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Resources by Topic: Healthcare business and finance

Medicare and Medicaid Programs: Minimum Staffing Standards for Long-Term Care Facilities and Medicaid Institutional Payment Transparency Reporting Final Rule (CMS 3442-F)
Fact sheet providing an overview of the Centers for Medicare & Medicaid Services (CMS) final rule for minimum staffing standards for long-term care facilities. Details three core staffing proposals: 1) minimum nurse staffing standards; 2) a requirement to have an RN onsite 24 hours a day, seven days a week; and 3) enhanced facility assessment requirements. Outlines a staggered implementation approach, including a later implementation date for rural facilities, and hardship exemption qualification requirements. Also describes Medicaid payment transparency reporting provisions for nursing and intermediate care facilities related to the percentage of Medicaid funds spent on compensation to direct care workers and support staff.
Additional links: External FAQs
Date: 04/2024
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Meeting Essential Health Services And Reimagining Obstetrics In A Rural Community
Case study profiling Kittitas Valley Healthcare (KVH) in rural Washington. Describes how KVH implemented a new staffing model to maintain essential obstetrics and gynecological care.
Date: 04/2024
Type: Document
Sponsoring organization: American Hospital Association
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Ten Things to Know About Consolidation in Health Care Provider Markets
Discusses consolidation in healthcare provider markets, including different types of consolidation, trends, benefits and harms for patients and other consumers, key research findings, policy options for increasing competition, and more. Highlights impacts on rural and underserved communities throughout.
Author(s): Zachary Levinson, Jamie Godwin, Scott Hulver, Tricia Neuman
Date: 04/2024
Type: Document
Sponsoring organization: KFF
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Quality in Motion: Acting on the CMS National Quality Strategy
Provides an overview of the Centers for Medicare & Medicaid Services (CMS) 2022 National Quality Strategy (NQS). Describes actions CMS has taken to meet the eight NQS goals across four priority areas: outcomes and alignment, equity and engagement, safety and resiliency, and interoperability and scientific achievement. Includes rural references throughout.
Date: 04/2024
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Creating a Sustainable Future for Value-Based Care: A Playbook of Voluntary Best Practices for VBC Payment Arrangements
Describes themes that emerged from workgroup meetings regarding the implementation of value-based care (VBC) models, with a focus on total cost of care arrangements. Outlines voluntary best practices and domains within VBC payment arrangements for health plans, facilities, clinicians, and VBC entities to consider during the design, implementation, and evaluation of VBC participation. Includes rural information and considerations throughout.
Date: 04/2024
Type: Document
Sponsoring organizations: AHIP, American Medical Association, National Association of ACOs
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Medicare Accountable Care Organizations: Past Performance and Future Directions
Summarizes research findings about Medicare accountable care organizations (ACOs) from recent peer-reviewed journals, official evaluations of Medicare ACOs, and research organization reports. Describes characteristics of certain ACOs associated with greater savings and factors that limit ACOs' ability to achieve net budgetary savings for the Medicare program. Identifies policy approaches that could increase savings for Medicare through ACOs and the Medicare Shared Savings Program. Includes a brief discussion of challenges facing ACOs in rural and underserved areas.
Date: 04/2024
Type: Document
Sponsoring organization: Congressional Budget Office
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What Would Shifting To A Single-Dose HPV Vaccine Mean For Health And Access?
Discusses the potential impact of single-dose human papilloma virus (HPV) vaccines on health disparities for rural residents, lower socioeconomic status patients, men, and sexual and gender minorities. Discusses relief of cost barriers for health systems and vaccine shortages.
Author(s): Matthew Najarian, Amanda F. Petrik
Citation: Health Affairs Forefront
Date: 04/2024
Type: Document
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Indian Health Service: Opportunities Exist to Improve Clinician Screening Adherence and Oversight
Examines the Indian Health Service's (IHS) oversight of the credentialing and privileging process that reviews and verifies the professional qualifications of IHS physicians. Describes administrative tasks performed by IHS clinicians at federally operated facilities and the amount of time spent on these tasks. Offers recommendations to IHS, including the development of a single, authoritative source outlining procedures to meet credentialing and privileging requirements.
Additional links: Full Report
Date: 04/2024
Type: Document
Sponsoring organization: Government Accountability Office
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Evaluation of the Maryland Total Cost of Care Model: Progress Report
Provides an overview of the Maryland Total Cost of Care Model and evaluates the first four years of the program, 2019-2022. Explores the effects of the model on Medicare spending; service use, including preventable hospital use; and healthcare quality measures. Estimates the potential impact of switching Maryland to the Medicare prospective payment system (PPS) on Medicare spending and service use, including implications for rural and safety net hospitals.
Additional links: Appendices, Findings at a Glance, Transformation Spotlight
Date: 04/2024
Type: Document
Sponsoring organizations: Centers for Medicare and Medicaid Services, Mathematica
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2023 National CAH Quality Inventory & Assessment National Report
Presents a high-level summary of key data points from the October-December 2023 National Critical Access Hospital (CAH) Quality Inventory and Assessment. Includes data on CAH system affiliation; median average daily census and emergency department volume; hospital inpatient, behavioral health and specialty care, and outpatient and other service lines; and CAH quality payment model participation.
Author(s): Megan Lahr, Robert Barclay, Madeleine Pick
Date: 04/2024
Type: Document
Sponsoring organization: Flex Monitoring Team
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