Rural Health
Resources by Topic: Health insurance
CMS Framework for Advancing Health Care in Rural, Tribal, and Geographically Isolated Communities
Report outlines the Centers for Medicare & Medicaid Services (CMS) plan for improving health equity and health outcomes across the U.S. for rural, tribal, and geographically isolated communities. Details a 6 priority framework emphasizing the application of a community-informed geographic lens; the collection and use of standardized data; support for healthcare professionals; the optimization of medical and communication technology; the expansion of access to comprehensive healthcare coverage, benefits, and services and supports; and innovation and value-based care. Highlights examples of activities CMS is undertaking in support of each priority and recent CMS efforts that align with each priority.
Date: 11/2022
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Report outlines the Centers for Medicare & Medicaid Services (CMS) plan for improving health equity and health outcomes across the U.S. for rural, tribal, and geographically isolated communities. Details a 6 priority framework emphasizing the application of a community-informed geographic lens; the collection and use of standardized data; support for healthcare professionals; the optimization of medical and communication technology; the expansion of access to comprehensive healthcare coverage, benefits, and services and supports; and innovation and value-based care. Highlights examples of activities CMS is undertaking in support of each priority and recent CMS efforts that align with each priority.
Date: 11/2022
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Advancing Rural Health Equity: Fiscal Year 2022 Year in Review
Summarizes Centers for Medicare & Medicaid Services (CMS) activities in fiscal year 2022 to advance health equity for people living in rural, tribal, and geographically isolated communities. Covers 10 priority focus areas: Medicaid and the Children's Health Insurance Program (CHIP), Medicare, Marketplace, the rural health workforce, payment and delivery system models and demonstrations, long-term services and supports, maternal health, mental health and substance use disorders, quality, and COVID-19.
Date: 11/2022
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Summarizes Centers for Medicare & Medicaid Services (CMS) activities in fiscal year 2022 to advance health equity for people living in rural, tribal, and geographically isolated communities. Covers 10 priority focus areas: Medicaid and the Children's Health Insurance Program (CHIP), Medicare, Marketplace, the rural health workforce, payment and delivery system models and demonstrations, long-term services and supports, maternal health, mental health and substance use disorders, quality, and COVID-19.
Date: 11/2022
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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2022 Rural-Urban Disparities in Health Care in Medicare
Examines rural/urban differences in the quality of healthcare received by Medicare beneficiaries in 2021, with breakdowns by race and ethnicity. Focuses on patient experience and clinical care measures, including screening for and management of health conditions and medication-related issues.
Date: 11/2022
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Examines rural/urban differences in the quality of healthcare received by Medicare beneficiaries in 2021, with breakdowns by race and ethnicity. Focuses on patient experience and clinical care measures, including screening for and management of health conditions and medication-related issues.
Date: 11/2022
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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A Global Equity Model (GEM) for the Advancement of Community Health and Health Equity
Provides an overview of existing and emerging payment systems and their roles in promoting community health and health equity. Proposes a global payment model for health systems' inpatient, emergency department (ED), and outpatient sites of care with community health and health equity as its organizing features. Includes information on the Pennsylvania Rural Health Model, the ACO REACH model, and other rural-relevant payment models.
Author(s): Anaeze C. Offodile II, Jason B. Gibbons, Samantha Murrell, Donna Kinzer, Joshua M. Sharfstein
Date: 11/2022
Type: Document
Sponsoring organization: National Academy of Medicine
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Provides an overview of existing and emerging payment systems and their roles in promoting community health and health equity. Proposes a global payment model for health systems' inpatient, emergency department (ED), and outpatient sites of care with community health and health equity as its organizing features. Includes information on the Pennsylvania Rural Health Model, the ACO REACH model, and other rural-relevant payment models.
Author(s): Anaeze C. Offodile II, Jason B. Gibbons, Samantha Murrell, Donna Kinzer, Joshua M. Sharfstein
Date: 11/2022
Type: Document
Sponsoring organization: National Academy of Medicine
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Patterns of Health Care Use among Rural-Urban Medicare Beneficiaries Age 85 and Older, 2010-2017
Policy brief examining how rural and urban Medicare beneficiaries age 85+ differ in terms of their socioeconomic and health characteristics that may inform healthcare use. Features statistics on trends in healthcare use, including inpatient and emergency department care, outpatient and prescription services, specialists and dentists, and home health and durable medical equipment, with breakdowns by urban and rural location.
Author(s): Yvonne Jonk, Heidi O'Connor, Amanda Burgess, Carly Milkowski
Date: 11/2022
Type: Document
Sponsoring organization: Maine Rural Health Research Center
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Policy brief examining how rural and urban Medicare beneficiaries age 85+ differ in terms of their socioeconomic and health characteristics that may inform healthcare use. Features statistics on trends in healthcare use, including inpatient and emergency department care, outpatient and prescription services, specialists and dentists, and home health and durable medical equipment, with breakdowns by urban and rural location.
Author(s): Yvonne Jonk, Heidi O'Connor, Amanda Burgess, Carly Milkowski
Date: 11/2022
Type: Document
Sponsoring organization: Maine Rural Health Research Center
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Person-Centered Innovation – An Update on the Implementation of the CMS Innovation Center's Strategy
Provides an update on the Centers for Medicare and Medicaid Services' (CMS) Innovation Center's progress in the implementation of the strategy refresh announced in 2021. Describes accomplishments from the first year of implementing the strategy refresh and outlines areas of focus for the upcoming year across the five strategic objectives: driving accountable care, advancing health equity, supporting innovation, addressing affordability, and partnering to achieve healthcare system transformation. Includes information on the Accountable Care Organization Realizing Equity, Access, and Community Health (ACO REACH) Model and the Community Health Access and Rural Transformation (CHART) Model.
Additional links: Supplemental Document
Date: 11/2022
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Provides an update on the Centers for Medicare and Medicaid Services' (CMS) Innovation Center's progress in the implementation of the strategy refresh announced in 2021. Describes accomplishments from the first year of implementing the strategy refresh and outlines areas of focus for the upcoming year across the five strategic objectives: driving accountable care, advancing health equity, supporting innovation, addressing affordability, and partnering to achieve healthcare system transformation. Includes information on the Accountable Care Organization Realizing Equity, Access, and Community Health (ACO REACH) Model and the Community Health Access and Rural Transformation (CHART) Model.
Additional links: Supplemental Document
Date: 11/2022
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Medicare Program: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems and Quality Reporting Programs; Organ Acquisition; Rural Emergency Hospitals: Payment Policies, Conditions of Participation, Provider Enrollment, Physician Self-Referral; New Service Category for Hospital Outpatient Department Prior Authorization Process; Overall Hospital Quality Star Rating; COVID-19
Establishes the Rural Emergency Hospital (REH) provider type. Outlines REH payment policy, Conditions of Participation (CoPs), quality measures, and enrollment policy. Outlines changes to the Critical Access Hospitals (CAH) CoPs regarding location and distance requirements, patient's rights requirements, and flexibilities for CAHs that are part of a larger health system. Among other things, this rule also revises the Medicare Hospital Outpatient Prospective Payment System (OPPS) and Medicare Ambulatory Surgical Center (ACS) payment system for calendar year 2023 and finalizes provisions included in the COVID-19 interim final rules.
Additional links: Fact Sheet
Date: 11/2022
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Establishes the Rural Emergency Hospital (REH) provider type. Outlines REH payment policy, Conditions of Participation (CoPs), quality measures, and enrollment policy. Outlines changes to the Critical Access Hospitals (CAH) CoPs regarding location and distance requirements, patient's rights requirements, and flexibilities for CAHs that are part of a larger health system. Among other things, this rule also revises the Medicare Hospital Outpatient Prospective Payment System (OPPS) and Medicare Ambulatory Surgical Center (ACS) payment system for calendar year 2023 and finalizes provisions included in the COVID-19 interim final rules.
Additional links: Fact Sheet
Date: 11/2022
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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CY 2023 Medicare Hospital Outpatient Prospective Payment System and Ambulatory Surgical Center Payment System Final Rule (CMS 1772-FC) Rural Emergency Hospitals — New Medicare Provider Type
Provides an overview of Rural Emergency Hospitals, a Medicare provider type established by the Consolidated Appropriations Act, 2021. Details key policies outlined in the Calendar Year 2023 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System Final Rule, including payment policies, conditions of participation, REH provider enrollment, and exceptions to the physician self-referral law.
Date: 11/2022
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Provides an overview of Rural Emergency Hospitals, a Medicare provider type established by the Consolidated Appropriations Act, 2021. Details key policies outlined in the Calendar Year 2023 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System Final Rule, including payment policies, conditions of participation, REH provider enrollment, and exceptions to the physician self-referral law.
Date: 11/2022
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Financial Characteristics of Critical Access Hospitals (CAHs) Participating in Accountable Care Organizations (ACO)
Examines Critical Access Hospital (CAH) participation in Medicare and non-Medicare Accountable Care Organizations (ACOs) in 2019. Compares the organizational and financial characteristics of CAHs across facilities that participate in ACOs and those that do not participate in an ACO. Includes data on profitability, liquidity, outpatient revenue, and Medicare payer mix.
Author(s): Angelina Budko, George Pink, Susie Gurzenda, Ann Howard, Kristin L. Reiter
Date: 11/2022
Type: Document
Sponsoring organization: Flex Monitoring Team
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Examines Critical Access Hospital (CAH) participation in Medicare and non-Medicare Accountable Care Organizations (ACOs) in 2019. Compares the organizational and financial characteristics of CAHs across facilities that participate in ACOs and those that do not participate in an ACO. Includes data on profitability, liquidity, outpatient revenue, and Medicare payer mix.
Author(s): Angelina Budko, George Pink, Susie Gurzenda, Ann Howard, Kristin L. Reiter
Date: 11/2022
Type: Document
Sponsoring organization: Flex Monitoring Team
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Rural Hospital Services Strategic Plan Progress Report
Reports on the progress, strategies, and milestones of the Rural Hospital Services Strategic Plan, as required by the Texas Legislature. Discusses the status of strategies related to Medicaid reimbursements, rural hospital revenue opportunities, and challenges providing care to patients covered by Medicare and other payers. Outlines future strategic and operational goals to support rural hospitals and offers a map of hospitals affected by new rural definitions.
Date: 11/2022
Type: Document
Sponsoring organization: Texas Health and Human Services
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Reports on the progress, strategies, and milestones of the Rural Hospital Services Strategic Plan, as required by the Texas Legislature. Discusses the status of strategies related to Medicaid reimbursements, rural hospital revenue opportunities, and challenges providing care to patients covered by Medicare and other payers. Outlines future strategic and operational goals to support rural hospitals and offers a map of hospitals affected by new rural definitions.
Date: 11/2022
Type: Document
Sponsoring organization: Texas Health and Human Services
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