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Resources by Topic: Medicare

State Innovation Models (SIM) Round 2: Model Design Final Report
Shares results from a federal evaluation of the Round 2 State Innovation Models (SIM) Initiative awards, which focused on reforming payment and delivery systems, health information exchanges, workforce development, and sustainability. Provides a summary and review of each awardees' final State Health System Innovations Plan (SHSIP). Includes several suggestions and recommendations for improving rural healthcare delivery, payment, and access.
Author(s): Donald Nichols, Kathleen Farrell, Marisa Morrison, et al.
Date: 08/2017
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Medicare Advantage Enrollment Update 2017
Reports on the percentage of rural Medicare beneficiaries enrolled in Medicare Advantage (MA) and other prepaid enrollment plans by metropolitan and nonmetropolitan location, and variability by state.
Author(s): Fred Ullrich, Keith Mueller
Date: 08/2017
Type: Document
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Home is Where the Heart Is: Insights on the Coordination and Delivery of Home Health Services in Rural America
Identifies facilitators and barriers to providing home health services in rural areas, discusses how rural home health services are currently provided, and offers thoughts about the provision of home health services in the future. Addresses electronic health records, reimbursement issues, workforce challenges, value-based payment, and more.
Author(s): Alana Knudson, Britta Anderson, Kellie Schueler, Emily Arsen
Date: 08/2017
Type: Document
Sponsoring organization: Rural Health Reform Policy Research Center
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Differences in Medicare Service Use in the Last Six Months of Life among Rural and Urban Dual-Eligible Beneficiaries
Reports on a study of healthcare utilization by Medicare beneficiaries in the last six months of life in both urban and rural areas. Compares beneficiaries with dual eligibility with those who are eligible for Medicare only. Looks specifically at inpatient care, outpatient care, and home health, as well as other types of healthcare services.
Author(s): Elizabeth Crouch, Kevin J. Bennett, Janice C. Probst
Date: 08/2017
Type: Document
Sponsoring organization: Rural and Minority Health Research Center (formerly the South Carolina Rural Health Research Center)
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Evaluation of the Round Two Health Care Innovation Awards (HCIA R2): Second Annual Report
Summarizes the second year evaluation results of the 39 Health Care Innovation Awards Round Two projects. Describes implementation experiences during the second program year and examines pre-enrollment characteristics of participants. Focuses on program enrollment, implementation of service delivery models, development and implementation of payment models, and sustainability plans. Provides findings for the individual grantees, which include projects that serve rural areas.
Date: 08/2017
Type: Document
Sponsoring organizations: Centers for Medicare and Medicaid Services, Mathematica Policy Research
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Medicare Fee-For-Service Beneficiaries with Disabilities, by End Stage Renal Disease Status, 2014
Data highlight describing the characteristics of disabled Medicare beneficiaries by end stage renal disease (ESRD) status. Uses data from the Centers for Medicare and Medicaid Services' (CMS) Chronic Conditions Data Warehouse (CCW) and includes a breakdown of metropolitan, micropolitan, or rural residence of disabled Medicare beneficiaries with ESRD.
Author(s): Elsa Haile, Sonya Bowen, Kenneth Lindenfelser, Chris Haffer
Date: 07/2017
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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The Financial Importance of Medicare Post-Acute and Hospice Care to Rural Hospitals
Findings brief describing variation in the number of hospitals in rural areas providing Medicare post-acute care (PAC) and hospice care, average amount of revenue generated for these services, and financial importance to rural hospitals. Includes statistics on 2015 Medicare PAC and hospice care revenue as percentage of patient revenue in 1,205 Critical Access Hospitals and 964 Prospective Payment System hospitals.
Author(s): Alex Schulte, H. Ann Howard, George H. Pink
Date: 07/2017
Type: Document
Sponsoring organization: North Carolina Rural Health Research Program
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Telehealth: Use in Medicare and Medicaid
Discusses the extent to which telehealth is used by Medicare and Medicaid, the factors affecting the use of telehealth in Medicare, and how emerging payment and delivery models could affect future telehealth use. Includes rural-specific information throughout with particular attention paid to the role of rural healthcare facilities as originating sites.
Additional links: Full Report
Date: 07/2017
Type: Document
Sponsoring organization: Government Accountability Office
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Changes in Hospital Quality Associated with Hospital Value-Based Purchasing
Examines whether quality improved more in acute care hospitals exposed to Medicare's Hospital Value-Based Purchasing (HVBP) program. Uses Critical Access Hospitals as a comparison for clinical process, patient experience, and mortality measures.
Author(s): Andrew M. Ryan, Sam Krinsky, Kristen A. Maurer, Justin B. Dimick
Citation: New England Journal of Medicine, 376(24), 2358-2366
Date: 06/2017
Type: Document
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Hospital Value-Based Purchasing: CMS Should Take Steps to Ensure Lower Quality Hospitals Do Not Qualify for Bonuses
Examines the scoring methodology used by the Hospital Value-Based Purchasing (HVBP) program, which measures quality and efficiency within multiple hospital types including small, rural, and safety-net hospitals. Addresses differences in how safety net, small rural, and small urban hospitals performed, how payment adjustments changed for them over time, and the impact of an efficiency score on payment adjustments. Supports revising the methodology to apply the standards more evenly.
Additional links: Full Report
Date: 06/2017
Type: Document
Sponsoring organization: Government Accountability Office
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