Rural Health
Resources by Topic: Medicare
Effort Required and Lessons Learned from Recruiting Health Plans and Rural Primary Care Practices for a Cancer Screening Outreach Study
Explores factors influencing recruitment and enrollment of primary care practices for SMARTER CRC, a rural colorectal cancer (CRC) screening trial in Oregon. Discusses outreach strategies, relationship-building, messaging, reasons for participation among clinical practices and Medicare health plans, and more. Highlights rural-specific factors throughout.
Author(s): Brittany Badicke, Jennifer Coury, Emily Myers, et al.
Citation: Journal of Primary Care & Community Health, 15
Date: 06/2024
Type: Document
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Explores factors influencing recruitment and enrollment of primary care practices for SMARTER CRC, a rural colorectal cancer (CRC) screening trial in Oregon. Discusses outreach strategies, relationship-building, messaging, reasons for participation among clinical practices and Medicare health plans, and more. Highlights rural-specific factors throughout.
Author(s): Brittany Badicke, Jennifer Coury, Emily Myers, et al.
Citation: Journal of Primary Care & Community Health, 15
Date: 06/2024
Type: Document
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Report to Congress on Medicaid and CHIP, June 2024
Semi-annual report to Congress from the Medicaid and CHIP Payment and Access Commission (MACPAC). Covers recommendations for increased transparency in Medicaid and CHIP financing, tools for optimizing state Medicaid agency contracts (SMACs), enrollment trends in Medicare Savings Programs (MSPs), and demographic data collection in Medicaid. Includes rural references throughout.
Date: 06/2024
Type: Document
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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Semi-annual report to Congress from the Medicaid and CHIP Payment and Access Commission (MACPAC). Covers recommendations for increased transparency in Medicaid and CHIP financing, tools for optimizing state Medicaid agency contracts (SMACs), enrollment trends in Medicare Savings Programs (MSPs), and demographic data collection in Medicaid. Includes rural references throughout.
Date: 06/2024
Type: Document
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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MedPAC Comment on CMS's Proposed Rule on the Hospital Inpatient PPS and the Long-term Care Hospital PPS for FY 2025
Comments on a May 2, 2024, Federal Register proposed rule revising the hospital inpatient and long-term care hospital (LTCH) prospective payment systems (PPS). Discusses proposals on rate-setting in both the inpatient prospective payment systems (IPPS) and LTCH PPS; the Transforming Episode Accountability Model (TEAM), including the definition of rural hospitals eligible to participate in a lower-risk track; new payments to small, independent hospitals that establish and maintain a 6-month buffer supply of essential medicines; updates to wage index values and policies; and updates to outlier reconciliation thresholds.
Date: 06/2024
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Comments on a May 2, 2024, Federal Register proposed rule revising the hospital inpatient and long-term care hospital (LTCH) prospective payment systems (PPS). Discusses proposals on rate-setting in both the inpatient prospective payment systems (IPPS) and LTCH PPS; the Transforming Episode Accountability Model (TEAM), including the definition of rural hospitals eligible to participate in a lower-risk track; new payments to small, independent hospitals that establish and maintain a 6-month buffer supply of essential medicines; updates to wage index values and policies; and updates to outlier reconciliation thresholds.
Date: 06/2024
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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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
Type: Document
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
Type: Document
Sponsoring organization: Congressional Research Service
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Merit-Based Incentive Payment System (MIPS): Traditional MIPS Scoring Guide for the 2024 Performance Year
Provides details on how scores are calculated for the Merit-Based Incentive Payment System (MIPS), one of two tracks under the Medicare Quality Payment Program. Explains the four performance categories that affect Medicare Physician Fee Schedule payments: quality, cost, improvement activities, and promoting interoperability. Includes information for small practices.
Date: 06/2024
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Provides details on how scores are calculated for the Merit-Based Incentive Payment System (MIPS), one of two tracks under the Medicare Quality Payment Program. Explains the four performance categories that affect Medicare Physician Fee Schedule payments: quality, cost, improvement activities, and promoting interoperability. Includes information for small practices.
Date: 06/2024
Type: Document
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
Type: Document
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
Type: Document
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
Type: Document
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
Type: Document
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
Type: Document
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
Type: Document
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
Type: Document
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
Type: Document
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
Type: Document
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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
Type: Document
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