Rural Health
Resources by Topic: Medicare
Inflation Reduction Act Research Series: Medicare Enrollees' Use and Out-of-Pocket Expenditures for Drugs Selected for Negotiation under the Medicare Drug Price Negotiation Program
Provides an overview of the Medicare Drug Price Negotiation Program established by the Inflation Reduction Act. Examines prescription drug use and out-of-pocket spending by Medicare Part D enrollees in calendar year 2022 for each of the first 10 drugs selected for price negotiations, which will be applicable in 2026. Includes data on the demographic characteristics of Medicare Part D enrollees taking each drug, including urban-rural status, as well as the number of enrollees and mean out-of-pocket spending on each drug by state.
Date: 09/2023
Type: Document
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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Provides an overview of the Medicare Drug Price Negotiation Program established by the Inflation Reduction Act. Examines prescription drug use and out-of-pocket spending by Medicare Part D enrollees in calendar year 2022 for each of the first 10 drugs selected for price negotiations, which will be applicable in 2026. Includes data on the demographic characteristics of Medicare Part D enrollees taking each drug, including urban-rural status, as well as the number of enrollees and mean out-of-pocket spending on each drug by state.
Date: 09/2023
Type: Document
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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Who's Accountable? Low-Value Care Received By Medicare Beneficiaries Outside Of Their Attributed Health Systems
Examines how much low-volume care and health system spending can be attributed to fee-for-service Medicare beneficiaries aged 65-years-old and older receiving care outside of the health system between 2017-2018. Explores beneficiary and health system factors associated with receiving the thirty most common low-value services, including beneficiaries' rurality and whether the low-value services originated from primary care physicians or specialists.
Author(s): Ishani Ganguli, Maia L. Crawford, Benjamin Usadi, et al.
Citation: Health Affairs, 42(8), 1128-1139
Date: 08/2023
Type: Document
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Examines how much low-volume care and health system spending can be attributed to fee-for-service Medicare beneficiaries aged 65-years-old and older receiving care outside of the health system between 2017-2018. Explores beneficiary and health system factors associated with receiving the thirty most common low-value services, including beneficiaries' rurality and whether the low-value services originated from primary care physicians or specialists.
Author(s): Ishani Ganguli, Maia L. Crawford, Benjamin Usadi, et al.
Citation: Health Affairs, 42(8), 1128-1139
Date: 08/2023
Type: Document
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Evaluation of the Million Hearts® Cardiovascular Disease Risk Reduction Model: Final Evaluation Report
Describes the results of the Centers for Medicare & Medicaid Services (CMS) Million Hearts Cardiovascular Disease Risk Reduction Model, a five-year randomized trial that aimed to reduce the incidence of first-time heart attacks and strokes among Medicare beneficiaries. Covers participant characteristics, including rural or urban status and organization type; changes in cardiovascular disease risk scores; effects of the model on healthcare utilization; intermediate- and long-term impacts on beneficiaries; and the contribution of these findings to the broader literature on cardiovascular disease prevention and value-based care.
Additional links: Findings at a Glance
Date: 08/2023
Type: Document
Sponsoring organizations: Centers for Medicare and Medicaid Services, Mathematica, RAND Corporation
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Describes the results of the Centers for Medicare & Medicaid Services (CMS) Million Hearts Cardiovascular Disease Risk Reduction Model, a five-year randomized trial that aimed to reduce the incidence of first-time heart attacks and strokes among Medicare beneficiaries. Covers participant characteristics, including rural or urban status and organization type; changes in cardiovascular disease risk scores; effects of the model on healthcare utilization; intermediate- and long-term impacts on beneficiaries; and the contribution of these findings to the broader literature on cardiovascular disease prevention and value-based care.
Additional links: Findings at a Glance
Date: 08/2023
Type: Document
Sponsoring organizations: Centers for Medicare and Medicaid Services, Mathematica, RAND Corporation
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Iowa Community Health Centers and Value-Based Care
Describes how Iowa Primary Care Association (Iowa PCA) and two sister organizations, IowaHealth+ and INConcertCare, pursued value-based care opportunities before joining the Medicare Shared Savings Program. Discusses the network's Medicaid value-based care contract; a partnership with Main Street Health to expand value-based contracting and provide more comprehensive, integrated primary care to patients with Medicare Advantage; data analytics; strategic planning and roadmaps; and next steps.
Date: 08/2023
Type: Document
Sponsoring organization: Rural Health Value
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Describes how Iowa Primary Care Association (Iowa PCA) and two sister organizations, IowaHealth+ and INConcertCare, pursued value-based care opportunities before joining the Medicare Shared Savings Program. Discusses the network's Medicaid value-based care contract; a partnership with Main Street Health to expand value-based contracting and provide more comprehensive, integrated primary care to patients with Medicare Advantage; data analytics; strategic planning and roadmaps; and next steps.
Date: 08/2023
Type: Document
Sponsoring organization: Rural Health Value
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MedPAC Comment on CMS's Proposed Rule on the Home Health Prospective Payment System for FY 2024
Comments on a July 10, 2023, Federal Register proposed rule related to Medicare payment policies for home health agencies. Includes comments on expanding the Home Health Value-Based Purchasing Model nationwide, wage index adjustments, the Hospice Special Focus Program (SFP), and more.
Date: 08/2023
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Comments on a July 10, 2023, Federal Register proposed rule related to Medicare payment policies for home health agencies. Includes comments on expanding the Home Health Value-Based Purchasing Model nationwide, wage index adjustments, the Hospice Special Focus Program (SFP), and more.
Date: 08/2023
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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MedPAC Comment on CMS's Proposed Rule on the End-Stage Renal Disease Payment System Update for FY 2024
Comments on a June 30, 2023, Federal Register proposed rule related to Medicare payment policies for end-stage renal disease (ESRD). Includes comments addressing the low-volume payment adjustment (LVPA) and recommending the development of a new payment adjustment based on geographic isolation.
Date: 08/2023
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Comments on a June 30, 2023, Federal Register proposed rule related to Medicare payment policies for end-stage renal disease (ESRD). Includes comments addressing the low-volume payment adjustment (LVPA) and recommending the development of a new payment adjustment based on geographic isolation.
Date: 08/2023
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Rates of Nursing Home Closures Were Relatively Stable Over the Past Decade, but Warrant Continuous Monitoring
Evaluates nursing home closures between 2011 and 2021 to identify trends and characteristics associated with closure. Considers location, Medicaid and Medicare, resident race, and more.
Author(s): Kelly Hughes, Zhanlian Feng, Qinghua Li, et al.
Citation: Health Affairs Scholar, 1(2)
Date: 08/2023
Type: Document
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Evaluates nursing home closures between 2011 and 2021 to identify trends and characteristics associated with closure. Considers location, Medicaid and Medicare, resident race, and more.
Author(s): Kelly Hughes, Zhanlian Feng, Qinghua Li, et al.
Citation: Health Affairs Scholar, 1(2)
Date: 08/2023
Type: Document
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Distributional Analysis of Variation in Medicare Advantage Participation Within and Between Metropolitan, Micropolitan, and Noncore Counties
Policy brief identifying penetration rates, number of plans, and enrollment patterns and trends in Medicare Advantage participation in metropolitan and nonmetropolitan counties from 2017-2022. Features statistics with breakdowns by year and metropolitan, micropolitan, and noncore areas.
Author(s): Dan Shane, Ufuoma Ejughemre, Fred Ullrich, Keith Mueller
Date: 08/2023
Type: Document
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Policy brief identifying penetration rates, number of plans, and enrollment patterns and trends in Medicare Advantage participation in metropolitan and nonmetropolitan counties from 2017-2022. Features statistics with breakdowns by year and metropolitan, micropolitan, and noncore areas.
Author(s): Dan Shane, Ufuoma Ejughemre, Fred Ullrich, Keith Mueller
Date: 08/2023
Type: Document
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Merit-Based Incentive Payment System (MIPS): 2024 Payment Year - Payment Adjustment User Guide
Provides information on Merit-Based Incentive Payment System (MIPS) payment adjustments for calendar year 2024. Describes how 2022 MIPS scores relate to 2024 payment adjustments and how payment adjustments are applied. Offers answers to frequently asked questions.
Date: 08/2023
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Provides information on Merit-Based Incentive Payment System (MIPS) payment adjustments for calendar year 2024. Describes how 2022 MIPS scores relate to 2024 payment adjustments and how payment adjustments are applied. Offers answers to frequently asked questions.
Date: 08/2023
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Participation in a Medicare Advanced Primary Care Model and the Delivery of High-Value Services
Examines if participation in the Comprehensive Primary Care Plus Initiative (CPC+) impacted the high-value services delivered by primary care providers. Utilizes multiple national data sets to estimate the association of CPC+ and services such as annual wellness visits (AWVs), advance care planning (ACP), flu shots, tobacco prevention counseling, and depression screening. Provides data on intervention groups and comparison groups by patient demographics as well as provider demographics, specialty, and location, including urban, large rural, small rural, and isolated rural.
Author(s): Fang He, Angela Gasdaska, Lindsay White, Yan Tang, Chris Beadles
Citation: Health Services Research, 58(6), 1266-1291
Date: 08/2023
Type: Document
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Examines if participation in the Comprehensive Primary Care Plus Initiative (CPC+) impacted the high-value services delivered by primary care providers. Utilizes multiple national data sets to estimate the association of CPC+ and services such as annual wellness visits (AWVs), advance care planning (ACP), flu shots, tobacco prevention counseling, and depression screening. Provides data on intervention groups and comparison groups by patient demographics as well as provider demographics, specialty, and location, including urban, large rural, small rural, and isolated rural.
Author(s): Fang He, Angela Gasdaska, Lindsay White, Yan Tang, Chris Beadles
Citation: Health Services Research, 58(6), 1266-1291
Date: 08/2023
Type: Document
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