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Rural Health
Resources by Topic: Healthcare quality

Medicare: Performance-Based and Geographic Adjustments to Physician Payments
Statement to the U.S. House of Representatives Committee on Energy and Commerce, Subcommittee on Health, summarizing the Government Accountability Organization's (GAO) 2021 reports on the Quality Payment Program and the two tracks it established to incentivize Medicare providers and its 2022 report on geographic adjustments to physician payments. Includes information on the participation of providers in rural and underserved areas in Advanced Alternative Payment Models (APMs) and the challenges these providers face in transitioning to APMs.
Additional links: Full Report
Date: 10/2023
Sponsoring organization: Government Accountability Office
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A Formal Framework For Incorporating Equity Into Health Care Quality Measurement
Describes equity weighting, a measurement used to address population health disparities by examining multiple demographic factors that then interpret healthcare quality for specific population groups. Utilizes 2017 Medicare colorectal cancer screening data to show examples of equity weighting, with demographics broken down by patient race and rurality.
Author(s): Denis Agniel, Irineo Cabreros, Cheryl L. Damberg, Marc N. Elliott, Rhianna Rogers
Citation: Health Affairs, 42(10)
Date: 10/2023
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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
Sponsoring organizations: Centers for Medicare and Medicaid Services, RAND Corporation
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Merit-Based Incentive Payment System (MIPS): Small Practice Countdown to Performance Year 2023 Data Submission Checklist
Checklist outlining the steps small practices must follow to submit Merit-based Incentive Payment System (MIPS) 2023 performance year data. Highlights key dates and links to key resources for small practices.
Date: 09/2023
Sponsoring organization: Centers for Medicare and Medicaid Services
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Characteristics of 30-Day All-cause Hospital Readmissions, 2016–2020
Examines trends in 30-day all-cause hospital readmissions among patients 1 year old and older in the United States between 2016 and 2020. Explores changes in readmission rates from the pre-pandemic period (2016-2019) to 2020. Presents data by primary payer, patient location, and race and ethnicity.
Author(s): H. Joanna Jiang, Molly Hensche
Date: 09/2023
Sponsoring organization: Agency for Healthcare Research and Quality
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Guideline-Discordant Inhaler Regimens after COPD Hospitalization: Associations with Rurality, Drive Time to Care, and Fragmented Care – a United States Cohort Study
Examines the factors related to guideline-discordant inhaler regimens following chronic obstructive pulmonary disease (COPD) hospitalization. Analyzes 33,785 patient inhaler prescriptions between 2017-2020 according to rurality, drive time to pulmonary specialty care, and fragmented care.
Author(s): Arianne K. Baldomero, Ken M. Kunisaki, Chris H. Wendt, et al.
Citation: The Lancet Regional Health - Americas, 26
Date: 09/2023
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Improving Hospital Transfers: A Step Toward Equitable, Patient-Centered Acute Care
Discuss emergency department (ED) transfers, including the importance of timely transfers, where patients transferred from the ED are more likely to initially present, and how transferred patients are considered in hospital quality metrics. Identifies three ways to incentivize hospital coordination to improve patient-centered care for transfer patients.
Author(s): Charleen Hsuan
Citation: Health Affairs Forefront
Date: 09/2023
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Evaluation of the Home Health Value-Based Purchasing (HHVBP) Model: Final Report
Evaluates the Home Health Value-Based Purchasing (HHVBP) Model, which tests the impact of providing financial incentives to home health agencies in nine states: Arizona, Florida, Iowa, Massachusetts, Maryland, Nebraska, North Carolina, Tennessee, and Washington. Examines how the financial incentives under the model influenced agency behavior. Describes impacts across key outcomes, including service utilization, quality of care, and patient experience, and examines the model's effects on access to care, health equity, and Medicare spending. Explores whether the model had unique impacts on access to home health care in rural areas.
Additional links: Appendices, Findings at a Glance
Date: 09/2023
Sponsoring organizations: Arbor Research Collaborative for Health, Centers for Medicare and Medicaid Services, L&M Policy Research
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MedPAC Comment on CMS's Proposed Rule on the Outpatient Prospective Payment System for FY 2024
Comment on the July 31, 2023, Federal Register proposed rule revising the physician fee schedule to improve Medicare Hospital Outpatient Prospective Payment System (OPPS) and Medicare Ambulatory Surgical Center (ACS) payments for calendar year 2024. Includes discussions on extending the use of the hospital market basket to update ASC payment rates, a proposed quality measure for emergency department visits in Rural Emergency Hospitals (REHs), and more.
Date: 09/2023
Sponsoring organization: Medicare Payment Advisory Commission
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Year Three Evaluation Report: Evaluation of the EMS Supplemental Funding Grants
Provides an overview of the eight Flex Program Emergency Medical Services (EMS) Supplemental funding grant recipients, including a summary of the project goals, partners, and outcome measures. Details each grantee's project accomplishments, lessons learned, and sustainability strategies.
Author(s): John Gale, Karen Pearson
Date: 09/2023
Sponsoring organization: Flex Monitoring Team
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