Rural Health
Resources by Topic: Medicare
Building Capacity for Value
Slides presented at the 2020 Nebraska Rural Health Conference describing the evolution of value-based care. Discusses different approaches to value-based care transformation, including the Medicare Shared Savings Program Accountable Care Organizations and global budgeting. Presents management and leadership strategies to navigate future changes while meeting community health needs.
Author(s): Karla Weng
Date: 09/2020
Type: Presentation Slides
Sponsoring organization: Rural Health Value
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Slides presented at the 2020 Nebraska Rural Health Conference describing the evolution of value-based care. Discusses different approaches to value-based care transformation, including the Medicare Shared Savings Program Accountable Care Organizations and global budgeting. Presents management and leadership strategies to navigate future changes while meeting community health needs.
Author(s): Karla Weng
Date: 09/2020
Type: Presentation Slides
Sponsoring organization: Rural Health Value
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Understanding Rural Hospital Bypass Among Medicare Fee-for-Service (FFS) Beneficiaries in 2018
Examines the extent to which rural Medicare beneficiaries receive inpatient services at hospitals that are not their nearest rural hospital. Explores which hospital services rural Medicare beneficiaries most often seek locally and at distant hospitals.
Date: 09/2020
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Examines the extent to which rural Medicare beneficiaries receive inpatient services at hospitals that are not their nearest rural hospital. Explores which hospital services rural Medicare beneficiaries most often seek locally and at distant hospitals.
Date: 09/2020
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Federal and State Policy Changes Since COVID-19
Video recording of a presentation on federal and state telehealth policy changes during the COVID-19 pandemic. Discusses Centers for Medicare and Medicaid (CMS) policies related to geographic and site location for the patient, provider location and type, and telehealth delivery modality. Addresses common issues related to reimbursement and payment codes, Medicare billing guidance for Federally Qualified Health Centers and Rural Health Clinics, and notes post-COVID policy questions and issues. Transcript available in the video description.
Date: 09/2020
Type: Video/Multimedia
Sponsoring organizations: Centers for Connected Health Policy, Northwest Regional Telehealth Resource Center
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Video recording of a presentation on federal and state telehealth policy changes during the COVID-19 pandemic. Discusses Centers for Medicare and Medicaid (CMS) policies related to geographic and site location for the patient, provider location and type, and telehealth delivery modality. Addresses common issues related to reimbursement and payment codes, Medicare billing guidance for Federally Qualified Health Centers and Rural Health Clinics, and notes post-COVID policy questions and issues. Transcript available in the video description.
Date: 09/2020
Type: Video/Multimedia
Sponsoring organizations: Centers for Connected Health Policy, Northwest Regional Telehealth Resource Center
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A Toolkit for Building and Growing a Sustainable Telehealth Program in Your Practice
Offers information for family practices to develop and implement telehealth strategies in light of the COVID-19 pandemic's impacts on regulatory and reimbursement policies. Topics include telehealth services, payment considerations, program sustainability, licensing and technology requirements, and workflow. Includes 10 telehealth scenarios with breakdowns of payer, technology, staff, coding, and other special considerations.
Date: 09/2020
Type: Document
Sponsoring organizations: American Academy of Family Physicians, Manatt Health
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Offers information for family practices to develop and implement telehealth strategies in light of the COVID-19 pandemic's impacts on regulatory and reimbursement policies. Topics include telehealth services, payment considerations, program sustainability, licensing and technology requirements, and workflow. Includes 10 telehealth scenarios with breakdowns of payer, technology, staff, coding, and other special considerations.
Date: 09/2020
Type: Document
Sponsoring organizations: American Academy of Family Physicians, Manatt Health
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Third Evaluation Report: Next Generation Accountable Care Organization Model Evaluation
Reports on implementation experiences and outcomes for 50 Next Generation Accountable Care Organizations (NGACOs) that participated in the model in the 2018 performance year. Also evaluates findings of the model to date, from NGACOs entering the model in 2016, 2017, and 2018. Includes information on the extent to which NGACOs served rural areas.
Additional links: CMS Perspective, October 2020, Findings at a Glance, Technical Appendices
Date: 09/2020
Type: Document
Sponsoring organizations: Centers for Medicare and Medicaid Services, NORC at the University of Chicago
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Reports on implementation experiences and outcomes for 50 Next Generation Accountable Care Organizations (NGACOs) that participated in the model in the 2018 performance year. Also evaluates findings of the model to date, from NGACOs entering the model in 2016, 2017, and 2018. Includes information on the extent to which NGACOs served rural areas.
Additional links: CMS Perspective, October 2020, Findings at a Glance, Technical Appendices
Date: 09/2020
Type: Document
Sponsoring organizations: Centers for Medicare and Medicaid Services, NORC at the University of Chicago
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A Comparison of Rural and Urban Specialty Hospitals
Results of a study examining differences in long-term acute care hospitals, inpatient psychiatric hospitals, and inpatient rehabilitation facilities in urban and rural areas. Features statistics on ownership type, location, number of beds, percent of inpatient days for rural residents, percent of inpatient days for Medicare beneficiaries, operating expenses, percent of Medicaid days, and profitability.
Author(s): George H. Pink, Andrew Osgood, Pranathi Sana
Date: 09/2020
Type: Document
Sponsoring organization: North Carolina Rural Health Research Program
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Results of a study examining differences in long-term acute care hospitals, inpatient psychiatric hospitals, and inpatient rehabilitation facilities in urban and rural areas. Features statistics on ownership type, location, number of beds, percent of inpatient days for rural residents, percent of inpatient days for Medicare beneficiaries, operating expenses, percent of Medicaid days, and profitability.
Author(s): George H. Pink, Andrew Osgood, Pranathi Sana
Date: 09/2020
Type: Document
Sponsoring organization: North Carolina Rural Health Research Program
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Preliminary Cost and Quality Findings from the National Evaluation of the Certified Community Behavioral Health Clinic Demonstration
Provides an overview of the Certified Community Behavioral Health Clinic (CCBHC) demonstration through April 2019. Describes the CCBHC payment rates and costs of care through the first demonstration year as well as the experiences of states and CCBHCs reporting the required quality measures. Includes a comparison of payment rates by urban and rural clinic location.
Author(s): Joshua Breslau, Brian Briscombe, Michael Dunbar, et al.
Date: 09/2020
Type: Document
Sponsoring organizations: HHS Office of the Assistant Secretary for Planning and Evaluation, Mathematica
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Provides an overview of the Certified Community Behavioral Health Clinic (CCBHC) demonstration through April 2019. Describes the CCBHC payment rates and costs of care through the first demonstration year as well as the experiences of states and CCBHCs reporting the required quality measures. Includes a comparison of payment rates by urban and rural clinic location.
Author(s): Joshua Breslau, Brian Briscombe, Michael Dunbar, et al.
Date: 09/2020
Type: Document
Sponsoring organizations: HHS Office of the Assistant Secretary for Planning and Evaluation, Mathematica
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Rural-Relevant Quality Measures for Testing of Statistical Approaches to Address Low Case-Volume
Describes 15 rural-relevant quality measures susceptible to low case-volume challenges that could be used to test statistical approaches designed to address this problem. Discusses reporting challenges and gaps in rural health care quality measurement.
Additional links: Final List: Rural-Relevant Quality Measures for Future Testing of Technical Expert Panel (TEP) Recommended Statistical Approaches
Date: 09/2020
Type: Document
Sponsoring organization: National Quality Forum
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Describes 15 rural-relevant quality measures susceptible to low case-volume challenges that could be used to test statistical approaches designed to address this problem. Discusses reporting challenges and gaps in rural health care quality measurement.
Additional links: Final List: Rural-Relevant Quality Measures for Future Testing of Technical Expert Panel (TEP) Recommended Statistical Approaches
Date: 09/2020
Type: Document
Sponsoring organization: National Quality Forum
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Urban Hospitals with a High Percentage of Inpatient Days for Rural Patients
Results of a study evaluating differences in urban hospitals with high and low percentages of rural inpatient days. Features a map showing locations of urban hospitals with greater than 40% rural inpatient days and statistics on urban hospitals with breakdowns by rural inpatient day percentage categories and Medicare payment classifications.
Author(s): Randall John, Kathleen Knocke, George H. Pink
Date: 09/2020
Type: Document
Sponsoring organization: North Carolina Rural Health Research Program
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Results of a study evaluating differences in urban hospitals with high and low percentages of rural inpatient days. Features a map showing locations of urban hospitals with greater than 40% rural inpatient days and statistics on urban hospitals with breakdowns by rural inpatient day percentage categories and Medicare payment classifications.
Author(s): Randall John, Kathleen Knocke, George H. Pink
Date: 09/2020
Type: Document
Sponsoring organization: North Carolina Rural Health Research Program
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Evaluation of the Accountable Care Organization Investment Model: Final Report
Examines the ACO Investment Model (AIM) over three performance years. AIM tested the use of prepaid shared savings to encourage new ACOs to form in rural and underserved areas and to encourage current Medicare Shared Savings Program ACOs to transition to arrangements with greater financial risk. Reports on AIM results related to ACO formation, risk-taking, and sustainability, including the impact of rurality. Also discusses impacts on healthcare costs, utilization, and quality of care.
Additional links: Appendices, CMS Perspective Report, Findings at a Glance
Date: 09/2020
Type: Document
Sponsoring organizations: Abt Associates, Centers for Medicare and Medicaid Services
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Examines the ACO Investment Model (AIM) over three performance years. AIM tested the use of prepaid shared savings to encourage new ACOs to form in rural and underserved areas and to encourage current Medicare Shared Savings Program ACOs to transition to arrangements with greater financial risk. Reports on AIM results related to ACO formation, risk-taking, and sustainability, including the impact of rurality. Also discusses impacts on healthcare costs, utilization, and quality of care.
Additional links: Appendices, CMS Perspective Report, Findings at a Glance
Date: 09/2020
Type: Document
Sponsoring organizations: Abt Associates, Centers for Medicare and Medicaid Services
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