Rural Health
Resources by Topic: Health insurance
Configuration and Delivery of Primary Care in Rural and Urban Settings
Compares structure, capabilities, and payment reform participation of isolated, small town, micropolitan, and metropolitan physician practices. Features statistics on characteristics of physician practices, Medicare beneficiaries, and beneficiary utilization in 2017, with breakdowns by rurality.
Author(s): Taressa K. Fraze, Valerie A. Lewis, Andrew Wood, Helen Newton, Carrie H. Colla
Citation: Journal of General Internal Medicine, 37(12), 3045-3053
Date: 09/2022
Type: Document
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Compares structure, capabilities, and payment reform participation of isolated, small town, micropolitan, and metropolitan physician practices. Features statistics on characteristics of physician practices, Medicare beneficiaries, and beneficiary utilization in 2017, with breakdowns by rurality.
Author(s): Taressa K. Fraze, Valerie A. Lewis, Andrew Wood, Helen Newton, Carrie H. Colla
Citation: Journal of General Internal Medicine, 37(12), 3045-3053
Date: 09/2022
Type: Document
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September 2022 MedPAC Meeting Transcript
Transcript from the Medicare Payment Advisory Commission's (MedPAC) September 2022 meeting. Covers Medicare payments to safety-net clinicians, the development of a prototype post-acute care prospective payment system, nursing facility staffing requirements and data, the expansion of telehealth during the COVID-19 public health emergency (PHE) and payment for telehealth services after the PHE, inpatient psychiatric facility care, and Part D data on drug rebates and discounts. Includes rural references and considerations throughout.
Date: 09/2022
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Transcript from the Medicare Payment Advisory Commission's (MedPAC) September 2022 meeting. Covers Medicare payments to safety-net clinicians, the development of a prototype post-acute care prospective payment system, nursing facility staffing requirements and data, the expansion of telehealth during the COVID-19 public health emergency (PHE) and payment for telehealth services after the PHE, inpatient psychiatric facility care, and Part D data on drug rebates and discounts. Includes rural references and considerations throughout.
Date: 09/2022
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Health Panel Comment Letter – Medicare Shared Savings Program Requirements
Comments offered in response to a July 29, 2022, proposed rule regarding changes to the Medicare Shared Savings Program (SSP) to facilitate more widespread participation in Accountable Care Organizations (ACOs). Discusses how changes will impact rural Medicare beneficiaries, as well as challenges to extending ACOs to all rural counties. Covers advanced interest payments, extended time in one-sided risk, changes to calculating benchmarks, proposals to allow low revenue ACOs to realize shared savings at a lower minimum, a health equity adjustment, and social determinants of health measures.
Date: 09/2022
Type: Document
Sponsoring organization: Rural Policy Research Institute Rural Health Panel
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Comments offered in response to a July 29, 2022, proposed rule regarding changes to the Medicare Shared Savings Program (SSP) to facilitate more widespread participation in Accountable Care Organizations (ACOs). Discusses how changes will impact rural Medicare beneficiaries, as well as challenges to extending ACOs to all rural counties. Covers advanced interest payments, extended time in one-sided risk, changes to calculating benchmarks, proposals to allow low revenue ACOs to realize shared savings at a lower minimum, a health equity adjustment, and social determinants of health measures.
Date: 09/2022
Type: Document
Sponsoring organization: Rural Policy Research Institute Rural Health Panel
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Medicaid: Efforts to Address Fraud in Nonemergency Medical Transportation
Describes state approaches to administering the non-emergency medical transportation (NEMT) Medicaid benefit. Highlights how Colorado uses different approaches to serve urban and rural counties. Discusses the outcomes and findings of related fraud investigations and program audits and strategies selected states used to address related fraud.
Additional links: Full Report
Date: 09/2022
Type: Document
Sponsoring organization: Government Accountability Office
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Describes state approaches to administering the non-emergency medical transportation (NEMT) Medicaid benefit. Highlights how Colorado uses different approaches to serve urban and rural counties. Discusses the outcomes and findings of related fraud investigations and program audits and strategies selected states used to address related fraud.
Additional links: Full Report
Date: 09/2022
Type: Document
Sponsoring organization: Government Accountability Office
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Medicare Telehealth: Actions Needed to Strengthen Oversight and Help Providers Educate Patients on Privacy and Security Risks
Analyzes 2019 and 2020 Medicare claims data to explore the utilization of telehealth services before and after the implementation of regulatory flexibilities and waivers in March 2020 in response to the COVID-19 pandemic. Describes efforts taken by the Centers for Medicare & Medicaid Services (CMS) to identify and monitor risks posed by Medicare telehealth waivers, as well as a change made to the enforcement of regulations governing patients' protected health information during the COVID-19 public health emergency. Offers three recommendations to CMS to strengthen oversight and assess the quality of telehealth services and one recommendation regarding assistance to providers to explain the privacy and security risks of telehealth to patients.
Additional links: Full Report
Date: 09/2022
Type: Document
Sponsoring organization: Government Accountability Office
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Analyzes 2019 and 2020 Medicare claims data to explore the utilization of telehealth services before and after the implementation of regulatory flexibilities and waivers in March 2020 in response to the COVID-19 pandemic. Describes efforts taken by the Centers for Medicare & Medicaid Services (CMS) to identify and monitor risks posed by Medicare telehealth waivers, as well as a change made to the enforcement of regulations governing patients' protected health information during the COVID-19 public health emergency. Offers three recommendations to CMS to strengthen oversight and assess the quality of telehealth services and one recommendation regarding assistance to providers to explain the privacy and security risks of telehealth to patients.
Additional links: Full Report
Date: 09/2022
Type: Document
Sponsoring organization: Government Accountability Office
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Measure Applications Partnership 2022 Considerations for Measure Set Review in Federal Programs: Clinician, Hospital, and Post-Acute Care/Long-Term Care
Reviews the 32 healthcare quality and efficiency measures used by the National Quality Forum's Measure Applications Partnership (MAP) during 2022. Discusses measures for clinician programs, hospital programs, and post-acute care/long-term care programs. Includes the MAP Rural Health Advisory Group's support or determination of the suitability of each measure for rural providers.
Date: 09/2022
Type: Document
Sponsoring organization: National Quality Forum
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Reviews the 32 healthcare quality and efficiency measures used by the National Quality Forum's Measure Applications Partnership (MAP) during 2022. Discusses measures for clinician programs, hospital programs, and post-acute care/long-term care programs. Includes the MAP Rural Health Advisory Group's support or determination of the suitability of each measure for rural providers.
Date: 09/2022
Type: Document
Sponsoring organization: National Quality Forum
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Next Steps for the Rural Emergency Hospital Model
Blog post discussing rural hospital closures and how the Rural Emergency Hospital (REH) model can help financially vulnerable hospitals align their services to the needs of the community. Highlights recommendations to the U.S. Department of Health and Human Services regarding REH Conditions of Participation and payment.
Date: 09/2022
Type: Document
Sponsoring organization: Bipartisan Policy Center
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Blog post discussing rural hospital closures and how the Rural Emergency Hospital (REH) model can help financially vulnerable hospitals align their services to the needs of the community. Highlights recommendations to the U.S. Department of Health and Human Services regarding REH Conditions of Participation and payment.
Date: 09/2022
Type: Document
Sponsoring organization: Bipartisan Policy Center
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September 2022 MACPAC Meeting Transcript
Transcript from the Medicaid and CHIP Payment and Access Commission's (MACPAC) September 2022 meeting. Covers Medicaid race and ethnicity data collection and reporting, state processes and stakeholder engagement for unwinding continuous coverage requirement, countercyclical disproportionate share hospital policies, and integrating care for dually eligible beneficiaries in Medicaid fee-for-services, among other things. Includes rural references throughout.
Date: 09/2022
Type: Document
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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Transcript from the Medicaid and CHIP Payment and Access Commission's (MACPAC) September 2022 meeting. Covers Medicaid race and ethnicity data collection and reporting, state processes and stakeholder engagement for unwinding continuous coverage requirement, countercyclical disproportionate share hospital policies, and integrating care for dually eligible beneficiaries in Medicaid fee-for-services, among other things. Includes rural references throughout.
Date: 09/2022
Type: Document
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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Receipt of Out-of-State Telemedicine Visits Among Medicare Beneficiaries During the COVID-19 Pandemic
Study examining out-of-state telemedicine utilization during the COVID-19 pandemic by Medicare beneficiaries from January to June 2021 based on Medicare fee-for-service claims. Presents patient characteristics, variation in out-of-state telemedicine by geography, and benefits of out-of-state telemedicine access for rural beneficiaries.
Author(s): Ateev Mehrotra, Haiden A. Huskamp, Alok Nimgaonkar, et al.
Citation: JAMA Health Forum, 3(9), e223013
Date: 09/2022
Type: Document
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Study examining out-of-state telemedicine utilization during the COVID-19 pandemic by Medicare beneficiaries from January to June 2021 based on Medicare fee-for-service claims. Presents patient characteristics, variation in out-of-state telemedicine by geography, and benefits of out-of-state telemedicine access for rural beneficiaries.
Author(s): Ateev Mehrotra, Haiden A. Huskamp, Alok Nimgaonkar, et al.
Citation: JAMA Health Forum, 3(9), e223013
Date: 09/2022
Type: Document
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Health Panel Comment Letter – Hospital Outpatient Prospective Payment System and Rural Emergency Hospitals
Comments offered in response to a July 26, 2022, Federal Register proposed rule revising the Medicare Hospital Outpatient Prospective Payment System (OPPS) and Medicare Ambulatory Surgical Center (ACS) payment system for calendar year 2023 and establishing Rural Emergency Hospital (REH) payment policy, quality measures, and enrollment policy. Discusses telehealth services for mental healthcare; REH quality measures, telehealth, and Conditions of Participation; and the use of Centers for Medicare & Medicaid Services (CMS) data on hospital and skilled nursing facilities changes in ownership.
Date: 09/2022
Type: Document
Sponsoring organization: Rural Policy Research Institute Rural Health Panel
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Comments offered in response to a July 26, 2022, Federal Register proposed rule revising the Medicare Hospital Outpatient Prospective Payment System (OPPS) and Medicare Ambulatory Surgical Center (ACS) payment system for calendar year 2023 and establishing Rural Emergency Hospital (REH) payment policy, quality measures, and enrollment policy. Discusses telehealth services for mental healthcare; REH quality measures, telehealth, and Conditions of Participation; and the use of Centers for Medicare & Medicaid Services (CMS) data on hospital and skilled nursing facilities changes in ownership.
Date: 09/2022
Type: Document
Sponsoring organization: Rural Policy Research Institute Rural Health Panel
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