Rural Health
Resources by Topic: Medicare
Sources of Federal Funding for Health Care Facilities: Frequently Asked Questions
Provides an overview of how the federal government supports healthcare facilities, with a focus on hospitals. Discusses how Medicare and Medicaid pay acute care hospitals and for services rendered to beneficiaries and enrollees, as well as other payments these programs make. Identifies federal grants, loans, and technical assistance programs that can support health facilities. Describes how federal agencies, including the Health Resources and Services Administration (HRSA) and the U.S. Department of Agriculture (USDA), have supported healthcare facilities during emergencies.
Date: 06/2024
Sponsoring organization: Congressional Research Service
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Provides an overview of how the federal government supports healthcare facilities, with a focus on hospitals. Discusses how Medicare and Medicaid pay acute care hospitals and for services rendered to beneficiaries and enrollees, as well as other payments these programs make. Identifies federal grants, loans, and technical assistance programs that can support health facilities. Describes how federal agencies, including the Health Resources and Services Administration (HRSA) and the U.S. Department of Agriculture (USDA), have supported healthcare facilities during emergencies.
Date: 06/2024
Sponsoring organization: Congressional Research Service
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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: 06/2024
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: 06/2024
Sponsoring organization: Centers for Medicare and Medicaid Services
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CMS Bundled Payments for Care Improvement Advanced Model: Fifth Annual Evaluation Report
Fifth annual report of the Bundled Payments for Care Improvement Advanced (BPCI Advanced) Model, which tests whether linking payments for a clinical episode of care can reduce Medicare expenditures while maintaining or improving the quality of care. Explores the impact of BPCI Advanced on episode payments, utilization, and quality of care, as well as estimates of Medicare program savings in Model Year 4. Describes changes to the model that were implemented in Model Year 4 and how BPCI Advanced relates to Medicare Accountable Care Organizations (ACOs). Analyzes BPCI Advanced outcomes for beneficiaries from populations that have been historically underserved. Includes rural references throughout.
Additional links: Appendices, Executive Summary, Findings at a Glance
Author(s): The Lewin Group, Abt Associates, GDIT, Telligen
Date: 05/2024
Sponsoring organization: Centers for Medicare and Medicaid Services
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Fifth annual report of the Bundled Payments for Care Improvement Advanced (BPCI Advanced) Model, which tests whether linking payments for a clinical episode of care can reduce Medicare expenditures while maintaining or improving the quality of care. Explores the impact of BPCI Advanced on episode payments, utilization, and quality of care, as well as estimates of Medicare program savings in Model Year 4. Describes changes to the model that were implemented in Model Year 4 and how BPCI Advanced relates to Medicare Accountable Care Organizations (ACOs). Analyzes BPCI Advanced outcomes for beneficiaries from populations that have been historically underserved. Includes rural references throughout.
Additional links: Appendices, Executive Summary, Findings at a Glance
Author(s): The Lewin Group, Abt Associates, GDIT, Telligen
Date: 05/2024
Sponsoring organization: Centers for Medicare and Medicaid Services
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Senate Finance Committee Bipartisan Medicare GME Working Group Draft Proposal Outline and Questions for Consideration
Outlines draft policy proposals regarding the Medicare Graduate Medical Education (GME) program aimed at addressing healthcare workforce shortages. Proposals cover the distribution of Medicare GME slots to rural areas and key specialties, encouraging hospitals to train physicians in rural areas, the establishment of a Medicare GME Policy Council, GME data collection and transparency, and more. Includes questions for consideration on policies under consideration.
Date: 05/2024
Sponsoring organization: Senate Committee on Finance
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Outlines draft policy proposals regarding the Medicare Graduate Medical Education (GME) program aimed at addressing healthcare workforce shortages. Proposals cover the distribution of Medicare GME slots to rural areas and key specialties, encouraging hospitals to train physicians in rural areas, the establishment of a Medicare GME Policy Council, GME data collection and transparency, and more. Includes questions for consideration on policies under consideration.
Date: 05/2024
Sponsoring organization: Senate Committee on Finance
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MedPAC Comment on CMS's Proposed Rule on the Payment System for Inpatient Psychiatric Facilities for FY 2025
Comment on an April 3, 2024, Federal Register proposed rule revising the Inpatient Psychiatric Facility Prospective Payment System (IPF PPS) for fiscal year 2025. Includes a discussion of rural IPF PPS payment adjustments.
Date: 05/2024
Sponsoring organization: Medicare Payment Advisory Commission
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Comment on an April 3, 2024, Federal Register proposed rule revising the Inpatient Psychiatric Facility Prospective Payment System (IPF PPS) for fiscal year 2025. Includes a discussion of rural IPF PPS payment adjustments.
Date: 05/2024
Sponsoring organization: Medicare Payment Advisory Commission
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A Closer Look at the Final Nursing Facility Rule and Which Facilities Might Meet New Staffing Requirements
Summarizes new Centers for Medicare & Medicaid Services's (CMS) nurse staffing requirements for nursing facilities outlined in the April 22, 2024, final rule. Analyzes Nursing Home Compare data from April 2024, which reflects nursing home staffing levels from December 2023, to explore the percentage of facilities that meet each of the new nurse staffing requirements. Presents data by nursing ownership status, rural and urban location, special focus facility status, and state.
Author(s): Priya Chidambaram, Alice Burns, Tricia Neuman, Robin Rudowitz
Date: 05/2024
Sponsoring organization: KFF
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Summarizes new Centers for Medicare & Medicaid Services's (CMS) nurse staffing requirements for nursing facilities outlined in the April 22, 2024, final rule. Analyzes Nursing Home Compare data from April 2024, which reflects nursing home staffing levels from December 2023, to explore the percentage of facilities that meet each of the new nurse staffing requirements. Presents data by nursing ownership status, rural and urban location, special focus facility status, and state.
Author(s): Priya Chidambaram, Alice Burns, Tricia Neuman, Robin Rudowitz
Date: 05/2024
Sponsoring organization: KFF
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Calculation of Overall Hospital Quality Star Ratings With and Without Inclusion of the Peer Grouping Step
Examines potential implications of including a peer grouping step in the calculation of Centers for Medicare & Medicaid Services (CMS) Overall Star Ratings. Uses January 2023 Medicare Care Compare data on 3,076 hospitals that received a star rating to calculate the peer groups based on the number of quality measure groups for which hospitals had 3 or more reported measures. Presents data on the characteristics of each peer group, the distribution of star ratings whether the peer grouping step was used or not used, and the number of hospitals with a higher, lower, or identical star rating when the peer grouping step was applied. Compares data by hospital characteristics, including safety-net status, Critical Access Hospital status, rural or urban location, and more.
Author(s): Cameron J. Gettel, Kyle Bagshaw, Li Qin, et al.
Citation: JAMA Network Open, 7(5), e2411933
Date: 05/2024
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Examines potential implications of including a peer grouping step in the calculation of Centers for Medicare & Medicaid Services (CMS) Overall Star Ratings. Uses January 2023 Medicare Care Compare data on 3,076 hospitals that received a star rating to calculate the peer groups based on the number of quality measure groups for which hospitals had 3 or more reported measures. Presents data on the characteristics of each peer group, the distribution of star ratings whether the peer grouping step was used or not used, and the number of hospitals with a higher, lower, or identical star rating when the peer grouping step was applied. Compares data by hospital characteristics, including safety-net status, Critical Access Hospital status, rural or urban location, and more.
Author(s): Cameron J. Gettel, Kyle Bagshaw, Li Qin, et al.
Citation: JAMA Network Open, 7(5), e2411933
Date: 05/2024
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Converting to Rural Emergency Hospitals
Podcast episode featuring a discussion with Rural Emergency Hospital (REH) Chief Executive Officers in New Mexico and Oklahoma regarding the conversion to REH status. Discusses the conversion process of each REH; how they built trust and buy-in from patients and communities, including state and federal policymakers; and financial considerations of conversion.
Date: 05/2024
Sponsoring organization: American Hospital Association
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Podcast episode featuring a discussion with Rural Emergency Hospital (REH) Chief Executive Officers in New Mexico and Oklahoma regarding the conversion to REH status. Discusses the conversion process of each REH; how they built trust and buy-in from patients and communities, including state and federal policymakers; and financial considerations of conversion.
Date: 05/2024
Sponsoring organization: American Hospital Association
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Social Determinants of Health and Delivery of Rehabilitation to Older Adults During ICU Hospitalization
Analyzes likelihood of receiving physical therapy or occupational therapy during ICU hospitalization among older adults. Utilizes 2011-2018 National Health and Aging Trends Study (NHATS) data of 1,618 hospitalizations. Highlights social determinants of health associated with disparities in rehabilitation service delivery, including rural status, dual eligibility for Medicare and Medicaid, and limited English proficiency.
Author(s): Snigdha Jain, Terrence E. Murphy, Jason R. Falvey, et al.
Citation: JAMA Network Open, 7(5), e2410713
Date: 05/2024
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Analyzes likelihood of receiving physical therapy or occupational therapy during ICU hospitalization among older adults. Utilizes 2011-2018 National Health and Aging Trends Study (NHATS) data of 1,618 hospitalizations. Highlights social determinants of health associated with disparities in rehabilitation service delivery, including rural status, dual eligibility for Medicare and Medicaid, and limited English proficiency.
Author(s): Snigdha Jain, Terrence E. Murphy, Jason R. Falvey, et al.
Citation: JAMA Network Open, 7(5), e2410713
Date: 05/2024
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Trends and Disparities in Pandemic Telehealth Use among People with Disabilities
Examines the use of telehealth services by Medicare beneficiaries with disabilities by analyzing data from the Medicare Telehealth Trends Dashboard; the 2021 Medicare Current Beneficiary Survey (MCBS) and MCBS Winter 2021 Supplement; and the Census Bureau's Household Pulse Survey data from July 21, 2021, to August 8, 2022. Presents data on patterns of telehealth utilization by Medicare beneficiaries with disabilities by type of Medicare eligibility and number and type of disabilities, modes of telehealth used by the number and type of disabilities, and the availability of different modes of telehealth and access to video-enabled services. Exhibit 8 compares telehealth utilization trends among Medicare fee-for-service beneficiaries between 2019 and 2021 by Medicare eligibility and rural and urban status.
Author(s): Madjid Karimi, Lok Wong Samson, Sara J. Couture, et al.
Date: 05/2024
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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Examines the use of telehealth services by Medicare beneficiaries with disabilities by analyzing data from the Medicare Telehealth Trends Dashboard; the 2021 Medicare Current Beneficiary Survey (MCBS) and MCBS Winter 2021 Supplement; and the Census Bureau's Household Pulse Survey data from July 21, 2021, to August 8, 2022. Presents data on patterns of telehealth utilization by Medicare beneficiaries with disabilities by type of Medicare eligibility and number and type of disabilities, modes of telehealth used by the number and type of disabilities, and the availability of different modes of telehealth and access to video-enabled services. Exhibit 8 compares telehealth utilization trends among Medicare fee-for-service beneficiaries between 2019 and 2021 by Medicare eligibility and rural and urban status.
Author(s): Madjid Karimi, Lok Wong Samson, Sara J. Couture, et al.
Date: 05/2024
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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