Rural Health
Resources by Topic: Medicare
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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MedPAC Report to the Congress: Medicare and the Health Care Delivery System, June 2020
Evaluates Medicare payment issues and offers recommendations to the U.S. Congress. Includes chapters on value-based payment in Medicare, Accountable Care Organizations (ACOs), the Medicare Advantage quality bonus program, the impact of changes in the 21st Century Cures Act to risk adjustment for Medicare Advantage enrollees, Medicare Part D, separately payable drugs in the hospital outpatient prospective payment system, and the Medicare end-stage renal disease prospective payment system. Examines the current payment policy for low-volume and rural dialysis facilities and proposes changes.
Additional links: Executive Summary
Date: 06/2020
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Evaluates Medicare payment issues and offers recommendations to the U.S. Congress. Includes chapters on value-based payment in Medicare, Accountable Care Organizations (ACOs), the Medicare Advantage quality bonus program, the impact of changes in the 21st Century Cures Act to risk adjustment for Medicare Advantage enrollees, Medicare Part D, separately payable drugs in the hospital outpatient prospective payment system, and the Medicare end-stage renal disease prospective payment system. Examines the current payment policy for low-volume and rural dialysis facilities and proposes changes.
Additional links: Executive Summary
Date: 06/2020
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Report to Congress on Medicaid and CHIP, June 2020
Semi-annual report to Congress from the Medicaid and CHIP Payment and Access Commission (MACPAC). Discusses care integration for beneficiaries dually eligible for Medicaid and Medicare, recommendations for increasing enrollment in Medicare Shared Savings Programs, the role of Medicaid in relation to TRICARE, how to address increasing mortality and morbidity among pregnant and postpartum women, and the effects of substance use disorder on pregnant and postpartum women and their infants. Includes rural references throughout.
Date: 06/2020
Type: Document
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 care integration for beneficiaries dually eligible for Medicaid and Medicare, recommendations for increasing enrollment in Medicare Shared Savings Programs, the role of Medicaid in relation to TRICARE, how to address increasing mortality and morbidity among pregnant and postpartum women, and the effects of substance use disorder on pregnant and postpartum women and their infants. Includes rural references throughout.
Date: 06/2020
Type: Document
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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Rural/Urban Disparities in Utilization of Diabetes Self-Management Training to the Fee-for-Service Medicare Population
Compares the utilization of Diabetes Self-Management Training (DSMT) services of Medicare recipients in rural and urban areas in 2016. Includes data on DSMT providers, service units, beneficiaries, and average utilization rate in rural and urban counties.
Author(s): Christian Rhudy, Aric Schadler, Jeffery C. Talbert
Date: 06/2020
Type: Document
Sponsoring organization: Rural and Underserved Health Research Center
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Compares the utilization of Diabetes Self-Management Training (DSMT) services of Medicare recipients in rural and urban areas in 2016. Includes data on DSMT providers, service units, beneficiaries, and average utilization rate in rural and urban counties.
Author(s): Christian Rhudy, Aric Schadler, Jeffery C. Talbert
Date: 06/2020
Type: Document
Sponsoring organization: Rural and Underserved Health Research Center
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Rural/Urban Disparities in Utilization of Medical Nutrition Therapy to the Fee-for-Service Medicare Population
Compares the utilization of Medical Nutrition Therapy (MNT) services by Medicare recipients in rural and urban areas in 2016. Includes data on MNT providers, service units, beneficiaries, and average utilization rate in rural and urban counties.
Author(s): Christian Rhudy, Eugene Shin, Jeffery Talbert
Date: 06/2020
Type: Document
Sponsoring organization: Rural and Underserved Health Research Center
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Compares the utilization of Medical Nutrition Therapy (MNT) services by Medicare recipients in rural and urban areas in 2016. Includes data on MNT providers, service units, beneficiaries, and average utilization rate in rural and urban counties.
Author(s): Christian Rhudy, Eugene Shin, Jeffery Talbert
Date: 06/2020
Type: Document
Sponsoring organization: Rural and Underserved Health Research Center
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