Rural Health
Resources by Topic: Medicare
Driving Health System Transformation - A Strategy for the CMS Innovation Center's Second Decade
White paper describing the new vision and strategic objectives for the Center for Medicare and Medicaid Innovation (CMS Innovation Center) for the next 10 years that seeks to achieve equitable health outcomes through the provision of high-quality, affordable, person-centered care. Shares beneficiary and healthcare provider goals for each strategic objective in Table 2. Strategic objectives include: driving accountable care, advancing health equity, supporting innovation, addressing affordability, and partnering to achieve healthcare system transformation. Includes discussion on models focused on improving rural health and ways of increasing participation in those models for rural and underserved populations.
Additional links: At a Glance
Date: 10/2021
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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White paper describing the new vision and strategic objectives for the Center for Medicare and Medicaid Innovation (CMS Innovation Center) for the next 10 years that seeks to achieve equitable health outcomes through the provision of high-quality, affordable, person-centered care. Shares beneficiary and healthcare provider goals for each strategic objective in Table 2. Strategic objectives include: driving accountable care, advancing health equity, supporting innovation, addressing affordability, and partnering to achieve healthcare system transformation. Includes discussion on models focused on improving rural health and ways of increasing participation in those models for rural and underserved populations.
Additional links: At a Glance
Date: 10/2021
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Medicare: Provider Performance and Experiences Under the Merit-Based Incentive Payment System
Examines Centers for Medicare and Medicaid Services (CMS) data on Merit-Based Incentive Payment System (MIPS) performance category scores, final scores, and payment adjustments from performance years 2017 through 2019. Summarizes interviews with 11 stakeholder groups and identifies strengths and challenges of the MIPS program. Presents data on MIPS performance scores and related payment adjustments by practice size, geographic location, method of participation, and specialty.
Additional links: Full Report
Date: 10/2021
Type: Document
Sponsoring organization: Government Accountability Office
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Examines Centers for Medicare and Medicaid Services (CMS) data on Merit-Based Incentive Payment System (MIPS) performance category scores, final scores, and payment adjustments from performance years 2017 through 2019. Summarizes interviews with 11 stakeholder groups and identifies strengths and challenges of the MIPS program. Presents data on MIPS performance scores and related payment adjustments by practice size, geographic location, method of participation, and specialty.
Additional links: Full Report
Date: 10/2021
Type: Document
Sponsoring organization: Government Accountability Office
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An Evaluation of Telehealth Use by Medicare Beneficiaries in 2020
Research brief examining telehealth use for outpatient evaluation and management from January 2019 to December 2020 based on a 20% sample of fee-for-service Medicare beneficiaries. Charts monthly trends for in-person and telehealth visits and compares rural and urban telehealth use, offering policy implications related to rural access to services.
Author(s): Chad Ellimoottil, Ziwei Zhu, Rod Dunn, et al.
Date: 09/2021
Type: Document
Sponsoring organization: University of Michigan Institute for Healthcare Policy and Innovation
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Research brief examining telehealth use for outpatient evaluation and management from January 2019 to December 2020 based on a 20% sample of fee-for-service Medicare beneficiaries. Charts monthly trends for in-person and telehealth visits and compares rural and urban telehealth use, offering policy implications related to rural access to services.
Author(s): Chad Ellimoottil, Ziwei Zhu, Rod Dunn, et al.
Date: 09/2021
Type: Document
Sponsoring organization: University of Michigan Institute for Healthcare Policy and Innovation
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Health Panel Comment Letter – Rural Emergency Hospitals (REH)
Offers comments in response to the Centers for Medicare and Medicaid Services (CMS) Request for Information on Rural Emergency Hospitals (REH). Addresses the type and scope of services REHs could offer, conditions of participation, health equity, collaboration and care coordination, quality measurement, payment, and enrollment.
Date: 09/2021
Type: Document
Sponsoring organization: Rural Policy Research Institute Rural Health Panel
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Offers comments in response to the Centers for Medicare and Medicaid Services (CMS) Request for Information on Rural Emergency Hospitals (REH). Addresses the type and scope of services REHs could offer, conditions of participation, health equity, collaboration and care coordination, quality measurement, payment, and enrollment.
Date: 09/2021
Type: Document
Sponsoring organization: Rural Policy Research Institute Rural Health Panel
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Utilization of Z Codes for Social Determinants of Health among Medicare Fee-for-Service Beneficiaries, 2019
Discusses how Z codes help report and track social determinants of health and reduce health disparities. Describes Z code claim data collected from 2016-2019, including the top 5 Z codes used in 2019 and the propositions of Medicare beneficiaries with Z codes across demographic characteristics. Highlights potential strategies to increase Z code utilization.
Date: 09/2021
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Discusses how Z codes help report and track social determinants of health and reduce health disparities. Describes Z code claim data collected from 2016-2019, including the top 5 Z codes used in 2019 and the propositions of Medicare beneficiaries with Z codes across demographic characteristics. Highlights potential strategies to increase Z code utilization.
Date: 09/2021
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Medicare Advantage Enrollment Update 2021
Reports on the percentage of rural Medicare beneficiaries enrolled in Medicare Advantage (MA) and other prepaid enrollment plans by metropolitan and nonmetropolitan location, from 2009-2021.
Author(s): Mina Shrestha, Fred Ullrich, Keith Mueller
Date: 09/2021
Type: Document
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Reports on the percentage of rural Medicare beneficiaries enrolled in Medicare Advantage (MA) and other prepaid enrollment plans by metropolitan and nonmetropolitan location, from 2009-2021.
Author(s): Mina Shrestha, Fred Ullrich, Keith Mueller
Date: 09/2021
Type: Document
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Disparities in Health Care in Medicare Advantage Associated with Dual Eligibility or Eligibility for a Low-Income Subsidy
Shares Medicare Advantage (MA) plan performance data for specific healthcare quality measures reported in 2019, which represents care received in 2018. Analyzes and compares the quality of clinical care for dual-eligible (DE) beneficiaries, those who qualify for both Medicare and Medicaid, and Medicare beneficiaries who are eligible for a Part D low-income subsidy (LIS) with the quality of care for beneficiaries who do not qualify as DE nor LIS by racial/ethnic groups and rural status.
Date: 09/2021
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Shares Medicare Advantage (MA) plan performance data for specific healthcare quality measures reported in 2019, which represents care received in 2018. Analyzes and compares the quality of clinical care for dual-eligible (DE) beneficiaries, those who qualify for both Medicare and Medicaid, and Medicare beneficiaries who are eligible for a Part D low-income subsidy (LIS) with the quality of care for beneficiaries who do not qualify as DE nor LIS by racial/ethnic groups and rural status.
Date: 09/2021
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Evaluation of the Rural Community Hospital Demonstration: Report Covering 2005-2017 (Interim Report 1)
Provides an overview of the Rural Community Hospital Demonstration (RCHD). Describes the characteristics of RCHD participants that entered the demonstration between 2005-2012, the Medicare payments received under program, and the impact of the RCHD on hospital finances between 2005-2017.
Additional links: Findings at a Glance
Date: 09/2021
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Provides an overview of the Rural Community Hospital Demonstration (RCHD). Describes the characteristics of RCHD participants that entered the demonstration between 2005-2012, the Medicare payments received under program, and the impact of the RCHD on hospital finances between 2005-2017.
Additional links: Findings at a Glance
Date: 09/2021
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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MedPAC Comment on CMS's Proposed Rule on Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems and Quality Reporting Programs for CY 2022
Comments on an August 4, 2021, Federal Register proposed rule revising the Medicare Hospital Outpatient Prospective Payment System (OPPS) and Medicare Ambulatory Surgical Center (ACS) payment system for calendar year 2022. Includes considerations for Rural Emergency Hospital payments and emergency department staffing requirements.
Date: 09/2021
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Comments on an August 4, 2021, Federal Register proposed rule revising the Medicare Hospital Outpatient Prospective Payment System (OPPS) and Medicare Ambulatory Surgical Center (ACS) payment system for calendar year 2022. Includes considerations for Rural Emergency Hospital payments and emergency department staffing requirements.
Date: 09/2021
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Air Ambulance Use and Surprise Billing
Provides an overview of air ambulance services, including the types and number of air ambulance providers and suppliers, utilization rates by patients, average costs, and the potential for balance billing for air ambulance transport. Summarizes key policies and legislation related to air ambulances, including the No Surprises Act. Presents data on air ambulance utilization by rurality between 2014-2018.
Author(s): Gina Turrini, Joel Ruhter, Andre R. Chappel, Nancy De Lew
Date: 09/2021
Type: Document
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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Provides an overview of air ambulance services, including the types and number of air ambulance providers and suppliers, utilization rates by patients, average costs, and the potential for balance billing for air ambulance transport. Summarizes key policies and legislation related to air ambulances, including the No Surprises Act. Presents data on air ambulance utilization by rurality between 2014-2018.
Author(s): Gina Turrini, Joel Ruhter, Andre R. Chappel, Nancy De Lew
Date: 09/2021
Type: Document
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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