Rural Health
Resources by Topic: Medicare
Tackling America's Mental Health and Addiction Crisis Through Primary Care Integration
Explores how primary and behavioral healthcare integration can overcome the unmet needs for mental health and substance use services. Discusses barriers to integrated care delivery. Offers policy recommendations to improve the integration of primary and behavioral healthcare services through enhanced payments, training, and technical assistance, and improving access to behavioral health providers for consultation and referral.
Additional links: Infographic
Date: 03/2021
Type: Document
Sponsoring organization: Bipartisan Policy Center
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Explores how primary and behavioral healthcare integration can overcome the unmet needs for mental health and substance use services. Discusses barriers to integrated care delivery. Offers policy recommendations to improve the integration of primary and behavioral healthcare services through enhanced payments, training, and technical assistance, and improving access to behavioral health providers for consultation and referral.
Additional links: Infographic
Date: 03/2021
Type: Document
Sponsoring organization: Bipartisan Policy Center
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Update to Rural Health Clinic (RHC) Payment Limits
Provides an overview of the updates to Rural Health Clinic (RHC) payment limits per visit beginning April 1, 2021, through 2028.
Date: 03/2021
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Provides an overview of the updates to Rural Health Clinic (RHC) payment limits per visit beginning April 1, 2021, through 2028.
Date: 03/2021
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Post-Acute Care Trajectories for Rural Medicare Beneficiaries: Planned versus Actual Hospital Discharges to Skilled Nursing Facilities and Home Health Agencies
Examines care transitions among rural fee-for-service Medicare beneficiaries following discharge from an acute care hospital. Compares planned and actual discharges to home health agencies and skilled nursing facilities. Discusses implications of these findings on rural healthcare policy and practice.
Author(s): Tracy M. Mroz, Lisa A. Garberson, C. Holly A. Andrilla, et al.
Date: 03/2021
Type: Document
Sponsoring organization: WWAMI Rural Health Research Center
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Examines care transitions among rural fee-for-service Medicare beneficiaries following discharge from an acute care hospital. Compares planned and actual discharges to home health agencies and skilled nursing facilities. Discusses implications of these findings on rural healthcare policy and practice.
Author(s): Tracy M. Mroz, Lisa A. Garberson, C. Holly A. Andrilla, et al.
Date: 03/2021
Type: Document
Sponsoring organization: WWAMI Rural Health Research Center
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Telehealth Policy and Regulatory Considerations During a Pandemic
Toolkit examining policies related to telehealth regarding coverage and payment, licensing, patient privacy and security, remote prescribing, and others, noting temporary changes due to COVID-19. Offers policy recommendations and highlights other important policy areas for healthcare providers to be aware of.
Date: 03/2021
Type: Website
Sponsoring organization: National Telehealth Technology Assessment Resource Center
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Toolkit examining policies related to telehealth regarding coverage and payment, licensing, patient privacy and security, remote prescribing, and others, noting temporary changes due to COVID-19. Offers policy recommendations and highlights other important policy areas for healthcare providers to be aware of.
Date: 03/2021
Type: Website
Sponsoring organization: National Telehealth Technology Assessment Resource Center
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MedPAC Report to the Congress: Medicare Payment Policy, 2021
Annual review of Medicare payment policies, with recommendations to Congress. Includes discussion on Medicare payment policies directly affecting rural providers and beneficiaries. Addresses payment adequacy for healthcare facilities and services, improving Medicare payment for post-acute care, Medicare Advantage, Medicare Part D, and the impact of healthcare provider consolidation. Contains information on the effects of the COVID-19 pandemic on Medicare beneficiary healthcare access, mortality, and service use. Presents an option for Medicare's coverage of telehealth beyond the public health emergency.
Date: 03/2021
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Annual review of Medicare payment policies, with recommendations to Congress. Includes discussion on Medicare payment policies directly affecting rural providers and beneficiaries. Addresses payment adequacy for healthcare facilities and services, improving Medicare payment for post-acute care, Medicare Advantage, Medicare Part D, and the impact of healthcare provider consolidation. Contains information on the effects of the COVID-19 pandemic on Medicare beneficiary healthcare access, mortality, and service use. Presents an option for Medicare's coverage of telehealth beyond the public health emergency.
Date: 03/2021
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Report to Congress on Medicaid and CHIP, March 2021
Reports on five aspects of Medicaid: 1) improving Medicaid's responsiveness during economic downturns; 2) addressing concerns about high rates of maternal morbidity and mortality; 3) reexamining Medicaid's estate recovery policies; 4) integrating care for people who are dually eligible for Medicaid and Medicare; and 5) improving hospital payment policy for the nation's safety-net hospitals. Chapter 5 examines the relationship between disproportionate share hospital (DSH) allotments to states and the number of uninsured individuals, the amounts and sources of hospitals' uncompensated care costs, and the amounts and sources of hospitals' uncompensated care costs. Table 5-1 details DSH spending for urban and rural hospitals and for Critical Access Hospitals.
Date: 03/2021
Type: Document
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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Reports on five aspects of Medicaid: 1) improving Medicaid's responsiveness during economic downturns; 2) addressing concerns about high rates of maternal morbidity and mortality; 3) reexamining Medicaid's estate recovery policies; 4) integrating care for people who are dually eligible for Medicaid and Medicare; and 5) improving hospital payment policy for the nation's safety-net hospitals. Chapter 5 examines the relationship between disproportionate share hospital (DSH) allotments to states and the number of uninsured individuals, the amounts and sources of hospitals' uncompensated care costs, and the amounts and sources of hospitals' uncompensated care costs. Table 5-1 details DSH spending for urban and rural hospitals and for Critical Access Hospitals.
Date: 03/2021
Type: Document
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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2021 RHC Billing and Coding Update
Recording of a March 9, 2021, webinar providing an overview of coding and billing changes relevant to Rural Health Clinics (RHCs). Discusses guidelines for reporting COVID-19 immunizations and monoclonal antibody infusions, telehealth coding and billing during the COVID-19 public health emergency, ICD-10-CM diagnosis coding for COVID-19, and RHC lab billing and COVID test reporting. Part of the Rural Health Clinic Technical Assistance Series.
Additional links: AMA Code & Guideline Changes, COVID Vaccine Log, Presentation Slides, Transcript
Date: 03/2021
Type: Video/Multimedia
Sponsoring organization: National Association of Rural Health Clinics
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Recording of a March 9, 2021, webinar providing an overview of coding and billing changes relevant to Rural Health Clinics (RHCs). Discusses guidelines for reporting COVID-19 immunizations and monoclonal antibody infusions, telehealth coding and billing during the COVID-19 public health emergency, ICD-10-CM diagnosis coding for COVID-19, and RHC lab billing and COVID test reporting. Part of the Rural Health Clinic Technical Assistance Series.
Additional links: AMA Code & Guideline Changes, COVID Vaccine Log, Presentation Slides, Transcript
Date: 03/2021
Type: Video/Multimedia
Sponsoring organization: National Association of Rural Health Clinics
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Medicare Hospital Payments: Adjusting for Variation in Geographic Area Wages
Provides an overview of the use of the hospital wage index applied to the Medicare inpatient prospective payment system (IPPS) to account for geographic differences in hospitals' labor costs. Discusses the effect of the wage index on Medicare payments for inpatient hospital services, exceptions to wage index adjustments, and proposals for wage index reforms.
Date: 03/2021
Type: Document
Sponsoring organization: Congressional Research Service
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Provides an overview of the use of the hospital wage index applied to the Medicare inpatient prospective payment system (IPPS) to account for geographic differences in hospitals' labor costs. Discusses the effect of the wage index on Medicare payments for inpatient hospital services, exceptions to wage index adjustments, and proposals for wage index reforms.
Date: 03/2021
Type: Document
Sponsoring organization: Congressional Research Service
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The Effect of Medicare Payment Standardization Methods on the Perceived Cost of Post-Acute Swing Bed Care in Critical Access Hospitals
Discusses the different payment systems the Centers for Medicare and Medicaid Services (CMS) uses to reimburse for post-acute care in Critical Access Hospitals (CAHs), prospective payment system (IPPS) hospitals, and skilled nursing facilities (SNFs). Describes how the payment standardization methods may influence post-acute care discharge patterns and access to care for rural residents. Examines the effects of these payment methods on the perceived cost of CAH swing bed care as it relates to the Medicare Spending per Beneficiary performance measure.
Author(s): Tyler Malone, Denise Kirk, Kristin Reiter
Date: 03/2021
Type: Document
Sponsoring organization: North Carolina Rural Health Research Program
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Discusses the different payment systems the Centers for Medicare and Medicaid Services (CMS) uses to reimburse for post-acute care in Critical Access Hospitals (CAHs), prospective payment system (IPPS) hospitals, and skilled nursing facilities (SNFs). Describes how the payment standardization methods may influence post-acute care discharge patterns and access to care for rural residents. Examines the effects of these payment methods on the perceived cost of CAH swing bed care as it relates to the Medicare Spending per Beneficiary performance measure.
Author(s): Tyler Malone, Denise Kirk, Kristin Reiter
Date: 03/2021
Type: Document
Sponsoring organization: North Carolina Rural Health Research Program
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Sources of Insurance Coverage in Nonmetropolitan Areas: The Role of Public and Private Insurance Since 2009
Describes regional variation in insurance coverage rates, using the American Community Survey 5-year estimates from 2009-2013 and 2013-2017 to compare types of health insurance coverage for people less than 65 years of age. Features statistics including share of nonmetropolitan nonelderly population per region, health insurance rates for nonelderly with breakdowns by metropolitan and nonmetropolitan areas, and source of health insurance for nonelderly by region.
Author(s): Linda Li, Matthew Najarian, Abigail R. Barker, Timothy D. McBride, Keith J. Mueller
Date: 03/2021
Type: Document
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Describes regional variation in insurance coverage rates, using the American Community Survey 5-year estimates from 2009-2013 and 2013-2017 to compare types of health insurance coverage for people less than 65 years of age. Features statistics including share of nonmetropolitan nonelderly population per region, health insurance rates for nonelderly with breakdowns by metropolitan and nonmetropolitan areas, and source of health insurance for nonelderly by region.
Author(s): Linda Li, Matthew Najarian, Abigail R. Barker, Timothy D. McBride, Keith J. Mueller
Date: 03/2021
Type: Document
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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