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Rural Health
Resources by Topic: Outpatient care

January 2025 MedPAC Meeting Transcript
Transcript from the Medicare Payment Advisory Commission's (MedPAC) January 2025 meeting. Covers payment adequacy and updates for physician and other health professional services, hospital inpatient and outpatient services, skilled nursing facility services, home health agency services, inpatient rehabilitation facility services, outpatient dialysis services, and hospice services. Discusses status reports on Medicare Part D, ambulatory surgical centers, and the Medicare Advantage program, as well as policy options for modifying the cost-sharing liability for beneficiaries who receive care at Critical Access Hospitals. Includes rural references and considerations throughout.
Additional links: Reducing Beneficiary Cost-sharing for Outpatient Services at Critical Access Hospitals
Date: 01/2025
Sponsoring organization: Medicare Payment Advisory Commission
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Impact of the Medicare Improvements for Patients And Providers Act on Mental Health Service Utilization And Spending among Older Adults
Examines the impact of the Medicare Improvements for Patients and Providers Act (MIPPA) on outpatient mental healthcare utilization. Utilizes 2008-2017 Medicare claims and administrative data to analyze MIPPA in a pre-implementation phase as well as 4 post-implementation phases. Includes data on mental healthcare outpatient visits by age group, race, dual eligibility status, substance use disorder, comorbidities, and urban, large rural, small rural, or isolated rural location.
Author(s): Matt Toth, Brent Gibbons, Abbie Levinson, et al.
Date: 01/2025
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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Understanding Barriers and Facilitators to Implementation of a Patient Safety Bundle for Pregnancy-Related Severe Hypertension in 3 North Carolina Outpatient Clinics: A Qualitative Study
Examines the Alliance for Innovation on Maternal Health's Patient Safety Bundle (Bundle) implementation in North Carolina, which aims to address complications of pregnancy related hypertension. Utilizes feedback from 11 key informant interviews working at a rural outpatient Federally Qualified Health Center (FQHC) in central North Carolina. Discusses facilitators and barriers of the Bundle implementation, with a focus on access issues in rural and underserved communities.
Author(s): Aparna G. Kachoria, Hiba Fatima, Alexandra F. Lightfoot, et al.
Citation: Implementation Science Communications, 6, 7
Date: 01/2025
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Effects of Rural Hospital Closures on Nurse Staffing Levels and Health Care Utilization at Nearby Hospitals
Analyzes healthcare utilization and nurse staffing levels when nearby rural hospitals close. Utilizes 2014-2019 American Hospital Association Survey data to examine vocational nurse/licensed practical nurse (LPN), registered nurse (RN), and advanced practice nurse (APN) staffing levels as well as inpatient and outpatient surgical operations and emergency department (ED) visits within 4 years of a hospital closure.
Author(s): Jing Dong, Siying Liu, Asefeh Faraz Covelli, Guido Cataife
Citation: Health Economics, 33(12), 2687-2707
Date: 12/2024
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National Hospital Ambulatory Medical Care Survey: 2022 Emergency Department Summary Tables
Provides data on ambulatory care emergency department (ED) hospital visits in 2022. Table 1 provides metropolitan/nonmetropolitan ED visit data based on hospital location.
Date: 11/2024
Sponsoring organization: National Center for Health Statistics
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CY 2025 Medicare Hospital Outpatient Prospective Payment System and Ambulatory Surgical Center Payment System Final Rule (CMS 1809-FC)
Fact sheet providing an overview of the Centers for Medicare & Medicaid Services (CMS) final rule regarding updates and changes to the Medicare payments for hospital outpatient and Ambulatory Surgical Center (ASC) services for calendar year 2025. Summarizes provisions regarding changes to Intensive Outpatient Program (IOP) and partial hospital program rate setting; incorporating an add-on payment to the Medicare outpatient hospital all-inclusive rate (AIR) for certain high-cost drugs for people with Medicare who receive care at Indian Health Service (IHS) or tribal hospitals; updates to the Hospital Outpatient Quality Reporting (OQR), Ambulatory Surgical Center Quality Reporting (ASCQR), and Rural Emergency Hospital Quality Reporting (REHQR) Programs; a new Conditions of Participation (CoPs) for hospitals and Critical Access Hospitals (CAHs) for obstetrical services; Medicaid and CHIP continuous eligibility; Medicaid clinic services "four walls" exceptions; and more.
Date: 11/2024
Sponsoring organization: Centers for Medicare and Medicaid Services
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Medicare Payment Basics: Outpatient Hospital Services Payment System
Outlines Medicare's payments for outpatient hospital services, including considerations for rural sole community hospitals.
Date: 10/2024
Sponsoring organization: Medicare Payment Advisory Commission
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Medicare Payment Basics: Outpatient Dialysis Services Payment System
Overview of Medicare payment methods for outpatient dialysis services of beneficiaries with end-stage renal disease (ESRD). Describes the base payment rate for freestanding and hospital-based facilities and identifies facility-level adjustments, including facilities located in rural areas.
Date: 10/2024
Sponsoring organization: Medicare Payment Advisory Commission
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Rural Community Health Worker Programs: Proving Value and Finding Sustainability
Features four rural healthcare organizations describing the impact of their community health worker (CHW) programs and strategies for sustaining them. Discusses CHW roles, activities, reimbursement options, and more.
Author(s): Kay Miller Temple
Citation: Rural Monitor
Date: 07/2024
Sponsoring organization: Rural Health Information Hub
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MedPAC Data Book: Health Care Spending and the Medicare Program, 2024
Provides an overview of Medicare spending and highlights data on Medicare beneficiary demographics, dual-eligible beneficiaries, quality of care provided through the Medicare program, and other payer liability. Examines settings of care, including rural-specific provider sites, as they relate to spending, access to care, and profit margins. Compares rural and urban beneficiaries and providers throughout. Chart 6-2 addresses rural hospital closures.
Date: 07/2024
Sponsoring organization: Medicare Payment Advisory Commission
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