Rural Health
Resources by Topic: Medicare
2020 Quality Payment Program Experience Report
Reports on the clinician experience for those participating in the Quality Payment Program in 2020. Presents data on Merit-based Incentive Payment System (MIPS) eligibility and participation rates for clinicians in small practices and rural areas, as well as their mean payment adjustment scores.
Date: 08/2022
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Reports on the clinician experience for those participating in the Quality Payment Program in 2020. Presents data on Merit-based Incentive Payment System (MIPS) eligibility and participation rates for clinicians in small practices and rural areas, as well as their mean payment adjustment scores.
Date: 08/2022
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Hospice Care Index Technical Report
Provides an overview of the Hospice Care Index (HCI), a new Hospice Quality Reporting Program (HQRP) quality measure. Presents data and descriptive trends for the overall index score and each of the ten claims-based indicators that make up the HCI using Medicare claims data from fiscal years 2019-2021. Includes comparisons of hospices by the number of claims, decade of certification, ownership, facility type, region, and urban/rural location.
Date: 07/2022
Type: Document
Sponsoring organizations: Abt Associates, Centers for Medicare and Medicaid Services
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Provides an overview of the Hospice Care Index (HCI), a new Hospice Quality Reporting Program (HQRP) quality measure. Presents data and descriptive trends for the overall index score and each of the ten claims-based indicators that make up the HCI using Medicare claims data from fiscal years 2019-2021. Includes comparisons of hospices by the number of claims, decade of certification, ownership, facility type, region, and urban/rural location.
Date: 07/2022
Type: Document
Sponsoring organizations: Abt Associates, Centers for Medicare and Medicaid Services
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MedPAC Comment on CMS's Proposed Rule on Conditions of Participation (CoPs) for Rural Emergency Hospitals and Critical Access Hospital CoP Updates
Comments on July 2022 Federal Register proposed rule regarding staffing requirements for rural emergency hospitals (REHs). Discusses whether proposed staffing requirements are sufficient to ensure access to emergency care.
Date: 07/2022
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Comments on July 2022 Federal Register proposed rule regarding staffing requirements for rural emergency hospitals (REHs). Discusses whether proposed staffing requirements are sufficient to ensure access to emergency care.
Date: 07/2022
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Types of Rural and Urban Hospitals and Counties Where They Are Located
Offers a snapshot of the types of rural and urban hospitals and the counties where they are located. Presents data on the number and percent of acute care hospitals and average daily census by hospital type, special payment designation, and county size. Includes descriptions of Medicare special payment designations for hospitals.
Date: 07/2022
Type: Document
Sponsoring organization: North Carolina Rural Health Research Program
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Offers a snapshot of the types of rural and urban hospitals and the counties where they are located. Presents data on the number and percent of acute care hospitals and average daily census by hospital type, special payment designation, and county size. Includes descriptions of Medicare special payment designations for hospitals.
Date: 07/2022
Type: Document
Sponsoring organization: North Carolina Rural Health Research Program
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Integrating Behavioral Health into Your RHC
Recording of a July 19, 2022, webinar regarding Rural Health Clinic (RHC) billing for behavioral health services. Part of the Rural Health Clinic Technical Assistance Series.
Additional links: Presentation Slides, Transcript
Date: 07/2022
Type: Video/Multimedia
Sponsoring organization: National Association of Rural Health Clinics
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Recording of a July 19, 2022, webinar regarding Rural Health Clinic (RHC) billing for behavioral health services. Part of the Rural Health Clinic Technical Assistance Series.
Additional links: Presentation Slides, Transcript
Date: 07/2022
Type: Video/Multimedia
Sponsoring organization: National Association of Rural Health Clinics
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Synthesis of Evaluation Results across 21 Medicare Models, 2012-2020
Summarizes results from evaluations of 21 Centers for Medicare & Medicaid (CMS) Innovation Center models. Examines measures related to gross and net Medicare spending, utilization, and quality of care. Identifies themes among models with similar participant types and interventions used. Offers considerations for acute or specialty care and targeted populations models and prevention and population management models.
Additional links: Findings at a Glance, Synthesis of Evaluation Results Across 21 Medicare Models Slides, Transcript, Webinar Recording
Date: 07/2022
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Summarizes results from evaluations of 21 Centers for Medicare & Medicaid (CMS) Innovation Center models. Examines measures related to gross and net Medicare spending, utilization, and quality of care. Identifies themes among models with similar participant types and interventions used. Offers considerations for acute or specialty care and targeted populations models and prevention and population management models.
Additional links: Findings at a Glance, Synthesis of Evaluation Results Across 21 Medicare Models Slides, Transcript, Webinar Recording
Date: 07/2022
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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The Association Between Primary Care Use and Potentially-Preventable Hospitalization Among Dual Eligibles Age 65 and Over
Examines the relationship between primary care and ambulatory care sensitive condition (ACSC) hospitalization among people age 65 and older who are dually-enrolled in Medicare and Medicaid. Features statistics with breakdowns by urban or rural location.
Author(s): N. Loren Oh, Andrew J. Potter, Lindsay M. Sabik, et al.
Citation: BMC Health Services Research, 22(927)
Date: 07/2022
Type: Document
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Examines the relationship between primary care and ambulatory care sensitive condition (ACSC) hospitalization among people age 65 and older who are dually-enrolled in Medicare and Medicaid. Features statistics with breakdowns by urban or rural location.
Author(s): N. Loren Oh, Andrew J. Potter, Lindsay M. Sabik, et al.
Citation: BMC Health Services Research, 22(927)
Date: 07/2022
Type: Document
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Report to Congress: Unified Payment for Medicare-Covered Post-Acute Care
Presents a prototype for a Unified Post-acute Care (PAC) prospective payment system (PPS) that would set payment for PAC services on the basis of the clinical characteristics of the patient rather than the type of provider. Details the structure of the prototype and the data used in the analyses to design and calibrate the PPS. Explores key considerations for unifying PAC payment, such as cost-sharing and value-based payment. Includes data on PAC provider characteristics, including facility size and rural status, as well as rural payment adjustments.
Additional links: Appendices
Author(s): Benjamin Silver, Anne Deutsch, Nicole Coomer, et al.
Date: 07/2022
Type: Document
Sponsoring organizations: Centers for Medicare and Medicaid Services, RTI International
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Presents a prototype for a Unified Post-acute Care (PAC) prospective payment system (PPS) that would set payment for PAC services on the basis of the clinical characteristics of the patient rather than the type of provider. Details the structure of the prototype and the data used in the analyses to design and calibrate the PPS. Explores key considerations for unifying PAC payment, such as cost-sharing and value-based payment. Includes data on PAC provider characteristics, including facility size and rural status, as well as rural payment adjustments.
Additional links: Appendices
Author(s): Benjamin Silver, Anne Deutsch, Nicole Coomer, et al.
Date: 07/2022
Type: Document
Sponsoring organizations: Centers for Medicare and Medicaid Services, RTI International
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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 2023
Comments on a May 10, 2022, 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, promoting stability in the IPPS and LTCH PPS, creating a permanent supplemental payment for Puerto Rico and Indian Health Service (IHS) hospitals, establishing a payment adjustment for domestic N95 respirators, adding new measures to the LTCH quality reporting program, and establishing overarching principles for measuring equity and health care quality disparities across CMS quality programs.
Date: 06/2022
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Comments on a May 10, 2022, 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, promoting stability in the IPPS and LTCH PPS, creating a permanent supplemental payment for Puerto Rico and Indian Health Service (IHS) hospitals, establishing a payment adjustment for domestic N95 respirators, adding new measures to the LTCH quality reporting program, and establishing overarching principles for measuring equity and health care quality disparities across CMS quality programs.
Date: 06/2022
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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MedPAC Report to the Congress: Medicare and the Health Care Delivery System, June 2022
Evaluates Medicare payment issues and provides recommendations to the U.S. Congress. Chapter 2 presents a report on access to care for beneficiaries in Medically Underserved Areas (MUAs), who are dually eligible for Medicare and Medicaid, or have multiple chronic conditions. Also includes chapters on alternative payment models, safety net providers, the cost of drugs covered under Medicare Part B, the accuracy of Medicare Advantage payments, the alignment of fee-for-service payment rates across ambulatory settings, and segmentation in the stand-alone Part D plan market.
Date: 06/2022
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 2 presents a report on access to care for beneficiaries in Medically Underserved Areas (MUAs), who are dually eligible for Medicare and Medicaid, or have multiple chronic conditions. Also includes chapters on alternative payment models, safety net providers, the cost of drugs covered under Medicare Part B, the accuracy of Medicare Advantage payments, the alignment of fee-for-service payment rates across ambulatory settings, and segmentation in the stand-alone Part D plan market.
Date: 06/2022
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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