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Rural Health
Resources by Topic: Medicare

Indian Health Care: Impact of the Affordable Care Act (ACA)
Summarizes key changes made in the re-authorization of the Indian Health Care Improvement Act (IHCIA), including the Affordable Care Act (ACA) provisions related to American Indians and Alaska Natives enrolled in and receiving services from Medicare, Medicaid, and the Children's Health Insurance Program (CHIP).
Date: 01/2014
Type: Document
Sponsoring organization: Congressional Research Service
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Evaluation of the Medicare Frontier Extended Stay Clinic Demonstration: Report to Congress
Reports on the results of a Medicare Frontier Extended Stay Clinic (FESC) demonstration project that used an enhanced clinic model in frontier areas to address the needs of seriously ill or injured patients who could not be transferred to a hospital or needed monitoring and observation for a limited period of time. Includes an overview of the demonstration and key findings from the project.
Date: 2014
Type: Document
Sponsoring organization: U.S. Department of Health and Human Services
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Change in Profitability and Financial Distress of Critical Access Hospitals from Loss of Cost-Based Reimbursement
Examines how proposed changes to Critical Access Hospital (CAH) cost-based reimbursement would affect the financial vulnerability of CAHs. Uses models to forecast the financial impact of 20 and 30 percent reductions in Medicare revenue, and the resulting implications for rural healthcare access.
Author(s): Mark Holmes, George H. Pink
Date: 12/2013
Type: Document
Sponsoring organization: North Carolina Rural Health Research Program
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March 2013: Medicare Advantage Update
Policy brief discussing rural Medicare Advantage enrollment data from March 2012-March 2013.
Author(s): Sarah Sayavong, Leah Kemper, Abigail Barker,Timothy McBride
Date: 09/2013
Type: Document
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Trends in Observation Care Among Medicare Fee-for-Service Beneficiaries at Critical Access Hospitals, 2007 – 2009
Highlights a study on the prevalence and duration of observational care in Critical Access Hospitals (CAHs) compared to Prospective Payment System (PPS) hospitals using Medicare claims data from 2007-2009, as well as 2007 American Hospital Association data to identify hospitals as CAHs or PPS hospitals and whether they were in rural or urban areas.
Author(s): Brad Wright, Hye-Young Jung, Zhanlian Feng, Vincent Mor
Citation: Journal of Rural Health, 29(s1), s1-s6
Date: 08/2013
Type: Document
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Provision of Uncompensated Care by Rural Hospitals: A Preliminary Look at Medicare Cost Report Worksheet S-10
Conducts a preliminary assessment of the quality of uncompensated care data included in Medicare Cost Report Worksheet S-10 for rural hospitals and identifies the implications of data quality issues for research and policy decisions. Addresses differences between Critical Access Hospitals and other rural hospitals.
Author(s): Caroline Crews, Kristin L. Reiter, Randy Randolph, G Mark Holmes, George H Pink
Date: 08/2013
Type: Document
Sponsoring organization: North Carolina Rural Health Research Program
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Rural Implications of Changes to the Medicare Hospice Benefit
Policy brief highlights an April 2013 meeting in Grand Junction, Colorado, of the National Advisory Committee on Rural Health and Human Services. Presents the committee's recommendations and analyses of ACA provisions which may have rural implications regarding challenges and innovations in hospice and palliative care in rural and frontier areas.
Date: 08/2013
Type: Document
Sponsoring organization: National Advisory Committee on Rural Health and Human Services
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Most Critical Access Hospitals Would Not Meet the Location Requirements if Required to Re-Enroll in Medicare
Recommends that CMS seek legislative authority to remove the permanent distance exemption for Critical Access Hospitals (CAHs) that currently have Necessary Provider designations.
Date: 08/2013
Type: Document
Sponsoring organization: Office of Inspector General (HHS)
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Examination of the Relative Importance of Hospital Employment in Non-Metropolitan Counties Using Location Quotients
Examines hospital employment in rural counties compared to the nation. Draws conclusions regarding how potential changes in Medicare and Medicaid might affect rural populations.
Author(s): Jon Smith
Citation: Rural and Remote Health, 13(3), 2497
Date: 07/2013
Type: Document
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Accountable Care Organizations in Rural America
Examines the prevalence of Medicare Accountable Care Organizations (ACOs) in the U.S. Includes breakdowns by non-metropolitan, metropolitan, and mixed counties, as well as a map of ACO locations.
Additional links: National and Regional Maps
Author(s): A. Clinton MacKinney, Thomas Vaughn, Xi Zhu, Keith J. Mueller, Fred Ullrich
Date: 07/2013
Type: Document
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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