Rural Health
Resources by Topic: Medicare
Calendar Year (CY) 2015 Rural Health Clinic (RHC) and Federally Qualified Health Centers (FQHC) Updates: Payment Rate Increases for RHCs and FQHCs Billing Under the All-Inclusive Rate System (AIR), and Urban and Rural Designations for FQHCs Billing Under the AIR
Provides updates for RHCs and FQHCs that are submitting claims to Medicare Administrative Contractors (MACs) for services to Medicare beneficiaries.
Date: 12/2024
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Provides updates for RHCs and FQHCs that are submitting claims to Medicare Administrative Contractors (MACs) for services to Medicare beneficiaries.
Date: 12/2024
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Disruptors, Essential Services, and Reflections on a Career in Rural Health, with John Supplitt
An episode of the Exploring Rural Health podcast featuring John Supplitt, Senior Director of Rural Health Services for the American Hospital Association. Focuses on the importance of maintaining rural essential services, along with insights from Supplitt's long career in rural health.
Date: 07/2024
Type: Audio
Sponsoring organization: Rural Health Information Hub
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An episode of the Exploring Rural Health podcast featuring John Supplitt, Senior Director of Rural Health Services for the American Hospital Association. Focuses on the importance of maintaining rural essential services, along with insights from Supplitt's long career in rural health.
Date: 07/2024
Type: Audio
Sponsoring organization: Rural Health Information Hub
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Nurse Staffing Estimates in US Nursing Homes, May 2024
Provides an overview of the Centers for Medicare & Medicaid Services (CMS) April 2024 final rule that established minimum nurse staffing requirements for nursing homes. Analyzes May 2024 data from Nursing Home Care Compare to examine current staffing levels in U.S. nursing homes relative to specific minimum staffing requirements in the final rule. Includes an illustrative example of a 100-bed facility to explore how many nurse staff would need to be added per shift during the final rule's implementation phase to meet or exceed the final rule's minimum requirements. Presents data by facility characteristics, including ownership type, rural or urban location, and bed size.
Author(s): Martin Blanco, Iara Oliveira, Marie Squillace, Damian Da Costa
Date: 06/2024
Type: Document
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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Provides an overview of the Centers for Medicare & Medicaid Services (CMS) April 2024 final rule that established minimum nurse staffing requirements for nursing homes. Analyzes May 2024 data from Nursing Home Care Compare to examine current staffing levels in U.S. nursing homes relative to specific minimum staffing requirements in the final rule. Includes an illustrative example of a 100-bed facility to explore how many nurse staff would need to be added per shift during the final rule's implementation phase to meet or exceed the final rule's minimum requirements. Presents data by facility characteristics, including ownership type, rural or urban location, and bed size.
Author(s): Martin Blanco, Iara Oliveira, Marie Squillace, Damian Da Costa
Date: 06/2024
Type: Document
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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Evaluation of the Vermont All-Payer Accountable Care Organization Model: 2018-2022 - Fourth Evaluation Report
Evaluates the first five performance years of the Vermont All-Payer Accountable Care Organization Model (VTAPM), which aims to assess whether scaling an Accountable Care Organization (ACO) across all payers in the state can reduce program expenditures while preserving or improving care quality. Discusses the implementation of the model, provider engagement, efforts to address population health goals; characteristics of participating hospitals, practitioners, and beneficiaries; and the model's impacts on Medicare spending, utilization, and quality of care. Includes analyses of Medicare ACO subgroups and Medicaid spending, utilization, and quality of care trends. Outlines challenges and lessons learned.
Additional links: Findings at a Glance, Technical Appendices
Date: 06/2024
Type: Document
Sponsoring organizations: Centers for Medicare and Medicaid Services, NORC at the University of Chicago
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Evaluates the first five performance years of the Vermont All-Payer Accountable Care Organization Model (VTAPM), which aims to assess whether scaling an Accountable Care Organization (ACO) across all payers in the state can reduce program expenditures while preserving or improving care quality. Discusses the implementation of the model, provider engagement, efforts to address population health goals; characteristics of participating hospitals, practitioners, and beneficiaries; and the model's impacts on Medicare spending, utilization, and quality of care. Includes analyses of Medicare ACO subgroups and Medicaid spending, utilization, and quality of care trends. Outlines challenges and lessons learned.
Additional links: Findings at a Glance, Technical Appendices
Date: 06/2024
Type: Document
Sponsoring organizations: Centers for Medicare and Medicaid Services, NORC at the University of Chicago
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Health Subcommittee Hearing on Improving Value-Based Care for Patients and Providers
Recording of a June 26, 2024, House Committee on Ways and Means Subcommittee on Health hearing on the challenges and opportunities associated with delivering better health outcomes and Medicare savings through value-based care. Features testimony from Sarah Chouinard, Chief Medical Officer of Main Street Health, regarding value-based care delivery in rural areas.
Additional links: Sarah Chouinard, Main Street Health - Testimony
Date: 06/2024
Type: Video/Multimedia
Sponsoring organization: House Ways and Means Committee, Subcommittee on Health
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Recording of a June 26, 2024, House Committee on Ways and Means Subcommittee on Health hearing on the challenges and opportunities associated with delivering better health outcomes and Medicare savings through value-based care. Features testimony from Sarah Chouinard, Chief Medical Officer of Main Street Health, regarding value-based care delivery in rural areas.
Additional links: Sarah Chouinard, Main Street Health - Testimony
Date: 06/2024
Type: Video/Multimedia
Sponsoring organization: House Ways and Means Committee, Subcommittee on Health
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2018‐23 Profitability of Rural and Urban Hospitals by Medicare Payment Designation
Examines the profitability of rural and urban hospitals according to special Medicare payment designations, including: Critical Access Hospitals (CAHs), Prospective Payment System (PPS) hospitals, Medicare Dependent Hospitals (MDHs), Sole Community Hospitals (SCHs), Rural Referral Centers (RRCs), and Essential Access Community Hospitals (EAC). Utilizes 2018-2023 data to analyze hospital profitability by rural versus urban status and facility/payment type.
Author(s): Sruthi Malavika Srinivasan, Kristie Thompson, George Pink
Date: 06/2024
Type: Document
Sponsoring organization: North Carolina Rural Health Research Program
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Examines the profitability of rural and urban hospitals according to special Medicare payment designations, including: Critical Access Hospitals (CAHs), Prospective Payment System (PPS) hospitals, Medicare Dependent Hospitals (MDHs), Sole Community Hospitals (SCHs), Rural Referral Centers (RRCs), and Essential Access Community Hospitals (EAC). Utilizes 2018-2023 data to analyze hospital profitability by rural versus urban status and facility/payment type.
Author(s): Sruthi Malavika Srinivasan, Kristie Thompson, George Pink
Date: 06/2024
Type: Document
Sponsoring organization: North Carolina Rural Health Research Program
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Rural Health Leaders Overcoming Challenges with Alan Morgan, Kathy Kuepers and Steve Tenhouse
Podcast episode featuring two Critical Access Hospital (CAH) executives discussing factors that influence a rural health organization's growth and vitality, replacement facility projects, and building trust and stakeholder engagement. Also highlights a national partnership addressing rural hospital cybersecurity involving the White House, Google, Microsoft, the American Hospital Association, and the National Rural Health Association.
Date: 06/2024
Type: Audio
Sponsoring organization: Impact! Communications, Inc.
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Podcast episode featuring two Critical Access Hospital (CAH) executives discussing factors that influence a rural health organization's growth and vitality, replacement facility projects, and building trust and stakeholder engagement. Also highlights a national partnership addressing rural hospital cybersecurity involving the White House, Google, Microsoft, the American Hospital Association, and the National Rural Health Association.
Date: 06/2024
Type: Audio
Sponsoring organization: Impact! Communications, Inc.
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Five Things to Know About Medicare Site-Neutral Payment Reforms
Discusses site-neutral payment reforms that seek to align Medicare payments with outpatient services in different settings. Examines benefits and drawbacks of the policy and discusses how the policy would impact rural hospitals.
Author(s): Zachary Levinson, Tricia Neuman, Scott Hulver
Date: 06/2024
Type: Document
Sponsoring organization: KFF
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Discusses site-neutral payment reforms that seek to align Medicare payments with outpatient services in different settings. Examines benefits and drawbacks of the policy and discusses how the policy would impact rural hospitals.
Author(s): Zachary Levinson, Tricia Neuman, Scott Hulver
Date: 06/2024
Type: Document
Sponsoring organization: KFF
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Updated Analysis: Using Population-Based Outcome Measures to Assess the Impact of Telehealth Expansion on Medicare Beneficiaries' Access to Care and Quality of Care
Explores the association between telehealth use, quality of care, and access to care when both telehealth and in-person visits are available to fee-for-service (FFS) Medicare beneficiaries. Compares data from the second half of 2018 and 2019 to the second half of 2022 by the level of telehealth utilization in Hospital Service Areas (HSAs). Describes the effects of telehealth for urban and rural beneficiaries and differentiates between telehealth utilization for behavioral and non-behavioral health services. Updates a June 2023 report that analyzed data from 2021.
Author(s): Tanvi Rao, Angshuman Gooptu, Karin Johnson, Guido Cataife, Steven Susana-Castillo
Date: 06/2024
Type: Document
Sponsoring organizations: American Institutes for Research, Medicare Payment Advisory Commission
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Explores the association between telehealth use, quality of care, and access to care when both telehealth and in-person visits are available to fee-for-service (FFS) Medicare beneficiaries. Compares data from the second half of 2018 and 2019 to the second half of 2022 by the level of telehealth utilization in Hospital Service Areas (HSAs). Describes the effects of telehealth for urban and rural beneficiaries and differentiates between telehealth utilization for behavioral and non-behavioral health services. Updates a June 2023 report that analyzed data from 2021.
Author(s): Tanvi Rao, Angshuman Gooptu, Karin Johnson, Guido Cataife, Steven Susana-Castillo
Date: 06/2024
Type: Document
Sponsoring organizations: American Institutes for Research, Medicare Payment Advisory Commission
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MedPAC Report to the Congress: Medicare and the Health Care Delivery System, June 2024
Evaluates Medicare payment issues and provides recommendations to the U.S. Congress. Covers approaches for updating fee-for-service (FFS) Medicare's physician fee schedule (PFS) payments and incentivizing participation in alternative payment models; provider networks and prior authorization in Medicare Advantage (MA) plans; an assessment of the relative completeness of MA encounter data and other data sources; Medicare coverage and payments for medical software; alternate approaches to lower Medicare payment rates for select conditions in inpatient rehabilitation facilities; and Medicare's Acute Hospital Care at Home program. Includes rural references throughout.
Additional links: Executive Summary
Date: 06/2024
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Evaluates Medicare payment issues and provides recommendations to the U.S. Congress. Covers approaches for updating fee-for-service (FFS) Medicare's physician fee schedule (PFS) payments and incentivizing participation in alternative payment models; provider networks and prior authorization in Medicare Advantage (MA) plans; an assessment of the relative completeness of MA encounter data and other data sources; Medicare coverage and payments for medical software; alternate approaches to lower Medicare payment rates for select conditions in inpatient rehabilitation facilities; and Medicare's Acute Hospital Care at Home program. Includes rural references throughout.
Additional links: Executive Summary
Date: 06/2024
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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