Rural Health
Resources by Topic: Medicare
CY 2024 Medicare Hospital Outpatient Prospective Payment System and Ambulatory Surgical Center Payment System Final Rule (CMS 1786-FC)
Fact sheet providing an overview of the Centers for Medicare & Medicaid Services (CMS) final rule regarding updates and changes to the Medicare payments for hospital outpatient and Ambulatory Surgical Center (ASC) services for calendar year 2024. Summarizes provisions regarding changes to the community mental health centers (CMHC) Conditions of Participation (CoPs); payment for intensive outpatient program (IOP) services; payment methodology for Indian Health Service (IHS) and tribal facilities that convert to Rural Emergency Hospital (REH) status; the Hospital Outpatient Quality Reporting (OQR), Ambulatory Surgical Center Quality Reporting (ASCQR), and Rural Emergency Hospital Quality Reporting (REHQR) Programs; and more.
Date: 11/2023
Sponsoring organization: Centers for Medicare and Medicaid Services
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Fact sheet providing an overview of the Centers for Medicare & Medicaid Services (CMS) final rule regarding updates and changes to the Medicare payments for hospital outpatient and Ambulatory Surgical Center (ASC) services for calendar year 2024. Summarizes provisions regarding changes to the community mental health centers (CMHC) Conditions of Participation (CoPs); payment for intensive outpatient program (IOP) services; payment methodology for Indian Health Service (IHS) and tribal facilities that convert to Rural Emergency Hospital (REH) status; the Hospital Outpatient Quality Reporting (OQR), Ambulatory Surgical Center Quality Reporting (ASCQR), and Rural Emergency Hospital Quality Reporting (REHQR) Programs; and more.
Date: 11/2023
Sponsoring organization: Centers for Medicare and Medicaid Services
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Calendar Year (CY) 2024 Medicare Physician Fee Schedule Final Rule
Fact sheet providing an overview of the Centers for Medicare & Medicaid Services (CMS) final rule regarding updates and changes to the Medicare payments under the Physician Fee Schedule (PFS) and other Medicare Part B issues for calendar year 2024. Summarizes provisions related to paying separately for Community Health Integration, Social Determinants of Health (SDOH) Risk Assessment, and Principal Illness Navigation services; telehealth services; mental health visits furnished by Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs), including marriage and family therapists and mental health counselors as eligible for payment at RHCs and FQHCs; and more.
Date: 11/2023
Sponsoring organization: Centers for Medicare and Medicaid Services
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Fact sheet providing an overview of the Centers for Medicare & Medicaid Services (CMS) final rule regarding updates and changes to the Medicare payments under the Physician Fee Schedule (PFS) and other Medicare Part B issues for calendar year 2024. Summarizes provisions related to paying separately for Community Health Integration, Social Determinants of Health (SDOH) Risk Assessment, and Principal Illness Navigation services; telehealth services; mental health visits furnished by Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs), including marriage and family therapists and mental health counselors as eligible for payment at RHCs and FQHCs; and more.
Date: 11/2023
Sponsoring organization: Centers for Medicare and Medicaid Services
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MBQIP Quality Measures National Annual Report - 2022
Summarizes quality measure reporting rates and performance among Critical Access Hospitals (CAHs) in 2022. Presents data on the four Medicare Beneficiary Quality Improvement Project (MBQIP) domains: patient safety/inpatient, outpatient, patient engagement, and care transitions.
Author(s): Megan Lahr, Alyssa Furukawa, Madeleine Pick, Robert Barclay
Date: 10/2023
Sponsoring organization: Flex Monitoring Team
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Summarizes quality measure reporting rates and performance among Critical Access Hospitals (CAHs) in 2022. Presents data on the four Medicare Beneficiary Quality Improvement Project (MBQIP) domains: patient safety/inpatient, outpatient, patient engagement, and care transitions.
Author(s): Megan Lahr, Alyssa Furukawa, Madeleine Pick, Robert Barclay
Date: 10/2023
Sponsoring organization: Flex Monitoring Team
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Rural Health Policy for the Next Decade: Changes are Upon Us
Presentation slides that discuss the future of rural health policy, with a focus on the comprehensive community wealth approach, healthcare modalities and sites of care, and healthcare payment models, including Medicare Advantage.
Author(s): Keith J. Mueller
Date: 10/2023
Sponsoring organizations: Iowa College of Public Health, Rural Policy Research Institute
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Presentation slides that discuss the future of rural health policy, with a focus on the comprehensive community wealth approach, healthcare modalities and sites of care, and healthcare payment models, including Medicare Advantage.
Author(s): Keith J. Mueller
Date: 10/2023
Sponsoring organizations: Iowa College of Public Health, Rural Policy Research Institute
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Medicare: Performance-Based and Geographic Adjustments to Physician Payments
Statement to the U.S. House of Representatives Committee on Energy and Commerce, Subcommittee on Health, summarizing the Government Accountability Organization's (GAO) 2021 reports on the Quality Payment Program and the two tracks it established to incentivize Medicare providers and its 2022 report on geographic adjustments to physician payments. Includes information on the participation of providers in rural and underserved areas in Advanced Alternative Payment Models (APMs) and the challenges these providers face in transitioning to APMs.
Additional links: Full Report
Date: 10/2023
Sponsoring organization: Government Accountability Office
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Statement to the U.S. House of Representatives Committee on Energy and Commerce, Subcommittee on Health, summarizing the Government Accountability Organization's (GAO) 2021 reports on the Quality Payment Program and the two tracks it established to incentivize Medicare providers and its 2022 report on geographic adjustments to physician payments. Includes information on the participation of providers in rural and underserved areas in Advanced Alternative Payment Models (APMs) and the challenges these providers face in transitioning to APMs.
Additional links: Full Report
Date: 10/2023
Sponsoring organization: Government Accountability Office
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October 2023 MedPAC Meeting Transcript
Transcript from the Medicare Payment Advisory Commission's (MedPAC) October 2023 meeting. Covers updates to Medicare payment rates for clinician services, staffing ratios and turnover rates in nursing facilities, an alternative method to establish Medicare payments for select conditions treated in inpatient rehabilitation facilities, and a work plan relating to generic drug prices under Medicare Part D. Includes rural references and considerations throughout.
Date: 10/2023
Sponsoring organization: Medicare Payment Advisory Commission
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Transcript from the Medicare Payment Advisory Commission's (MedPAC) October 2023 meeting. Covers updates to Medicare payment rates for clinician services, staffing ratios and turnover rates in nursing facilities, an alternative method to establish Medicare payments for select conditions treated in inpatient rehabilitation facilities, and a work plan relating to generic drug prices under Medicare Part D. Includes rural references and considerations throughout.
Date: 10/2023
Sponsoring organization: Medicare Payment Advisory Commission
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MedPAC Payment Basics
Series of briefs providing an of Medicare payment systems. Covers payments systems including Accountable Care Organizations (ACO), Critical Access Hospitals (CAH), Federally Qualified Health Centers and Rural Health Clinics, hospital acute inpatient services, and more.
Date: 10/2023
Sponsoring organization: Medicare Payment Advisory Commission
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Series of briefs providing an of Medicare payment systems. Covers payments systems including Accountable Care Organizations (ACO), Critical Access Hospitals (CAH), Federally Qualified Health Centers and Rural Health Clinics, hospital acute inpatient services, and more.
Date: 10/2023
Sponsoring organization: Medicare Payment Advisory Commission
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CMS Native American Contacts
Features Centers for Medicare and Medicaid Services contacts for personnel in the Division of Tribal Affairs and the contacts responsible for the different Indian Health Services areas.
Date: 10/2023
Sponsoring organization: Centers for Medicare and Medicaid Services
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Features Centers for Medicare and Medicaid Services contacts for personnel in the Division of Tribal Affairs and the contacts responsible for the different Indian Health Services areas.
Date: 10/2023
Sponsoring organization: Centers for Medicare and Medicaid Services
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Environmental Scan on Encouraging Rural Participation in Population-Based TCOC Models
Presents results of an environmental scan regarding population-based total cost of care (PB-TCOC) payment models and encouraging rural participation in these models. Describes challenges affecting rural patients and providers; opportunities for alternative payment models (APMs) and PB-TCOC models to address challenges in rural areas; trends in rural providers' participation in APMs; driving care delivery transformation in rural providers, including models that include or target rural participants in their model designs; leveraging financial incentives to improve rural health care; adoption and use of health information technology, including telehealth and data analytics among rural providers; and the measurement of rural providers' performance in APMs.
Date: 09/2023
Sponsoring organizations: HHS Office of the Assistant Secretary for Planning and Evaluation, NORC at the University of Chicago
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Presents results of an environmental scan regarding population-based total cost of care (PB-TCOC) payment models and encouraging rural participation in these models. Describes challenges affecting rural patients and providers; opportunities for alternative payment models (APMs) and PB-TCOC models to address challenges in rural areas; trends in rural providers' participation in APMs; driving care delivery transformation in rural providers, including models that include or target rural participants in their model designs; leveraging financial incentives to improve rural health care; adoption and use of health information technology, including telehealth and data analytics among rural providers; and the measurement of rural providers' performance in APMs.
Date: 09/2023
Sponsoring organizations: HHS Office of the Assistant Secretary for Planning and Evaluation, NORC at the University of Chicago
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Medicare Advantage Value-Based Insurance Design Model Phase II: Second Annual Evaluation Report
Presents findings from an evaluation of Phase II of the Medicare Advantage (MA) Value-Based Insurance Design (VBID) Model, which allows participating MA parent organizations to offer supplemental benefits and incentives to beneficiaries, hospice benefits, and wellness and healthcare planning through their MA plans. Summarizes findings from interviews with representatives of participating MA organizations, in-network and out-of-network hospices, and beneficiaries. Covers MA organization and beneficiary implementation experiences, plan enrollment, quality of care, health outcomes, and more, for the VBID Model generally and for the VBID Hospice Benefit Component.
Additional links: Appendices, Findings at a Glance, Hospice Benefit Component Findings at a Glance
Date: 09/2023
Sponsoring organizations: Centers for Medicare and Medicaid Services, RAND Corporation
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Presents findings from an evaluation of Phase II of the Medicare Advantage (MA) Value-Based Insurance Design (VBID) Model, which allows participating MA parent organizations to offer supplemental benefits and incentives to beneficiaries, hospice benefits, and wellness and healthcare planning through their MA plans. Summarizes findings from interviews with representatives of participating MA organizations, in-network and out-of-network hospices, and beneficiaries. Covers MA organization and beneficiary implementation experiences, plan enrollment, quality of care, health outcomes, and more, for the VBID Model generally and for the VBID Hospice Benefit Component.
Additional links: Appendices, Findings at a Glance, Hospice Benefit Component Findings at a Glance
Date: 09/2023
Sponsoring organizations: Centers for Medicare and Medicaid Services, RAND Corporation
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