Rural Health
Resources by Topic: Medicare
Differences in the Merit-Based Incentive Payment System (MIPS) Performance of Clinicians in Metropolitan and Nonmetropolitan Counties in 2018
Provides a brief overview of the Merit-Based Incentive Payment System (MIPS) and describes rural clinician performance in MIPS in 2018. Compares rural and urban MIPS performance scores, payment adjustments, and risk-adjusted standardized Medicare Spending per Beneficiary (MSPB). Also compares rural and urban MIPS performance by practice size and the proportion of racial/ethnic minorities served. Presents the most frequently reported MIPS measures by urban and rural practices.
Date: 06/2023
Type: Document
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Provides a brief overview of the Merit-Based Incentive Payment System (MIPS) and describes rural clinician performance in MIPS in 2018. Compares rural and urban MIPS performance scores, payment adjustments, and risk-adjusted standardized Medicare Spending per Beneficiary (MSPB). Also compares rural and urban MIPS performance by practice size and the proportion of racial/ethnic minorities served. Presents the most frequently reported MIPS measures by urban and rural practices.
Date: 06/2023
Type: Document
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Critical Access Hospitals: Views on How Medicare Payment and Other Factors Affect Behavioral Health Services
Provides an overview of how Medicare payment policies for care provided by Critical Access Hospitals (CAHs). Explores how CAHs provide behavioral health services in their communities. Summarizes findings from interviews with officials from 10 CAHs, stakeholder organizations, the Centers for Medicare & Medicaid Services (CMS), and the Health Resources and Services Administration (HRSA) regarding how Medicare payment policies and other factors affect CAHs' ability to provide behavioral health services.
Additional links: Full Report
Date: 06/2023
Type: Document
Sponsoring organization: Government Accountability Office
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Provides an overview of how Medicare payment policies for care provided by Critical Access Hospitals (CAHs). Explores how CAHs provide behavioral health services in their communities. Summarizes findings from interviews with officials from 10 CAHs, stakeholder organizations, the Centers for Medicare & Medicaid Services (CMS), and the Health Resources and Services Administration (HRSA) regarding how Medicare payment policies and other factors affect CAHs' ability to provide behavioral health services.
Additional links: Full Report
Date: 06/2023
Type: Document
Sponsoring organization: Government Accountability Office
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Access to Care among Medicare Beneficiaries Aged 65 and Over Living with High-Impact Chronic Pain
Examines access to care and its association with high-impact chronic pain among Medicare recipients over 65 and not living in a long-term care facility between 2018 and 2020. Includes data breakdown between metro area and non-metro area residents. Discusses delay in seeking medical care due to cost and general access to care.
Author(s): Jared Sawyer, Laura Stoff, Carrie Goetsch, et al.
Date: 06/2023
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Examines access to care and its association with high-impact chronic pain among Medicare recipients over 65 and not living in a long-term care facility between 2018 and 2020. Includes data breakdown between metro area and non-metro area residents. Discusses delay in seeking medical care due to cost and general access to care.
Author(s): Jared Sawyer, Laura Stoff, Carrie Goetsch, et al.
Date: 06/2023
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Updated Simulation of a Prospective Payment System for Post-Acute Care
Updates a potential unified post-acute care (PAC) prospective payment system (PPS) and estimates the impact of a PAC PPS on providers and Medicare beneficiaries. Presents data comparing the estimated costs payments to actual payments by rurality and region.
Author(s): Doug Wissoker, Bowen Garrett
Date: 06/2023
Type: Document
Sponsoring organizations: Medicare Payment Advisory Commission, Urban Institute
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Updates a potential unified post-acute care (PAC) prospective payment system (PPS) and estimates the impact of a PAC PPS on providers and Medicare beneficiaries. Presents data comparing the estimated costs payments to actual payments by rurality and region.
Author(s): Doug Wissoker, Bowen Garrett
Date: 06/2023
Type: Document
Sponsoring organizations: Medicare Payment Advisory Commission, Urban Institute
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Using Population-Based Outcome Measures to Assess the Impact of Telehealth Expansion on Medicare Beneficiaries' Access to Care and Quality of Care
Explores the feasibility of using population-based measures to estimate the association between telehealth use, quality of care, and access to care when both telehealth and in-person visits are available to fee-for-service (FFS) Medicare beneficiaries. Compares data from the second half of 2019 to the second half of 2021 by the level of telehealth utilization in Hospital Service Areas (HSAs). Includes rural references throughout.
Author(s): Morteza Saharkhiz, Tanvi Rao, Sara Parker Lue, et al.
Date: 06/2023
Type: Document
Sponsoring organizations: American Institutes for Research, Medicare Payment Advisory Commission
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Explores the feasibility of using population-based measures to estimate the association between telehealth use, quality of care, and access to care when both telehealth and in-person visits are available to fee-for-service (FFS) Medicare beneficiaries. Compares data from the second half of 2019 to the second half of 2021 by the level of telehealth utilization in Hospital Service Areas (HSAs). Includes rural references throughout.
Author(s): Morteza Saharkhiz, Tanvi Rao, Sara Parker Lue, et al.
Date: 06/2023
Type: Document
Sponsoring organizations: American Institutes for Research, Medicare Payment Advisory Commission
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MedPAC Report to the Congress: Medicare and the Health Care Delivery System, June 2023
Evaluates Medicare payment issues and provides recommendations to the U.S. Congress. Chapter 7 presents a report on the use, payment, and quality of telehealth services that Medicare pays for separately under the physician fee schedule (PFS). Also includes chapters on the cost of drugs covered under Medicare Part B, postsale rebates for prescription drugs in Medicare Part D, standardized benefits in Medicare Advantage plans, future directions for Medicare Advantage payment policy, disparities in outcomes for beneficiaries with different social risks, Medicare behavioral health services, the alignment of fee-for-service payment rates across ambulatory settings, and the evaluation of a post-acute care prospective payment system prototype.
Date: 06/2023
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Evaluates Medicare payment issues and provides recommendations to the U.S. Congress. Chapter 7 presents a report on the use, payment, and quality of telehealth services that Medicare pays for separately under the physician fee schedule (PFS). Also includes chapters on the cost of drugs covered under Medicare Part B, postsale rebates for prescription drugs in Medicare Part D, standardized benefits in Medicare Advantage plans, future directions for Medicare Advantage payment policy, disparities in outcomes for beneficiaries with different social risks, Medicare behavioral health services, the alignment of fee-for-service payment rates across ambulatory settings, and the evaluation of a post-acute care prospective payment system prototype.
Date: 06/2023
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Report to Congress on Medicaid and CHIP, June 2023
Semi-annual report to Congress from the Medicaid and CHIP Payment and Access Commission (MACPAC). Covers recommendations on disproportionate share hospital (DSH) payments, care integration for people who are dually eligible for Medicaid and Medicare, access to Medicaid coverage for adults leaving incarceration, and barriers to Medicaid home- and community-based services (HCBS). Includes rural references throughout.
Date: 06/2023
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 on disproportionate share hospital (DSH) payments, care integration for people who are dually eligible for Medicaid and Medicare, access to Medicaid coverage for adults leaving incarceration, and barriers to Medicaid home- and community-based services (HCBS). Includes rural references throughout.
Date: 06/2023
Type: Document
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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Health Panel Comment Letter - Hospital Inpatient Prospective Payment System for Acute Care Hospitals Proposed Rule
Comments offered in response to a May 1, 2023, proposed rule revising the Medicare Hospital Inpatient Prospective Payment System (IPPS) and Long-Term Care Hospital PPS for fiscal year 2024. Discusses methodologies used to calculate the Medicare Disproportionate Share Hospital (DSH) and uncompensated care payments; two potential geriatric care quality measures; and the identification of, and challenges facing, safety net hospitals.
Date: 06/2023
Type: Document
Sponsoring organization: Rural Policy Research Institute Rural Health Panel
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Comments offered in response to a May 1, 2023, proposed rule revising the Medicare Hospital Inpatient Prospective Payment System (IPPS) and Long-Term Care Hospital PPS for fiscal year 2024. Discusses methodologies used to calculate the Medicare Disproportionate Share Hospital (DSH) and uncompensated care payments; two potential geriatric care quality measures; and the identification of, and challenges facing, safety net hospitals.
Date: 06/2023
Type: Document
Sponsoring organization: Rural Policy Research Institute Rural Health Panel
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The Benefits and Challenges of Converting to a Rural Emergency Hospital
Podcast episode with Anson General Hospital's Chief Executive Office and Chief Nursing Officer regarding the hospital's transition to a Rural Emergency Hospital. Discusses changes to services offered, financial and operational impacts of the conversion, and what the local patient population thinks about the transition.
Date: 06/2023
Type: Audio
Sponsoring organization: American Hospital Association
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Podcast episode with Anson General Hospital's Chief Executive Office and Chief Nursing Officer regarding the hospital's transition to a Rural Emergency Hospital. Discusses changes to services offered, financial and operational impacts of the conversion, and what the local patient population thinks about the transition.
Date: 06/2023
Type: Audio
Sponsoring organization: American Hospital Association
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QPP 2021: Participation Results At-a-Glance
Provides an overview of the results of the Quality Payment Program (QPP) for the 2021 performance year. Highlights mean and median final scores in the Merit-based Incentive Payment System (MIPS) for small and rural practices and compares results to those in 2020.
Date: 06/2023
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Provides an overview of the results of the Quality Payment Program (QPP) for the 2021 performance year. Highlights mean and median final scores in the Merit-based Incentive Payment System (MIPS) for small and rural practices and compares results to those in 2020.
Date: 06/2023
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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