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Rural Health Information Hub

Rural Health
Resources by Topic: Healthcare business and finance

Access to Marketplace Plans with Low Premiums on the Federal Platform Part I: Availability among Uninsured Non-Elderly Adults and Healthcare.gov Enrollees Prior to the American Rescue Plan
Analyzes access to federally-sponsored Health Insurance Marketplace low premium plans among uninsured non-elderly adults as of March 1, 2021, prior to the enhanced subsidies created by American Rescue Plan (ARP). Table 2 includes demographic data for the uninsured non-elderly adult population and current HealthCare.gov enrollees on zero- and low-premium plan availability by rural status, age, income, and race/ethnicity.
Author(s): D. Keith Branham, Ann B. Conmy, Thomas DeLeire, et al.
Date: 03/2021
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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CMS Bundled Payments for Care Improvement Initiative Models 2­-4: Year 7 Evaluation & Monitoring Annual Report
Seventh and final report describing findings from an evaluation of Models 2, 3, and 4 of the Bundled Payments for Care Improvement (BPCI) initiative, linking provider payments for an episode of care with the goal of decreasing cost of care while improving quality. Includes information specific to rural BPCI-participating hospitals, skilled nursing facilities, and home health agencies.
Additional links: Appendices, Findings at a Glance
Author(s): The Lewin Group, Abt Associates, GDIT, Telligen
Date: 03/2021
Sponsoring organization: Centers for Medicare and Medicaid Services
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CMS Bundled Payments for Care Improvement Advanced Model: Year 2 Evaluation Report
Second annual report of the Bundled Payments for Care Improvement Advanced (BPCI Advanced) Model, which tests whether linking payments for a clinical episode of care can reduce Medicare expenditures while maintaining or improving quality of care. Covers the period from October 1, 2018, through January 1, 2020. Describes participants in the model; clinical episodes included; the reach of the model; and the impact of BPCI Advanced on episode payments, utilization, and quality of care. Includes information on rural hospital participation in the model.
Additional links: Appendices
Author(s): The Lewin Group, Abt Associates, GDIT, Telligen
Date: 03/2021
Sponsoring organization: Centers for Medicare and Medicaid Services
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State-Driven Initiatives to Support Moving to Value-Based Care in the Era of COVID-19
Describes four areas where state-driven strategies can facilitate and promote the adoption of value-based payment (VBP) models. Presents case examples throughout, including the Pennsylvania Rural Health Model. Discusses how additional federal actions could support transitions to VBP at the state level.
Author(s): Caroline Picher, Lauren Block, Mark Japinga, Hemi Tewarson
Date: 03/2021
Sponsoring organizations: Duke-Margolis Center for Health Policy, National Governors Association
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Meeting the Needs of Older Adults Living in Rural Communities: The Roles of Area Agencies on Aging
Presents results from the 2019 National Survey of Area Agencies on Aging. Describes the role of Area Agencies on Aging (AAA) in serving older adults in rural communities. Compares the organizational structure, services and programs offered, budget, and workforce of rural and non-rural AAAs.
Date: 03/2021
Sponsoring organization: USAging
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Tackling America's Mental Health and Addiction Crisis Through Primary Care Integration
Explores how primary and behavioral healthcare integration can overcome the unmet needs for mental health and substance use services. Discusses barriers to integrated care delivery. Offers policy recommendations to improve the integration of primary and behavioral healthcare services through enhanced payments, training, and technical assistance, and improving access to behavioral health providers for consultation and referral.
Additional links: Infographic
Date: 03/2021
Sponsoring organization: Bipartisan Policy Center
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Update to Rural Health Clinic (RHC) Payment Limits
Provides an overview of the updates to Rural Health Clinic (RHC) payment limits per visit beginning April 1, 2021, through 2028.
Date: 03/2021
Sponsoring organization: Centers for Medicare and Medicaid Services
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Which Hospitals Could Be Financially Affected by a Public Option?
Describes the potential impacts of a public option health insurance plan on hospital finances, including rural hospitals. Analyzes hospital discharge data to identify hospitals that had a greater share of total charges paid by private insurance across 25 states. Presents data by hospital and patient characteristics.
Author(s): Anuj Gangopadhyaya, Claire O'Brien
Date: 03/2021
Sponsoring organization: Urban Institute
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Post-Acute Care Trajectories for Rural Medicare Beneficiaries: Planned versus Actual Hospital Discharges to Skilled Nursing Facilities and Home Health Agencies
Examines care transitions among rural fee-for-service Medicare beneficiaries following discharge from an acute care hospital. Compares planned and actual discharges to home health agencies and skilled nursing facilities. Discusses implications of these findings on rural healthcare policy and practice.
Author(s): Tracy M. Mroz, Lisa A. Garberson, C. Holly A. Andrilla, et al.
Date: 03/2021
Sponsoring organization: WWAMI Rural Health Research Center
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COVID-19 in 2021: Pressure Continues on Hospital Margins
Examines the potential effect of COVID-19 on hospital operating margins in 2021. Explores optimistic and pessimistic scenarios for hospital margins as a whole, for hospitals with negative margins, and for rural hospitals.
Date: 03/2021
Sponsoring organization: Kaufman, Hall & Associates, LLC
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