Rural Health
Resources by Topic: Medicare
Rural Health Insurance Market Challenges
Policy brief examining challenges affecting rural health insurance markets with a focus on Medicare Advantage, Medicare Part D, Medicaid Managed Care, and the Health Insurance Marketplace. Provides recommendations related to health insurance availability, network development and adequacy, and consumer and provider engagement.
Date: 08/2018
Sponsoring organization: National Advisory Committee on Rural Health and Human Services
view details
Policy brief examining challenges affecting rural health insurance markets with a focus on Medicare Advantage, Medicare Part D, Medicaid Managed Care, and the Health Insurance Marketplace. Provides recommendations related to health insurance availability, network development and adequacy, and consumer and provider engagement.
Date: 08/2018
Sponsoring organization: National Advisory Committee on Rural Health and Human Services
view details
Evaluation of the Accountable Care Organization Investment Model: AIM Impacts in the First Performance Year
Evaluation examining the first year performance of the 47 Accountable Care Organizations (ACOs) participating in the ACO Investment Model (AIM), which tests the use of prepaid shared savings to encourage new ACOs to form in rural and underserved areas (Test 1) and to encourage current Medicare Shared Savings Program ACOs to transition to arrangements with greater financial risk (Test 2). Describes provider characteristics, beneficiary characteristics, and impacts of the 41 Test 1 AIM ACOs. Includes data on rurality for both Test 1 and Test 2 AIM ACOs.
Additional links: Appendices, Findings At-A-Glance
Date: 08/2018
Sponsoring organizations: Abt Associates, Centers for Medicare and Medicaid Services
view details
Evaluation examining the first year performance of the 47 Accountable Care Organizations (ACOs) participating in the ACO Investment Model (AIM), which tests the use of prepaid shared savings to encourage new ACOs to form in rural and underserved areas (Test 1) and to encourage current Medicare Shared Savings Program ACOs to transition to arrangements with greater financial risk (Test 2). Describes provider characteristics, beneficiary characteristics, and impacts of the 41 Test 1 AIM ACOs. Includes data on rurality for both Test 1 and Test 2 AIM ACOs.
Additional links: Appendices, Findings At-A-Glance
Date: 08/2018
Sponsoring organizations: Abt Associates, Centers for Medicare and Medicaid Services
view details
MedPAC Comment on CMS's Proposed Rule on the CY 2019 Home Health PPS Update and 2020 Case Mix Refinements
Comment on a July 12, 2018, Federal Register proposed rule revising payments for home health services. Includes a section addressing a proposed rural add-on payment policy.
Date: 08/2018
Sponsoring organization: Medicare Payment Advisory Commission
view details
Comment on a July 12, 2018, Federal Register proposed rule revising payments for home health services. Includes a section addressing a proposed rural add-on payment policy.
Date: 08/2018
Sponsoring organization: Medicare Payment Advisory Commission
view details
First Annual Report: Next Generation Accountable Care Organization (NGACO) Model Evaluation
Reports initial descriptive and analytic findings for the 18 Next Generation ACOs (NGACOs) that launched in 2016. Includes information on NGACO organizational characteristics, market characteristics, model implementation, and performance. Offers some data and discussion related to the inclusion of rural areas. Also provides information on institutional providers by type of facility, including Critical Access Hospitals, Rural Health Clinics, and Federally Qualified Health Centers.
Additional links: Findings at a Glance, Volume II: Technical Appendices, January 2018
Date: 08/2018
Sponsoring organizations: Centers for Medicare and Medicaid Services, NORC at the University of Chicago
view details
Reports initial descriptive and analytic findings for the 18 Next Generation ACOs (NGACOs) that launched in 2016. Includes information on NGACO organizational characteristics, market characteristics, model implementation, and performance. Offers some data and discussion related to the inclusion of rural areas. Also provides information on institutional providers by type of facility, including Critical Access Hospitals, Rural Health Clinics, and Federally Qualified Health Centers.
Additional links: Findings at a Glance, Volume II: Technical Appendices, January 2018
Date: 08/2018
Sponsoring organizations: Centers for Medicare and Medicaid Services, NORC at the University of Chicago
view details
Medicare Fee-for-Service: Information on the First Year of Nationwide Reduced Payment Rates for Durable Medical Equipment
Examines the effects of reduced payment rates for certain durable medical equipment (DME) in non-bid areas. Reports on changes in the number of suppliers, utilization of rate-adjusted items, and beneficiaries' access to rate-adjusted items. Includes information on changes in rural and non-rural non-bid areas.
Additional links: Full Report
Date: 08/2018
Sponsoring organization: Government Accountability Office
view details
Examines the effects of reduced payment rates for certain durable medical equipment (DME) in non-bid areas. Reports on changes in the number of suppliers, utilization of rate-adjusted items, and beneficiaries' access to rate-adjusted items. Includes information on changes in rural and non-rural non-bid areas.
Additional links: Full Report
Date: 08/2018
Sponsoring organization: Government Accountability Office
view details
Insuring Rural America: Health Insurance Challenges and Opportunities
Details a study focusing on the challenges of designing an insurance market that works in rural America. Looks at the needs of rural people and current health insurance policy.
Author(s): Keith J. Mueller, Charlie Alfero, Andrew F. Coburn, et al.
Date: 07/2018
Sponsoring organization: Rural Policy Research Institute Rural Health Panel
view details
Details a study focusing on the challenges of designing an insurance market that works in rural America. Looks at the needs of rural people and current health insurance policy.
Author(s): Keith J. Mueller, Charlie Alfero, Andrew F. Coburn, et al.
Date: 07/2018
Sponsoring organization: Rural Policy Research Institute Rural Health Panel
view details
MedPAC Comment on CMS's Interim Final Rule on Durable Medical Equipment Fee Schedule Adjustments
Describes Medicare's method of setting payment rates for durable medical equipment, prosthetics, orthotics, and supplies, and explains the reinstitution of 50/50 blended payment rates for rural and non-contiguous areas from June 1, 2018 to December 31, 2018.
Author(s): Francis J. Crosson
Date: 07/2018
Sponsoring organization: Medicare Payment Advisory Commission
view details
Describes Medicare's method of setting payment rates for durable medical equipment, prosthetics, orthotics, and supplies, and explains the reinstitution of 50/50 blended payment rates for rural and non-contiguous areas from June 1, 2018 to December 31, 2018.
Author(s): Francis J. Crosson
Date: 07/2018
Sponsoring organization: Medicare Payment Advisory Commission
view details
Small and Rural Practices' Experiences in Previous Programs and Expected Performance in the Merit-Based Incentive Payment System
Examines how small and rural physician practices fared in legacy Medicare programs and reviews the projected effect of Merit-Based Incentive Payment System (MIPS). Discusses Medicare legacy program challenges small and rural physician practices experience including technology, financial and staff resources, and legacy program requirements. Covers efforts to assist small and rural physician practices participate in MIPS. Includes 2014 and 2015 data on Medicare legacy payment incentive programs by rural and urban status.
Additional links: Full Report
Date: 07/2018
Sponsoring organization: Government Accountability Office
view details
Examines how small and rural physician practices fared in legacy Medicare programs and reviews the projected effect of Merit-Based Incentive Payment System (MIPS). Discusses Medicare legacy program challenges small and rural physician practices experience including technology, financial and staff resources, and legacy program requirements. Covers efforts to assist small and rural physician practices participate in MIPS. Includes 2014 and 2015 data on Medicare legacy payment incentive programs by rural and urban status.
Additional links: Full Report
Date: 07/2018
Sponsoring organization: Government Accountability Office
view details
Estimate of Federal Payment Reductions to Hospitals Following the ACA 2010-2028: Estimates and Methodology
Examines cumulative federal payment reductions to hospitals for 2010-2028. Addresses the impact of sequestration, changes in Medicare payments for bad debt including to Critical Access Hospitals, federal Medicaid Disproportionate Share Hospital (DSH) allotments, and other legislation affecting hospital reimbursement.
Author(s): Allen Dobson, Joan DaVanzo, Randy Haught, Phap-Hoa Luu
Date: 06/2018
Sponsoring organizations: American Hospital Association, Dobson DaVanzo & Associates, Federation of American Hospitals
view details
Examines cumulative federal payment reductions to hospitals for 2010-2028. Addresses the impact of sequestration, changes in Medicare payments for bad debt including to Critical Access Hospitals, federal Medicaid Disproportionate Share Hospital (DSH) allotments, and other legislation affecting hospital reimbursement.
Author(s): Allen Dobson, Joan DaVanzo, Randy Haught, Phap-Hoa Luu
Date: 06/2018
Sponsoring organizations: American Hospital Association, Dobson DaVanzo & Associates, Federation of American Hospitals
view details
Evaluation of the Round Two Health Care Innovation Awards (HCIA R2): Third Annual Report
Summarizes the third year evaluation results of 38 Health Care Innovation Awards Round Two projects, one awardee of the original 39 having left the program in September 2016. Focuses on implementation effectiveness, developing payment models, planning for sustainability, and some preliminary work related to evaluating program impacts. Provides findings for the individual awardees, which include projects that serve rural areas.
Date: 06/2018
Sponsoring organizations: Centers for Medicare and Medicaid Services, Mathematica Policy Research
view details
Summarizes the third year evaluation results of 38 Health Care Innovation Awards Round Two projects, one awardee of the original 39 having left the program in September 2016. Focuses on implementation effectiveness, developing payment models, planning for sustainability, and some preliminary work related to evaluating program impacts. Provides findings for the individual awardees, which include projects that serve rural areas.
Date: 06/2018
Sponsoring organizations: Centers for Medicare and Medicaid Services, Mathematica Policy Research
view details