Rural Health
Resources by Topic: Medicare
Public Law 114-10: Medicare Access and CHIP Reauthorization Act of 2015
Full text of the Medicare Access and CHIP Reauthorization Act of 2015, commonly referred to as MACRA. MACRA seeks to transition healthcare from fee-for-service to value-based care by repealing the Sustainable Growth Rate (SGR) formula and replacing it with the Quality Payment Program (QPP). The QPP streamlines data collection efforts and rewards providers based on value instead of volume through the Merit-Based Incentive Payment System (MIPS) and Advanced Alternative Payment Models (Advanced APMs).
Date: 04/2015
Type: Document
Sponsoring organization: U.S. Congress
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Full text of the Medicare Access and CHIP Reauthorization Act of 2015, commonly referred to as MACRA. MACRA seeks to transition healthcare from fee-for-service to value-based care by repealing the Sustainable Growth Rate (SGR) formula and replacing it with the Quality Payment Program (QPP). The QPP streamlines data collection efforts and rewards providers based on value instead of volume through the Merit-Based Incentive Payment System (MIPS) and Advanced Alternative Payment Models (Advanced APMs).
Date: 04/2015
Type: Document
Sponsoring organization: U.S. Congress
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Compendium of Unimplemented Recommendations: March 2015
Annual report identifying the top 25 unimplemented recommendations from the Office of Inspector General (OIG) that, in OIG's view, would have the most substantial positive impact on Health and Human Services (HHS) programs. Positive impact may refer to cost savings, program efficacy and efficiency, and/or quality improvement. Primary areas of interest in the March 2015 edition include: Medicare payment policies and oversight mechanisms, face-to-face requirements for home health agencies, and strengthening fraud prevention in electronic health record (EHR) technology across all providers, including Critical Access Hospitals (CAHs).
Date: 03/2015
Type: Document
Sponsoring organization: Office of Inspector General (HHS)
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Annual report identifying the top 25 unimplemented recommendations from the Office of Inspector General (OIG) that, in OIG's view, would have the most substantial positive impact on Health and Human Services (HHS) programs. Positive impact may refer to cost savings, program efficacy and efficiency, and/or quality improvement. Primary areas of interest in the March 2015 edition include: Medicare payment policies and oversight mechanisms, face-to-face requirements for home health agencies, and strengthening fraud prevention in electronic health record (EHR) technology across all providers, including Critical Access Hospitals (CAHs).
Date: 03/2015
Type: Document
Sponsoring organization: Office of Inspector General (HHS)
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Evaluation of Hospital-Setting HCIA Awards: First Annual Report, Final
Evaluations of 10 Health Care Innovation Awards Round One projects undertaken in a hospital inpatient or emergency department. Covers projects that involved Critical Access Hospitals and other rural hospitals. Includes projects focused on improved care for sepsis and projects using remote electronic intensive care unit (eICU) services.
Date: 03/2015
Type: Document
Sponsoring organizations: Abt Associates, Centers for Medicare and Medicaid Services
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Evaluations of 10 Health Care Innovation Awards Round One projects undertaken in a hospital inpatient or emergency department. Covers projects that involved Critical Access Hospitals and other rural hospitals. Includes projects focused on improved care for sepsis and projects using remote electronic intensive care unit (eICU) services.
Date: 03/2015
Type: Document
Sponsoring organizations: Abt Associates, Centers for Medicare and Medicaid Services
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Acceptance of New Patients With Public and Private Insurance by Office-based Physicians: United States, 2013
Provides data on office-based physicians accepting new patients with Medicaid, Medicare, and private insurance. See Figure 2 for comparison of metropolitan to nonmetropolitan acceptance rates by patient payment source. Also includes state-level data.
Author(s): Esther Hing, Sandra L. Decker, Eric Jamoom
Date: 03/2015
Type: Document
Sponsoring organization: National Center for Health Statistics
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Provides data on office-based physicians accepting new patients with Medicaid, Medicare, and private insurance. See Figure 2 for comparison of metropolitan to nonmetropolitan acceptance rates by patient payment source. Also includes state-level data.
Author(s): Esther Hing, Sandra L. Decker, Eric Jamoom
Date: 03/2015
Type: Document
Sponsoring organization: National Center for Health Statistics
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A Critique of the Office of the Inspector General's Report on Swing Beds in Critical Access Hospitals
Evaluates the methods and data of a March 2015 report from the Office of the Inspector General (OIG), U.S. Department of Health and Human Services, commenting on Medicare reimbursement policy for swing bed services in Critical Access Hospitals (CAHs).
Author(s): Kristin L. Reiter, G. Mark Holmes
Date: 03/2015
Type: Document
Sponsoring organization: North Carolina Rural Health Research Program
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Evaluates the methods and data of a March 2015 report from the Office of the Inspector General (OIG), U.S. Department of Health and Human Services, commenting on Medicare reimbursement policy for swing bed services in Critical Access Hospitals (CAHs).
Author(s): Kristin L. Reiter, G. Mark Holmes
Date: 03/2015
Type: Document
Sponsoring organization: North Carolina Rural Health Research Program
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MedPAC Report to the Congress: Medicare Payment Policy, 2015
Annual review of Medicare payment policies, with recommendations to Congress. Discussions of rural aspects of Medicare payment policies are included throughout the report.
Date: 03/2015
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Annual review of Medicare payment policies, with recommendations to Congress. Discussions of rural aspects of Medicare payment policies are included throughout the report.
Date: 03/2015
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Medicare Could Have Saved Billions at Critical Access Hospitals If Swing-Bed Services Were Reimbursed Using the Skilled Nursing Facility Prospective Payment System Rates
Reports the Inspector General's findings from a study of swing bed services and reimbursement at Critical Access Hospitals (CAHs). Addresses changes in swing bed usage over time and examines the potential impact to Medicare of reimbursing swing bed services at skilled nursing facility (SNF) prospective payment system (PPS) rates.
Date: 03/2015
Type: Document
Sponsoring organization: Office of Inspector General (HHS)
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Reports the Inspector General's findings from a study of swing bed services and reimbursement at Critical Access Hospitals (CAHs). Addresses changes in swing bed usage over time and examines the potential impact to Medicare of reimbursing swing bed services at skilled nursing facility (SNF) prospective payment system (PPS) rates.
Date: 03/2015
Type: Document
Sponsoring organization: Office of Inspector General (HHS)
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Developmental Strategies and Challenges of Rural Accountable Care Organizations
Reports information gathered from 4 Accountable Care Organizations (ACOs) serving rural Medicare beneficiaries in 2013. Highlights lessons learned, opportunities for success, and challenges observed by the ACOs.
Author(s): Jure Baloh, A. Clinton MacKinney, Keith Mueller, et al.
Date: 02/2015
Type: Document
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Reports information gathered from 4 Accountable Care Organizations (ACOs) serving rural Medicare beneficiaries in 2013. Highlights lessons learned, opportunities for success, and challenges observed by the ACOs.
Author(s): Jure Baloh, A. Clinton MacKinney, Keith Mueller, et al.
Date: 02/2015
Type: Document
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Do Current Medicare Rural Hospital Payment Systems Align with Cost Determinants?
Discusses various payment models that may affect the financial performance of rural hospitals and the variables (geographic, community, market, and hospital) that affect rural hospital costs.
Author(s): Kristin Moss, G. Mark Holmes, George H. Pink,
Date: 02/2015
Type: Document
Sponsoring organization: North Carolina Rural Health Research Program
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Discusses various payment models that may affect the financial performance of rural hospitals and the variables (geographic, community, market, and hospital) that affect rural hospital costs.
Author(s): Kristin Moss, G. Mark Holmes, George H. Pink,
Date: 02/2015
Type: Document
Sponsoring organization: North Carolina Rural Health Research Program
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International Classification of Disease: CMS's Efforts to Prepare for the New Version of the Disease and Procedure Codes
Review of the efforts undertaken by the Centers for Medicare and Medicaid Services (CMS) to prepare for the transition to the 10th revision of the International Classification of Diseases (ICD-10) codes. Evaluates the materials developed and activities undertaken by CMS to help providers' transition and describes concerns of stakeholder organizations, including rural-specific considerations.
Additional links: Full Report
Date: 01/2015
Type: Document
Sponsoring organization: Government Accountability Office
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Review of the efforts undertaken by the Centers for Medicare and Medicaid Services (CMS) to prepare for the transition to the 10th revision of the International Classification of Diseases (ICD-10) codes. Evaluates the materials developed and activities undertaken by CMS to help providers' transition and describes concerns of stakeholder organizations, including rural-specific considerations.
Additional links: Full Report
Date: 01/2015
Type: Document
Sponsoring organization: Government Accountability Office
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