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Rural Health
Resources by Topic: Health reform

Report to Congress: Social Risk Factors and Performance Under Medicare's Value-Based Purchasing Program
Uses Medicare data to examine the relationship between social risk factors and the performance of value-based purchasing programs. Discusses policy considerations that could help ensure value-based purchasing programs achieve their intended results, especially among high social risk populations. Categorizes rurality as a community risk factor and discusses whether beneficiaries with social risk factors such as rurality have worse outcomes due to their social risk profile, or because of the providers they see. Also provides rural-specific statistics and recommendations for using value-based purchasing to improve health outcomes among high social risk populations. Appendices summarize and provide additional details for each of the 9 programs evaluated. See the second report.
Additional links: Appendices
Date: 12/2016
Type: Document
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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Medicare Value-Based Payment Models: Participation Challenges and Available Assistance for Small and Rural Practices
Identifies challenges faced by small and rural physician practices when participating in Medicare's new value-based payment models, and groups them into five key areas: financial resources and risk management, health IT and data, population health management care delivery, quality and efficiency performance measurement and reporting, and effects of model participation and managing compliance with requirements. Also identifies two types of organizations, partner and non-partner, along with the services they provide, that can help small and rural practices overcome these challenges.
Additional links: Full Report
Date: 12/2016
Type: Document
Sponsoring organization: Government Accountability Office
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Improving Community Health through Hospital Community Benefit Spending: Charting a Path to Reform
Provides background on the origin and importance of nonprofit hospital community benefit spending, and explains the difference between community building and community benefit activities. Examines policy options that the IRS could use to enhance community benefit spending focused on improving social determinants of health community-wide. Includes rural-specific statistics and multiple comparisons of items identified in community health needs assessments (CHNAs).
Author(s): Sara Rosenbaum, Maureen Byrnes, Sara Rothenberg, Rachel Gunsalus
Date: 12/2016
Type: Document
Sponsoring organizations: George Washington University Milken Institute School of Public Health Department of Health Policy and Management, Milken Institute School of Public Health
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Healthcare Eligibility and Availability and Healthcare Reform: Are We Addressing Rural Women's Barriers to Accessing Care?
Reports the results from a focus group of women living in 7 rural Illinois counties to identify barriers in accessing healthcare prior to the Patient Protection and Affordable Care Act (ACA). Covers potential gaps in the legislation and how they can add to the existing barriers rural populations experience when accessing healthcare.
Author(s): Kristine Zimmermann, Leslie Carnahan, Ellen Paulsey, Yamile Molina
Citation: Journal of Health Care for the Poor and Underserved, 27(4A), 204-219
Date: 11/2016
Type: Document
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Evaluation of Hospital-Setting HCIA Awards: Third Annual Report, Final
Third and final report evaluating 10 Health Care Innovation Awards Round One projects undertaken in a hospital inpatient or emergency department. Presents awardee-specific information on program impact and lessons learned. Includes projects that involved Critical Access Hospitals and other rural hospitals. Includes projects focused on improved care for sepsis and projects using remote electronic intensive care unit (eICU) services.
Additional links: Addendum, March 2017
Date: 11/2016
Type: Document
Sponsoring organizations: Abt Associates, Centers for Medicare and Medicaid Services
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Health Insurance CO-OPs: Product Availability and Premiums in Rural Counties
Describes the role of CO-OPs, their regional distribution, and national prevalence in rural and urban counties. Compares the number of products available in counties with and without CO-OP plans in 2014 and 2015.
Author(s): Erika C. Ziller, Zachariah Croll, Andrew F. Coburn
Date: 10/2016
Type: Document
Sponsoring organization: Maine Rural Health Research Center
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State Innovation Models (SIM) Initiative Evaluation: Model Test Year Two Annual Report
Second annual report detailing the findings of CMS's State Innovation Models (SIM) Initiative, which tests the ability of the governments in six states - Arkansas, Maine, Massachusetts, Minnesota, Vermont, and Oregon - to accelerate health system transformation in the areas of delivery systems, payment models, information technology, workforce development, and more. Presents results from the second of three planned site visits to the states, including interviews, focus groups, and surveys. Connections made throughout to issues specifically affecting rural healthcare.
Date: 08/2016
Type: Document
Sponsoring organizations: Centers for Medicare and Medicaid Services, RTI International
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Evaluation of the Round Two Health Care Innovation Awards (HCIA R2): First Annual Report
Summarizes the first year evaluation results of the 39 Health Care Innovation Awards Round Two projects. Includes findings for the individual grantees, which include 14 projects that serve rural areas.
Date: 08/2016
Type: Document
Sponsoring organizations: Centers for Medicare and Medicaid Services, Mathematica Policy Research
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Hospital Closures and the Current Healthcare Climate: The Future of Rural Hospitals in the USA
Discusses impact of Affordable Care Act on rural hospitals, including financial considerations, and explores steps that may be taken in order to ensure that these facilities remain open.
Author(s): Soma Balasubramanian, Erick Jones
Citation: Rural and Remote Health, 16(3), 3935
Date: 07/2016
Type: Document
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Stroudwater Population Health
An 8-part video series designed to help rural healthcare organizations transition from payment for volume to payment for value and advance population health strategies. Each part discusses an important strategy for achieving population health, including: quality and efficiency, network relationships and service rationalization, employer-sponsored health plans and fee-for-service payments, shared savings plans, and full risk payments and capitation.
Date: 06/2016
Type: Video/Multimedia
Sponsoring organization: Stroudwater Associates
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