Rural Health
Resources by Topic: Medicare
2021 RHC Billing and Coding Update
Recording of a March 9, 2021, webinar providing an overview of coding and billing changes relevant to Rural Health Clinics (RHCs). Discusses guidelines for reporting COVID-19 immunizations and monoclonal antibody infusions, telehealth coding and billing during the COVID-19 public health emergency, ICD-10-CM diagnosis coding for COVID-19, and RHC lab billing and COVID test reporting. Part of the Rural Health Clinic Technical Assistance Series.
Additional links: AMA Code & Guideline Changes, COVID Vaccine Log, Presentation Slides, Transcript
Date: 03/2021
Sponsoring organization: National Association of Rural Health Clinics
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Recording of a March 9, 2021, webinar providing an overview of coding and billing changes relevant to Rural Health Clinics (RHCs). Discusses guidelines for reporting COVID-19 immunizations and monoclonal antibody infusions, telehealth coding and billing during the COVID-19 public health emergency, ICD-10-CM diagnosis coding for COVID-19, and RHC lab billing and COVID test reporting. Part of the Rural Health Clinic Technical Assistance Series.
Additional links: AMA Code & Guideline Changes, COVID Vaccine Log, Presentation Slides, Transcript
Date: 03/2021
Sponsoring organization: National Association of Rural Health Clinics
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Medicare Hospital Payments: Adjusting for Variation in Geographic Area Wages
Provides an overview of the use of the hospital wage index applied to the Medicare inpatient prospective payment system (IPPS) to account for geographic differences in hospitals' labor costs. Discusses the effect of the wage index on Medicare payments for inpatient hospital services, exceptions to wage index adjustments, and proposals for wage index reforms.
Date: 03/2021
Sponsoring organization: Congressional Research Service
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Provides an overview of the use of the hospital wage index applied to the Medicare inpatient prospective payment system (IPPS) to account for geographic differences in hospitals' labor costs. Discusses the effect of the wage index on Medicare payments for inpatient hospital services, exceptions to wage index adjustments, and proposals for wage index reforms.
Date: 03/2021
Sponsoring organization: Congressional Research Service
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The Effect of Medicare Payment Standardization Methods on the Perceived Cost of Post-Acute Swing Bed Care in Critical Access Hospitals
Discusses the different payment systems the Centers for Medicare and Medicaid Services (CMS) uses to reimburse for post-acute care in Critical Access Hospitals (CAHs), prospective payment system (IPPS) hospitals, and skilled nursing facilities (SNFs). Describes how the payment standardization methods may influence post-acute care discharge patterns and access to care for rural residents. Examines the effects of these payment methods on the perceived cost of CAH swing bed care as it relates to the Medicare Spending per Beneficiary performance measure.
Author(s): Tyler Malone, Denise Kirk, Kristin Reiter
Date: 03/2021
Sponsoring organization: North Carolina Rural Health Research Program
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Discusses the different payment systems the Centers for Medicare and Medicaid Services (CMS) uses to reimburse for post-acute care in Critical Access Hospitals (CAHs), prospective payment system (IPPS) hospitals, and skilled nursing facilities (SNFs). Describes how the payment standardization methods may influence post-acute care discharge patterns and access to care for rural residents. Examines the effects of these payment methods on the perceived cost of CAH swing bed care as it relates to the Medicare Spending per Beneficiary performance measure.
Author(s): Tyler Malone, Denise Kirk, Kristin Reiter
Date: 03/2021
Sponsoring organization: North Carolina Rural Health Research Program
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Sources of Insurance Coverage in Nonmetropolitan Areas: The Role of Public and Private Insurance Since 2009
Describes regional variation in insurance coverage rates, using the American Community Survey 5-year estimates from 2009-2013 and 2013-2017 to compare types of health insurance coverage for people less than 65 years of age. Features statistics including share of nonmetropolitan nonelderly population per region, health insurance rates for nonelderly with breakdowns by metropolitan and nonmetropolitan areas, and source of health insurance for nonelderly by region.
Author(s): Linda Li, Matthew Najarian, Abigail R. Barker, Timothy D. McBride, Keith J. Mueller
Date: 03/2021
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Describes regional variation in insurance coverage rates, using the American Community Survey 5-year estimates from 2009-2013 and 2013-2017 to compare types of health insurance coverage for people less than 65 years of age. Features statistics including share of nonmetropolitan nonelderly population per region, health insurance rates for nonelderly with breakdowns by metropolitan and nonmetropolitan areas, and source of health insurance for nonelderly by region.
Author(s): Linda Li, Matthew Najarian, Abigail R. Barker, Timothy D. McBride, Keith J. Mueller
Date: 03/2021
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Rural-Urban Disparities in All-cause Mortality among Low-Income Medicare Beneficiaries, 2004–17
Examines the change in all-cause mortality rates among low-income Medicare beneficiaries dually-enrolled in Medicaid between 2004 and 2017. Compares rates between rural and urban beneficiaries by age, ethnicity, insurance type, and census region.
Author(s): Emefah Loccoh, Karen E. Joynt Maddox, Jiaman Xu, et al.
Citation: Health Affairs, 40(2), 289-296
Date: 02/2021
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Examines the change in all-cause mortality rates among low-income Medicare beneficiaries dually-enrolled in Medicaid between 2004 and 2017. Compares rates between rural and urban beneficiaries by age, ethnicity, insurance type, and census region.
Author(s): Emefah Loccoh, Karen E. Joynt Maddox, Jiaman Xu, et al.
Citation: Health Affairs, 40(2), 289-296
Date: 02/2021
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Medicare Reimbursement in Rural America
Policy brief discussing Medicare reimbursement for services provided at rural hospitals and how it impacts hospital finances. Provides policy recommendations for rural health reimbursement, and identifies and other considerations for addressing rural healthcare sustainability.
Author(s): Eric Schlidt, Cody Wilkinson
Date: 02/2021
Sponsoring organization: National Rural Health Association
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Policy brief discussing Medicare reimbursement for services provided at rural hospitals and how it impacts hospital finances. Provides policy recommendations for rural health reimbursement, and identifies and other considerations for addressing rural healthcare sustainability.
Author(s): Eric Schlidt, Cody Wilkinson
Date: 02/2021
Sponsoring organization: National Rural Health Association
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Availability of Supplemental Benefits in Medicare Advantage Plans in Rural and Urban Areas
Examines differences in Medicare Advantage (MA) plans with supplemental benefits that are available to enrollees in nonmetropolitan and metropolitan areas. Features statistics including average number of organizations offering MA plans, proportion of MA plans offering supplemental benefits, and MA plan premiums as of 2020, with breakdowns by noncore, micropolitan, and metropolitan counties.
Author(s): Jason Semprini, Fred Ullrich, Keith J. Mueller
Date: 02/2021
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Examines differences in Medicare Advantage (MA) plans with supplemental benefits that are available to enrollees in nonmetropolitan and metropolitan areas. Features statistics including average number of organizations offering MA plans, proportion of MA plans offering supplemental benefits, and MA plan premiums as of 2020, with breakdowns by noncore, micropolitan, and metropolitan counties.
Author(s): Jason Semprini, Fred Ullrich, Keith J. Mueller
Date: 02/2021
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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High-Functioning Rural Medicare ACOs – A Qualitative Review
Describes the success factors common to high-performing Accountable Care Organizations (ACOs) based in rural areas of New York, Maine, Missouri and Arkansas, and New Hampshire. Examines these organizations' governance, ACO history, operations, finances, population health, and lessons learned.
Author(s): Thomas Vaughn, Keith Mueller, Clinton MacKinney
Date: 02/2021
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Describes the success factors common to high-performing Accountable Care Organizations (ACOs) based in rural areas of New York, Maine, Missouri and Arkansas, and New Hampshire. Examines these organizations' governance, ACO history, operations, finances, population health, and lessons learned.
Author(s): Thomas Vaughn, Keith Mueller, Clinton MacKinney
Date: 02/2021
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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MBQIP Quality Measures National Annual Report - 2019
Summarizes quality measure reporting rates and performance among Critical Access Hospitals (CAHs) in 2019. Presents data on the four Medicare Beneficiary Quality Improvement Project (MBQIP) domains: patient safety/inpatient, outpatient, patient engagement, and care transitions.
Author(s): Megan Lahr, Madeleine Pick, Tongtan Chantarat, Nathan Bean, Ira Moscovice
Date: 02/2021
Sponsoring organization: Flex Monitoring Team
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Summarizes quality measure reporting rates and performance among Critical Access Hospitals (CAHs) in 2019. Presents data on the four Medicare Beneficiary Quality Improvement Project (MBQIP) domains: patient safety/inpatient, outpatient, patient engagement, and care transitions.
Author(s): Megan Lahr, Madeleine Pick, Tongtan Chantarat, Nathan Bean, Ira Moscovice
Date: 02/2021
Sponsoring organization: Flex Monitoring Team
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Health System Challenges for Critical Access Hospitals: Findings from a National Survey of CAH Executives
Results of a 2019 survey of 174 respondents, examining challenges including uncompensated care, affordability of health insurance, patients seeking care beyond their local hospital, and prescription drug prices. Intended to help rural health policymakers in development of strategies to maintain Critical Access Hospital viability and access to healthcare in rural communities.
Author(s): Sharita Thomas, Kristie Thompson, Kathleen Knocke, George Pink
Date: 02/2021
Sponsoring organization: North Carolina Rural Health Research Program
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Results of a 2019 survey of 174 respondents, examining challenges including uncompensated care, affordability of health insurance, patients seeking care beyond their local hospital, and prescription drug prices. Intended to help rural health policymakers in development of strategies to maintain Critical Access Hospital viability and access to healthcare in rural communities.
Author(s): Sharita Thomas, Kristie Thompson, Kathleen Knocke, George Pink
Date: 02/2021
Sponsoring organization: North Carolina Rural Health Research Program
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