Rural Health
Resources by Topic: Healthcare quality
Organizational Challenges to Improving Quality of Care in Indian Health Service Hospitals
Identifies organizational issues hindering the Indian Health Service (IHS) from improving the management of IHS hospitals. Discusses concerns related to formal structure, policies and roles; awareness of hospital performance and problems; and IHS officials' confidence in the agency's ability to make sustained improvements. Recommends strategies for improvement.
Author(s): Suzanne Murrin
Date: 08/2019
Sponsoring organization: Office of Inspector General (HHS)
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Identifies organizational issues hindering the Indian Health Service (IHS) from improving the management of IHS hospitals. Discusses concerns related to formal structure, policies and roles; awareness of hospital performance and problems; and IHS officials' confidence in the agency's ability to make sustained improvements. Recommends strategies for improvement.
Author(s): Suzanne Murrin
Date: 08/2019
Sponsoring organization: Office of Inspector General (HHS)
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Impact of Rural and Urban Hospital Closures on Inpatient Mortality
Examines the impact of California's hospital closures from 1995-2011 on adjusted inpatient mortality for sepsis, stroke, asthma/chronic obstructive pulmonary disease, and acute myocardial infarction. Features statistics including the number of closures by year, patient demographics with breakdowns by urban or rural location, and differential impacts of rural and urban closures with breakdowns by condition.
Author(s): Kritee Gujral, Anirban Basu
Citation: NBER Working Paper Series, Working Paper 26182
Date: 08/2019
Sponsoring organization: National Bureau of Economic Research
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Examines the impact of California's hospital closures from 1995-2011 on adjusted inpatient mortality for sepsis, stroke, asthma/chronic obstructive pulmonary disease, and acute myocardial infarction. Features statistics including the number of closures by year, patient demographics with breakdowns by urban or rural location, and differential impacts of rural and urban closures with breakdowns by condition.
Author(s): Kritee Gujral, Anirban Basu
Citation: NBER Working Paper Series, Working Paper 26182
Date: 08/2019
Sponsoring organization: National Bureau of Economic Research
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Patient Experience and Function, Fall 2018 Cycle: CDP Report
Evaluates 5 new measures related to patient function and experience of care and supports using them for quality improvement efforts and public reporting. Measures focus on care coordination, particularly following discharge in order to reduce hospital readmissions. Includes Critical Access Hospitals under acute care hospitals, with exclusions for swing bed stays.
Date: 08/2019
Sponsoring organization: National Quality Forum
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Evaluates 5 new measures related to patient function and experience of care and supports using them for quality improvement efforts and public reporting. Measures focus on care coordination, particularly following discharge in order to reduce hospital readmissions. Includes Critical Access Hospitals under acute care hospitals, with exclusions for swing bed stays.
Date: 08/2019
Sponsoring organization: National Quality Forum
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Geriatrics and Palliative Care, Fall 2018 Cycle: CDP Report
Evaluates 5 quality measures related to geriatrics and palliative care and supports using them for quality improvement efforts and reporting programs. The measures include 1) improvement in ambulation/locomotion; 2) improvement in bathing; 3) improvement in bed transferring; 4) improvement in management of oral medication; and 5) improvement in pain interfering with activity. The measures were not risk-adjusted for rurality.
Date: 08/2019
Sponsoring organization: National Quality Forum
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Evaluates 5 quality measures related to geriatrics and palliative care and supports using them for quality improvement efforts and reporting programs. The measures include 1) improvement in ambulation/locomotion; 2) improvement in bathing; 3) improvement in bed transferring; 4) improvement in management of oral medication; and 5) improvement in pain interfering with activity. The measures were not risk-adjusted for rurality.
Date: 08/2019
Sponsoring organization: National Quality Forum
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Developing Risk-Adjusted Avoidable Hospitalizations and Emergency Department Visits Quality Measures: Final Report
Defines avoidable hospitalization (AH) and avoidable emergency department (ED) visits (AVs) and summarizes the development of a model for calculating expected AH and AV rates using Medicare claims data. Seeks to inform Medicare quality payment models and target areas for quality improvement. Table 3-10 includes AH and AV risk-standardized rates for a number of rural market areas.
Author(s): Zhanlian Feng, Benjamin Silver, Micah Segelman, et al.
Date: 08/2019
Sponsoring organizations: Medicare Payment Advisory Commission, RTI International
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Defines avoidable hospitalization (AH) and avoidable emergency department (ED) visits (AVs) and summarizes the development of a model for calculating expected AH and AV rates using Medicare claims data. Seeks to inform Medicare quality payment models and target areas for quality improvement. Table 3-10 includes AH and AV risk-standardized rates for a number of rural market areas.
Author(s): Zhanlian Feng, Benjamin Silver, Micah Segelman, et al.
Date: 08/2019
Sponsoring organizations: Medicare Payment Advisory Commission, RTI International
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Accelerating Value-Based Payment in California's Federally Qualified Health Centers: Options for Medicaid Health Plans
Highlights examples of value-based payment (VBP) models for Federally Qualified Health Centers (FQHCs), including a rural Hawaii model and a Colorado model that incorporates rural FQHCs. Covers Accountable Care Organization (ACO) models, state-led Capitated Alternative Payment Models (APMs), state-led quality payment adjustments, and Medicaid shared savings ACO models. Addresses how FQHCs and health plans can overcome challenges when launching new VBP models and offers recommendations for California's health plans.
Author(s): Greg Howe, Tricia McGinnis, Rob Houston
Date: 08/2019
Sponsoring organization: Center for Health Care Strategies
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Highlights examples of value-based payment (VBP) models for Federally Qualified Health Centers (FQHCs), including a rural Hawaii model and a Colorado model that incorporates rural FQHCs. Covers Accountable Care Organization (ACO) models, state-led Capitated Alternative Payment Models (APMs), state-led quality payment adjustments, and Medicaid shared savings ACO models. Addresses how FQHCs and health plans can overcome challenges when launching new VBP models and offers recommendations for California's health plans.
Author(s): Greg Howe, Tricia McGinnis, Rob Houston
Date: 08/2019
Sponsoring organization: Center for Health Care Strategies
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Department of Health Care Services: It Has Not Ensured That Medi-Cal Beneficiaries in Some Rural Counties Have Reasonable Access to Care
Findings from a study to determine whether rural beneficiaries of the Medi-Cal Regional Model health plan were given acceptable access to care and adequate quality of care after the state transitioned into managed care plans in 2013. Includes county-level map showing Medi-Cal Managed Care Models and statistics showing maximum distance required to access care, with breakdowns by provider type.
Author(s): Elaine M. Howle
Citation: California State Auditor Report 2018-122
Date: 08/2019
Sponsoring organization: Auditor of the State of California
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Findings from a study to determine whether rural beneficiaries of the Medi-Cal Regional Model health plan were given acceptable access to care and adequate quality of care after the state transitioned into managed care plans in 2013. Includes county-level map showing Medi-Cal Managed Care Models and statistics showing maximum distance required to access care, with breakdowns by provider type.
Author(s): Elaine M. Howle
Citation: California State Auditor Report 2018-122
Date: 08/2019
Sponsoring organization: Auditor of the State of California
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ACOs' Strategies for Transitioning to Value-Based Care: Lessons From the Medicare Shared Savings Program
Describes strategies used by successful Accountable Care Organizations (ACOs) to reduce spending and increase healthcare quality. Addresses social determinants of health, behavioral health, reducing hospitalizations, using technology to share information, and more. Two of the 20 ACOs included in the study served rural communities.
Date: 07/2019
Sponsoring organization: Office of Inspector General (HHS)
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Describes strategies used by successful Accountable Care Organizations (ACOs) to reduce spending and increase healthcare quality. Addresses social determinants of health, behavioral health, reducing hospitalizations, using technology to share information, and more. Two of the 20 ACOs included in the study served rural communities.
Date: 07/2019
Sponsoring organization: Office of Inspector General (HHS)
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Solutions to Reduce Fraud, Waste, and Abuse in HHS Programs: OIG's Top Recommendations
Annual report identifying the top 25 unimplemented recommendations from the Office of Inspector General (OIG) that, in their view, would have the most substantial positive impact on Health and Human Services (HHS) programs. Positive impact may refer to cost savings, program efficacy and efficiency, and/or quality improvement. Primary areas of interest in the July 2019 edition include: reforming the hospital wage index system, a quality program and disaster planning for Indian Health Service (IHS) hospitals, and Medicaid payments for 340B drugs.
Date: 07/2019
Sponsoring organization: Office of Inspector General (HHS)
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Annual report identifying the top 25 unimplemented recommendations from the Office of Inspector General (OIG) that, in their view, would have the most substantial positive impact on Health and Human Services (HHS) programs. Positive impact may refer to cost savings, program efficacy and efficiency, and/or quality improvement. Primary areas of interest in the July 2019 edition include: reforming the hospital wage index system, a quality program and disaster planning for Indian Health Service (IHS) hospitals, and Medicaid payments for 340B drugs.
Date: 07/2019
Sponsoring organization: Office of Inspector General (HHS)
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Rosebud Hospital: Indian Health Service Management of Emergency Department Closure and Reopening, A Case Study
Examines management of Indian Health Services (IHS) closure of Rosebud Hospital in South Dakota and its reopening to identify lessons learned. Addresses reasons for hospital closure, the impact of the closure, corrective actions taken following its reopening, and issues with sustaining improvements and compliance. Supports developing procedures for temporary emergency department closures and investing in rural workforce recruitment, retention, and training, among other recommendations.
Date: 07/2019
Sponsoring organization: Office of Inspector General (HHS)
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Examines management of Indian Health Services (IHS) closure of Rosebud Hospital in South Dakota and its reopening to identify lessons learned. Addresses reasons for hospital closure, the impact of the closure, corrective actions taken following its reopening, and issues with sustaining improvements and compliance. Supports developing procedures for temporary emergency department closures and investing in rural workforce recruitment, retention, and training, among other recommendations.
Date: 07/2019
Sponsoring organization: Office of Inspector General (HHS)
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