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Rural Health
Resources by Topic: Medicare

Aiming for Fewer Hospital U-turns: The Medicare Hospital Readmission Reduction Program
Describes the Medicare Hospital Readmission Reduction Program (HRRP), analyzes the impact of the program on Medicare beneficiaries and healthcare facilities, and highlights identified issues regarding its implementation. Tables and charts display differences in penalties incurred by urban and rural facilities, and include estimates for FY 2017.
Author(s): Cristina Boccuti, Giselle Casillas
Date: 03/2017
Type: Document
Sponsoring organization: KFF
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Evaluation of the Medication Management (MM) Health Care Innovation Awardees: Third Annual Report
Evaluations of 6 Health Care Innovation Awards Round One projects focused on medication management programs, including programs serving rural areas.
Additional links: Addendum, June 2017
Date: 02/2017
Type: Document
Sponsoring organizations: Acumen, Centers for Medicare and Medicaid Services, Westat
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Getting Started with the Quality Payment Program: An Overview of MIPS for Small, Rural, and Underserved Practices
Provides a webinar recording discussing the effects of the Merit-Based Incentive Payment System (MIPS) on small, rural, and underserved practices. Includes sections on eligibility, participation, reporting, performance categories, and submission and scoring methods. Outlines specific eligibility requirements for Rural Health Clinics (RHCs), Federally Qualified Health Centers (FQHCs), and Critical Access Hospitals (CAHs), and provides a checklist for preparing and participating in MIPS.
Additional links: Presentation Slides, Transcript, Webinar Playlist by Section
Date: 02/2017
Type: Video/Multimedia
Sponsoring organization: Centers for Medicare and Medicaid Services
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Third Annual Report: HCIA Disease-Specific Evaluation
Findings from the third year for 18 Health Care Innovation Awards Round One projects targeting patient populations with specific diseases. Provides information on program effectiveness based on Medicare and Medicaid claims data and awardee-collected data. Includes projects that serve a variety of rural areas and address conditions such as diabetes, cancer, cardiovascular disease, and chronic pain. Approaches discussed include care coordination, education, and telehealth.
Additional links: Addendum, June 2017
Date: 02/2017
Type: Document
Sponsoring organizations: Centers for Medicare and Medicaid Services, NORC at the University of Chicago
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HCIA Complex/High-Risk Patient Targeting: Third Annual Report
Third annual evaluations of Health Care Innovation Awards Round One projects focused on patients with medically complex conditions at high risk for hospitalization, re-hospitalization, emergency department visits, or nursing home stays. Presents program effectiveness findings based on Medicare and Medicaid claims data, surveys, site visits, and interviews. Several projects serve rural areas, offering caregiver education and support, telehealth services, and various care coordination approaches.
Additional links: Addendum, April 2017
Date: 02/2017
Type: Document
Sponsoring organizations: Centers for Medicare and Medicaid Services, NORC at the University of Chicago
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Making the Most of Evolving Payment Policies to Enhance Hospital-based Care in Rural Communities
Presentation slides from the 2017 Rural Health Care Leadership Conference that discuss the transition from volume to value for rural hospital payment and how to make the most of resources available to facilities. Includes examples of services and documents for reference as well as data and statistics surrounding Medicare Advantage and Accountable Care Organizations in rural communities.
Author(s): Keith J. Mueller
Date: 02/2017
Type: Document
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Telemedicine and Primary Care Obesity Management in Rural Areas – Innovative Approach for Older Adults?
Explores telemedicine as a potential delivery tool for the Medicare Obesity Benefit in primary care settings. Describes challenges in implementing the benefit in rural areas, including increasing older adult populations, shortages in primary care and specialized healthcare providers, reimbursement issues, and transportation barriers. Presents the potential utility of telemedicine in rural obesity care and non-physician staff delivery options, which require regulatory changes.
Author(s): John Batsis, Sarah Pletcher, James Stahl
Citation: BMC Geriatrics, 17, 6
Date: 01/2017
Type: Document
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Evaluating the HCIA - Behavioral Health/Substance Abuse Awards: Third Annual Report
Third annual evaluations of 10 Health Care Innovation Awards Round One projects focused on mental health and substance abuse services. Awardee-specific chapters focus on program objectives, implementation experiences, and participant outcomes. Programs include HealthLinkNow, which uses telehealth to provide behavioral care services in rural areas, and the Prevention and Recovery in Early Psychosis Program, which was expanded to serve to rural counties in California.
Additional links: Addendum, July 2017
Date: 01/2017
Type: Document
Sponsoring organizations: Centers for Medicare and Medicaid Services, Mathematica Policy Research
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Accounting for Social Risk Factors in Medicare Payment
Fifth and final report in a series designed to identify social risk factors that affect the health outcomes of Medicare beneficiaries and methods to account for these factors in Medicare payment programs. Offers thoughts about selecting the best methods to account for social risk factors and achieve policy goals. Chapter 2 includes a discussion about urbanicity and rurality, and suggests that a beneficiary's place of residence is a stronger indicator of social risk than their provider's location. Report was assembled by an ad hoc committee under the direction of the U.S. Department of Health and Human Services, Office of the Assistant Secretary of Planning and Evaluation.
Additional links: Read Online
Author(s): Committee on Accounting for Socioeconomic Status in Medicare Payment Programs
Date: 01/2017
Type: Document
Sponsoring organization: Health and Medicine Division (HMD), National Academies of Sciences, Engineering, and Medicine
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Critical Access Hospital Financial Model
Excel-based modeling tool designed to help Critical Access Hospitals (CAHs) anticipate and analyze the financial impacts of joining a Medicare Shared Savings Program (MSSP) Accountable Care Organization (ACO).
Date: 2017
Type: Tool
Sponsoring organization: Rural Health Value
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