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Rural Health
Resources by Topic: Medicare

Does Rurality Affect Observation Care Services Use in CAHs for Medicare Beneficiaries?
Describes the use of observation services across levels of rurality by Medicare beneficiaries in Critical Access Hospitals (CAHs), the demographics and health status of patients receiving these services, and the characteristics of their observation stays.
Author(s): Yvonne Jonk, Heidi O'Connor, Walter Gregg
Date: 10/2014
Type: Document
Sponsoring organization: University of Minnesota Rural Health Research Center
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Observation Care Services for Medicare Beneficiaries in Rural Hospitals: Policy Issues and Stakeholder Perspectives
Seeks to provide a greater understanding of rural-specific issues surrounding hospital outpatient observation status and the related implications for rural hospitals, skilled nursing facilities (SNFs), and Medicare beneficiaries. Results are based on a multi-state, qualitative analysis of input from three respondent groups: state hospital associations, long-term care ombudsman offices, and Quality Improvement Organizations (QIOs). Analysis focuses on the use of observation status by Medicare beneficiaries from 2010-2013.
Author(s): Walter Gregg, Samantha Mills, Yvonne Jonk
Date: 10/2014
Type: Document
Sponsoring organization: University of Minnesota Rural Health Research Center
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Medicare Beneficiaries Paid Nearly Half of the Costs for Outpatient Services at Critical Access Hospitals
Compares the system Medicare used to calculate outpatient coinsurance amounts for patients who receive services at Critical Access Hospitals (CAHs) with the system used for acute-care hospital patients. Recommends that the Centers for Medicare and Medicaid Services seek legislative authority to modify the coinsurance calculation.
Date: 10/2014
Type: Document
Sponsoring organization: Office of Inspector General (HHS)
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Differences in Case-Mix Between Rural and Urban Recipients of Home Health Care
Provides a description of the health status and service needs of rural and urban Medicare home health patients based on a professional assessment of their condition at the start of care.
Additional links: Fact Sheet
Author(s): Janice C. Probst, Grishma P. Bhavsar
Date: 10/2014
Type: Document
Sponsoring organization: Rural and Minority Health Research Center (formerly the South Carolina Rural Health Research Center)
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State Innovation Models (SIM) Initiative Evaluation: Model Design and Model Pre-Test Evaluation Report
Reports on the experiences of 19 states that received federal support to work on state health care innovation plans focused on developing innovative healthcare delivery and payment models. Discusses rural concerns in these states, as well as strategies to address rural healthcare needs. Some topics addressed include patient-centered medical homes, accountable care organizations, workforce, broadband access, electronic health record adoption, and telehealth.
Date: 07/2014
Type: Document
Sponsoring organizations: Centers for Medicare and Medicaid Services, RTI International
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Facilitating the Formation of Accountable Care Organizations in Rural Areas
Presents characteristics contributing to the formation of four accountable care organizations (ACOs) that serve rural Medicare beneficiaries and discusses implications for policies that facilitate rural ACO formation. Three of the ACOs in this study operate in both rural and metropolitan areas, and one operates exclusively in a rural area.
Author(s): Jure Baloh, Xi Zhu, Tom Vaughn, et al.
Date: 07/2014
Type: Document
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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The Effect of Medicare Payment Policy Changes on Rural Primary Care Practice Revenue
Discusses the effect of Medicare payment adjustments on Medicare-derived revenues to rural primary care providers.
Additional links: Supplemental Table
Author(s): Paula Weigel, A. Clinton MacKinney, Fred Ullrich, Keith J. Mueller
Date: 07/2014
Type: Document
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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MedPAC Report to the Congress: Medicare and the Health Care Delivery System, June 2014
Includes chapters on synchronizing Medicare policy across payment models; improving risk adjustment; measuring quality of care; financial assistance for low-income beneficiaries; per beneficiary payment for primary care; site-neutral payments for select conditions treated in inpatient rehabilitation facilities and skilled nursing facilities; and measuring the effects of medication adherence for the Medicare population. Mentions rural throughout.
Date: 06/2014
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Medicare Program; Prospective Payment System for FQHCs; Changes to Contracting Policies for RHCs; and Changes to Clinical Laboratory Improvement Amendments of 1988 Enforcement Actions for Proficiency Testing Referral
The final rule with comment period that implements the methodology and payment rates for a prospective payment system (PPS) for Federally Qualified Health Centers (FQHCs) services beginning October 1, 2014, under Medicare Part B, in compliance with the Affordable Care Act (ACA). Identifies the policy allowing Rural Health Clinics (RHCs) to contract with nonphysician practitioners when statutory requirements for employment of nurse practitioners and physician assistants are met, and incorporated other technical changes to FQHC and RHC regulations. Changes to the Clinical Laboratory Improvement Amendments of 1988 enforcement actions for proficiency testing referral are included.
Date: 05/2014
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Safety Net Clinics Serving the Elderly in Rural Areas: Rural Health Clinic Patients Compared to Federally Qualified Health Center Patients
Compares the distribution of Rural Health Clinics (RHCs) and nonmetro Federally Qualified Health Centers (FQHCs). Looks at how the Medicare populations served by these types of facilities differ, including their age distribution.
Author(s): Andrea D. Radford, Victoria A. Freeman, Denise A. Kirk, Hilda A. Howard, Mark Holmes
Date: 05/2014
Type: Document
Sponsoring organization: North Carolina Rural Health Research Program
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