Rural Health
Resources by Topic: Health reform
Health Panel Comment Letter – Encouraging Rural Participation in Population-Based Total Cost of Care Models
Offers comments in response to the Physician-Focused Payment Model Technical Advisory Committee (PTAC) Request for Information regarding rural participation in population-based total cost of care models. Covers considerations for determining the most relevant definition of rural, barriers that impact rural providers' participation in alternative payment models (APMs), service delivery models and resources that are effective in encouraging value-based care (VBC) transformation in rural areas, and more.
Date: 10/2023
Type: Document
Sponsoring organization: Rural Policy Research Institute Rural Health Panel
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Offers comments in response to the Physician-Focused Payment Model Technical Advisory Committee (PTAC) Request for Information regarding rural participation in population-based total cost of care models. Covers considerations for determining the most relevant definition of rural, barriers that impact rural providers' participation in alternative payment models (APMs), service delivery models and resources that are effective in encouraging value-based care (VBC) transformation in rural areas, and more.
Date: 10/2023
Type: Document
Sponsoring organization: Rural Policy Research Institute Rural Health Panel
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Medicare Advantage Value-Based Insurance Design Model Phase II: Second Annual Evaluation Report
Presents findings from an evaluation of Phase II of the Medicare Advantage (MA) Value-Based Insurance Design (VBID) Model, which allows participating MA parent organizations to offer supplemental benefits and incentives to beneficiaries, hospice benefits, and wellness and healthcare planning through their MA plans. Summarizes findings from interviews with representatives of participating MA organizations, in-network and out-of-network hospices, and beneficiaries. Covers MA organization and beneficiary implementation experiences, plan enrollment, quality of care, health outcomes, and more, for the VBID Model generally and for the VBID Hospice Benefit Component.
Additional links: Appendices, Findings at a Glance, Hospice Benefit Component Findings at a Glance
Date: 09/2023
Type: Document
Sponsoring organizations: Centers for Medicare and Medicaid Services, RAND Corporation
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Presents findings from an evaluation of Phase II of the Medicare Advantage (MA) Value-Based Insurance Design (VBID) Model, which allows participating MA parent organizations to offer supplemental benefits and incentives to beneficiaries, hospice benefits, and wellness and healthcare planning through their MA plans. Summarizes findings from interviews with representatives of participating MA organizations, in-network and out-of-network hospices, and beneficiaries. Covers MA organization and beneficiary implementation experiences, plan enrollment, quality of care, health outcomes, and more, for the VBID Model generally and for the VBID Hospice Benefit Component.
Additional links: Appendices, Findings at a Glance, Hospice Benefit Component Findings at a Glance
Date: 09/2023
Type: Document
Sponsoring organizations: Centers for Medicare and Medicaid Services, RAND Corporation
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The Pennsylvania Rural Health Model (PARHM): Third Annual Evaluation Report
Evaluates the third performance year of the Pennsylvania Rural Health Model (PARHM), an initiative designed to test if global budgets can help rural hospitals improve their financial viability, provide flexibility to meet locally defined community health needs, and reduce overall healthcare spending. Provides an overview of the model and describes the implementation experience of participating hospitals and payers. Presents a descriptive quantitative assessment of financial performance, spending and utilization, access to care, and quality of care outcomes from 2016, the model's baseline, through 2021. Includes three case studies discussing three themes: the recruitment and retention of system-affiliated hospitals, engagement and coordination with community organizations and providers, and exploring service line changes.
Additional links: Appendix, Findings at a Glance
Date: 09/2023
Type: Document
Sponsoring organizations: Centers for Medicare and Medicaid Services, NORC at the University of Chicago
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Evaluates the third performance year of the Pennsylvania Rural Health Model (PARHM), an initiative designed to test if global budgets can help rural hospitals improve their financial viability, provide flexibility to meet locally defined community health needs, and reduce overall healthcare spending. Provides an overview of the model and describes the implementation experience of participating hospitals and payers. Presents a descriptive quantitative assessment of financial performance, spending and utilization, access to care, and quality of care outcomes from 2016, the model's baseline, through 2021. Includes three case studies discussing three themes: the recruitment and retention of system-affiliated hospitals, engagement and coordination with community organizations and providers, and exploring service line changes.
Additional links: Appendix, Findings at a Glance
Date: 09/2023
Type: Document
Sponsoring organizations: Centers for Medicare and Medicaid Services, NORC at the University of Chicago
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Evaluation of the Vermont All-Payer Accountable Care Organization Model: Third Evaluation Report
Evaluates the first four and a half performance years of the Vermont All-Payer Accountable Care Organization Model (VTAPM), which aims to assess whether scaling an Accountable Care Organization (ACO) across all payers in the state can reduce program expenditures while preserving or improving care quality. Discusses the implementation of the model, provider engagement, efforts to address population health goals; characteristics of participating hospitals, practitioners, and beneficiaries; and the model's impacts on Medicare spending, utilization, and quality of care. Describes trends in substance use disorder diagnosis and treatment for Medicaid members. Outlines challenges and lessons learned, as well as areas for future research.
Additional links: Findings at a Glance, Technical Appendices
Date: 07/2023
Type: Document
Sponsoring organizations: Centers for Medicare and Medicaid Services, NORC at the University of Chicago
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Evaluates the first four and a half performance years of the Vermont All-Payer Accountable Care Organization Model (VTAPM), which aims to assess whether scaling an Accountable Care Organization (ACO) across all payers in the state can reduce program expenditures while preserving or improving care quality. Discusses the implementation of the model, provider engagement, efforts to address population health goals; characteristics of participating hospitals, practitioners, and beneficiaries; and the model's impacts on Medicare spending, utilization, and quality of care. Describes trends in substance use disorder diagnosis and treatment for Medicaid members. Outlines challenges and lessons learned, as well as areas for future research.
Additional links: Findings at a Glance, Technical Appendices
Date: 07/2023
Type: Document
Sponsoring organizations: Centers for Medicare and Medicaid Services, NORC at the University of Chicago
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Evaluation of the Primary Care First Model: First Annual Report
Provides an overview of the Primary Care First (PCF) model, which aims to enhance primary care and move primary care practitioners toward value-based payment. Describes the first performance year of the PCF model for Cohort 1 practices. Explores advanced primary care attributes that Cohort 1 practices report they possessed at the start of PCF and the approaches these practices have taken or plan to take to change how they deliver advanced primary care. Presents findings on the 13 payers that are partnering with the Centers for Medicare & Medicaid Services (CMS) as payer partners, including why they chose to partner with CMS and efforts made to align their payments with CMS in the PCF model.
Additional links: Findings at a Glance
Date: 12/2022
Type: Document
Sponsoring organizations: Centers for Medicare and Medicaid Services, Mathematica
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Provides an overview of the Primary Care First (PCF) model, which aims to enhance primary care and move primary care practitioners toward value-based payment. Describes the first performance year of the PCF model for Cohort 1 practices. Explores advanced primary care attributes that Cohort 1 practices report they possessed at the start of PCF and the approaches these practices have taken or plan to take to change how they deliver advanced primary care. Presents findings on the 13 payers that are partnering with the Centers for Medicare & Medicaid Services (CMS) as payer partners, including why they chose to partner with CMS and efforts made to align their payments with CMS in the PCF model.
Additional links: Findings at a Glance
Date: 12/2022
Type: Document
Sponsoring organizations: Centers for Medicare and Medicaid Services, Mathematica
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Evaluation of the Vermont All-Payer Accountable Care Organization Model: Second Evaluation Report
Evaluates the first three performance years of the Vermont All-Payer Accountable Care Organization Model (VTAPM), which aims to assess whether scaling an Accountable Care Organization (ACO) across all payers in the state can reduce program expenditures while preserving or improving care quality. Discusses the implementation of the model, provider engagement, efforts to address population health goals; characteristics of participating hospitals, practitioners, and beneficiaries; and the model's impacts on Medicare spending, utilization, and quality of care. Describes changes to the model's design in response to the COVID-19 public health emergency and how COVID-19 and a cyberattack impacted healthcare utilization. Includes information on hospital and provider participation in rural areas and limited participation by Critical Access Hospitals.
Additional links: Findings at a Glance, Technical Appendices
Date: 12/2022
Type: Document
Sponsoring organizations: Centers for Medicare and Medicaid Services, NORC at the University of Chicago
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Evaluates the first three performance years of the Vermont All-Payer Accountable Care Organization Model (VTAPM), which aims to assess whether scaling an Accountable Care Organization (ACO) across all payers in the state can reduce program expenditures while preserving or improving care quality. Discusses the implementation of the model, provider engagement, efforts to address population health goals; characteristics of participating hospitals, practitioners, and beneficiaries; and the model's impacts on Medicare spending, utilization, and quality of care. Describes changes to the model's design in response to the COVID-19 public health emergency and how COVID-19 and a cyberattack impacted healthcare utilization. Includes information on hospital and provider participation in rural areas and limited participation by Critical Access Hospitals.
Additional links: Findings at a Glance, Technical Appendices
Date: 12/2022
Type: Document
Sponsoring organizations: Centers for Medicare and Medicaid Services, NORC at the University of Chicago
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The Pennsylvania Rural Health Model (PARHM): Second Annual Evaluation Report
Evaluates the second year of the Pennsylvania Rural Health Model (PARHM), an initiative designed to test if global budgets can help rural hospitals improve their financial viability, provide flexibility to meet locally defined community health needs, and reduce overall healthcare spending. Provides an overview of the model and describes the implementation experience of participating hospitals and payers. Presents a descriptive quantitative assessment of financial performance, spending and utilization, access to care, and quality of care outcomes during the second performance year.
Additional links: Appendix, Findings at a Glance
Date: 06/2022
Type: Document
Sponsoring organizations: Centers for Medicare and Medicaid Services, NORC at the University of Chicago
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Evaluates the second year of the Pennsylvania Rural Health Model (PARHM), an initiative designed to test if global budgets can help rural hospitals improve their financial viability, provide flexibility to meet locally defined community health needs, and reduce overall healthcare spending. Provides an overview of the model and describes the implementation experience of participating hospitals and payers. Presents a descriptive quantitative assessment of financial performance, spending and utilization, access to care, and quality of care outcomes during the second performance year.
Additional links: Appendix, Findings at a Glance
Date: 06/2022
Type: Document
Sponsoring organizations: Centers for Medicare and Medicaid Services, NORC at the University of Chicago
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State Innovation Model Testing Awards from the Centers for Medicare & Medicaid Services Innovation Center: Highlighting Rural Focus
Summarizes the activities and accomplishments of rural-specific State Innovation Models (SIM) in 11 states: Arkansas, Colorado, Idaho, Iowa, Maine, Michigan, Minnesota, New York, Ohio, Oregon, and Vermont. Describes the SIM initiative, which began in 2012 to support states committed to designing and testing strategies for payment model and delivery system reform.
Date: 06/2022
Type: Document
Sponsoring organization: Rural Health Value
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Summarizes the activities and accomplishments of rural-specific State Innovation Models (SIM) in 11 states: Arkansas, Colorado, Idaho, Iowa, Maine, Michigan, Minnesota, New York, Ohio, Oregon, and Vermont. Describes the SIM initiative, which began in 2012 to support states committed to designing and testing strategies for payment model and delivery system reform.
Date: 06/2022
Type: Document
Sponsoring organization: Rural Health Value
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The Affordable Care Act Medicaid Expansion, Social Disadvantage, and the Practice Location Choices of New General Internists
Examines levels of social disadvantage in states that lost general internal medicine physicians (internists) and states that gained internists after Medicaid expansion. Analyzes 32,102 internists who established their first practice between 2009 and 2019 and their location of choice. Outlines characteristics of internist location choices by population demographics such as age, race and ethnicity, education levels, income levels, social disadvantage level, medical school availability, and rurality.
Author(s): José J. Escarce, Gregory D. Wozniak, Stavros Tsipas, et al.
Citation: Medical Care, 60(5), 342-350
Date: 05/2022
Type: Document
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Examines levels of social disadvantage in states that lost general internal medicine physicians (internists) and states that gained internists after Medicaid expansion. Analyzes 32,102 internists who established their first practice between 2009 and 2019 and their location of choice. Outlines characteristics of internist location choices by population demographics such as age, race and ethnicity, education levels, income levels, social disadvantage level, medical school availability, and rurality.
Author(s): José J. Escarce, Gregory D. Wozniak, Stavros Tsipas, et al.
Citation: Medical Care, 60(5), 342-350
Date: 05/2022
Type: Document
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Independent Evaluation of Comprehensive Primary Care Plus (CPC+): Fourth Annual Report
Reports on the first four program years of the Comprehensive Primary Care Plus (CPC+) model, a CMS primary care payment and delivery reform effort. Discusses CPC+ participating practices, payer partners, and health information technology (HIT) vendors supporting the program. Describes practice changes regarding care delivery and outcomes for Medicare fee-for-service beneficiaries.
Additional links: Appendices, Findings at a Glance
Date: 05/2022
Type: Document
Sponsoring organizations: Centers for Medicare and Medicaid Services, Mathematica
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Reports on the first four program years of the Comprehensive Primary Care Plus (CPC+) model, a CMS primary care payment and delivery reform effort. Discusses CPC+ participating practices, payer partners, and health information technology (HIT) vendors supporting the program. Describes practice changes regarding care delivery and outcomes for Medicare fee-for-service beneficiaries.
Additional links: Appendices, Findings at a Glance
Date: 05/2022
Type: Document
Sponsoring organizations: Centers for Medicare and Medicaid Services, Mathematica
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