomes and how reimbursement rates illustrate what healthcare areas are given priority. Utilizes Medicare fee-for-service data to estimate primary care spending and provides data breakdowns according to beneficiary characteristics, including rural versus urban location.
Date: 03/2024
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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A Lack of Behavioral Health Providers in Medicare and Medicaid Impedes Enrollees' Access to Care
Examines the availability of behavioral health providers who actively serve Medicare or Medicaid enrollees in 20 counties, 10 urban and 10 rural, across 10 states in 2021. Explores the extent to which traditional Medicare, Medicare Advantage, and Medicaid enrollees received behavioral health services and whether they used telehealth or in-person services. Offers recommendations to encourage more behavioral health providers to serve these enrollees and expand coverage to additional behavioral health provider types. Includes rural and urban comparisons throughout.
Additional links: Report Highlights
Date: 03/2024
Sponsoring organization: Office of Inspector General (HHS)
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Environmental Scan on Developing and Implementing Performance Measures for Population-Based Total Cost of Care (PB-TCOC) Models
Presents results of an environmental scan regarding the development and implementation of population-based total cost of care (PB-TCOC) payment models. Describes types of performance measures used in value-based payment models and pay-for-reporting programs, data sources used for constructing performance measures, features of PB-TCOC models, challenges in developing and implementing performance measures and opportunities for Alternative Payment Models (APMs) and PB-TCOC models to address these challenges, trends in existing performance measures across several Center for Medicare and Medicaid Innovation (CMMI) models and Medicare value-based care programs, and more. Includes rural references and considerations throughout.
Date: 03/2024
Sponsoring organizations: HHS Office of the Assistant Secretary for Planning and Evaluation, NORC at the University of Chicago
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Identifying Rural Health Clinics Within the Transformed Medicaid Statistical Information System (T-MSIS) Analytic Files
Provides an overview and history of the Rural Health Clinic (RHC) Program and the services provided to Medicaid recipients. Examines the methodology for locating RHC encounters within Medicaid claims files utilizing the Transformed Statistical Information System (T-MSIS) Analytic Files.
Author(s): Katherine Ahrens, Zachariah Croll, Yvonne Jonk, John Gale, Heidi O'Connor
Date: 03/2024
Sponsoring organization: Maine Rural Health Research Center
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The State of Georgia's Healthcare System
Fact sheet on income-based gaps in healthcare coverage in Georgia. Provides county-level maps and data on areas with the most significant coverage gaps, economic impacts of uninsured population, rural hospital and provider shortages, and more.
Date: 03/2024
Sponsoring organization: Georgia Budget & Policy Institute (GBPI)
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March 2024 MedPAC Meeting Transcript
Transcript from the Medicare Payment Advisory Commission's (MedPAC) March 2024 meeting. Covers proposed approaches and research topics related to evaluating rural hospital and clinician payment policies, an assessment of the completeness of Medicare Advantage (MA) encounter data and other sources of information about MA enrollees' healthcare utilization, a preliminary analysis of MA quality, the Acute Hospital Care at Home program, and Medicare inpatient psychiatric service trends and issues.
Additional links: Rural Hospital and Clinician Payment Policy: A Workplan for 2024–2025 - Presentation Slides
Date: 03/2024
Sponsoring organization: Medicare Payment Advisory Commission
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