Rural Health
Resources by Topic: Medicare
Access to Health Care in Rural America: Current Trends and Key Challenges
Highlights patterns in insurance coverage and uninsurance rates in rural and urban areas, explores non-financial challenges in accessing care faced by rural residents, and describes disparities in health outcomes between urban and rural areas. Features statistics on number of uninsured rural non-elderly adults by state, in 2010 and 2023.
Author(s): Gina Turrini, Eden Volkov, Christie Peters, Nancy De Lew, Thomas Buchmueller
Date: 10/2024
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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Highlights patterns in insurance coverage and uninsurance rates in rural and urban areas, explores non-financial challenges in accessing care faced by rural residents, and describes disparities in health outcomes between urban and rural areas. Features statistics on number of uninsured rural non-elderly adults by state, in 2010 and 2023.
Author(s): Gina Turrini, Eden Volkov, Christie Peters, Nancy De Lew, Thomas Buchmueller
Date: 10/2024
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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Beneficiary and Clinician Perspectives on Medicare and Other Issues: Findings from 2024 Focus Groups in Select States
Summarizes findings from 24 focus groups of Medicare beneficiaries, Medicare and Medicaid (dual eligible) beneficiaries, and clinicians conducted between May and June 2024, including three virtual focus groups of rural Medicare beneficiaries. Highlights themes that emerged across the focus groups covering Medicare coverage options, access to care, telehealth, organization of care, and prescription drugs.
Date: 10/2024
Sponsoring organizations: Medicare Payment Advisory Commission, NORC at the University of Chicago
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Summarizes findings from 24 focus groups of Medicare beneficiaries, Medicare and Medicaid (dual eligible) beneficiaries, and clinicians conducted between May and June 2024, including three virtual focus groups of rural Medicare beneficiaries. Highlights themes that emerged across the focus groups covering Medicare coverage options, access to care, telehealth, organization of care, and prescription drugs.
Date: 10/2024
Sponsoring organizations: Medicare Payment Advisory Commission, NORC at the University of Chicago
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Frontier Community Health Integration Project (FCHIP) Demonstration Extension Fact Sheet
Provides an overview of the Frontier Community Health Integration Project (FCHIP) Demonstration Extension, which tests new healthcare delivery models in the most sparsely populated rural counties. Identifies participating Critical Access Hospitals and models tested.
Date: 10/2024
Sponsoring organization: Centers for Medicare and Medicaid Services
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Provides an overview of the Frontier Community Health Integration Project (FCHIP) Demonstration Extension, which tests new healthcare delivery models in the most sparsely populated rural counties. Identifies participating Critical Access Hospitals and models tested.
Date: 10/2024
Sponsoring organization: Centers for Medicare and Medicaid Services
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Minnesota Chartbook Section 5: Public Health Insurance Programs
Provides information on public insurance programs in Minnesota, including Medicare, Medical Assistance (Medicaid), and MinnesotaCare. Includes data on enrollment, spending, distribution of enrollees, and enrollee location by region and county.
Date: 10/2024
Sponsoring organization: Minnesota Department of Health
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Provides information on public insurance programs in Minnesota, including Medicare, Medical Assistance (Medicaid), and MinnesotaCare. Includes data on enrollment, spending, distribution of enrollees, and enrollee location by region and county.
Date: 10/2024
Sponsoring organization: Minnesota Department of Health
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The Rural Emergency Hospital Model: Year Two Progress Report
Provides an overview of the Rural Emergency Hospital (REH) payment designation, including the growth in REHs through September 1, 2024, factors that contribute to a hospital seeking REH conversion, and the impacts of REH conversion. Outlines concerns identified by REH leaders, facilities considering converting to REH status, and other rural stakeholders related to the REH designation, as well as policy recommendations to address these concerns.
Author(s): Emma Sheffert, Julia Harris, Marilyn Werber Serafini
Date: 10/2024
Sponsoring organization: Bipartisan Policy Center
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Provides an overview of the Rural Emergency Hospital (REH) payment designation, including the growth in REHs through September 1, 2024, factors that contribute to a hospital seeking REH conversion, and the impacts of REH conversion. Outlines concerns identified by REH leaders, facilities considering converting to REH status, and other rural stakeholders related to the REH designation, as well as policy recommendations to address these concerns.
Author(s): Emma Sheffert, Julia Harris, Marilyn Werber Serafini
Date: 10/2024
Sponsoring organization: Bipartisan Policy Center
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Medicare Part D Enrollees Reaching the Out-of-Pocket Limit by June 2024
Examines the number of Medicare Part D enrollees who reached the catastrophic Inflation Reduction Act (IRA) out-of-pocket prescription drug spending cap by June 2024. Provides demographic information on enrollees who reach the catastrophic phase and the related savings, including breakdowns for state and metropolitan, micropolitan, or rural/unknown location.
Author(s): Kenneth Finegold, Kristen L. King, Bisma A. Sayed, Rachael Zuckerman
Date: 10/2024
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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Examines the number of Medicare Part D enrollees who reached the catastrophic Inflation Reduction Act (IRA) out-of-pocket prescription drug spending cap by June 2024. Provides demographic information on enrollees who reach the catastrophic phase and the related savings, including breakdowns for state and metropolitan, micropolitan, or rural/unknown location.
Author(s): Kenneth Finegold, Kristen L. King, Bisma A. Sayed, Rachael Zuckerman
Date: 10/2024
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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Nationwide Availability of and Enrollment in Medicare and Medicaid Dual-Eligible Special Needs Plans With Exclusively Aligned Enrollment
Explores the availability and enrollment of dual-eligible special needs plans (D-SNPs) with exclusively aligned enrollment, in which the beneficiary can receive Medicare and Medicaid benefits through the same plan or affiliated plans within the same organization. Analyzes 2021-2022 beneficiary data and examines D-SNP plan availability and enrollment according to beneficiary demographics, health status, rurality, and more.
Author(s): Kenton J. Johnston, Michelle Hendricks, Megha Dabas, et al.
Citation: JAMA Health Forum, 5(10)
Date: 10/2024
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Explores the availability and enrollment of dual-eligible special needs plans (D-SNPs) with exclusively aligned enrollment, in which the beneficiary can receive Medicare and Medicaid benefits through the same plan or affiliated plans within the same organization. Analyzes 2021-2022 beneficiary data and examines D-SNP plan availability and enrollment according to beneficiary demographics, health status, rurality, and more.
Author(s): Kenton J. Johnston, Michelle Hendricks, Megha Dabas, et al.
Citation: JAMA Health Forum, 5(10)
Date: 10/2024
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What to Know About Medicare Coverage of Telehealth
Discusses telehealth use by Medicare patients before, during, and after declaration of the COVID-19 public health emergency. Notes temporary telehealth provisions set to expire December 31, 2024, telehealth provisions made permanent, and trends in use since 2020. Includes rural and urban comparisons of telehealth use since 2020. Discusses payment models for Medicare and Medicare Advantage, current policies related to telehealth, fraud, and the cost of coverage through Medicare.
Author(s): Alex Cottrill, Juliette Cubanski, Tricia Neuman
Date: 10/2024
Sponsoring organization: KFF
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Discusses telehealth use by Medicare patients before, during, and after declaration of the COVID-19 public health emergency. Notes temporary telehealth provisions set to expire December 31, 2024, telehealth provisions made permanent, and trends in use since 2020. Includes rural and urban comparisons of telehealth use since 2020. Discusses payment models for Medicare and Medicare Advantage, current policies related to telehealth, fraud, and the cost of coverage through Medicare.
Author(s): Alex Cottrill, Juliette Cubanski, Tricia Neuman
Date: 10/2024
Sponsoring organization: KFF
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Health Care Transparency: CMS Needs More Information on Hospital Pricing Data Completeness and Accuracy
Provides an overview of the Centers for Medicare & Medicaid Services (CMS) hospital price transparency requirements before and after 2024 updates to the requirements. Describes users' experiences with hospital pricing data before the 2024 updates. Examines CMS's enforcement of hospital price transparency requirements and offers recommendations to CMS regarding the sufficiency and accuracy of the data reported. Table 3 compares CMS enforcement actions by hospitals' rural or urban designation between 2021 and 2023.
Additional links: Full Report
Date: 10/2024
Sponsoring organization: Government Accountability Office
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Provides an overview of the Centers for Medicare & Medicaid Services (CMS) hospital price transparency requirements before and after 2024 updates to the requirements. Describes users' experiences with hospital pricing data before the 2024 updates. Examines CMS's enforcement of hospital price transparency requirements and offers recommendations to CMS regarding the sufficiency and accuracy of the data reported. Table 3 compares CMS enforcement actions by hospitals' rural or urban designation between 2021 and 2023.
Additional links: Full Report
Date: 10/2024
Sponsoring organization: Government Accountability Office
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Merit-Based Incentive Payment System (MIPS): 2025 MIPS Payment Year (2023 Performance Year) - Payment Adjustment User Guide
Provides information on Merit-Based Incentive Payment System (MIPS) payment adjustments for calendar year 2025. Describes how 2023 MIPS scores relate to 2025 payment adjustments and how payment adjustments are applied. Offers answers to frequently asked questions.
Date: 10/2024
Sponsoring organization: Centers for Medicare and Medicaid Services
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Provides information on Merit-Based Incentive Payment System (MIPS) payment adjustments for calendar year 2025. Describes how 2023 MIPS scores relate to 2025 payment adjustments and how payment adjustments are applied. Offers answers to frequently asked questions.
Date: 10/2024
Sponsoring organization: Centers for Medicare and Medicaid Services
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