Rural Health
Resources by Topic: Medicare
Developing Risk-Adjusted Avoidable Hospitalizations and Emergency Department Visits Quality Measures: Final Report
Defines avoidable hospitalization (AH) and avoidable emergency department (ED) visits (AVs) and summarizes the development of a model for calculating expected AH and AV rates using Medicare claims data. Seeks to inform Medicare quality payment models and target areas for quality improvement. Table 3-10 includes AH and AV risk-standardized rates for a number of rural market areas.
Author(s): Zhanlian Feng, Benjamin Silver, Micah Segelman, et al.
Date: 08/2019
Type: Document
Sponsoring organizations: Medicare Payment Advisory Commission, RTI International
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Defines avoidable hospitalization (AH) and avoidable emergency department (ED) visits (AVs) and summarizes the development of a model for calculating expected AH and AV rates using Medicare claims data. Seeks to inform Medicare quality payment models and target areas for quality improvement. Table 3-10 includes AH and AV risk-standardized rates for a number of rural market areas.
Author(s): Zhanlian Feng, Benjamin Silver, Micah Segelman, et al.
Date: 08/2019
Type: Document
Sponsoring organizations: Medicare Payment Advisory Commission, RTI International
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Addressing Rural Hospital Closures Through Infrastructure Reform
Provides a historical overview of rural Medicare reimbursement and provider designations and discusses their impact on hospital closures. Supports changing the rural health infrastructure to provide more flexibility for rural hospitals and to emphasize primary care and emergency care access.
Author(s): Eleni Salyers
Date: 08/2019
Type: Document
Sponsoring organization: Bipartisan Policy Center
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Provides a historical overview of rural Medicare reimbursement and provider designations and discusses their impact on hospital closures. Supports changing the rural health infrastructure to provide more flexibility for rural hospitals and to emphasize primary care and emergency care access.
Author(s): Eleni Salyers
Date: 08/2019
Type: Document
Sponsoring organization: Bipartisan Policy Center
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Solutions to Reduce Fraud, Waste, and Abuse in HHS Programs: OIG's Top Recommendations
Annual report identifying the top 25 unimplemented recommendations from the Office of Inspector General (OIG) that, in their view, would have the most substantial positive impact on Health and Human Services (HHS) programs. Positive impact may refer to cost savings, program efficacy and efficiency, and/or quality improvement. Primary areas of interest in the July 2019 edition include: reforming the hospital wage index system, a quality program and disaster planning for Indian Health Service (IHS) hospitals, and Medicaid payments for 340B drugs.
Date: 07/2019
Type: Document
Sponsoring organization: Office of Inspector General (HHS)
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Annual report identifying the top 25 unimplemented recommendations from the Office of Inspector General (OIG) that, in their view, would have the most substantial positive impact on Health and Human Services (HHS) programs. Positive impact may refer to cost savings, program efficacy and efficiency, and/or quality improvement. Primary areas of interest in the July 2019 edition include: reforming the hospital wage index system, a quality program and disaster planning for Indian Health Service (IHS) hospitals, and Medicaid payments for 340B drugs.
Date: 07/2019
Type: Document
Sponsoring organization: Office of Inspector General (HHS)
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Support and Services at Home (SASH) Evaluation: SASH Evaluation Findings, 2010-2016
Evaluates the Support and Services at Home (SASH) program in Vermont, which provides support services and care coordination for older adults and people with disabilities in conjunction with affordable housing. Addresses Medicaid and Medicare expenditures, medication management, property management, challenges, and lessons learned. Identifies the percent of rural SASH host properties and differences for rural areas.
Additional links: Highlights
Author(s): Amy Kandilov, Vincent Keyes, Noëlle Siegfried, et al.
Date: 07/2019
Type: Document
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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Evaluates the Support and Services at Home (SASH) program in Vermont, which provides support services and care coordination for older adults and people with disabilities in conjunction with affordable housing. Addresses Medicaid and Medicare expenditures, medication management, property management, challenges, and lessons learned. Identifies the percent of rural SASH host properties and differences for rural areas.
Additional links: Highlights
Author(s): Amy Kandilov, Vincent Keyes, Noëlle Siegfried, et al.
Date: 07/2019
Type: Document
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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A Rural Health Crisis: The Changing Landscape of the 1980s and Beyond
Brief video overview of issues in the 1980s that resulted in a wave of rural hospital closures, including an economic shift from manufacturing, farm closures, and changes in the Medicare payment system.
Date: 06/2019
Type: Video/Multimedia
Sponsoring organization: Rural Health Information Hub
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Brief video overview of issues in the 1980s that resulted in a wave of rural hospital closures, including an economic shift from manufacturing, farm closures, and changes in the Medicare payment system.
Date: 06/2019
Type: Video/Multimedia
Sponsoring organization: Rural Health Information Hub
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Accountable Care Organizations Exiting the Medicare Shared Savings Program: Policy and Organizational Determinants
Poster presented at the 2019 AcademyHealth Annual Research Meeting on trends in Accountable Care Organization (ACO) exits. Identifies organizational factors such as rural/urban location affecting ACO exit, as well as policy-related motivations, such as financial incentives.
Author(s): Huang Huang, Xi Zhu, Keith Mueller, Clinton MacKinney
Date: 06/2019
Type: Document
Sponsoring organization: University of Iowa College of Public Health
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Poster presented at the 2019 AcademyHealth Annual Research Meeting on trends in Accountable Care Organization (ACO) exits. Identifies organizational factors such as rural/urban location affecting ACO exit, as well as policy-related motivations, such as financial incentives.
Author(s): Huang Huang, Xi Zhu, Keith Mueller, Clinton MacKinney
Date: 06/2019
Type: Document
Sponsoring organization: University of Iowa College of Public Health
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MedPAC Comment on CMS's Proposed Rule on the Hospital Inpatient Prospective Payment System and the Long-term Care Hospital Prospective Payment System for FY 2020
Comments on a May 3, 2019, Federal Register proposed rule revising the hospital inpatient and long-term care hospital (LTCH) prospective payment systems. Addresses proposed changes to the hospital wage index, including rural floor calculations, uncompensated care measurements that affect disproportionate share (DSH) payments, inpatient and outpatient proposals related to drugs and devices, and the LTCH prospective payment system.
Date: 06/2019
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Comments on a May 3, 2019, Federal Register proposed rule revising the hospital inpatient and long-term care hospital (LTCH) prospective payment systems. Addresses proposed changes to the hospital wage index, including rural floor calculations, uncompensated care measurements that affect disproportionate share (DSH) payments, inpatient and outpatient proposals related to drugs and devices, and the LTCH prospective payment system.
Date: 06/2019
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Insurer Participation in Rural Health Insurance Marketplaces: Are Some Markets Intrinsically More Competitive Than Others?
Policy position brief reporting on analyses of insurer participation data in the Federal Employees Health Benefits Program, Medicare Advantage, and Health Insurance Marketplaces (HIMs). Assesses to what extent participation in HIMs may be associated with prior levels of local market competition. Includes statistics on prior market competition in low-population-density counties in 2014 and 2017, and county characteristics associated with low insurer participation, with comparisons between metro and nonmetro counties.
Author(s): Abigail R. Barker, Timothy D. McBride, Keith J. Mueller
Date: 06/2019
Type: Document
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Policy position brief reporting on analyses of insurer participation data in the Federal Employees Health Benefits Program, Medicare Advantage, and Health Insurance Marketplaces (HIMs). Assesses to what extent participation in HIMs may be associated with prior levels of local market competition. Includes statistics on prior market competition in low-population-density counties in 2014 and 2017, and county characteristics associated with low insurer participation, with comparisons between metro and nonmetro counties.
Author(s): Abigail R. Barker, Timothy D. McBride, Keith J. Mueller
Date: 06/2019
Type: Document
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Lower Health Care Costs Act
Recording of a U.S. Senate Committee on Health, Education, Labor and Pensions hearing on the Lower Health Care Costs Act, which covers access to healthcare, surprise medical bills, market competition, drug prices, and other issues. Includes testimony from an organization that works primarily with small and rural practices, the American Hospital Association, American Enterprise Institute, and others.
Additional links: Benedic N. Ippolito Testimony, Sean Cavanaugh Testimony, Tom Nickels Testimony
Date: 06/2019
Type: Video/Multimedia
Sponsoring organization: Senate Committee on Health, Education, Labor & Pensions
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Recording of a U.S. Senate Committee on Health, Education, Labor and Pensions hearing on the Lower Health Care Costs Act, which covers access to healthcare, surprise medical bills, market competition, drug prices, and other issues. Includes testimony from an organization that works primarily with small and rural practices, the American Hospital Association, American Enterprise Institute, and others.
Additional links: Benedic N. Ippolito Testimony, Sean Cavanaugh Testimony, Tom Nickels Testimony
Date: 06/2019
Type: Video/Multimedia
Sponsoring organization: Senate Committee on Health, Education, Labor & Pensions
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MedPAC Comment on CMS's Proposed Rule on the Skilled Nursing Facility PPS for FY 2020
Comments on an April 25, 2019, Federal Register proposed rule updating payments for Skilled Nursing Facilities (SNFs) and SNF quality reporting. Addresses proposed changes to the wage index system that would adjust for geographical differences, potentially impacting rural areas.
Date: 06/2019
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Comments on an April 25, 2019, Federal Register proposed rule updating payments for Skilled Nursing Facilities (SNFs) and SNF quality reporting. Addresses proposed changes to the wage index system that would adjust for geographical differences, potentially impacting rural areas.
Date: 06/2019
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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