Rural Health
Resources by Topic: Medicare
The Effectiveness of Policies to Improve Primary Care Access for Underserved Populations: An Assessment of the Literature
Review of research literature to assess whether policy initiatives targeting primary care access for rural and underserved populations has been effective in reducing healthcare disparities. Initiatives considered include availability, accessibility, accommodation, affordability, and acceptability.
Additional links: Fact Sheet: Alleviating Structural Barriers to Obtaining Primary Care Services, Fact Sheet: Bringing Outpatient Clinics into Communities, Fact Sheet: Ensuring Comfort and Communication in the Delivery of Primary Care Services, Fact Sheet: Increasing the Availability of Primary Care Clinicians, Fact Sheet: Removing Financial Barriers to Primary Care
Author(s): Maanasa Kona, Megan Houston, Nia Gooding
Date: 01/2022
Type: Document
Sponsoring organization: Milbank Memorial Fund
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Review of research literature to assess whether policy initiatives targeting primary care access for rural and underserved populations has been effective in reducing healthcare disparities. Initiatives considered include availability, accessibility, accommodation, affordability, and acceptability.
Additional links: Fact Sheet: Alleviating Structural Barriers to Obtaining Primary Care Services, Fact Sheet: Bringing Outpatient Clinics into Communities, Fact Sheet: Ensuring Comfort and Communication in the Delivery of Primary Care Services, Fact Sheet: Increasing the Availability of Primary Care Clinicians, Fact Sheet: Removing Financial Barriers to Primary Care
Author(s): Maanasa Kona, Megan Houston, Nia Gooding
Date: 01/2022
Type: Document
Sponsoring organization: Milbank Memorial Fund
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CARES Act Telehealth Expansion: Trends in Post-Discharge Follow-Up and Association with 30-Day Readmissions for Hospital Readmissions Reduction Program Health Conditions
Provides an overview of the Hospital Readmissions Reduction Program (HRRP) and examines the impact of expanded Medicare payment for telehealth services on post-discharge follow-up and hospital readmissions for HRRP conditions. Describes trends in post-discharge follow-up before and after the telehealth expansion and compares trends by health condition, sociodemographic characteristics, rurality, and follow-up method.
Date: 01/2022
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Provides an overview of the Hospital Readmissions Reduction Program (HRRP) and examines the impact of expanded Medicare payment for telehealth services on post-discharge follow-up and hospital readmissions for HRRP conditions. Describes trends in post-discharge follow-up before and after the telehealth expansion and compares trends by health condition, sociodemographic characteristics, rurality, and follow-up method.
Date: 01/2022
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Prescription Drug Affordability among Medicare Beneficiaries
Examines the affordability of prescription drugs among Medicare beneficiaries. Explores whether Medicare beneficiaries skipped doses, took less medication, delayed filling a prescription, or did not fill needed prescriptions due to cost concerns. Explores affordability concerns by race and ethnicity, sex, family income, urban versus rural counties, and presence of select chronic conditions.
Author(s): Wafa Tarazi, Kenneth Finegold, Steven Sheingold, Nancy De Lew, Benjamin D. Sommers
Date: 01/2022
Type: Document
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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Examines the affordability of prescription drugs among Medicare beneficiaries. Explores whether Medicare beneficiaries skipped doses, took less medication, delayed filling a prescription, or did not fill needed prescriptions due to cost concerns. Explores affordability concerns by race and ethnicity, sex, family income, urban versus rural counties, and presence of select chronic conditions.
Author(s): Wafa Tarazi, Kenneth Finegold, Steven Sheingold, Nancy De Lew, Benjamin D. Sommers
Date: 01/2022
Type: Document
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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Medicare and Beneficiaries Pay More for Preadmission Services at Affiliated Hospitals Than at Wholly Owned Settings
Provides an overview of the Medicare diagnosis-related group (DRG) window policy. Examines how much Medicare and Medicare beneficiaries paid affiliated settings, including Critical Access Hospitals, for admission-related outpatient services in 2019 that would have otherwise been covered by the DRG policy at wholly-owned hospitals. Offers recommendations to the Centers for Medicare & Medicaid Services (CMS) for updating the DRG policy.
Date: 12/2021
Type: Document
Sponsoring organization: Office of Inspector General (HHS)
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Provides an overview of the Medicare diagnosis-related group (DRG) window policy. Examines how much Medicare and Medicare beneficiaries paid affiliated settings, including Critical Access Hospitals, for admission-related outpatient services in 2019 that would have otherwise been covered by the DRG policy at wholly-owned hospitals. Offers recommendations to the Centers for Medicare & Medicaid Services (CMS) for updating the DRG policy.
Date: 12/2021
Type: Document
Sponsoring organization: Office of Inspector General (HHS)
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COVID-19 National Emergency: Early Trends in Hospitalizations for Hospital Readmissions Reduction Program Health Conditions and 30-Day Readmission Rates
Provides an overview of the Hospital Readmissions Reduction Program (HRRP). Describes monthly trends in hospitalizations of Medicare beneficiaries for HRRP conditions before and after the implementation of COVID-19 emergency measures through September 30, 2020. Examines how monthly trends in unadjusted 30-day readmission rates before and after implementation of COVID-19 emergency measures and how these rates differ by sociodemographic characteristics, including rurality. Discusses policy opportunities and interventions to enhance post-discharge follow-up and reduce readmission rates.
Date: 12/2021
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Provides an overview of the Hospital Readmissions Reduction Program (HRRP). Describes monthly trends in hospitalizations of Medicare beneficiaries for HRRP conditions before and after the implementation of COVID-19 emergency measures through September 30, 2020. Examines how monthly trends in unadjusted 30-day readmission rates before and after implementation of COVID-19 emergency measures and how these rates differ by sociodemographic characteristics, including rurality. Discusses policy opportunities and interventions to enhance post-discharge follow-up and reduce readmission rates.
Date: 12/2021
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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December 2021 MedPAC Meeting Transcript
Transcript from the Medicare Payment Advisory Commission's (MedPAC) December 2021 meeting. Covers payment adequacy and updates for hospital inpatient and outpatient services and the mandated report on changes to the low-volume hospital payment adjustment, physician and other health professional services, ambulatory surgical center services, outpatient dialysis services, and hospice services. Highlights the effect of COVID-19 relief funding on rural hospital margins, rural hospital bypass, and rural hospice payment utilization, among other rural references.
Date: 12/2021
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Transcript from the Medicare Payment Advisory Commission's (MedPAC) December 2021 meeting. Covers payment adequacy and updates for hospital inpatient and outpatient services and the mandated report on changes to the low-volume hospital payment adjustment, physician and other health professional services, ambulatory surgical center services, outpatient dialysis services, and hospice services. Highlights the effect of COVID-19 relief funding on rural hospital margins, rural hospital bypass, and rural hospice payment utilization, among other rural references.
Date: 12/2021
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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No Surprises Act Webinar
Recording of a December 14, 2021, webinar providing an overview of the No Surprises Act and how it impacts Rural Health Clinics. Outlines price transparency and good faith estimate requirements and enforcement. Part of the Rural Health Clinic Technical Assistance Series.
Additional links: CMS Regulations, CMS-10791 Good Faith Estimate for Health Care Items and Services, Good Faith Estimate Information and Webinar Q&A Follow-Up, Presentation Slides, Transcript
Date: 12/2021
Type: Video/Multimedia
Sponsoring organization: National Association of Rural Health Clinics
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Recording of a December 14, 2021, webinar providing an overview of the No Surprises Act and how it impacts Rural Health Clinics. Outlines price transparency and good faith estimate requirements and enforcement. Part of the Rural Health Clinic Technical Assistance Series.
Additional links: CMS Regulations, CMS-10791 Good Faith Estimate for Health Care Items and Services, Good Faith Estimate Information and Webinar Q&A Follow-Up, Presentation Slides, Transcript
Date: 12/2021
Type: Video/Multimedia
Sponsoring organization: National Association of Rural Health Clinics
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Medicare Telemedicine Snapshot
Presents data on telemedicine utilization by Medicare beneficiaries from March 1, 2020 to February 28, 2021, including pre- and post-pandemic rates of accessing telehealth services, trends in e-visits and virtual check-ins, geographic breakdowns including rural and urban residence, and beneficiary characteristics. Uses data from Medicare Fee-for-Service (FFS) claims, Medicare Advantage (MA) encounters, and Medicare enrollment.
Date: 12/2021
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Presents data on telemedicine utilization by Medicare beneficiaries from March 1, 2020 to February 28, 2021, including pre- and post-pandemic rates of accessing telehealth services, trends in e-visits and virtual check-ins, geographic breakdowns including rural and urban residence, and beneficiary characteristics. Uses data from Medicare Fee-for-Service (FFS) claims, Medicare Advantage (MA) encounters, and Medicare enrollment.
Date: 12/2021
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Medicare Beneficiaries' Use of Telehealth in 2020: Trends by Beneficiary Characteristics and Location
Report examining telehealth visits by Medicare beneficiaries in 2020 that compares urban and rural residence and breaks down data by visit location, race/ethnicity, visit specialty, and by state, with comparisons to 2019 data. Data drawn from Medicare FFS Part B outpatient and carrier claims submitted between January and December 2020 and the same period in 2019.
Date: 12/2021
Type: Document
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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Report examining telehealth visits by Medicare beneficiaries in 2020 that compares urban and rural residence and breaks down data by visit location, race/ethnicity, visit specialty, and by state, with comparisons to 2019 data. Data drawn from Medicare FFS Part B outpatient and carrier claims submitted between January and December 2020 and the same period in 2019.
Date: 12/2021
Type: Document
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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Annual Influenza Vaccination Disparities in Medicare Beneficiaries
Explores disparities among Medicare beneficiaries who received influenza vaccinations in 2019 and 2020. Presents data on influenza vaccinations by race and ethnicity, sex, and urban-rural residence. Compares data for Medicare fee-for-service and Medicare Advantage enrollees.
Date: 11/2021
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Explores disparities among Medicare beneficiaries who received influenza vaccinations in 2019 and 2020. Presents data on influenza vaccinations by race and ethnicity, sex, and urban-rural residence. Compares data for Medicare fee-for-service and Medicare Advantage enrollees.
Date: 11/2021
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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