Rural Health
Resources by Topic: Medicare
Perspectives of Physicians in Small Rural Practices on the Medicare Quality Payment Program
Provides feedback from small, rural practices on the implementation of Medicare's Quality Payment Program (QPP), which includes the Merit-Based Incentive Payment System (MIPS) and Advanced Alternative Payment Models (APMs). Identifies challenges rural physicians face and offers recommendations to help more small practices participate in the program.
Author(s): Peter Mendel, Christine Buttorff, Peggy G. Chen, et al.
Date: 2019
Sponsoring organizations: HHS Office of the Assistant Secretary for Planning and Evaluation, RAND Corporation
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Provides feedback from small, rural practices on the implementation of Medicare's Quality Payment Program (QPP), which includes the Merit-Based Incentive Payment System (MIPS) and Advanced Alternative Payment Models (APMs). Identifies challenges rural physicians face and offers recommendations to help more small practices participate in the program.
Author(s): Peter Mendel, Christine Buttorff, Peggy G. Chen, et al.
Date: 2019
Sponsoring organizations: HHS Office of the Assistant Secretary for Planning and Evaluation, RAND Corporation
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State Innovation Models (SIM) Initiative Evaluation: Model Test Year Five Annual Report
Fifth annual report on Round 1 of the CMS State Innovation Models (SIM) Initiative, which tests the ability of the governments in six states - Arkansas, Maine, Massachusetts, Minnesota, Oregon, and Vermont - to move providers to value-based payment models (VPMs). Presents the final summary findings for SIM Round 1. Includes information specific to rural areas.
Additional links: Appendices, Findings at a Glance
Date: 12/2018
Sponsoring organizations: Centers for Medicare and Medicaid Services, RTI International
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Fifth annual report on Round 1 of the CMS State Innovation Models (SIM) Initiative, which tests the ability of the governments in six states - Arkansas, Maine, Massachusetts, Minnesota, Oregon, and Vermont - to move providers to value-based payment models (VPMs). Presents the final summary findings for SIM Round 1. Includes information specific to rural areas.
Additional links: Appendices, Findings at a Glance
Date: 12/2018
Sponsoring organizations: Centers for Medicare and Medicaid Services, RTI International
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Medicare: Voluntary and Mandatory Episode-Based Payment Models and Their Participants
Reviews tests of 6 episode-based Medicare payment models. Describes the characteristics of providers that participated in these models, including rural or urban location, addresses factors affecting their decision to participate, and compares the advantages of mandatory versus voluntary participation.
Additional links: Full Report
Date: 12/2018
Sponsoring organization: Government Accountability Office
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Reviews tests of 6 episode-based Medicare payment models. Describes the characteristics of providers that participated in these models, including rural or urban location, addresses factors affecting their decision to participate, and compares the advantages of mandatory versus voluntary participation.
Additional links: Full Report
Date: 12/2018
Sponsoring organization: Government Accountability Office
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Medicare Fee-for-Service: Information on the Second Year of Nationwide Reduced Payment Rates for Durable Medical Equipment
Analyzes 2017 Medicare claims data to describe changes in the number of beneficiaries receiving and suppliers furnishing Medicare beneficiaries with rate-adjusted versus non-adjusted items in non-bid areas. Includes information on changes in rural and non-rural non-bid areas.
Additional links: Full Report
Date: 12/2018
Sponsoring organization: Government Accountability Office
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Analyzes 2017 Medicare claims data to describe changes in the number of beneficiaries receiving and suppliers furnishing Medicare beneficiaries with rate-adjusted versus non-adjusted items in non-bid areas. Includes information on changes in rural and non-rural non-bid areas.
Additional links: Full Report
Date: 12/2018
Sponsoring organization: Government Accountability Office
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Indian Health Service: Spending Levels and Characteristics of IHS and Three Other Federal Health Care Programs
Compares Indian Health Services (IHS) spending with other federal programs that provide healthcare services, such as the Veterans Health Administration (VHA), Medicare, and Medicaid. Looks at the different services provided by each program and the way each program is funded.
Additional links: Full Report
Date: 12/2018
Sponsoring organization: Government Accountability Office
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Compares Indian Health Services (IHS) spending with other federal programs that provide healthcare services, such as the Veterans Health Administration (VHA), Medicare, and Medicaid. Looks at the different services provided by each program and the way each program is funded.
Additional links: Full Report
Date: 12/2018
Sponsoring organization: Government Accountability Office
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Sources of Supplemental Coverage Among Medicare Beneficiaries in 2016
Examines sources of supplemental coverage for traditional Medicare beneficiaries with breakdowns by race/ethnicity, income, rural location, and more.
Author(s): Juliette Cubanski, Anthony Damico, Tricia Neuman, Gretchen Jacobson
Date: 11/2018
Sponsoring organization: KFF
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Examines sources of supplemental coverage for traditional Medicare beneficiaries with breakdowns by race/ethnicity, income, rural location, and more.
Author(s): Juliette Cubanski, Anthony Damico, Tricia Neuman, Gretchen Jacobson
Date: 11/2018
Sponsoring organization: KFF
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Significant Vulnerabilities Exist in the Hospital Wage Index System for Medicare Payments
Reports on 41 examinations of wage data of individual acute care hospitals from 2004 to 2017 to describe significant vulnerabilities observed in the wage index system for Medicare payments. Includes discussion on the rural floor wage index and the effects it has on wage index accuracy. Offers recommendations to reform the hospital wage index system.
Date: 11/2018
Sponsoring organization: Office of Inspector General (HHS)
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Reports on 41 examinations of wage data of individual acute care hospitals from 2004 to 2017 to describe significant vulnerabilities observed in the wage index system for Medicare payments. Includes discussion on the rural floor wage index and the effects it has on wage index accuracy. Offers recommendations to reform the hospital wage index system.
Date: 11/2018
Sponsoring organization: Office of Inspector General (HHS)
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Update: Rural/Urban Disparities in Pneumococcal Vaccine Service Delivery Among the Fee-for-Service Medicare Population, 2012-2015
Updated report on a study to identify disparities in vaccine provision to people ages 65 and over, and to assess the impact of pharmacies as alternate site providers in rural areas. Revised version specifically assesses the uptake of the 13-valent pneumococcal conjugate vaccine, in response to the revised vaccination recommendations issued in 2014. Includes statistics on pneumococcal vaccine services provided by fee-for-service pharmacies and primary care providers, with breakdowns by rural and urban frequency, and state-level maps with rate of service delivery per eligible population, using 2014 and 2015 data.
Author(s): Joseph C. Vanghelof, Aric Schadler, Patricia R. Freeman, Jeffery C. Talbert
Date: 11/2018
Sponsoring organization: Rural and Underserved Health Research Center
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Updated report on a study to identify disparities in vaccine provision to people ages 65 and over, and to assess the impact of pharmacies as alternate site providers in rural areas. Revised version specifically assesses the uptake of the 13-valent pneumococcal conjugate vaccine, in response to the revised vaccination recommendations issued in 2014. Includes statistics on pneumococcal vaccine services provided by fee-for-service pharmacies and primary care providers, with breakdowns by rural and urban frequency, and state-level maps with rate of service delivery per eligible population, using 2014 and 2015 data.
Author(s): Joseph C. Vanghelof, Aric Schadler, Patricia R. Freeman, Jeffery C. Talbert
Date: 11/2018
Sponsoring organization: Rural and Underserved Health Research Center
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Information on Medicare Telehealth
Report to Congress, as mandated by the 21st Century Cures Act, examining how Medicare patients are using telehealth, particularly in rural areas, with breakdowns by race/ethnicity, age group, and primary diagnoses including mental health issues. Includes an analysis of Medicare claims data regarding high volume services that could be delivered through telehealth, an overview of telehealth models funded by the Center for Medicare and Medicaid Innovation, and state-level breakdowns of Medicare telehealth data. Discusses who may benefit from telehealth expansion and barriers to expansion.
Date: 11/2018
Sponsoring organization: Centers for Medicare and Medicaid Services
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Report to Congress, as mandated by the 21st Century Cures Act, examining how Medicare patients are using telehealth, particularly in rural areas, with breakdowns by race/ethnicity, age group, and primary diagnoses including mental health issues. Includes an analysis of Medicare claims data regarding high volume services that could be delivered through telehealth, an overview of telehealth models funded by the Center for Medicare and Medicaid Innovation, and state-level breakdowns of Medicare telehealth data. Discusses who may benefit from telehealth expansion and barriers to expansion.
Date: 11/2018
Sponsoring organization: Centers for Medicare and Medicaid Services
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Report to Congress: Rural Community Hospital Demonstration
Summarizes findings from the Rural Community Hospital Demonstration (RCHD) over the twelve years authorized by the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) and the Patient Protection and Affordable Care Act (ACA). Reports on the characteristics of the participating hospitals and the effect of the demonstration on hospital finances and other outcomes. Also discusses steps the hospitals expected to take at the end of the demonstration, if it had not been extended for an additional five years by the 21st Century Cures Act of 2016.
Date: 10/2018
Sponsoring organization: Centers for Medicare and Medicaid Services
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Summarizes findings from the Rural Community Hospital Demonstration (RCHD) over the twelve years authorized by the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) and the Patient Protection and Affordable Care Act (ACA). Reports on the characteristics of the participating hospitals and the effect of the demonstration on hospital finances and other outcomes. Also discusses steps the hospitals expected to take at the end of the demonstration, if it had not been extended for an additional five years by the 21st Century Cures Act of 2016.
Date: 10/2018
Sponsoring organization: Centers for Medicare and Medicaid Services
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