Rural Health
Resources by Topic: Health insurance
Evaluation of the Impact of the No Surprises Act on Health Care Market Outcomes: Baseline Trends and Framework for Analysis - First 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. Details key trends in factors that will be important to evaluate the effects of the No Surprises Act, including the implementation and impacts of state surprise billing laws already in effect; trends in market consolidation and concentration; the impact of market consolidation and concentration on prices, quality, and spending; and trends in out-of-network billing. Describes a conceptual framework for considering the healthcare market effects of the No Surprises Act. Figure 4-3 shows rates of out-of-network billing prevalence by urban and rural patient residence.
Additional links: Cover Memo
Date: 07/2023
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. Details key trends in factors that will be important to evaluate the effects of the No Surprises Act, including the implementation and impacts of state surprise billing laws already in effect; trends in market consolidation and concentration; the impact of market consolidation and concentration on prices, quality, and spending; and trends in out-of-network billing. Describes a conceptual framework for considering the healthcare market effects of the No Surprises Act. Figure 4-3 shows rates of out-of-network billing prevalence by urban and rural patient residence.
Additional links: Cover Memo
Date: 07/2023
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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Rural Health on Life Support - Episode Three: Medicaid Unwinding
Podcast episode discussing the role of Medicaid in providing health insurance in rural areas. Covers the potential impact of Medicaid cuts on rural areas, the impact of Medicaid expansion on pediatric and maternal outcomes, and Medicaid unwinding after the COVID-19 public health emergency.
Date: 07/2023
Sponsoring organization: Impact! Communications, Inc.
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Podcast episode discussing the role of Medicaid in providing health insurance in rural areas. Covers the potential impact of Medicaid cuts on rural areas, the impact of Medicaid expansion on pediatric and maternal outcomes, and Medicaid unwinding after the COVID-19 public health emergency.
Date: 07/2023
Sponsoring organization: Impact! Communications, Inc.
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2021 Quality Payment Program Experience Report
Reports on the clinician experience for those participating in the Quality Payment Program in 2021. Presents data on Merit-based Incentive Payment System (MIPS) eligibility and participation rates for clinicians in small practices and rural areas, as well as their mean payment adjustment scores.
Date: 07/2023
Sponsoring organization: Centers for Medicare and Medicaid Services
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Reports on the clinician experience for those participating in the Quality Payment Program in 2021. Presents data on Merit-based Incentive Payment System (MIPS) eligibility and participation rates for clinicians in small practices and rural areas, as well as their mean payment adjustment scores.
Date: 07/2023
Sponsoring organization: Centers for Medicare and Medicaid Services
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Delta Region Community Health Systems Development (DRCHSD) Program: Revenue Cycle Management Best Practices Guide
Offers rural hospital executives and management teams best practice concepts in revenue cycle management by assisting them in identifying performance improvement within their hospitals and departments. Provides State Offices of Rural Health (SORH) directors and Flex Program coordinators a better understanding of the revenue cycle best practices to help them design educational training programs to support rural hospital administrators with performance improvement.
Additional links: Check List
Date: 07/2023
Sponsoring organizations: BKD CPAs & Advisors, National Rural Health Resource Center
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Offers rural hospital executives and management teams best practice concepts in revenue cycle management by assisting them in identifying performance improvement within their hospitals and departments. Provides State Offices of Rural Health (SORH) directors and Flex Program coordinators a better understanding of the revenue cycle best practices to help them design educational training programs to support rural hospital administrators with performance improvement.
Additional links: Check List
Date: 07/2023
Sponsoring organizations: BKD CPAs & Advisors, National Rural Health Resource Center
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Nursing Home Staffing Study: Comprehensive Report
Examines the level and type of staffing needed to promote acceptable nursing home quality and safety. Explores the potential implications and feasibility of increased staffing and costs to nursing homes. Presents four options for minimum staffing requirements and their cost, quality, and safety impacts. Includes rural references and considerations throughout.
Additional links: Literature Review Results Table, State Minimum Staffing Requirement
Date: 06/2023
Sponsoring organizations: Abt Associates, Centers for Medicare and Medicaid Services
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Examines the level and type of staffing needed to promote acceptable nursing home quality and safety. Explores the potential implications and feasibility of increased staffing and costs to nursing homes. Presents four options for minimum staffing requirements and their cost, quality, and safety impacts. Includes rural references and considerations throughout.
Additional links: Literature Review Results Table, State Minimum Staffing Requirement
Date: 06/2023
Sponsoring organizations: Abt Associates, Centers for Medicare and Medicaid Services
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Impact of Higher Payments for Rural Home Health Episodes on Rehospitalizations
Examines the impact of home health rural add-on payments on beneficiary outcomes, specifically on rehospitalizations. Uses Medicare data from 2007 to 2014 to compare rehospitalizations between rural and urban post-acute home health episodes before and after the implementation of the add-on payments in 2010. Discusses the implications of the findings on home health payment policy.
Author(s): Lacey Loomer, Momotazur Rahman, Tracy M. Mroz, Pedro L. Gozalo, Vincent Mor
Citation: Journal of Rural Health, 39(3), 604-610
Date: 06/2023
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Examines the impact of home health rural add-on payments on beneficiary outcomes, specifically on rehospitalizations. Uses Medicare data from 2007 to 2014 to compare rehospitalizations between rural and urban post-acute home health episodes before and after the implementation of the add-on payments in 2010. Discusses the implications of the findings on home health payment policy.
Author(s): Lacey Loomer, Momotazur Rahman, Tracy M. Mroz, Pedro L. Gozalo, Vincent Mor
Citation: Journal of Rural Health, 39(3), 604-610
Date: 06/2023
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Oral Health Disparities Through the Lifespan: Challenges and Opportunities
Recording of a June 7, 2023, conference session on oral health disparities as part of the Centers for Medicare & Medicaid Services (CMS) Health Equity Conference. Features a presentation from the CMS Office of the Administrator comparing differences in rural and urban dental opioid prescribing to adolescent/young adult and adult Medicaid/CHIP enrollees by patient and county characteristics. Transcript available below description.
Additional links: Carla Shoff, Centers for Medicare & Medicaid Services Office of the Administrator - Presentation Slides
Date: 06/2023
Sponsoring organization: Centers for Medicare and Medicaid Services
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Recording of a June 7, 2023, conference session on oral health disparities as part of the Centers for Medicare & Medicaid Services (CMS) Health Equity Conference. Features a presentation from the CMS Office of the Administrator comparing differences in rural and urban dental opioid prescribing to adolescent/young adult and adult Medicaid/CHIP enrollees by patient and county characteristics. Transcript available below description.
Additional links: Carla Shoff, Centers for Medicare & Medicaid Services Office of the Administrator - Presentation Slides
Date: 06/2023
Sponsoring organization: Centers for Medicare and Medicaid Services
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A Rural Accountable Care Organization's Journey
Profiles South East Rural Physicians Alliance Accountable Care Organization (SERPA‐ACO), a physician‐led ACO consisting of 16 Nebraska clinics - 13 of which are rural. Describes various value-based payment models SERPA-ACO clinics participated in and activities the clinics use to succeed in these models. Includes recommendations for primary care clinics considering joining an ACO.
Date: 06/2023
Sponsoring organization: Rural Health Value
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Profiles South East Rural Physicians Alliance Accountable Care Organization (SERPA‐ACO), a physician‐led ACO consisting of 16 Nebraska clinics - 13 of which are rural. Describes various value-based payment models SERPA-ACO clinics participated in and activities the clinics use to succeed in these models. Includes recommendations for primary care clinics considering joining an ACO.
Date: 06/2023
Sponsoring organization: Rural Health Value
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Expanded Report to Congress: Non-Emergency Medical Transportation in Medicaid, 2018–2021
Examines the Medicaid analysis of non-emergency medical transportation (NEMT) using Transformed Medicaid Statistical Information System (T-MSIS) data from 2018-2021. Explores the number and percentage of Medicaid beneficiaries using NEMT, the average number of NEMT "ride days" per NEMT user per month enrolled in Medicaid, the types of medical services accessed when using NEMT, monthly trends in the use of NEMT versus telehealth services before and during the COVID-19 public health emergency (PHE), and the volume of NEMT services used by type of NEMT delivery model. Offers recommendations for states and local stakeholders regarding Medicaid coverage of NEMT. Presents data by state and by beneficiary characteristics, including Medicaid eligibility category, health conditions, and urban-rural location.
Date: 06/2023
Sponsoring organizations: Centers for Medicare and Medicaid Services, U.S. Department of Health and Human Services
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Examines the Medicaid analysis of non-emergency medical transportation (NEMT) using Transformed Medicaid Statistical Information System (T-MSIS) data from 2018-2021. Explores the number and percentage of Medicaid beneficiaries using NEMT, the average number of NEMT "ride days" per NEMT user per month enrolled in Medicaid, the types of medical services accessed when using NEMT, monthly trends in the use of NEMT versus telehealth services before and during the COVID-19 public health emergency (PHE), and the volume of NEMT services used by type of NEMT delivery model. Offers recommendations for states and local stakeholders regarding Medicaid coverage of NEMT. Presents data by state and by beneficiary characteristics, including Medicaid eligibility category, health conditions, and urban-rural location.
Date: 06/2023
Sponsoring organizations: Centers for Medicare and Medicaid Services, U.S. Department of Health and Human Services
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A Path Forward: The Rural Healthcare System of the Future
Presentation slides that discuss federal and state healthcare policies, implementation of new models of care, and plans to transform patient modalities of care. Includes U.S. county-level map on the Medicare Shared Savings Program Accountable Care Organizations (ACO) assigned beneficiary population as well as county-level data on ACO attributed lives in Illinois and residents enrolled in Medicare advantage.
Author(s): Keith J. Mueller
Date: 06/2023
Sponsoring organizations: Iowa Department of Health Management and Policy, Rural Policy Research Institute
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Presentation slides that discuss federal and state healthcare policies, implementation of new models of care, and plans to transform patient modalities of care. Includes U.S. county-level map on the Medicare Shared Savings Program Accountable Care Organizations (ACO) assigned beneficiary population as well as county-level data on ACO attributed lives in Illinois and residents enrolled in Medicare advantage.
Author(s): Keith J. Mueller
Date: 06/2023
Sponsoring organizations: Iowa Department of Health Management and Policy, Rural Policy Research Institute
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