Rural Health
Resources by Topic: Medicare
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
Sponsoring organization: Centers for Medicare and Medicaid Services
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Final CY 2022 Physician Fee Schedule
Fact sheet addressing the Centers for Medicare and Medicaid Services policies for Medicare beginning on January 1, 2022. Includes sections on telehealth services, the Consolidated Appropriations Act, audio-only services, communications technology based services, Federally Qualified Health Centers and Rural Health Clinics, and additional policies.
Date: 11/2021
Sponsoring organization: Center for Connected Health Policy: The National Telehealth Policy Resource Center
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Fact sheet addressing the Centers for Medicare and Medicaid Services policies for Medicare beginning on January 1, 2022. Includes sections on telehealth services, the Consolidated Appropriations Act, audio-only services, communications technology based services, Federally Qualified Health Centers and Rural Health Clinics, and additional policies.
Date: 11/2021
Sponsoring organization: Center for Connected Health Policy: The National Telehealth Policy Resource Center
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Network Adequacy for Behavioral Health: Existing Standards and Considerations for Designing Standards
Summarizes findings from a technical expert panel and an environmental scan to examine federal and state network adequacy standards for behavioral health across Medicare Advantage, Medicaid managed care, and commercial insurance. Presents considerations and principles for designing, monitoring, and enforcing additional behavioral health network adequacy standards.
Author(s): Katharine Bradley, Allison Wishon, Alexandra C. Donnelly, Amanda Lechner
Date: 11/2021
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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Summarizes findings from a technical expert panel and an environmental scan to examine federal and state network adequacy standards for behavioral health across Medicare Advantage, Medicaid managed care, and commercial insurance. Presents considerations and principles for designing, monitoring, and enforcing additional behavioral health network adequacy standards.
Author(s): Katharine Bradley, Allison Wishon, Alexandra C. Donnelly, Amanda Lechner
Date: 11/2021
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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