Rural Health
Resources by Topic: Health insurance
OIG's Top Unimplemented Recommendations: Solutions To Reduce Fraud, Waste, and Abuse in HHS Programs: October 2021
Annual report identifying the top 25 unimplemented recommendations from the Office of Inspector General (OIG) that, in OIG's view, would have the most substantial positive impact on Health and Human Services (HHS) programs. Positive impact may refer to cost savings, program efficacy and efficiency, and/or quality improvement. Primary areas of interest in the October 2021 edition include: ensuring nursing homes are protecting residents from the spread of COVID-19; reforming the hospital wage index system; ensuring that Medicaid managed care enrollees have timely access to behavioral health services; and developing and implementing a staffing program for recruiting, retaining, and transitioning staff and leadership to remote Indian Health Service hospitals.
Date: 10/2021
Type: Document
Sponsoring organization: Office of Inspector General (HHS)
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Annual report identifying the top 25 unimplemented recommendations from the Office of Inspector General (OIG) that, in OIG's view, would have the most substantial positive impact on Health and Human Services (HHS) programs. Positive impact may refer to cost savings, program efficacy and efficiency, and/or quality improvement. Primary areas of interest in the October 2021 edition include: ensuring nursing homes are protecting residents from the spread of COVID-19; reforming the hospital wage index system; ensuring that Medicaid managed care enrollees have timely access to behavioral health services; and developing and implementing a staffing program for recruiting, retaining, and transitioning staff and leadership to remote Indian Health Service hospitals.
Date: 10/2021
Type: Document
Sponsoring organization: Office of Inspector General (HHS)
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Behavioral Health Equity Report 2021
Provides a breakdown and discussion of data drawn from the National Survey on Drug Use and Health from 2015 to 2019. Details youth and adult mental health and substance use indicators by race and ethnicity, income level, and metro or nonmetro county, among others.
Date: 10/2021
Type: Document
Sponsoring organization: Substance Abuse and Mental Health Services Administration
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Provides a breakdown and discussion of data drawn from the National Survey on Drug Use and Health from 2015 to 2019. Details youth and adult mental health and substance use indicators by race and ethnicity, income level, and metro or nonmetro county, among others.
Date: 10/2021
Type: Document
Sponsoring organization: Substance Abuse and Mental Health Services Administration
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Fourth Evaluation Report: Next Generation Accountable Care Organization Model Evaluation
Reports on implementation experiences and outcomes for 41 Next Generation Accountable Care Organizations (NGACOs) that participated in the model in the 2019 performance year. Evaluates findings of the model to date by NGACO cohort. Also presents information on model-wide, cohort-level, and NGACO-level impacts on Medicare spending, utilization, and quality of care. Includes information on the extent to which NGACOs served rural areas.
Additional links: Findings at a Glance, Technical Appendices
Date: 10/2021
Type: Document
Sponsoring organizations: Centers for Medicare and Medicaid Services, NORC at the University of Chicago
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Reports on implementation experiences and outcomes for 41 Next Generation Accountable Care Organizations (NGACOs) that participated in the model in the 2019 performance year. Evaluates findings of the model to date by NGACO cohort. Also presents information on model-wide, cohort-level, and NGACO-level impacts on Medicare spending, utilization, and quality of care. Includes information on the extent to which NGACOs served rural areas.
Additional links: Findings at a Glance, Technical Appendices
Date: 10/2021
Type: Document
Sponsoring organizations: Centers for Medicare and Medicaid Services, NORC at the University of Chicago
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Driving Health System Transformation - A Strategy for the CMS Innovation Center's Second Decade
White paper describing the new vision and strategic objectives for the Center for Medicare and Medicaid Innovation (CMS Innovation Center) for the next 10 years that seeks to achieve equitable health outcomes through the provision of high-quality, affordable, person-centered care. Shares beneficiary and healthcare provider goals for each strategic objective in Table 2. Strategic objectives include: driving accountable care, advancing health equity, supporting innovation, addressing affordability, and partnering to achieve healthcare system transformation. Includes discussion on models focused on improving rural health and ways of increasing participation in those models for rural and underserved populations.
Additional links: At a Glance
Date: 10/2021
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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White paper describing the new vision and strategic objectives for the Center for Medicare and Medicaid Innovation (CMS Innovation Center) for the next 10 years that seeks to achieve equitable health outcomes through the provision of high-quality, affordable, person-centered care. Shares beneficiary and healthcare provider goals for each strategic objective in Table 2. Strategic objectives include: driving accountable care, advancing health equity, supporting innovation, addressing affordability, and partnering to achieve healthcare system transformation. Includes discussion on models focused on improving rural health and ways of increasing participation in those models for rural and underserved populations.
Additional links: At a Glance
Date: 10/2021
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Medicare: Provider Performance and Experiences Under the Merit-Based Incentive Payment System
Examines Centers for Medicare and Medicaid Services (CMS) data on Merit-Based Incentive Payment System (MIPS) performance category scores, final scores, and payment adjustments from performance years 2017 through 2019. Summarizes interviews with 11 stakeholder groups and identifies strengths and challenges of the MIPS program. Presents data on MIPS performance scores and related payment adjustments by practice size, geographic location, method of participation, and specialty.
Additional links: Full Report
Date: 10/2021
Type: Document
Sponsoring organization: Government Accountability Office
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Examines Centers for Medicare and Medicaid Services (CMS) data on Merit-Based Incentive Payment System (MIPS) performance category scores, final scores, and payment adjustments from performance years 2017 through 2019. Summarizes interviews with 11 stakeholder groups and identifies strengths and challenges of the MIPS program. Presents data on MIPS performance scores and related payment adjustments by practice size, geographic location, method of participation, and specialty.
Additional links: Full Report
Date: 10/2021
Type: Document
Sponsoring organization: Government Accountability Office
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An Evaluation of Telehealth Use by Medicare Beneficiaries in 2020
Research brief examining telehealth use for outpatient evaluation and management from January 2019 to December 2020 based on a 20% sample of fee-for-service Medicare beneficiaries. Charts monthly trends for in-person and telehealth visits and compares rural and urban telehealth use, offering policy implications related to rural access to services.
Author(s): Chad Ellimoottil, Ziwei Zhu, Rod Dunn, et al.
Date: 09/2021
Type: Document
Sponsoring organization: University of Michigan Institute for Healthcare Policy and Innovation
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Research brief examining telehealth use for outpatient evaluation and management from January 2019 to December 2020 based on a 20% sample of fee-for-service Medicare beneficiaries. Charts monthly trends for in-person and telehealth visits and compares rural and urban telehealth use, offering policy implications related to rural access to services.
Author(s): Chad Ellimoottil, Ziwei Zhu, Rod Dunn, et al.
Date: 09/2021
Type: Document
Sponsoring organization: University of Michigan Institute for Healthcare Policy and Innovation
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Health Panel Comment Letter – Rural Emergency Hospitals (REH)
Offers comments in response to the Centers for Medicare and Medicaid Services (CMS) Request for Information on Rural Emergency Hospitals (REH). Addresses the type and scope of services REHs could offer, conditions of participation, health equity, collaboration and care coordination, quality measurement, payment, and enrollment.
Date: 09/2021
Type: Document
Sponsoring organization: Rural Policy Research Institute Rural Health Panel
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Offers comments in response to the Centers for Medicare and Medicaid Services (CMS) Request for Information on Rural Emergency Hospitals (REH). Addresses the type and scope of services REHs could offer, conditions of participation, health equity, collaboration and care coordination, quality measurement, payment, and enrollment.
Date: 09/2021
Type: Document
Sponsoring organization: Rural Policy Research Institute Rural Health Panel
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Utilization of Z Codes for Social Determinants of Health among Medicare Fee-for-Service Beneficiaries, 2019
Discusses how Z codes help report and track social determinants of health and reduce health disparities. Describes Z code claim data collected from 2016-2019, including the top 5 Z codes used in 2019 and the propositions of Medicare beneficiaries with Z codes across demographic characteristics. Highlights potential strategies to increase Z code utilization.
Date: 09/2021
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Discusses how Z codes help report and track social determinants of health and reduce health disparities. Describes Z code claim data collected from 2016-2019, including the top 5 Z codes used in 2019 and the propositions of Medicare beneficiaries with Z codes across demographic characteristics. Highlights potential strategies to increase Z code utilization.
Date: 09/2021
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Medicare Advantage Enrollment Update 2021
Reports on the percentage of rural Medicare beneficiaries enrolled in Medicare Advantage (MA) and other prepaid enrollment plans by metropolitan and nonmetropolitan location, from 2009-2021.
Author(s): Mina Shrestha, Fred Ullrich, Keith Mueller
Date: 09/2021
Type: Document
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Reports on the percentage of rural Medicare beneficiaries enrolled in Medicare Advantage (MA) and other prepaid enrollment plans by metropolitan and nonmetropolitan location, from 2009-2021.
Author(s): Mina Shrestha, Fred Ullrich, Keith Mueller
Date: 09/2021
Type: Document
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Disparities in Health Care in Medicare Advantage Associated with Dual Eligibility or Eligibility for a Low-income Subsidy
Shares Medicare Advantage (MA) plan performance data for specific healthcare quality measures reported in 2019, which represents care received in 2018. Analyzes and compares the quality of clinical care for dual-eligible (DE) beneficiaries, those who qualify for both Medicare and Medicaid, and Medicare beneficiaries who are eligible for a Part D low-income subsidy (LIS) with the quality of care for beneficiaries who do not qualify as DE nor LIS by racial/ethnic groups and rural status.
Date: 09/2021
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Shares Medicare Advantage (MA) plan performance data for specific healthcare quality measures reported in 2019, which represents care received in 2018. Analyzes and compares the quality of clinical care for dual-eligible (DE) beneficiaries, those who qualify for both Medicare and Medicaid, and Medicare beneficiaries who are eligible for a Part D low-income subsidy (LIS) with the quality of care for beneficiaries who do not qualify as DE nor LIS by racial/ethnic groups and rural status.
Date: 09/2021
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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