Rural Health
Resources by Topic: Medicare
Estimated Reduction in CAH Profitability from Loss of Cost-Based Reimbursement for Swing Beds
Examines the impact of proposed legislation recommending changes to swing bed reimbursements for Critical Access Hospitals (CAHs) from cost-based to the Skilled Nursing Facility Prospective Payment System (SNF PPS). Estimates CAH profitability using reimbursement formulas from Medicare cost reports and discusses the characteristics of CAHs most affected by a change in swing bed reimbursement.
Author(s): Drake M. Broussard, Kristin L. Reiter
Date: 05/2020
Type: Document
Sponsoring organization: North Carolina Rural Health Research Program
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Examines the impact of proposed legislation recommending changes to swing bed reimbursements for Critical Access Hospitals (CAHs) from cost-based to the Skilled Nursing Facility Prospective Payment System (SNF PPS). Estimates CAH profitability using reimbursement formulas from Medicare cost reports and discusses the characteristics of CAHs most affected by a change in swing bed reimbursement.
Author(s): Drake M. Broussard, Kristin L. Reiter
Date: 05/2020
Type: Document
Sponsoring organization: North Carolina Rural Health Research Program
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As It Grows, Medicare Advantage is Enrolling More Low-Income and Medically Complex Beneficiaries
Examines how the demographics, socioeconomic status, and clinical characteristics of Medicare Advantage enrollees changed between 2012 and 2015. Explores how these changes related to changes in healthcare utilization and performance during this time.
Author(s): Christie Teigland, Zulkarnain Pulungan, Tanya Shah, Eric Schneider, Shawn Bishop
Date: 05/2020
Type: Document
Sponsoring organization: Commonwealth Fund
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Examines how the demographics, socioeconomic status, and clinical characteristics of Medicare Advantage enrollees changed between 2012 and 2015. Explores how these changes related to changes in healthcare utilization and performance during this time.
Author(s): Christie Teigland, Zulkarnain Pulungan, Tanya Shah, Eric Schneider, Shawn Bishop
Date: 05/2020
Type: Document
Sponsoring organization: Commonwealth Fund
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Medicare Primer
A general overview of the Medicare program. Describes the program's history, eligibility criteria, covered services, provider payment systems, and program administration, and financing. Includes information specific to rural areas.
Date: 05/2020
Type: Document
Sponsoring organization: Congressional Research Service
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A general overview of the Medicare program. Describes the program's history, eligibility criteria, covered services, provider payment systems, and program administration, and financing. Includes information specific to rural areas.
Date: 05/2020
Type: Document
Sponsoring organization: Congressional Research Service
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April 2020 MedPAC Meeting Transcript
Transcript from the Medicare Payment Advisory Commission's (MedPAC) April 2020 meeting. Covers value-based payment in Medicare, challenges in maintaining and increasing savings from accountable care organizations, incentives in Medicare Part D, the Medicare Advantage quality bonus program, and Medicare's end-stage renal disease (ESRD) prospective payment system. Includes a discussion of ESRD payment adjustments for rural and low-volume providers.
Date: 04/2020
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Transcript from the Medicare Payment Advisory Commission's (MedPAC) April 2020 meeting. Covers value-based payment in Medicare, challenges in maintaining and increasing savings from accountable care organizations, incentives in Medicare Part D, the Medicare Advantage quality bonus program, and Medicare's end-stage renal disease (ESRD) prospective payment system. Includes a discussion of ESRD payment adjustments for rural and low-volume providers.
Date: 04/2020
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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How & What Will Medicare Pay for RHC Telehealth Visits
Recording of an April 20, 2020, webinar providing information about the Coronavirus Aid, Relief, and Economic Security Act (CARES Act) authorizing Rural Health Clinics (RHCs) to provide telehealth services to Medicare beneficiaries during the COVID-19 public health emergency. Discusses payment procedures for telehealth visits, commonly used telehealth coding, and appropriate cost reporting. Part of the Rural Health Clinic Technical Assistance Series.
Additional links: Presentation Slides, Transcript
Date: 04/2020
Type: Video/Multimedia
Sponsoring organization: National Association of Rural Health Clinics
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Recording of an April 20, 2020, webinar providing information about the Coronavirus Aid, Relief, and Economic Security Act (CARES Act) authorizing Rural Health Clinics (RHCs) to provide telehealth services to Medicare beneficiaries during the COVID-19 public health emergency. Discusses payment procedures for telehealth visits, commonly used telehealth coding, and appropriate cost reporting. Part of the Rural Health Clinic Technical Assistance Series.
Additional links: Presentation Slides, Transcript
Date: 04/2020
Type: Video/Multimedia
Sponsoring organization: National Association of Rural Health Clinics
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Selected Health Provisions in Title III of the CARES Act (P.L. 116-136)
Provides an overview of the healthcare-related provisions of the Coronavirus Aid, Relief, and Economic Security (CARES) Act, passed in response to the COVID-19 pandemic. Focuses on sections of the law addressing medical supply shortages, testing and preventative services, and support for the healthcare workforce. Discusses provisions related to telehealth services and rural healthcare systems.
Date: 04/2020
Type: Document
Sponsoring organization: Congressional Research Service
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Provides an overview of the healthcare-related provisions of the Coronavirus Aid, Relief, and Economic Security (CARES) Act, passed in response to the COVID-19 pandemic. Focuses on sections of the law addressing medical supply shortages, testing and preventative services, and support for the healthcare workforce. Discusses provisions related to telehealth services and rural healthcare systems.
Date: 04/2020
Type: Document
Sponsoring organization: Congressional Research Service
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Social Determinants of Health and 90‐Day Mortality After Hospitalization for Heart Failure in the REGARDS Study
Uses data from the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study to examine associations between social determinants of health (SDOH) and risk of 90-day mortality after heart failure (HF) hospitalization among Medicare beneficiaries aged 65 years or older. Some of the SDOH considered include African American race, social isolation, rural residence, living in a high poverty ZIP code or Health Professional Shortage Area (HPSA), and more.
Author(s): Madeline R. Sterling, Joanna Bryan Ringel, Laura C. Pinheiro, et al.
Citation: Journal of the American Heart Association, 9(9)
Date: 04/2020
Type: Document
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Uses data from the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study to examine associations between social determinants of health (SDOH) and risk of 90-day mortality after heart failure (HF) hospitalization among Medicare beneficiaries aged 65 years or older. Some of the SDOH considered include African American race, social isolation, rural residence, living in a high poverty ZIP code or Health Professional Shortage Area (HPSA), and more.
Author(s): Madeline R. Sterling, Joanna Bryan Ringel, Laura C. Pinheiro, et al.
Citation: Journal of the American Heart Association, 9(9)
Date: 04/2020
Type: Document
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Health Care Provisions in the Families First Coronavirus Response Act, P.L. 116-127
Provides an overview of the healthcare-related provisions of the Families First Coronavirus Response Act, passed in response to the COVID-19 pandemic. Focuses on coverage of COVID-19 testing and related items for individuals covered by Medicare, Medicare Advantage, Medicaid, CHIP, TRICARE, Veterans healthcare, the IHS, and most private plans. Includes a discussion of changes to Medicare coverage of telehealth services.
Date: 04/2020
Type: Document
Sponsoring organization: Congressional Research Service
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Provides an overview of the healthcare-related provisions of the Families First Coronavirus Response Act, passed in response to the COVID-19 pandemic. Focuses on coverage of COVID-19 testing and related items for individuals covered by Medicare, Medicare Advantage, Medicaid, CHIP, TRICARE, Veterans healthcare, the IHS, and most private plans. Includes a discussion of changes to Medicare coverage of telehealth services.
Date: 04/2020
Type: Document
Sponsoring organization: Congressional Research Service
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Rural Hospital Participation in Medicare Accountable Care Organizations
Report explores the rates of rural hospital participation in Medicare Shared Savings Program (SSP) Accountable Care Organizations (ACOs). Details some of the factors that correspond to participation and compares rates by region and by rural status.
Date: 04/2020
Type: Document
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Report explores the rates of rural hospital participation in Medicare Shared Savings Program (SSP) Accountable Care Organizations (ACOs). Details some of the factors that correspond to participation and compares rates by region and by rural status.
Date: 04/2020
Type: Document
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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CMS Native American Contacts
Features Centers for Medicare and Medicaid Services contacts for personnel in the Division of Tribal Affairs and the contacts responsible for the different Indian Health Services areas.
Date: 04/2020
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Features Centers for Medicare and Medicaid Services contacts for personnel in the Division of Tribal Affairs and the contacts responsible for the different Indian Health Services areas.
Date: 04/2020
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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