Rural Health
Resources by Topic: Medicare
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
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
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
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
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
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
Sponsoring organization: Medicare Payment Advisory Commission
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Report to Congress on Medicaid and CHIP, June 2022
Semi-annual report to Congress from the Medicaid and CHIP Payment and Access Commission (MACPAC). Discusses access to care, the oversight and transparency of managed care directed payments, access to vaccines for adult Medicaid beneficiaries, how Medicaid policy can be used to support the adoption of health IT among behavioral health providers, care integration for people who are dually eligible for Medicaid and Medicare, and advancing health equity in Medicaid. Includes rural references throughout.
Date: 06/2022
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 access to care, the oversight and transparency of managed care directed payments, access to vaccines for adult Medicaid beneficiaries, how Medicaid policy can be used to support the adoption of health IT among behavioral health providers, care integration for people who are dually eligible for Medicaid and Medicare, and advancing health equity in Medicaid. Includes rural references throughout.
Date: 06/2022
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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State Innovation Model Testing Awards from the Centers for Medicare & Medicaid Services Innovation Center: Highlighting Rural Focus
Summarizes the activities and accomplishments of rural-specific State Innovation Models (SIM) in 11 states: Arkansas, Colorado, Idaho, Iowa, Maine, Michigan, Minnesota, New York, Ohio, Oregon, and Vermont. Describes the SIM initiative, which began in 2012 to support states committed to designing and testing strategies for payment model and delivery system reform.
Date: 06/2022
Sponsoring organization: Rural Health Value
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Summarizes the activities and accomplishments of rural-specific State Innovation Models (SIM) in 11 states: Arkansas, Colorado, Idaho, Iowa, Maine, Michigan, Minnesota, New York, Ohio, Oregon, and Vermont. Describes the SIM initiative, which began in 2012 to support states committed to designing and testing strategies for payment model and delivery system reform.
Date: 06/2022
Sponsoring organization: Rural Health Value
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MedPAC Comment on CMS's Proposed Rule on the Inpatient Rehabilitation Facility PPS for FY 2023
Comments on an April 6, 2022, Federal Register proposed rule addressing updates to the prospective payment system for inpatient rehabilitation facilities (IRFs) for fiscal year 2023. Includes comments on the IRF teaching and rural payment adjustments.
Date: 05/2022
Sponsoring organization: Medicare Payment Advisory Commission
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Comments on an April 6, 2022, Federal Register proposed rule addressing updates to the prospective payment system for inpatient rehabilitation facilities (IRFs) for fiscal year 2023. Includes comments on the IRF teaching and rural payment adjustments.
Date: 05/2022
Sponsoring organization: Medicare Payment Advisory Commission
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MedPAC Comment on CMS's Proposed Rule on the Inpatient Psychiatric Facility PPS for FY 2023
Comment on an April 4, 2022, Federal Register proposed rule revising the Inpatient Psychiatric Facility Prospective Payment System (IPF PPS) for fiscal year 2023. Includes a discussion of rural and Disproportionate Share Hospital (DSH) IPF PPS payment adjustments.
Date: 05/2022
Sponsoring organization: Medicare Payment Advisory Commission
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Comment on an April 4, 2022, Federal Register proposed rule revising the Inpatient Psychiatric Facility Prospective Payment System (IPF PPS) for fiscal year 2023. Includes a discussion of rural and Disproportionate Share Hospital (DSH) IPF PPS payment adjustments.
Date: 05/2022
Sponsoring organization: Medicare Payment Advisory Commission
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Independent Evaluation of Comprehensive Primary Care Plus (CPC+): Fourth Annual Report
Reports on the first four program years of the Comprehensive Primary Care Plus (CPC+) model, a CMS primary care payment and delivery reform effort. Discusses CPC+ participating practices, payer partners, and health information technology (HIT) vendors supporting the program. Describes practice changes regarding care delivery and outcomes for Medicare fee-for-service beneficiaries.
Additional links: Appendices, Findings at a Glance
Date: 05/2022
Sponsoring organizations: Centers for Medicare and Medicaid Services, Mathematica
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Reports on the first four program years of the Comprehensive Primary Care Plus (CPC+) model, a CMS primary care payment and delivery reform effort. Discusses CPC+ participating practices, payer partners, and health information technology (HIT) vendors supporting the program. Describes practice changes regarding care delivery and outcomes for Medicare fee-for-service beneficiaries.
Additional links: Appendices, Findings at a Glance
Date: 05/2022
Sponsoring organizations: Centers for Medicare and Medicaid Services, Mathematica
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The Impact of COVID-19 on the Rural Health Care Landscape: Challenges and Opportunities
Presents an overview of key findings from interviews with stakeholders in eight states - Iowa, Minnesota, Montana, Nebraska, Nevada, North Dakota, South Dakota, and Wyoming - regarding the rural healthcare landscape. Discusses rural hospital financial health, rural hospital transformation models, challenges facing the rural healthcare workforce, and the role of telehealth in increasing access to care. Provides recommendations aimed at further advancing the use of virtual care in all communities, including rural and frontier areas, beyond the temporary federal COVID-19 public health emergency flexibilities.
Author(s): Sabah Bhatnagar, Julia Harris, Tara Hartnett, et al.
Date: 05/2022
Sponsoring organization: Bipartisan Policy Center
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Presents an overview of key findings from interviews with stakeholders in eight states - Iowa, Minnesota, Montana, Nebraska, Nevada, North Dakota, South Dakota, and Wyoming - regarding the rural healthcare landscape. Discusses rural hospital financial health, rural hospital transformation models, challenges facing the rural healthcare workforce, and the role of telehealth in increasing access to care. Provides recommendations aimed at further advancing the use of virtual care in all communities, including rural and frontier areas, beyond the temporary federal COVID-19 public health emergency flexibilities.
Author(s): Sabah Bhatnagar, Julia Harris, Tara Hartnett, et al.
Date: 05/2022
Sponsoring organization: Bipartisan Policy Center
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April 2022 MedPAC Meeting Transcript
Transcript from the Medicare Payment Advisory Commission's (MedPAC) April 2022 meeting. Covers high prices of drugs covered under Medicare Part B, initial findings from MedPAC's analysis of Part D data on drug rebates and discounts, segmentation in the stand-alone Part D prescription drug plan market, leveraging Medicare policies to address social determinants of health, an approach to streamline and harmonize Medicare's portfolio of alternative payment models, and aligning fee-for-service payment rates across ambulatory settings. Includes rural references throughout.
Date: 04/2022
Sponsoring organization: Medicare Payment Advisory Commission
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Transcript from the Medicare Payment Advisory Commission's (MedPAC) April 2022 meeting. Covers high prices of drugs covered under Medicare Part B, initial findings from MedPAC's analysis of Part D data on drug rebates and discounts, segmentation in the stand-alone Part D prescription drug plan market, leveraging Medicare policies to address social determinants of health, an approach to streamline and harmonize Medicare's portfolio of alternative payment models, and aligning fee-for-service payment rates across ambulatory settings. Includes rural references throughout.
Date: 04/2022
Sponsoring organization: Medicare Payment Advisory Commission
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