Rural Health
Resources by Topic: Hospitals
Evaluation of the Use of CAH Cohorts for Quality Improvement Activities
Describes how State Flex Programs (SFPs) use cohorts of Critical Access Hospitals (CAHs) in quality improvement initiatives. Discusses the benefits and challenges of CAH cohorts, how SFPs are evaluating the impact of these initiatives, and opportunities to enhance the use of cohorts in Flex Program activities. Includes findings from interviews with six SFPs.
Author(s): John Gale, Celia Jewell, Sara Kahn-Troster, Nathan First
Date: 03/2021
Type: Document
Sponsoring organization: Flex Monitoring Team
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Describes how State Flex Programs (SFPs) use cohorts of Critical Access Hospitals (CAHs) in quality improvement initiatives. Discusses the benefits and challenges of CAH cohorts, how SFPs are evaluating the impact of these initiatives, and opportunities to enhance the use of cohorts in Flex Program activities. Includes findings from interviews with six SFPs.
Author(s): John Gale, Celia Jewell, Sara Kahn-Troster, Nathan First
Date: 03/2021
Type: Document
Sponsoring organization: Flex Monitoring Team
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MedPAC Report to the Congress: Medicare Payment Policy, 2021
Annual review of Medicare payment policies, with recommendations to Congress. Includes discussion on Medicare payment policies directly affecting rural providers and beneficiaries. Addresses payment adequacy for healthcare facilities and services, improving Medicare payment for post-acute care, Medicare Advantage, Medicare Part D, and the impact of healthcare provider consolidation. Contains information on the effects of the COVID-19 pandemic on Medicare beneficiary healthcare access, mortality, and service use. Presents an option for Medicare's coverage of telehealth beyond the public health emergency.
Date: 03/2021
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Annual review of Medicare payment policies, with recommendations to Congress. Includes discussion on Medicare payment policies directly affecting rural providers and beneficiaries. Addresses payment adequacy for healthcare facilities and services, improving Medicare payment for post-acute care, Medicare Advantage, Medicare Part D, and the impact of healthcare provider consolidation. Contains information on the effects of the COVID-19 pandemic on Medicare beneficiary healthcare access, mortality, and service use. Presents an option for Medicare's coverage of telehealth beyond the public health emergency.
Date: 03/2021
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Report to Congress on Medicaid and CHIP, March 2021
Reports on five aspects of Medicaid: 1) improving Medicaid's responsiveness during economic downturns; 2) addressing concerns about high rates of maternal morbidity and mortality; 3) reexamining Medicaid's estate recovery policies; 4) integrating care for people who are dually eligible for Medicaid and Medicare; and 5) improving hospital payment policy for the nation's safety-net hospitals. Chapter 5 examines the relationship between disproportionate share hospital (DSH) allotments to states and the number of uninsured individuals, the amounts and sources of hospitals' uncompensated care costs, and the amounts and sources of hospitals' uncompensated care costs. Table 5-1 details DSH spending for urban and rural hospitals and for Critical Access Hospitals.
Date: 03/2021
Type: Document
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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Reports on five aspects of Medicaid: 1) improving Medicaid's responsiveness during economic downturns; 2) addressing concerns about high rates of maternal morbidity and mortality; 3) reexamining Medicaid's estate recovery policies; 4) integrating care for people who are dually eligible for Medicaid and Medicare; and 5) improving hospital payment policy for the nation's safety-net hospitals. Chapter 5 examines the relationship between disproportionate share hospital (DSH) allotments to states and the number of uninsured individuals, the amounts and sources of hospitals' uncompensated care costs, and the amounts and sources of hospitals' uncompensated care costs. Table 5-1 details DSH spending for urban and rural hospitals and for Critical Access Hospitals.
Date: 03/2021
Type: Document
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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Innovations and Workforce Challenges for CAHs during COVID-19
Presents results from a survey of Critical Access Hospitals (CAHs) on hospital operation and workforce adaptations in response to the COVID-19 pandemic. Discusses innovative practices adopted by CAHs related to hospital processes and clinical care. Describes how CAHs overcame workforce challenges during COVID-19.
Author(s): Madeleine Pick, Megan Lahr, Keelia Silvis, Ira Moscovice
Date: 03/2021
Type: Document
Sponsoring organization: Flex Monitoring Team
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Presents results from a survey of Critical Access Hospitals (CAHs) on hospital operation and workforce adaptations in response to the COVID-19 pandemic. Discusses innovative practices adopted by CAHs related to hospital processes and clinical care. Describes how CAHs overcame workforce challenges during COVID-19.
Author(s): Madeleine Pick, Megan Lahr, Keelia Silvis, Ira Moscovice
Date: 03/2021
Type: Document
Sponsoring organization: Flex Monitoring Team
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Medicare Hospital Payments: Adjusting for Variation in Geographic Area Wages
Provides an overview of the use of the hospital wage index applied to the Medicare inpatient prospective payment system (IPPS) to account for geographic differences in hospitals' labor costs. Discusses the effect of the wage index on Medicare payments for inpatient hospital services, exceptions to wage index adjustments, and proposals for wage index reforms.
Date: 03/2021
Type: Document
Sponsoring organization: Congressional Research Service
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Provides an overview of the use of the hospital wage index applied to the Medicare inpatient prospective payment system (IPPS) to account for geographic differences in hospitals' labor costs. Discusses the effect of the wage index on Medicare payments for inpatient hospital services, exceptions to wage index adjustments, and proposals for wage index reforms.
Date: 03/2021
Type: Document
Sponsoring organization: Congressional Research Service
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The Effect of Medicare Payment Standardization Methods on the Perceived Cost of Post-Acute Swing Bed Care in Critical Access Hospitals
Discusses the different payment systems the Centers for Medicare and Medicaid Services (CMS) uses to reimburse for post-acute care in Critical Access Hospitals (CAHs), prospective payment system (IPPS) hospitals, and skilled nursing facilities (SNFs). Describes how the payment standardization methods may influence post-acute care discharge patterns and access to care for rural residents. Examines the effects of these payment methods on the perceived cost of CAH swing bed care as it relates to the Medicare Spending per Beneficiary performance measure.
Author(s): Tyler Malone, Denise Kirk, Kristin Reiter
Date: 03/2021
Type: Document
Sponsoring organization: North Carolina Rural Health Research Program
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Discusses the different payment systems the Centers for Medicare and Medicaid Services (CMS) uses to reimburse for post-acute care in Critical Access Hospitals (CAHs), prospective payment system (IPPS) hospitals, and skilled nursing facilities (SNFs). Describes how the payment standardization methods may influence post-acute care discharge patterns and access to care for rural residents. Examines the effects of these payment methods on the perceived cost of CAH swing bed care as it relates to the Medicare Spending per Beneficiary performance measure.
Author(s): Tyler Malone, Denise Kirk, Kristin Reiter
Date: 03/2021
Type: Document
Sponsoring organization: North Carolina Rural Health Research Program
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CAH Partnerships During the COVID-19 Pandemic
Presents findings from a survey of Critical Access Hospitals (CAHs) in eight states on how they partnered with communities and public health agencies in response to the COVID-19 pandemic. Discusses the type of support CAHs received from their State Flex Program (SFP).
Author(s): Madeleine Pick, Megan Lahr, Keelia Silvis, Ira Moscovice
Date: 03/2021
Type: Document
Sponsoring organization: Flex Monitoring Team
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Presents findings from a survey of Critical Access Hospitals (CAHs) in eight states on how they partnered with communities and public health agencies in response to the COVID-19 pandemic. Discusses the type of support CAHs received from their State Flex Program (SFP).
Author(s): Madeleine Pick, Megan Lahr, Keelia Silvis, Ira Moscovice
Date: 03/2021
Type: Document
Sponsoring organization: Flex Monitoring Team
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Trends in the Utilization of Emergency Department Services, 2009-2018
Examines emergency department (ED) utilization. Explores ED visits resulting in hospital admission, visits ending in release, and visits associated with mental health or substance use disorder diagnoses. Presents information on the patient, hospital, and payer characteristics for each of these three categories, including metropolitan status. Describes federal efforts to discourage inappropriate ED use.
Date: 03/2021
Type: Document
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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Examines emergency department (ED) utilization. Explores ED visits resulting in hospital admission, visits ending in release, and visits associated with mental health or substance use disorder diagnoses. Presents information on the patient, hospital, and payer characteristics for each of these three categories, including metropolitan status. Describes federal efforts to discourage inappropriate ED use.
Date: 03/2021
Type: Document
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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Monitoring State Flex Program Financial and Operational Improvement Activities
Presents the results of a qualitative evaluation of State Flex Program interventions implemented under Program Area 2: Financial and Operational Improvement (FOI). Describes the type of projects proposed by a subset of 14 State Flex Programs, key themes, and challenges faced to monitoring and documenting these interventions on financial and operational performance. Includes an inventory of all 45 State Flex Program FOI initiatives.
Author(s): John Gale, Sara Kahn-Troster, Zachariah Croll, Nathan First
Date: 03/2021
Type: Document
Sponsoring organization: Flex Monitoring Team
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Presents the results of a qualitative evaluation of State Flex Program interventions implemented under Program Area 2: Financial and Operational Improvement (FOI). Describes the type of projects proposed by a subset of 14 State Flex Programs, key themes, and challenges faced to monitoring and documenting these interventions on financial and operational performance. Includes an inventory of all 45 State Flex Program FOI initiatives.
Author(s): John Gale, Sara Kahn-Troster, Zachariah Croll, Nathan First
Date: 03/2021
Type: Document
Sponsoring organization: Flex Monitoring Team
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Rural Initiatives Addressing Community Social Needs
Describes the role of Critical Access Hospitals (CAHs) in improving population health and addressing social needs in their communities. Profiles two Critical Access Hospital social needs programs: Lakewood Health System's food access initiatives in Minnesota, and Northeastern Vermont Regional Hospital's NEK Prosper. Provides an overview of both programs and highlights best practices of each.
Author(s): Madeleine Pick, Megan Lahr, Ira Moscovice
Date: 03/2021
Type: Document
Sponsoring organization: Flex Monitoring Team
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Describes the role of Critical Access Hospitals (CAHs) in improving population health and addressing social needs in their communities. Profiles two Critical Access Hospital social needs programs: Lakewood Health System's food access initiatives in Minnesota, and Northeastern Vermont Regional Hospital's NEK Prosper. Provides an overview of both programs and highlights best practices of each.
Author(s): Madeleine Pick, Megan Lahr, Ira Moscovice
Date: 03/2021
Type: Document
Sponsoring organization: Flex Monitoring Team
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