Rural Health
Resources by Topic: Medicare
MedPAC Report to the Congress: Medicare Payment Policy, 2024
Annual review of Medicare payment policies, with recommendations to Congress. Includes discussion on Medicare payment policies directly affecting rural providers and beneficiaries. Addresses payment adequacy for Medicare fee-for-service payment systems, Medicare Advantage (MA), and Medicare Part D. Includes two mandated reports on special needs plans for beneficiaries dually eligible for Medicare and Medicaid and the Rural Emergency Hospital (REH) designation.
Date: 03/2024
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Annual review of Medicare payment policies, with recommendations to Congress. Includes discussion on Medicare payment policies directly affecting rural providers and beneficiaries. Addresses payment adequacy for Medicare fee-for-service payment systems, Medicare Advantage (MA), and Medicare Part D. Includes two mandated reports on special needs plans for beneficiaries dually eligible for Medicare and Medicaid and the Rural Emergency Hospital (REH) designation.
Date: 03/2024
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Generic Drug Utilization and Spending Among Medicare Part D Enrollees in 2022
Issue brief on prescriptions for generic drugs filled by Medicare Part D enrollees using 2022 Part D prescription drug event (PDE) data. Covers commonly used prescription drugs, costs, and conditions treated, and includes data breakdowns by plan type, race and ethnicity, and level of rurality throughout. Discusses formulary design to improve access by promoting affordability and reducing confusion among enrollees.
Author(s): Yevgeniy Feyman, Bisma Sayed, Kenneth Finegold, et al.
Date: 03/2024
Type: Document
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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Issue brief on prescriptions for generic drugs filled by Medicare Part D enrollees using 2022 Part D prescription drug event (PDE) data. Covers commonly used prescription drugs, costs, and conditions treated, and includes data breakdowns by plan type, race and ethnicity, and level of rurality throughout. Discusses formulary design to improve access by promoting affordability and reducing confusion among enrollees.
Author(s): Yevgeniy Feyman, Bisma Sayed, Kenneth Finegold, et al.
Date: 03/2024
Type: Document
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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2024 National Impact Assessment of the Centers for Medicare & Medicaid Services (CMS) Quality Measures Report
Evaluates the quality measures used across 26 Centers for Medicare & Medicaid Services (CMS) quality reporting programs. Explores whether quality measure scores during the COVID-19 public health emergency (2020-2021) differed from expected trends. Analyzes how different population groups, including urban and rural residents, performed at a national level in order to inform future quality measure development and advance health equity. Provides statistics concerning participation and performance within Medicare quality reporting programs, including statistics specific to rural populations and facilities.
Additional links: Appendices ZIP File
Date: 03/2024
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Evaluates the quality measures used across 26 Centers for Medicare & Medicaid Services (CMS) quality reporting programs. Explores whether quality measure scores during the COVID-19 public health emergency (2020-2021) differed from expected trends. Analyzes how different population groups, including urban and rural residents, performed at a national level in order to inform future quality measure development and advance health equity. Provides statistics concerning participation and performance within Medicare quality reporting programs, including statistics specific to rural populations and facilities.
Additional links: Appendices ZIP File
Date: 03/2024
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Merit-based Incentive Payment System (MIPS) 2024 Small Practice Eligibility and Participation Frequently Asked Questions
Provides answers to frequently asked questions regarding small practice participation and eligibility for the Merit-based Incentive Payment System (MIPS) for the 2024 performance year. Covers individual and group eligibility, the low-volume threshold, changes to group composition during the performance year, and more.
Date: 03/2024
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Provides answers to frequently asked questions regarding small practice participation and eligibility for the Merit-based Incentive Payment System (MIPS) for the 2024 performance year. Covers individual and group eligibility, the low-volume threshold, changes to group composition during the performance year, and more.
Date: 03/2024
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Breast Cancer Screening among Medicare Advantage Enrollees with Dementia
Compares rates of mammogram screening among screening-eligible women with Alzheimer's disease and related dementias (ADRD) using 2012-2019 Medicare Current Beneficiary Survey data. Compares screening rates of Medicare Advantage and fee-for-service Medicare enrollees, with data breakdowns by race and ethnicity, rural versus urban status, and more. Identifies potential risks related to over-screening.
Author(s): Eli Raver, Wendy Y. Xu, Jean Jung, Sunmin Lee
Citation: BMC Health Services Research, 24, 283
Date: 03/2024
Type: Document
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Compares rates of mammogram screening among screening-eligible women with Alzheimer's disease and related dementias (ADRD) using 2012-2019 Medicare Current Beneficiary Survey data. Compares screening rates of Medicare Advantage and fee-for-service Medicare enrollees, with data breakdowns by race and ethnicity, rural versus urban status, and more. Identifies potential risks related to over-screening.
Author(s): Eli Raver, Wendy Y. Xu, Jean Jung, Sunmin Lee
Citation: BMC Health Services Research, 24, 283
Date: 03/2024
Type: Document
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Inflation Reduction Act Research Series: Projected Impacts for Rural Medicare Enrollees
Provides an overview of how the Inflation Reduction Act (IRA) is intended to improve prescription drug affordability for Medicare enrollees. Describes Medicare enrollment in rural areas and rural residents' health status and access to care. Outlines the projected impact of drug-related IRA provisions for rural Medicare beneficiaries, including the expansion of financial assistance through the low-income subsidy program, out-of-pocket spending caps for insulin, changes in Part D benefit design, and more.
Date: 03/2024
Type: Document
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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Provides an overview of how the Inflation Reduction Act (IRA) is intended to improve prescription drug affordability for Medicare enrollees. Describes Medicare enrollment in rural areas and rural residents' health status and access to care. Outlines the projected impact of drug-related IRA provisions for rural Medicare beneficiaries, including the expansion of financial assistance through the low-income subsidy program, out-of-pocket spending caps for insulin, changes in Part D benefit design, and more.
Date: 03/2024
Type: Document
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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Catalog of Value-Based Initiatives for Rural Providers
Summarizes rural-relevant, value-based programs currently or recently implemented by the U.S. Department of Health and Human Services (HHS), including the Centers for Medicare and Medicaid Services (CMS) and the CMS Innovation Center. Designed to help rural healthcare leaders identify HHS value-based programs that are suitable for rural participation. Contains descriptions of each demonstration and provides direct links to the corresponding agency web page.
Date: 03/2024
Type: Document
Sponsoring organization: Rural Health Value
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Summarizes rural-relevant, value-based programs currently or recently implemented by the U.S. Department of Health and Human Services (HHS), including the Centers for Medicare and Medicaid Services (CMS) and the CMS Innovation Center. Designed to help rural healthcare leaders identify HHS value-based programs that are suitable for rural participation. Contains descriptions of each demonstration and provides direct links to the corresponding agency web page.
Date: 03/2024
Type: Document
Sponsoring organization: Rural Health Value
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Rural Health Research Recap: Post-Acute Care in Rural Areas: The Role of Swing Beds and Nursing Homes
Offers statistics on availability of post-acute care in rural areas through skilled nursing facilities, home health agencies, hospice, inpatient rehabilitation facilities, and swing beds. Includes sections on prospective payment system and cost-based reimbursement, and provides statistics on the proportion of nursing home closures in metropolitan and nonmetropolitan areas from 2008-2018.
Author(s): Per Ostmo
Date: 03/2024
Type: Document
Sponsoring organization: Rural Health Research Gateway
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Offers statistics on availability of post-acute care in rural areas through skilled nursing facilities, home health agencies, hospice, inpatient rehabilitation facilities, and swing beds. Includes sections on prospective payment system and cost-based reimbursement, and provides statistics on the proportion of nursing home closures in metropolitan and nonmetropolitan areas from 2008-2018.
Author(s): Per Ostmo
Date: 03/2024
Type: Document
Sponsoring organization: Rural Health Research Gateway
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Merit-Based Incentive Payment System (MIPS): 2024 Improvement Activities Performance Category Quick Start Guide
Provides an overview of Merit-based Incentive Payment System (MIPS) requirements, data collection, and data submission for the improvement activities performance category for the 2024 performance year. Includes information about special status scoring for small practices and clinicians located in a rural or Health Professional Shortage Area.
Date: 03/2024
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Provides an overview of Merit-based Incentive Payment System (MIPS) requirements, data collection, and data submission for the improvement activities performance category for the 2024 performance year. Includes information about special status scoring for small practices and clinicians located in a rural or Health Professional Shortage Area.
Date: 03/2024
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Merit-Based Incentive Payment System (MIPS): 2023 Opt-in and Voluntary Reporting Election Process Guide
Discusses the eligibility of clinicians, groups, and Alternative Payment Model (APM) participants that exceed some low-volume threshold criteria to opt-in to the Merit-Based Incentive Payment System (MIPS) and the APM Performance Pathway (APP) for the 2023 performance period. Compares opting in and voluntarily reporting MIPS data and provides an overview of the election process.
Date: 03/2024
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Discusses the eligibility of clinicians, groups, and Alternative Payment Model (APM) participants that exceed some low-volume threshold criteria to opt-in to the Merit-Based Incentive Payment System (MIPS) and the APM Performance Pathway (APP) for the 2023 performance period. Compares opting in and voluntarily reporting MIPS data and provides an overview of the election process.
Date: 03/2024
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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