Rural Health
Resources by Topic: Medicare
Medicare Claims Processing Manual Chapter 4 - Part B Hospital (Including Inpatient Hospital Part B and OPPS)
Outlines rules and regulations for processing Medicare Part B hospital claims. Covers special rules for Critical Access Hospital outpatient billing, hospital-based Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs) billing for non-RHC/FQHC services, and payment adjustments for Rural Emergency Hospitals (REHs).
Date: 01/2024
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Outlines rules and regulations for processing Medicare Part B hospital claims. Covers special rules for Critical Access Hospital outpatient billing, hospital-based Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs) billing for non-RHC/FQHC services, and payment adjustments for Rural Emergency Hospitals (REHs).
Date: 01/2024
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Medicare COVID-19 Hospitalization Trends Report
Reports cases and hospitalization data for Medicare beneficiaries diagnosed with COVID-19 between January 1, 2020, and June 30, 2023. Includes data on beneficiary demographics, case and hospitalization trends, and discharge status among beneficiaries hospitalized for COVID-19. Compares COVID-19 case and hospitalization rates by rural and urban status.
Date: 01/2024
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Reports cases and hospitalization data for Medicare beneficiaries diagnosed with COVID-19 between January 1, 2020, and June 30, 2023. Includes data on beneficiary demographics, case and hospitalization trends, and discharge status among beneficiaries hospitalized for COVID-19. Compares COVID-19 case and hospitalization rates by rural and urban status.
Date: 01/2024
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Enhancing Access and Impact of the Medicare Diabetes Prevention Program Using Telehealth: A Narrative Review
Evaluates the viability of telehealth delivery of the Medicare Diabetes Prevention Program (MDPP) via a literature review of telehealth-based disease prevention program research. Discusses clinical effectiveness, feasibility and acceptability, and policies affecting MDPP implementation. Highlights rural-relevant research findings and discusses access benefits of remote delivery.
Author(s): Natalie D. Ritchie, Melanie T. Turk
Citation: mHealth, 10, 10
Date: 12/2023
Type: Document
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Evaluates the viability of telehealth delivery of the Medicare Diabetes Prevention Program (MDPP) via a literature review of telehealth-based disease prevention program research. Discusses clinical effectiveness, feasibility and acceptability, and policies affecting MDPP implementation. Highlights rural-relevant research findings and discusses access benefits of remote delivery.
Author(s): Natalie D. Ritchie, Melanie T. Turk
Citation: mHealth, 10, 10
Date: 12/2023
Type: Document
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Medicare Advantage Growth and Its Impact on Rural Health Care
Policy position paper regarding the impact of the increase of Medicare Advantage (MA) enrollment in rural areas on healthcare access, delivery, and financial viability. Offers policy recommendations to support rural MA beneficiaries, healthcare providers, and hospitals at a local level, as well as rural healthcare provision within the MA framework.
Author(s): Carrie Shaver, Kevin Lambing, Lisa Rantz
Date: 12/2023
Type: Document
Sponsoring organization: National Rural Health Association
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Policy position paper regarding the impact of the increase of Medicare Advantage (MA) enrollment in rural areas on healthcare access, delivery, and financial viability. Offers policy recommendations to support rural MA beneficiaries, healthcare providers, and hospitals at a local level, as well as rural healthcare provision within the MA framework.
Author(s): Carrie Shaver, Kevin Lambing, Lisa Rantz
Date: 12/2023
Type: Document
Sponsoring organization: National Rural Health Association
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December 2023 MedPAC Meeting Transcript
Transcript from the Medicare Payment Advisory Commission's (MedPAC) December 2023 meeting. Covers payment adequacy and updates for physician and other health professional services, hospital inpatient and outpatient services, hospice services, outpatient dialysis services, ambulatory surgical center services, skilled nursing facilities, skilled nursing facility services, home health services, and inpatient rehabilitation facility services. Includes rural references throughout.
Date: 12/2023
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Transcript from the Medicare Payment Advisory Commission's (MedPAC) December 2023 meeting. Covers payment adequacy and updates for physician and other health professional services, hospital inpatient and outpatient services, hospice services, outpatient dialysis services, ambulatory surgical center services, skilled nursing facilities, skilled nursing facility services, home health services, and inpatient rehabilitation facility services. Includes rural references throughout.
Date: 12/2023
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Merit-Based Incentive Payment System (MIPS): 2024 Reporting MIPS Quality Measures through Medicare Part B Claims Quick Start Guide for Small Practices
Provides details on how small practices can report quality measures through Medicare Part B claims measures. Highlights changes to these measures in 2024, score redistribution policies for small practices, and information for clinicians at Critical Access Hospitals.
Date: 12/2023
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Provides details on how small practices can report quality measures through Medicare Part B claims measures. Highlights changes to these measures in 2024, score redistribution policies for small practices, and information for clinicians at Critical Access Hospitals.
Date: 12/2023
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Alternative Payment Models in the Quality Payment Program as of December 2023
A set of three tables that list brief information about Alternative Payment Models (APMs) that the Centers for Medicare and Medicaid Services (CMS) operates or has announced, as of December 2023. Identifies Advanced APMs, Merit Based Incentive Program (MIPs) APMs, and Other Payer Advanced APMs, which include Medicaid Other Payer Advanced APMs, Medicare Health Plan Payment Arrangements, and commercial payment arrangements.
Date: 12/2023
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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A set of three tables that list brief information about Alternative Payment Models (APMs) that the Centers for Medicare and Medicaid Services (CMS) operates or has announced, as of December 2023. Identifies Advanced APMs, Merit Based Incentive Program (MIPs) APMs, and Other Payer Advanced APMs, which include Medicaid Other Payer Advanced APMs, Medicare Health Plan Payment Arrangements, and commercial payment arrangements.
Date: 12/2023
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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NHPCO Facts and Figures: 2023 Edition
Provides an overview of hospice and palliative care in the United States. Includes information and data on patient characteristics, access to care, reimbursement, barriers and facilitators to care, quality of care, and more. Includes rural references throughout.
Date: 12/2023
Type: Document
Sponsoring organization: National Hospice and Palliative Care Organization
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Provides an overview of hospice and palliative care in the United States. Includes information and data on patient characteristics, access to care, reimbursement, barriers and facilitators to care, quality of care, and more. Includes rural references throughout.
Date: 12/2023
Type: Document
Sponsoring organization: National Hospice and Palliative Care Organization
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Independent Evaluation of Comprehensive Primary Care Plus (CPC+): Final Annual Report
Reports on the Comprehensive Primary Care Plus (CPC+) model, a CMS primary care payment and delivery reform effort that ran from 2017-2021. Outlines key findings from the model, including CPC+ supports to practices, care delivery changes made by practices, impacts on outcomes for Medicare fee-for-service beneficiaries, and implications for primary care models. Describes the experiences of payers, practices, health IT vendors, and patients. Includes rural references throughout.
Additional links: Appendices to the Final Report, Volume 1, Appendices to the Final Report, Volume 2, Findings at a Glance
Date: 12/2023
Type: Document
Sponsoring organizations: Centers for Medicare and Medicaid Services, Mathematica
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Reports on the Comprehensive Primary Care Plus (CPC+) model, a CMS primary care payment and delivery reform effort that ran from 2017-2021. Outlines key findings from the model, including CPC+ supports to practices, care delivery changes made by practices, impacts on outcomes for Medicare fee-for-service beneficiaries, and implications for primary care models. Describes the experiences of payers, practices, health IT vendors, and patients. Includes rural references throughout.
Additional links: Appendices to the Final Report, Volume 1, Appendices to the Final Report, Volume 2, Findings at a Glance
Date: 12/2023
Type: Document
Sponsoring organizations: Centers for Medicare and Medicaid Services, Mathematica
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A Snapshot of Sources of Coverage Among Medicare Beneficiaries
Examines the sources of healthcare and supplemental insurance coverage among Medicare beneficiaries in 2021. Presents data on the sources of coverage by beneficiary characteristics, including health status, metropolitan status, and income.
Author(s): Nancy Ochieng, Gabrielle Clerveau, Juliette Cubanski, Tricia Neuman
Date: 12/2023
Type: Document
Sponsoring organization: KFF
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Examines the sources of healthcare and supplemental insurance coverage among Medicare beneficiaries in 2021. Presents data on the sources of coverage by beneficiary characteristics, including health status, metropolitan status, and income.
Author(s): Nancy Ochieng, Gabrielle Clerveau, Juliette Cubanski, Tricia Neuman
Date: 12/2023
Type: Document
Sponsoring organization: KFF
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