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Rural Health Information Hub

Rural Health
Resources by Topic: Medicare

Annual Insurance Update 2024: Health Insurance in Kansas
Reports on health insurance coverage across Kansas and nationwide, including 2009-2022 trends in coverage. Presents 2021 county-level data on uninsured rates by age group and urban/rural classification, as well as Medicaid and Children's Health Insurance Program (CHIP) enrollment by county.
Author(s): Angela S Wu, Kaci Cink, Cynthia Snyder, Wen-Chieh Lin
Date: 04/2024
Sponsoring organization: Kansas Health Institute
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April 2024 MedPAC Meeting Transcript
Transcript from the Medicare Payment Advisory Commission's (MedPAC) April 2024 meeting. Covers telehealth in Medicare, alternative approaches to lowering Medicare payments for select conditions in inpatient rehabilitation facilities, approaches for updating the Medicare physician fee schedule, initial findings from an analysis of Medicare Part B payment rates and 340B ceiling prices, and more. Includes discussion of telehealth in rural areas and data on telehealth use in Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs) between 2020 and 2022.
Additional links: Telehealth in Medicare: Status Report - Presentation Slides
Date: 04/2024
Sponsoring organization: Medicare Payment Advisory Commission
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Survey Emphasizes Scale and Significance of the RHC Program
Summarizes results of a 2024 national survey of 930 Rural Health Clinics. Presents data on the average payer mix, use and attitude toward telehealth services, Medicare Advantage (MA) contract structures, and MA reimbursement relative to traditional Medicare reimbursement, and more.
Additional links: NARHC 2024 Policy Survey Results
Date: 04/2024
Sponsoring organization: National Association of Rural Health Clinics
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Medicare and Medicaid Programs: Minimum Staffing Standards for Long-Term Care Facilities and Medicaid Institutional Payment Transparency Reporting Final Rule (CMS 3442-F)
Fact sheet providing an overview of the Centers for Medicare & Medicaid Services (CMS) final rule for minimum staffing standards for long-term care facilities. Details three core staffing proposals: 1) minimum nurse staffing standards; 2) a requirement to have an RN onsite 24 hours a day, seven days a week; and 3) enhanced facility assessment requirements. Outlines a staggered implementation approach, including a later implementation date for rural facilities, and hardship exemption qualification requirements. Also describes Medicaid payment transparency reporting provisions for nursing and intermediate care facilities related to the percentage of Medicaid funds spent on compensation to direct care workers and support staff.
Additional links: External FAQs
Date: 04/2024
Sponsoring organization: Centers for Medicare and Medicaid Services
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Quality in Motion: Acting on the CMS National Quality Strategy
Provides an overview of the Centers for Medicare & Medicaid Services (CMS) 2022 National Quality Strategy (NQS). Describes actions CMS has taken to meet the eight NQS goals across four priority areas: outcomes and alignment, equity and engagement, safety and resiliency, and interoperability and scientific achievement. Includes rural references throughout.
Date: 04/2024
Sponsoring organization: Centers for Medicare and Medicaid Services
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Medicare Accountable Care Organizations: Past Performance and Future Directions
Summarizes research findings about Medicare accountable care organizations (ACOs) from recent peer-reviewed journals, official evaluations of Medicare ACOs, and research organization reports. Describes characteristics of certain ACOs associated with greater savings and factors that limit ACOs' ability to achieve net budgetary savings for the Medicare program. Identifies policy approaches that could increase savings for Medicare through ACOs and the Medicare Shared Savings Program. Includes a brief discussion of challenges facing ACOs in rural and underserved areas.
Date: 04/2024
Sponsoring organization: Congressional Budget Office
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Evaluation of the Maryland Total Cost of Care Model: Progress Report
Provides an overview of the Maryland Total Cost of Care Model and evaluates the first four years of the program, 2019-2022. Explores the effects of the model on Medicare spending; service use, including preventable hospital use; and healthcare quality measures. Estimates the potential impact of switching Maryland to the Medicare prospective payment system (PPS) on Medicare spending and service use, including implications for rural and safety net hospitals.
Additional links: Appendices, Findings at a Glance, Transformation Spotlight
Date: 04/2024
Sponsoring organizations: Centers for Medicare and Medicaid Services, Mathematica
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Medicare Payment for Rural or Geographically Isolated Hospitals
Displays data on Medicare payment adjustments for Sole Community Hospitals, Medicare-Dependent Hospitals, Low-Volume Hospitals, and Critical Access Hospitals. Includes information on the number of qualifying hospitals by state and eligibility criteria.
Date: 04/2024
Sponsoring organization: Congressional Research Service
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Primary Care Spending in Medicare Fee-for-Service: An Illustrative Analysis Using Alternative Definitions of Primary Care
Discusses the importance of primary care to promote positive health outcomes and how reimbursement rates illustrate what healthcare areas are given priority. Utilizes Medicare fee-for-service data to estimate primary care spending and provides data breakdowns according to sex, race, age, insurance status, rural versus urban location, and more.
Date: 03/2024
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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A Lack of Behavioral Health Providers in Medicare and Medicaid Impedes Enrollees' Access to Care
Examines the availability of behavioral health providers who actively serve Medicare or Medicaid enrollees in 20 counties, 10 urban and 10 rural, across 10 states in 2021. Explores the extent to which traditional Medicare, Medicare Advantage, and Medicaid enrollees received behavioral health services and whether they used telehealth or in-person services. Offers recommendations to encourage more behavioral health providers to serve these enrollees and expand coverage to additional behavioral health provider types. Includes rural and urban comparisons throughout.
Additional links: Report Highlights
Date: 03/2024
Sponsoring organization: Office of Inspector General (HHS)
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