Rural Health
Resources by Topic: Medicare
Market Saturation and Utilization State-County
Provides an interactive map and access to information on national, state and county-level, and Core-Based Statistical Area (CBSA)-level provider services and utilization based on Medicare claims data. Includes the following services: ambulance, hospice, home health, long-term care, Federally Qualified Health Centers (FQHCs), physical and occupational therapy, and more.
Additional links: Market Saturation and Utilization Core-Based Statistical Areas (CBSA)
Type: Website
Sponsoring organization: Centers for Medicare and Medicaid Services
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Provides an interactive map and access to information on national, state and county-level, and Core-Based Statistical Area (CBSA)-level provider services and utilization based on Medicare claims data. Includes the following services: ambulance, hospice, home health, long-term care, Federally Qualified Health Centers (FQHCs), physical and occupational therapy, and more.
Additional links: Market Saturation and Utilization Core-Based Statistical Areas (CBSA)
Type: Website
Sponsoring organization: Centers for Medicare and Medicaid Services
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Quality Payment Program (QPP) Small Practices
Section of the Quality Payment Program (QPP) website offering free resources and updates for practices with 15 or fewer clinicians participating in QPP. Includes resources on Merit-based Incentive Payment System (MIPS) eligibility, how to choose and report on quality measures, and flexibilities and reporting options to help clinicians in small practices meaningfully participate and succeed in MIPS.
Type: Website
Sponsoring organization: Centers for Medicare and Medicaid Services
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Section of the Quality Payment Program (QPP) website offering free resources and updates for practices with 15 or fewer clinicians participating in QPP. Includes resources on Merit-based Incentive Payment System (MIPS) eligibility, how to choose and report on quality measures, and flexibilities and reporting options to help clinicians in small practices meaningfully participate and succeed in MIPS.
Type: Website
Sponsoring organization: Centers for Medicare and Medicaid Services
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Medicare Learning Network: Health Professional Shortage Area Physician Bonus Program
Provides an overview of the Health Professional Shortage Area (HPSA) Physician Bonus Program and explains how bonus payments are calculated and paid. Includes information related to Critical Access Hospitals (CAHs) as well as primary care and mental health HPSAs.
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Provides an overview of the Health Professional Shortage Area (HPSA) Physician Bonus Program and explains how bonus payments are calculated and paid. Includes information related to Critical Access Hospitals (CAHs) as well as primary care and mental health HPSAs.
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Medicare Advantage Rates & Statistics
Provides links to information for Medicare Advantage (MA) organizations regarding MA payment policies, including announcements on payment methodology and advance notices of changes, rate books and supporting data, fee-for-service expenditure data by county, and more.
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Provides links to information for Medicare Advantage (MA) organizations regarding MA payment policies, including announcements on payment methodology and advance notices of changes, rate books and supporting data, fee-for-service expenditure data by county, and more.
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Medicare Physician Bonus Payment Eligibility Analyzer
Tool to determine if an address is in a Health Professional Shortage Area (HPSA) eligible for a Medicare Physician Bonus.
Type: Tool
Sponsoring organization: Health Resources and Services Administration
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Tool to determine if an address is in a Health Professional Shortage Area (HPSA) eligible for a Medicare Physician Bonus.
Type: Tool
Sponsoring organization: Health Resources and Services Administration
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Mapping Medicare Disparities
Provides access to county-level data and comparisons on chronic disease prevalence, Medicare spending, hospital and emergency department utilization, preventive services, and preventable hospitalizations, readmissions, and mortality rates for Medicare beneficiaries. Also offers 2018 Medicare Advantage encounter data. Includes hospital-level quality of care and cost of care data and comparisons as well as social determinants of health data for both the Medicare and non-Medicare population down to the census tract level.
Type: Map/Mapping System
Sponsoring organization: Centers for Medicare and Medicaid Services
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Provides access to county-level data and comparisons on chronic disease prevalence, Medicare spending, hospital and emergency department utilization, preventive services, and preventable hospitalizations, readmissions, and mortality rates for Medicare beneficiaries. Also offers 2018 Medicare Advantage encounter data. Includes hospital-level quality of care and cost of care data and comparisons as well as social determinants of health data for both the Medicare and non-Medicare population down to the census tract level.
Type: Map/Mapping System
Sponsoring organization: Centers for Medicare and Medicaid Services
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Medicare Part D Opioid Prescribing Mapping Tool
Interactive mapping tool identifies opioid prescription rates at the state, county, and zip code level for de-identified Medicare Part D claims in 2022. Also offers rural/urban opioid prescribing data, changes in prescribing rates in 1 year and 5 year increments, and hot spots and outliers in long-acting opioid prescribing.
Type: Map/Mapping System
Sponsoring organization: Centers for Medicare and Medicaid Services
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Interactive mapping tool identifies opioid prescription rates at the state, county, and zip code level for de-identified Medicare Part D claims in 2022. Also offers rural/urban opioid prescribing data, changes in prescribing rates in 1 year and 5 year increments, and hot spots and outliers in long-acting opioid prescribing.
Type: Map/Mapping System
Sponsoring organization: Centers for Medicare and Medicaid Services
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CMS State Operations Manual (SOM)
Provides guidance to state agencies that survey healthcare facilities and providers to determine if they are in compliance with the Medicare Conditions of Participation (CoP). Includes appendices with regulatory information specific to Critical Access Hospitals (Appendix W) and Federally Qualified Health Centers/Rural Health Clinics (Appendix G). Can be used by healthcare facilities as a tool to self-evaluate their compliance with Medicare CoP.
Type: Website
Sponsoring organization: Centers for Medicare and Medicaid Services
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Provides guidance to state agencies that survey healthcare facilities and providers to determine if they are in compliance with the Medicare Conditions of Participation (CoP). Includes appendices with regulatory information specific to Critical Access Hospitals (Appendix W) and Federally Qualified Health Centers/Rural Health Clinics (Appendix G). Can be used by healthcare facilities as a tool to self-evaluate their compliance with Medicare CoP.
Type: Website
Sponsoring organization: Centers for Medicare and Medicaid Services
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Code of Federal Regulations: Title 42 Public Health, Chapter 4, Subchapter G, Part 491, Subpart A - Rural Health Clinics: Conditions for Certification; and FQHCs Conditions for Coverage
Establishes the conditions Rural Health Clinics and Federally Qualified Health Centers must meet to qualify for reimbursement under Medicare, as well as those that Rural Health Clinics must meet to qualify for reimbursement under Medicaid.
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Establishes the conditions Rural Health Clinics and Federally Qualified Health Centers must meet to qualify for reimbursement under Medicare, as well as those that Rural Health Clinics must meet to qualify for reimbursement under Medicaid.
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Frontier Extended Stay Clinics (FESC) Demonstration
An overview of a completed CMS demonstration that looked at an enhanced clinic model in frontier areas to address the needs of seriously ill or injured patients who cannot be transferred to a hospital, or who need monitoring and observation for a limited period of time.
Type: Website
Sponsoring organization: Centers for Medicare and Medicaid Services
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An overview of a completed CMS demonstration that looked at an enhanced clinic model in frontier areas to address the needs of seriously ill or injured patients who cannot be transferred to a hospital, or who need monitoring and observation for a limited period of time.
Type: Website
Sponsoring organization: Centers for Medicare and Medicaid Services
view details