Rural Health
Resources by Topic: Policy
Evaluation of the Vermont All-Payer Accountable Care Organization Model: First Evaluation Report
Evaluates the first two performance years of the Vermont All-Payer Accountable Care Organization Model (VTAPM), which aims to assess whether scaling an Accountable Care Organization (ACO) across all payers in the state can reduce program expenditures while preserving or improving care quality. Discusses the implementation of the model, provider engagement, efforts to address population health goals; characteristics of participating hospitals, practitioners, and beneficiaries; and the model's impacts on Medicare spending, utilization, and quality of care. Includes information on hospital and provider participation in rural counties and unique challenges for rural Critical Access Hospitals.
Additional links: Findings at a Glance, Technical Appendices
Date: 08/2021
Sponsoring organizations: Centers for Medicare and Medicaid Services, NORC at the University of Chicago
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Evaluates the first two performance years of the Vermont All-Payer Accountable Care Organization Model (VTAPM), which aims to assess whether scaling an Accountable Care Organization (ACO) across all payers in the state can reduce program expenditures while preserving or improving care quality. Discusses the implementation of the model, provider engagement, efforts to address population health goals; characteristics of participating hospitals, practitioners, and beneficiaries; and the model's impacts on Medicare spending, utilization, and quality of care. Includes information on hospital and provider participation in rural counties and unique challenges for rural Critical Access Hospitals.
Additional links: Findings at a Glance, Technical Appendices
Date: 08/2021
Sponsoring organizations: Centers for Medicare and Medicaid Services, NORC at the University of Chicago
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The Pennsylvania Rural Health Model (PARHM): First Annual Report
Evaluates the first year of the Pennsylvania Rural Health Model (PARHM), an initiative designed to test if global budgets can help rural hospitals improve their financial viability, provide flexibility to meet locally defined community health needs, and reduce overall health care spending. Provides an overview of the model and describes the implementation experience of the first cohort of participating hospitals. Presents preliminary, descriptive data on the financial performance and utilization outcomes of Cohort 1 participants.
Additional links: Appendix, Findings at a Glance
Date: 08/2021
Sponsoring organizations: Centers for Medicare and Medicaid Services, NORC at the University of Chicago
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Evaluates the first year of the Pennsylvania Rural Health Model (PARHM), an initiative designed to test if global budgets can help rural hospitals improve their financial viability, provide flexibility to meet locally defined community health needs, and reduce overall health care spending. Provides an overview of the model and describes the implementation experience of the first cohort of participating hospitals. Presents preliminary, descriptive data on the financial performance and utilization outcomes of Cohort 1 participants.
Additional links: Appendix, Findings at a Glance
Date: 08/2021
Sponsoring organizations: Centers for Medicare and Medicaid Services, NORC at the University of Chicago
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Paying for Telemedicine in Smaller Rural Hospitals: Extending the Technology to Those Who Benefit Most
Viewpoint article discussing the positive financial impacts of telemedicine in emergency departments (EDs) and barriers to using telemedicine in small rural hospitals related to patient volume, high upfront costs, and reimbursement issues. Outlines policy interventions to support rural telemedicine.
Author(s): Kori S. Zachrison, Jessica V. Richard, Ateev Mehrotra
Citation: JAMA Health Forum, 2(8), e211570
Date: 08/2021
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Viewpoint article discussing the positive financial impacts of telemedicine in emergency departments (EDs) and barriers to using telemedicine in small rural hospitals related to patient volume, high upfront costs, and reimbursement issues. Outlines policy interventions to support rural telemedicine.
Author(s): Kori S. Zachrison, Jessica V. Richard, Ateev Mehrotra
Citation: JAMA Health Forum, 2(8), e211570
Date: 08/2021
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Primary Care Case Management in Medicaid: A Strategy for Supporting Primary Care in Rural Areas
Describes how Medicaid agencies in five states - Alabama, Colorado, Maine, Idaho, and Oklahoma - utilize primary care case management (PCCM) programs to strengthen primary care, particularly in rural areas. Identifies three strategies implemented by some or all of these states to support primary care providers, and highlights lessons learned for state Medicaid programs that want to strengthen primary care in rural areas.
Author(s): Neva Kaye
Date: 08/2021
Sponsoring organization: National Academy for State Health Policy
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Describes how Medicaid agencies in five states - Alabama, Colorado, Maine, Idaho, and Oklahoma - utilize primary care case management (PCCM) programs to strengthen primary care, particularly in rural areas. Identifies three strategies implemented by some or all of these states to support primary care providers, and highlights lessons learned for state Medicaid programs that want to strengthen primary care in rural areas.
Author(s): Neva Kaye
Date: 08/2021
Sponsoring organization: National Academy for State Health Policy
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MedPAC Comment on CMS's Proposed Rule on the ESRD PPS for CY 2022
Comments on a July 9, 2021, Federal Register proposed rule related to Medicare payment policies for end-stage renal disease (ESRD). Includes comments addressing the low-volume payment adjustment (LVPA) and the rural adjustment.
Date: 08/2021
Sponsoring organization: Medicare Payment Advisory Commission
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Comments on a July 9, 2021, Federal Register proposed rule related to Medicare payment policies for end-stage renal disease (ESRD). Includes comments addressing the low-volume payment adjustment (LVPA) and the rural adjustment.
Date: 08/2021
Sponsoring organization: Medicare Payment Advisory Commission
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Maternal Morbidity and Mortality Measurement Recommendations Report
Provides an overview of two measurement frameworks, one for maternal morbidity and one for maternal mortality. Includes a list of short- and long-term recommendations for each measurement topic, which cover equitable treatment; timely access to treatment and services; follow-up and care coordination of care; protocols and guidelines; substance use disorders, mental health, and behavioral health; access to pain management and labor support; and patient- and family-reported outcomes and experiences of care. Discusses three potential, actionable measure concepts for maternal mortality.
Date: 08/2021
Sponsoring organization: National Quality Forum
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Provides an overview of two measurement frameworks, one for maternal morbidity and one for maternal mortality. Includes a list of short- and long-term recommendations for each measurement topic, which cover equitable treatment; timely access to treatment and services; follow-up and care coordination of care; protocols and guidelines; substance use disorders, mental health, and behavioral health; access to pain management and labor support; and patient- and family-reported outcomes and experiences of care. Discusses three potential, actionable measure concepts for maternal mortality.
Date: 08/2021
Sponsoring organization: National Quality Forum
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Rural Residency Training as a Strategy to Address Rural Health Disparities: Barriers to Expansion and Possible Solutions
Identifies barriers rural communities face in developing and sustaining graduate medical education programs, and proposes potential solutions including regulatory fixes and legislative action. Includes definitions of key concepts and terminology in the Supplementary Data section.
Additional links: Supplementary Data
Author(s): Emily M. Hawes, Erin Fraher, Steven Crane, et al.
Citation: Journal of Graduate Medical Education, 13(4), 461-465
Date: 08/2021
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Identifies barriers rural communities face in developing and sustaining graduate medical education programs, and proposes potential solutions including regulatory fixes and legislative action. Includes definitions of key concepts and terminology in the Supplementary Data section.
Additional links: Supplementary Data
Author(s): Emily M. Hawes, Erin Fraher, Steven Crane, et al.
Citation: Journal of Graduate Medical Education, 13(4), 461-465
Date: 08/2021
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Potential Implications of SARS-CoV-2 Delta Variant Surges for Rural Areas and Hospitals
Opinion piece highlighting features of rural healthcare systems that make it more difficult for those hospitals to withstand surges in COVID-19 cases. Suggests possible solutions for institutions, governments, and society as they navigate the potentially rural-dominant Delta variant phase.
Author(s): Sameer S. Kadri, Steven Q. Simpson
Citation: JAMA
Date: 08/2021
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Opinion piece highlighting features of rural healthcare systems that make it more difficult for those hospitals to withstand surges in COVID-19 cases. Suggests possible solutions for institutions, governments, and society as they navigate the potentially rural-dominant Delta variant phase.
Author(s): Sameer S. Kadri, Steven Q. Simpson
Citation: JAMA
Date: 08/2021
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The Swing Bed Program: Impacting Patients, Providers, and Community
Brief video overview of the swing bed program, which helps rural hospitals provide patient- and community-centric post-acute healthcare. Describes the history, related policy issues, early implementation, and evolution of the program.
Date: 08/2021
Sponsoring organization: Rural Health Information Hub
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Brief video overview of the swing bed program, which helps rural hospitals provide patient- and community-centric post-acute healthcare. Describes the history, related policy issues, early implementation, and evolution of the program.
Date: 08/2021
Sponsoring organization: Rural Health Information Hub
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History of the Swing Bed: A Look Through the Rural Rearview Mirror
Reviews the history of the swing bed program, which helps rural hospitals serve patients and the community through provision of post-acute care. Shares insights from experts who describe early implementation and key program elements that have contributed to the program's success.
Author(s): Kay Miller Temple
Citation: Rural Monitor
Date: 08/2021
Sponsoring organization: Rural Health Information Hub
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Reviews the history of the swing bed program, which helps rural hospitals serve patients and the community through provision of post-acute care. Shares insights from experts who describe early implementation and key program elements that have contributed to the program's success.
Author(s): Kay Miller Temple
Citation: Rural Monitor
Date: 08/2021
Sponsoring organization: Rural Health Information Hub
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