Rural Health
Resources by Topic: Medicare
Merit-based Incentive Payment System (MIPS): 2024 What's New for Small Practices
Summarizes new elements of the Merit-based Incentive Payment System (MIPS) for small practices - a group of 15 or fewer clinicians billing under a practice's Taxpayer Identification Number (TIN) - during the 2024 performance year. Discusses changes to performance category requirements and flexibilities, new MIPS Value Pathways (MVPs), and performance threshold and payment adjustments. Includes information on performance category redistribution policies for small practices.
Date: 09/2024
Sponsoring organization: Centers for Medicare and Medicaid Services
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Summarizes new elements of the Merit-based Incentive Payment System (MIPS) for small practices - a group of 15 or fewer clinicians billing under a practice's Taxpayer Identification Number (TIN) - during the 2024 performance year. Discusses changes to performance category requirements and flexibilities, new MIPS Value Pathways (MVPs), and performance threshold and payment adjustments. Includes information on performance category redistribution policies for small practices.
Date: 09/2024
Sponsoring organization: Centers for Medicare and Medicaid Services
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Medicare Billing for Telehealth Encounters: An Introductory Guide on Fee-for-Service
Presents an overview of how to bill fee-for-service Medicare and Medicaid for telehealth encounters. Includes information on originating and distant sites, virtual healthcare, and coding telehealth services. Lists types of practice sites, including Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs), and implications for billing telehealth services. Provides contact information for Regional Telehealth Research Centers (RTRC).
Date: 09/2024
Sponsoring organization: Center for Connected Health Policy: The National Telehealth Policy Resource Center
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Presents an overview of how to bill fee-for-service Medicare and Medicaid for telehealth encounters. Includes information on originating and distant sites, virtual healthcare, and coding telehealth services. Lists types of practice sites, including Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs), and implications for billing telehealth services. Provides contact information for Regional Telehealth Research Centers (RTRC).
Date: 09/2024
Sponsoring organization: Center for Connected Health Policy: The National Telehealth Policy Resource Center
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Medicare Benefit Policy Manual: Chapter 13 - Rural Health Clinic (RHC) and Federally Qualified Health Center (FQHC) Services
Current regulations, as of January 2023, regarding Medicare payment policies for Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs).
Date: 09/2024
Sponsoring organization: Centers for Medicare and Medicaid Services
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Current regulations, as of January 2023, regarding Medicare payment policies for Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs).
Date: 09/2024
Sponsoring organization: Centers for Medicare and Medicaid Services
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Predictors of Telehealth Use after the Minnesota Telehealth Act: Analysis Using the Minnesota All Payer Claims Database
Examines factors contributing to telehealth use among commercially insured and Medicare Advantage patients in Minnesota. Factors evaluated include age, sex, various chronic health conditions, rurality, broadband access, and more.
Author(s): Arkadipta Ghosh, Ethan Jacobs, Elizabeth Greener, et al.
Citation: Health Affairs Scholar, 2(8)
Date: 08/2024
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Examines factors contributing to telehealth use among commercially insured and Medicare Advantage patients in Minnesota. Factors evaluated include age, sex, various chronic health conditions, rurality, broadband access, and more.
Author(s): Arkadipta Ghosh, Ethan Jacobs, Elizabeth Greener, et al.
Citation: Health Affairs Scholar, 2(8)
Date: 08/2024
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MedPAC Comment on CMS's Proposed Rule on the Payment System for End-Stage Renal Disease for CY 2025
Comments on a July 5, 2024, Federal Register proposed rule related to Medicare payment policies for end-stage renal disease (ESRD). Includes comments addressing modifications to the outlier policy, updates to the low-volume payment adjustment (LVPA), and updates to the wage index methodology.
Date: 08/2024
Sponsoring organization: Medicare Payment Advisory Commission
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Comments on a July 5, 2024, Federal Register proposed rule related to Medicare payment policies for end-stage renal disease (ESRD). Includes comments addressing modifications to the outlier policy, updates to the low-volume payment adjustment (LVPA), and updates to the wage index methodology.
Date: 08/2024
Sponsoring organization: Medicare Payment Advisory Commission
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MedPAC Comment on CMS's Proposed Rule on the Home Health Prospective Payment System for CY 2025
Comments on a July 3, 2024, Federal Register proposed rule related to Medicare payment policies for home health agencies. Includes comments regarding permanent and temporary budget-neutrality adjustments, the plan of care development and scope of services home health patients receive, and the proposed adoption of the core-based statistical area (CBSA) delineations for the home health wage index.
Date: 08/2024
Sponsoring organization: Medicare Payment Advisory Commission
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Comments on a July 3, 2024, Federal Register proposed rule related to Medicare payment policies for home health agencies. Includes comments regarding permanent and temporary budget-neutrality adjustments, the plan of care development and scope of services home health patients receive, and the proposed adoption of the core-based statistical area (CBSA) delineations for the home health wage index.
Date: 08/2024
Sponsoring organization: Medicare Payment Advisory Commission
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Access in Brief: Seniors and Adults with Physical Disabilities
Explores access to Medicaid-funded long-term services and supports (LTSS) among Medicaid beneficiaries age 65 and older and Medicaid beneficiaries aged 18-64 with physical disabilities. Describes the demographics, health status, service use, and experiences with Medicaid home and community-based services (HCBS) of these Medicaid beneficiaries using data from the 2017-2018 National Core Indicators Aging and Disabilities (NCI-AD) Adult Consumer Survey. Presents data by race and ethnicity, dually eligible status, and age.
Date: 08/2024
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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Explores access to Medicaid-funded long-term services and supports (LTSS) among Medicaid beneficiaries age 65 and older and Medicaid beneficiaries aged 18-64 with physical disabilities. Describes the demographics, health status, service use, and experiences with Medicaid home and community-based services (HCBS) of these Medicaid beneficiaries using data from the 2017-2018 National Core Indicators Aging and Disabilities (NCI-AD) Adult Consumer Survey. Presents data by race and ethnicity, dually eligible status, and age.
Date: 08/2024
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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Voice of the REH CEO: Perspectives from Those Who Have Led Their Organizations Through REH Conversion
Summarizes interviews with executives from three hospitals that converted to Rural Emergency Hospital (REH) status regarding their perspectives on conversion. Describes the assessment of the financial feasibility of REH status, preparation of the communities for conversion, staffing and service line adjustments, and the impact of conversion. Includes legislative considerations that could make REH status more attractive to rural hospitals.
Author(s): Hope Burch, Tracey Dorff, Anna Anna, Janice Walters
Date: 08/2024
Sponsoring organization: Rural Health Redesign Center
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Summarizes interviews with executives from three hospitals that converted to Rural Emergency Hospital (REH) status regarding their perspectives on conversion. Describes the assessment of the financial feasibility of REH status, preparation of the communities for conversion, staffing and service line adjustments, and the impact of conversion. Includes legislative considerations that could make REH status more attractive to rural hospitals.
Author(s): Hope Burch, Tracey Dorff, Anna Anna, Janice Walters
Date: 08/2024
Sponsoring organization: Rural Health Redesign Center
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Medicare Advantage in 2024: Enrollment Update and Key Trends
Explores trends related to the growth of the Medicare Advantage (MA) program. Provides statistics on MA enrollment, the types of plans in which beneficiaries are enrolled, and geographic variation. Includes interactive maps that display MA penetration rates by state and county.
Author(s): Meredith Freed, Jeannie Fuglesten Biniek, Anthony Damico, Tricia Neuman
Date: 08/2024
Sponsoring organization: KFF
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Explores trends related to the growth of the Medicare Advantage (MA) program. Provides statistics on MA enrollment, the types of plans in which beneficiaries are enrolled, and geographic variation. Includes interactive maps that display MA penetration rates by state and county.
Author(s): Meredith Freed, Jeannie Fuglesten Biniek, Anthony Damico, Tricia Neuman
Date: 08/2024
Sponsoring organization: KFF
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FY 2025 Hospital Inpatient Prospective Payment System (IPPS) and Long-Term Care Hospital Prospective Payment System (LTCH PPS) Final Rule – CMS-1808-F
Fact sheet providing an overview of the Centers for Medicare & Medicaid Services (CMS) fiscal year 2025 hospital inpatient prospective payment system (IPPS) and long-term care hospital prospective payment system (LTCH PPS) final rule. Includes information about the extension of the low-wage index hospital policy, a separate IPPS payment for small and independent hospitals to establish and maintain a buffer stock of essential medicines, the distribution of graduate medical education (GME) residency slots, updates to quality reporting programs, and more.
Date: 08/2024
Sponsoring organization: Centers for Medicare and Medicaid Services
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Fact sheet providing an overview of the Centers for Medicare & Medicaid Services (CMS) fiscal year 2025 hospital inpatient prospective payment system (IPPS) and long-term care hospital prospective payment system (LTCH PPS) final rule. Includes information about the extension of the low-wage index hospital policy, a separate IPPS payment for small and independent hospitals to establish and maintain a buffer stock of essential medicines, the distribution of graduate medical education (GME) residency slots, updates to quality reporting programs, and more.
Date: 08/2024
Sponsoring organization: Centers for Medicare and Medicaid Services
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