Rural Health
Resources by Topic: Medicare
Medicare Advantage Versus the Traditional Medicare Program: Costs of Inpatient Stays, 2009–2017
Examines the costs of hospital inpatient stays among patients 65 years of age and older with a primary expected payer of Medicare Advantage compared to traditional Medicare, based on data from 18 states. Includes data by location of patient residence for rural, micropolitan, small metropolitan, and large metropolitan areas.
Author(s): Brian J. Moore, Lan Liang
Date: 08/2020
Type: Document
Sponsoring organization: Agency for Healthcare Research and Quality
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Examines the costs of hospital inpatient stays among patients 65 years of age and older with a primary expected payer of Medicare Advantage compared to traditional Medicare, based on data from 18 states. Includes data by location of patient residence for rural, micropolitan, small metropolitan, and large metropolitan areas.
Author(s): Brian J. Moore, Lan Liang
Date: 08/2020
Type: Document
Sponsoring organization: Agency for Healthcare Research and Quality
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Medicare's Mental Health Coverage: How COVID-19 Highlights Gaps and Opportunities for Improvement
Report explores Medicare beneficiaries' access to mental healthcare during the COVID-19 pandemic. Breaks down data by beneficiary type, severity of illness, and rural versus urban location, among other measures. Highlights barriers to care and makes recommendations for the future.
Author(s): Beth McGinty
Date: 07/2020
Type: Document
Sponsoring organization: Commonwealth Fund
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Report explores Medicare beneficiaries' access to mental healthcare during the COVID-19 pandemic. Breaks down data by beneficiary type, severity of illness, and rural versus urban location, among other measures. Highlights barriers to care and makes recommendations for the future.
Author(s): Beth McGinty
Date: 07/2020
Type: Document
Sponsoring organization: Commonwealth Fund
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Medicare Beneficiary Use of Telehealth Visits: Early Data from the Start of the COVID-19 Pandemic
Examines changes in Medicare in-person primary care visits and the use of telehealth services at the start of the COVID-19 public health emergency. Discusses how Medicare telehealth flexibilities implemented in response to COVID-19 impacted access to these services. Compares the percentage of primary care telehealth visits between rural and urban providers. Includes a county-level map displaying the percentage of primary care visits conducted via telehealth services in April 2020.
Date: 07/2020
Type: Document
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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Examines changes in Medicare in-person primary care visits and the use of telehealth services at the start of the COVID-19 public health emergency. Discusses how Medicare telehealth flexibilities implemented in response to COVID-19 impacted access to these services. Compares the percentage of primary care telehealth visits between rural and urban providers. Includes a county-level map displaying the percentage of primary care visits conducted via telehealth services in April 2020.
Date: 07/2020
Type: Document
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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Independent Evaluation of Comprehensive Primary Care Plus (CPC+): Second Annual Report
Reports on the first two program years of the CPC+, 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 practices changes and outcomes for Medicare fee-for-service beneficiaries. Includes statistics with breakdowns by rural, suburban, or urban practice location.
Additional links: Appendices to the Supplemental Volume, CMS Perspective Report, Findings at a Glance, Supplemental Volume
Date: 07/2020
Type: Document
Sponsoring organizations: Centers for Medicare and Medicaid Services, Mathematica
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Reports on the first two program years of the CPC+, 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 practices changes and outcomes for Medicare fee-for-service beneficiaries. Includes statistics with breakdowns by rural, suburban, or urban practice location.
Additional links: Appendices to the Supplemental Volume, CMS Perspective Report, Findings at a Glance, Supplemental Volume
Date: 07/2020
Type: Document
Sponsoring organizations: Centers for Medicare and Medicaid Services, Mathematica
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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 2021
Comments on a May 29, 2020, Federal Register proposed rule revising the hospital inpatient and long-term care hospital (LTCH) prospective payment systems. Discusses proposals to use commercial insurer data to set Medicare severity–diagnosis related group (MS–DRG) relative weights and adopt changes to geographic area delineations to establish hospital wage indexes for the IPPS and LTCH PPS.
Date: 07/2020
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Comments on a May 29, 2020, Federal Register proposed rule revising the hospital inpatient and long-term care hospital (LTCH) prospective payment systems. Discusses proposals to use commercial insurer data to set Medicare severity–diagnosis related group (MS–DRG) relative weights and adopt changes to geographic area delineations to establish hospital wage indexes for the IPPS and LTCH PPS.
Date: 07/2020
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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The Impact of Medicare's Rural Add-on Payments on Supply of Home Health Agencies Serving Rural Counties
Examines how Medicare rural add-on payments affected the number of home health agencies serving rural counties between 2002-2017. Compares the population-adjusted number of home health agencies in urban, urban-adjacent non-urban-adjacent rural counties during periods with add-on payments and without add-on payments. Discusses implications for revised and future add-on payments to maintain or increase the supply of rural home health agencies.
Author(s): Tracy M. Mroz, Davis G. Patterson, Bianca K. Frogner
Citation: Health Affairs, 39(6), 949-957
Date: 06/2020
Type: Document
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Examines how Medicare rural add-on payments affected the number of home health agencies serving rural counties between 2002-2017. Compares the population-adjusted number of home health agencies in urban, urban-adjacent non-urban-adjacent rural counties during periods with add-on payments and without add-on payments. Discusses implications for revised and future add-on payments to maintain or increase the supply of rural home health agencies.
Author(s): Tracy M. Mroz, Davis G. Patterson, Bianca K. Frogner
Citation: Health Affairs, 39(6), 949-957
Date: 06/2020
Type: Document
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Out‐of‐Network Air Ambulance Bills: Prevalence, Magnitude, and Policy Solutions
Examines the prevalence and cost of surprise air ambulance bills among privately insured patients. Describes air ambulance rates for commercial payers in relation to Medicare rates. Compares the number of air ambulance claims from urban and rural locations. Offers policy solutions to address surprise and out-of-network bills for these services.
Author(s): Erin C. Fuse Brown, Erin Trish, Bich Ly, Mark Hall, Loren Adler
Citation: Milbank Quarterly, 98(3), 747-774
Date: 06/2020
Type: Document
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Examines the prevalence and cost of surprise air ambulance bills among privately insured patients. Describes air ambulance rates for commercial payers in relation to Medicare rates. Compares the number of air ambulance claims from urban and rural locations. Offers policy solutions to address surprise and out-of-network bills for these services.
Author(s): Erin C. Fuse Brown, Erin Trish, Bich Ly, Mark Hall, Loren Adler
Citation: Milbank Quarterly, 98(3), 747-774
Date: 06/2020
Type: Document
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How Telehealth Policy is Structured in the United States
June 23, 2020, webinar recording provides an overview of the telehealth policy landscape on the federal and state levels. Discusses telehealth reimbursement policies. Outlines federal and state telehealth policy changes as a result of the COVID-19 pandemic.
Additional links: Presentation Slides
Date: 06/2020
Type: Video/Multimedia
Sponsoring organization: Center for Connected Health Policy: The National Telehealth Policy Resource Center
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June 23, 2020, webinar recording provides an overview of the telehealth policy landscape on the federal and state levels. Discusses telehealth reimbursement policies. Outlines federal and state telehealth policy changes as a result of the COVID-19 pandemic.
Additional links: Presentation Slides
Date: 06/2020
Type: Video/Multimedia
Sponsoring organization: Center for Connected Health Policy: The National Telehealth Policy Resource Center
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Provision of Mental Health Services by Critical Access Hospital-Based Rural Health Clinics
Examines the extent to which Critical Access Hospital (CAH)-based Rural Health Clinics (RHCs) provide mental health services. Describes the characteristics and staffing patterns of CAH-based RHCs that offer these services. Explores challenges of providing mental health services at RHCs and strategies for integrating mental health and primary care services.
Author(s): John Gale, Zacharia Croll, Nathan First, Sara Kahn-Troster
Date: 06/2020
Type: Document
Sponsoring organization: Flex Monitoring Team
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Examines the extent to which Critical Access Hospital (CAH)-based Rural Health Clinics (RHCs) provide mental health services. Describes the characteristics and staffing patterns of CAH-based RHCs that offer these services. Explores challenges of providing mental health services at RHCs and strategies for integrating mental health and primary care services.
Author(s): John Gale, Zacharia Croll, Nathan First, Sara Kahn-Troster
Date: 06/2020
Type: Document
Sponsoring organization: Flex Monitoring Team
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CMS Bundled Payments for Care Improvement Advanced Model: Year 1 Evaluation Annual Report
A formative evaluation of the Bundled Payments for Care Improvement Advanced (BPCI Advanced) Model, which tests whether linking payments for a clinical episode of care can reduce Medicare expenditures while maintaining or improving quality of care. Covers the period from October 1, 2018 through March 31, 2019. Describes participants in the model, clinical episodes included, and the reach of the model. Includes information on rural hospital participation in the model.
Additional links: Appendices, Findings at a Glance
Author(s): The Lewin Group, Abt Associates, GDIT, Telligen
Date: 06/2020
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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A formative evaluation of the Bundled Payments for Care Improvement Advanced (BPCI Advanced) Model, which tests whether linking payments for a clinical episode of care can reduce Medicare expenditures while maintaining or improving quality of care. Covers the period from October 1, 2018 through March 31, 2019. Describes participants in the model, clinical episodes included, and the reach of the model. Includes information on rural hospital participation in the model.
Additional links: Appendices, Findings at a Glance
Author(s): The Lewin Group, Abt Associates, GDIT, Telligen
Date: 06/2020
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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