Rural Health
Resources by Topic: Medicare
Advancing Integrated Care for Dually Eligible Individuals: Factors Influencing State D-SNP Contracting Decisions
Presents results of a study on factors that influence states' use of a variety of Dual Eligible Special Needs Plans (D-SNP) contracting strategies to facilitate the integration of Medicare and Medicaid benefits. Discusses factors influencing state adoption of D-SNP contracting strategies, barriers to D-SNP contracting in rural areas, and benefits and challenges of adoption 11 specific contracting strategies.
Additional links: Issue Brief
Author(s): Erin Weir Lakhmani, Danielle Chelminsky, Alena Tourtellotte, et al.
Date: 07/2021
Type: Document
Sponsoring organization: Mathematica
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Presents results of a study on factors that influence states' use of a variety of Dual Eligible Special Needs Plans (D-SNP) contracting strategies to facilitate the integration of Medicare and Medicaid benefits. Discusses factors influencing state adoption of D-SNP contracting strategies, barriers to D-SNP contracting in rural areas, and benefits and challenges of adoption 11 specific contracting strategies.
Additional links: Issue Brief
Author(s): Erin Weir Lakhmani, Danielle Chelminsky, Alena Tourtellotte, et al.
Date: 07/2021
Type: Document
Sponsoring organization: Mathematica
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How Many Hospitals Might Convert to a Rural Emergency Hospital (REH)?
Results of a study to predict the number of rural hospitals with 50 beds or fewer that are likely to consider conversion to Rural Emergency Hospital designation under the Medicare program. Features statistics on number and percent of complete closures and converted closures between 2011-2020 among hospitals with 50 beds or fewer, and open hospitals as of 2019-2020, with breakdowns by financial measures, operational measures, Medicare payment type, and census division.
Author(s): George H. Pink, Kristie W. Thompson, H. Ann Howard, G. Mark Holmes
Date: 07/2021
Type: Document
Sponsoring organization: North Carolina Rural Health Research Program
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Results of a study to predict the number of rural hospitals with 50 beds or fewer that are likely to consider conversion to Rural Emergency Hospital designation under the Medicare program. Features statistics on number and percent of complete closures and converted closures between 2011-2020 among hospitals with 50 beds or fewer, and open hospitals as of 2019-2020, with breakdowns by financial measures, operational measures, Medicare payment type, and census division.
Author(s): George H. Pink, Kristie W. Thompson, H. Ann Howard, G. Mark Holmes
Date: 07/2021
Type: Document
Sponsoring organization: North Carolina Rural Health Research Program
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Resilience: A Commitment to Patient Safety Fuels Quality Initiatives During a Pandemic
A 2021 Wisconsin quality report that highlights measures aimed at improving patient safety as well as collaborations that support best practices in healthcare quality. Provides data on federal Medicare measures, Wisconsin quality initiatives, collaborative opportunities and resources, COVID-19 response stories, and a hospital quality improvement showcase. Includes initiatives and stories from rural healthcare facilities.
Date: 06/2021
Type: Document
Sponsoring organization: Wisconsin Hospital Association
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A 2021 Wisconsin quality report that highlights measures aimed at improving patient safety as well as collaborations that support best practices in healthcare quality. Provides data on federal Medicare measures, Wisconsin quality initiatives, collaborative opportunities and resources, COVID-19 response stories, and a hospital quality improvement showcase. Includes initiatives and stories from rural healthcare facilities.
Date: 06/2021
Type: Document
Sponsoring organization: Wisconsin Hospital Association
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Evaluation of the State Innovation Models (SIM) Initiative Round 2: Model Test Final Report
Final report on the Round 2 State Innovation Models (SIM) program across eleven participating states - Colorado, Connecticut, Delaware, Idaho, Iowa, Michigan, New York, Ohio, Rhode Island, Tennessee, and Washington. Discusses the adoption of delivery models and payment reforms related to value-based payment (VBP) and alternative payment models (APMs). Examines whether the implementation efforts and healthcare delivery system reforms impacted the quality of care, health outcomes, population health, and spending.
Additional links: Appendix, Findings at a Glance
Date: 06/2021
Type: Document
Sponsoring organizations: Centers for Medicare and Medicaid Services, RTI International
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Final report on the Round 2 State Innovation Models (SIM) program across eleven participating states - Colorado, Connecticut, Delaware, Idaho, Iowa, Michigan, New York, Ohio, Rhode Island, Tennessee, and Washington. Discusses the adoption of delivery models and payment reforms related to value-based payment (VBP) and alternative payment models (APMs). Examines whether the implementation efforts and healthcare delivery system reforms impacted the quality of care, health outcomes, population health, and spending.
Additional links: Appendix, Findings at a Glance
Date: 06/2021
Type: Document
Sponsoring organizations: Centers for Medicare and Medicaid Services, RTI International
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Basics of Value-based Care and Payment
Slides presented to the Rural Healthcare Provider Transition Project (RHPTP) providing an overview of value-based care and payment models. Includes examples of rural providers addressing patient social needs, tackling local health issues, and aligning services with community needs.
Author(s): Jennifer P. Lundblad
Date: 06/2021
Type: Presentation Slides
Sponsoring organization: Rural Health Value
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Slides presented to the Rural Healthcare Provider Transition Project (RHPTP) providing an overview of value-based care and payment models. Includes examples of rural providers addressing patient social needs, tackling local health issues, and aligning services with community needs.
Author(s): Jennifer P. Lundblad
Date: 06/2021
Type: Presentation Slides
Sponsoring organization: Rural Health Value
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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 2022
Comments on a May 10, 2021, Federal Register proposed rule revising the hospital inpatient and long-term care hospital (LTCH) prospective payment systems. Discusses proposals on rate-setting in both the hospital and LTCH prospective payment systems, the use of "market-based" data to set Medicare severity–diagnosis related group (MS–DRG) relative weights, and changes to rural reclassification cancellation requirements for hospitals.
Date: 06/2021
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Comments on a May 10, 2021, Federal Register proposed rule revising the hospital inpatient and long-term care hospital (LTCH) prospective payment systems. Discusses proposals on rate-setting in both the hospital and LTCH prospective payment systems, the use of "market-based" data to set Medicare severity–diagnosis related group (MS–DRG) relative weights, and changes to rural reclassification cancellation requirements for hospitals.
Date: 06/2021
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 2021
Evaluates Medicare payment issues and offers recommendations to the U.S. Congress. Chapter 5 presents an interim report on Medicare beneficiaries' access to care in rural areas. Also includes chapters on Medicare Advantage benchmark policy, alternative payment models, private equity and Medicare, the skilled nursing facility value-based purchasing program, indirect medical education payments, Medicare coverage of vaccines, separately payable drugs in the hospital outpatient prospective payment system, clinical laboratory fee schedule payment rates, and the relationship between clinician services and other Medicare services.
Additional links: Executive Summary
Date: 06/2021
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Evaluates Medicare payment issues and offers recommendations to the U.S. Congress. Chapter 5 presents an interim report on Medicare beneficiaries' access to care in rural areas. Also includes chapters on Medicare Advantage benchmark policy, alternative payment models, private equity and Medicare, the skilled nursing facility value-based purchasing program, indirect medical education payments, Medicare coverage of vaccines, separately payable drugs in the hospital outpatient prospective payment system, clinical laboratory fee schedule payment rates, and the relationship between clinician services and other Medicare services.
Additional links: Executive Summary
Date: 06/2021
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Report to Congress on Medicaid and CHIP, June 2021
Semi-annual report to Congress from the Medicaid and CHIP Payment and Access Commission (MACPAC). Discusses high-cost specialty drugs in the Medicaid program, access to mental health services for those enrolled in Medicaid and the State Children's Health Insurance Program (CHIP), integration of physical and behavioral health care through electronic health records (EHRs), Medicaid's non-emergency transportation (NEMT) benefit, and state strategies for integrating care for people who are dually eligible for Medicaid and Medicare. Includes rural references throughout.
Date: 06/2021
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). Discusses high-cost specialty drugs in the Medicaid program, access to mental health services for those enrolled in Medicaid and the State Children's Health Insurance Program (CHIP), integration of physical and behavioral health care through electronic health records (EHRs), Medicaid's non-emergency transportation (NEMT) benefit, and state strategies for integrating care for people who are dually eligible for Medicaid and Medicare. Includes rural references throughout.
Date: 06/2021
Type: Document
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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COVID-19 Health Care Flexibilities: Perspectives, Experiences, and Lessons Learned
Recording of a May 19, 2021, U.S. Senate Committee on Finance hearing on healthcare flexibilities implemented in response to the COVID-19 pandemic, with a focus on telehealth. Discusses lessons learned and considerations for the extension of these flexibilities beyond the pandemic.
Additional links: Kisha Davis Testimony, Narayana Murali Testimony
Date: 05/2021
Type: Document
Sponsoring organization: Senate Committee on Finance
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Recording of a May 19, 2021, U.S. Senate Committee on Finance hearing on healthcare flexibilities implemented in response to the COVID-19 pandemic, with a focus on telehealth. Discusses lessons learned and considerations for the extension of these flexibilities beyond the pandemic.
Additional links: Kisha Davis Testimony, Narayana Murali Testimony
Date: 05/2021
Type: Document
Sponsoring organization: Senate Committee on Finance
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Medicare and Telehealth: Coverage and Use During the COVID-19 Pandemic and Options for the Future
Provides an overview of changes made to Medicare's coverage of telehealth during the COVID-19 pandemic. Explores Medicare beneficiaries' use of telehealth in summer and fall 2020, and presents data by beneficiary age, race and ethnicity, dual-eligibility, presence and type of chronic conditions, and metropolitan status. Examines issues and questions regarding telehealth coverage beyond the COVID-19 public health emergency.
Author(s): Wyatt Koma, Juliette Cubanski, Tricia Neuman
Date: 05/2021
Type: Document
Sponsoring organization: KFF
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Provides an overview of changes made to Medicare's coverage of telehealth during the COVID-19 pandemic. Explores Medicare beneficiaries' use of telehealth in summer and fall 2020, and presents data by beneficiary age, race and ethnicity, dual-eligibility, presence and type of chronic conditions, and metropolitan status. Examines issues and questions regarding telehealth coverage beyond the COVID-19 public health emergency.
Author(s): Wyatt Koma, Juliette Cubanski, Tricia Neuman
Date: 05/2021
Type: Document
Sponsoring organization: KFF
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