Rural Health
Resources by Topic: Medicare
Rural Medicare Advantage Market Dynamics and Quality: Historical Context and Current Implications
Policy brief assessing ways in which market dynamics affect rural beneficiaries of Medicare Advantage (MA) plans and the variation in Medicare's star ratings of these plans. Features statistics including star ratings by urban and rural counties; MA contracts by star rating, rural characteristics, and experience; and percent enrollment in 4+ star plans with breakdowns by rural and urban counties.
Author(s): Leah Kemper, Abigail R. Barker, Lyndsey Wilbers, Timothy D. McBride, Keith Mueller
Date: 07/2016
Type: Document
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Policy brief assessing ways in which market dynamics affect rural beneficiaries of Medicare Advantage (MA) plans and the variation in Medicare's star ratings of these plans. Features statistics including star ratings by urban and rural counties; MA contracts by star rating, rural characteristics, and experience; and percent enrollment in 4+ star plans with breakdowns by rural and urban counties.
Author(s): Leah Kemper, Abigail R. Barker, Lyndsey Wilbers, Timothy D. McBride, Keith Mueller
Date: 07/2016
Type: Document
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Medicare Access and CHIP Reauthorization Act of 2015: Ensuring Successful Implementation of Physician Payment Reforms
Recording of a July 13, 2016, U.S. Senate Finance Committee hearing regarding the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). Andy Slavitt, Acting Administrator for the Centers for Medicare and Medicaid Services, discusses the input received from stakeholders and the resulting focus on patient-first, physician-driven, collaborative care. He also emphasizes the need to support small, rural practices and those in underserved areas to achieve success.
Additional links: Andrew M. Slavitt, Centers for Medicare & Medicaid Services - Testimony
Date: 07/2016
Type: Video/Multimedia
Sponsoring organization: Senate Committee on Finance
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Recording of a July 13, 2016, U.S. Senate Finance Committee hearing regarding the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). Andy Slavitt, Acting Administrator for the Centers for Medicare and Medicaid Services, discusses the input received from stakeholders and the resulting focus on patient-first, physician-driven, collaborative care. He also emphasizes the need to support small, rural practices and those in underserved areas to achieve success.
Additional links: Andrew M. Slavitt, Centers for Medicare & Medicaid Services - Testimony
Date: 07/2016
Type: Video/Multimedia
Sponsoring organization: Senate Committee on Finance
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2016 Financial Leadership Summit Report: Strategies for Rural Hospitals Transitioning to Value-based Purchasing and Population Health
Provides rural hospital administrators strategies for meeting the challenges of a changing healthcare environment. Includes discussion on alternative payment models, the impact of market forces, successful examples. and lessons learned. Offers information for developing tools to support hospitals and networks as they transition to value-based purchasing and population health.
Additional links: Webinar Playback: Rural Strategies for Transitioning to Value-based Purchasing and Population Health, Webinar Slides: Rural Strategies for Transitioning to Value-based Purchasing and Population Health
Author(s): Mark Chustz
Date: 07/2016
Type: Document
Sponsoring organization: National Rural Health Resource Center
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Provides rural hospital administrators strategies for meeting the challenges of a changing healthcare environment. Includes discussion on alternative payment models, the impact of market forces, successful examples. and lessons learned. Offers information for developing tools to support hospitals and networks as they transition to value-based purchasing and population health.
Additional links: Webinar Playback: Rural Strategies for Transitioning to Value-based Purchasing and Population Health, Webinar Slides: Rural Strategies for Transitioning to Value-based Purchasing and Population Health
Author(s): Mark Chustz
Date: 07/2016
Type: Document
Sponsoring organization: National Rural Health Resource Center
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Medicare Copayments for Critical Access Hospital Outpatient Services - Update
Estimates the impact of Medicare Part B coinsurance on beneficiaries receiving outpatient services at Critical Access Hospitals (CAHs), and identifies the Medicare fee-for-service (FFS) proportion of key services provided in CAHs.
Author(s): Allison Briggs, Matthew Toth, Sara Freeman
Date: 06/2016
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Estimates the impact of Medicare Part B coinsurance on beneficiaries receiving outpatient services at Critical Access Hospitals (CAHs), and identifies the Medicare fee-for-service (FFS) proportion of key services provided in CAHs.
Author(s): Allison Briggs, Matthew Toth, Sara Freeman
Date: 06/2016
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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MedPAC Report to the Congress: Medicare and the Health Care Delivery System, June 2016
Includes chapters on pricing and payment systems, Medicare drug spending, Part B drug and oncology payment policy issues, improving Part D, improving efficiency and preserving access to emergency care in rural areas, telehealth services and Medicare, and issues affecting dual-eligible beneficiaries. Rural providers and rural patient populations are discussed throughout the report.
Date: 06/2016
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Includes chapters on pricing and payment systems, Medicare drug spending, Part B drug and oncology payment policy issues, improving Part D, improving efficiency and preserving access to emergency care in rural areas, telehealth services and Medicare, and issues affecting dual-eligible beneficiaries. Rural providers and rural patient populations are discussed throughout the report.
Date: 06/2016
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Medicare Accountable Care Organizations: Beneficiary Assignment Update
Clarifies the changes issued in June 2015 regarding Accountable Care Organization's (ACO) beneficiary assignment under the Centers for Medicare and Medicaid Services (CMS) ACO regulations. Addresses how the changes make it easier for Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs) to participate in ACOs.
Author(s): Thomas Vaughn, A. Clinton MacKinney, Keith J. Mueller, Fred Ullrich, Xi Zhu
Date: 06/2016
Type: Document
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Clarifies the changes issued in June 2015 regarding Accountable Care Organization's (ACO) beneficiary assignment under the Centers for Medicare and Medicaid Services (CMS) ACO regulations. Addresses how the changes make it easier for Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs) to participate in ACOs.
Author(s): Thomas Vaughn, A. Clinton MacKinney, Keith J. Mueller, Fred Ullrich, Xi Zhu
Date: 06/2016
Type: Document
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Comprehensive Primary Care Plus - A Rural Commentary
Review of Comprehensive Primary Care Plus (CPC+), a program of the Center for Medicare & Medicaid Innovation (CMMI) initiative, designed to enhance the delivery of primary healthcare and support the shift from volume-based to value-based healthcare payment. Offers a rural perspective, noting the importance and challenges of this payment model for rural healthcare.
Author(s): A. Clinton MacKinney
Date: 06/2016
Type: Document
Sponsoring organization: Rural Health Value
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Review of Comprehensive Primary Care Plus (CPC+), a program of the Center for Medicare & Medicaid Innovation (CMMI) initiative, designed to enhance the delivery of primary healthcare and support the shift from volume-based to value-based healthcare payment. Offers a rural perspective, noting the importance and challenges of this payment model for rural healthcare.
Author(s): A. Clinton MacKinney
Date: 06/2016
Type: Document
Sponsoring organization: Rural Health Value
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Association Between the Value-Based Purchasing Pay for Performance Program and Patient Mortality in US Hospitals: Observational Study
Examines the impact of Medicare's Hospital Value-Based Purchasing (HVBP) program on mortality for pneumonia, heart failure, and acute myocardial infarction by comparing data from acute care hospitals participating in the program to data from over 1,300 Critical Access Hospitals (CAHs) and 44 hospitals in Maryland not in the program.
Author(s): Jose F. Figueroa, Yusuke Tsugawa, Jie Zheng, E. John Orav, Ashish K. Jha
Citation: BMJ, 9(353), i2214
Date: 05/2016
Type: Document
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Examines the impact of Medicare's Hospital Value-Based Purchasing (HVBP) program on mortality for pneumonia, heart failure, and acute myocardial infarction by comparing data from acute care hospitals participating in the program to data from over 1,300 Critical Access Hospitals (CAHs) and 44 hospitals in Maryland not in the program.
Author(s): Jose F. Figueroa, Yusuke Tsugawa, Jie Zheng, E. John Orav, Ashish K. Jha
Citation: BMJ, 9(353), i2214
Date: 05/2016
Type: Document
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Utilization of Telemedicine Among Rural Medicare Beneficiaries
Demonstrates the trends in the use of telemedicine utilization by rural Medicare beneficiaries between 2004 and 2013. Data is derived from Current Procedural Terminology (CPT) codes or telemedicine-specific codes, using Medicare's definition for rural. Includes a table comparing patient characteristics for Medicare beneficiaries with and without a telemedicine visit in 2013.
Author(s): Ateev Mehrotra, Anupam B. Jena, Alisa B. Busch, et al.
Citation: JAMA: Journal of the American Medical Association, 315(18), 2015–2016
Date: 05/2016
Type: Document
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Demonstrates the trends in the use of telemedicine utilization by rural Medicare beneficiaries between 2004 and 2013. Data is derived from Current Procedural Terminology (CPT) codes or telemedicine-specific codes, using Medicare's definition for rural. Includes a table comparing patient characteristics for Medicare beneficiaries with and without a telemedicine visit in 2013.
Author(s): Ateev Mehrotra, Anupam B. Jena, Alisa B. Busch, et al.
Citation: JAMA: Journal of the American Medical Association, 315(18), 2015–2016
Date: 05/2016
Type: Document
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Proactively Pursuing Value-Based Payment
Profiles a program developed at a Critical Access Hospital (CAH) located in rural Washington that is transitioning from volume- to value-based care. The CEO of the hospital is working with payers to design a value-based payment contract to help the facility fund the continued transition to value-based care and hopefully create a payment model other CAHs in the state can adopt.
Date: 05/2016
Type: Document
Sponsoring organization: Rural Health Value
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Profiles a program developed at a Critical Access Hospital (CAH) located in rural Washington that is transitioning from volume- to value-based care. The CEO of the hospital is working with payers to design a value-based payment contract to help the facility fund the continued transition to value-based care and hopefully create a payment model other CAHs in the state can adopt.
Date: 05/2016
Type: Document
Sponsoring organization: Rural Health Value
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