Rural Health
Resources by Topic: Policy
MedPAC Report to the Congress: Medicare and the Health Care Delivery System, June 2024
Evaluates Medicare payment issues and provides recommendations to the U.S. Congress. Covers approaches for updating fee-for-service (FFS) Medicare's physician fee schedule (PFS) payments and incentivizing participation in alternative payment models; provider networks and prior authorization in Medicare Advantage (MA) plans; an assessment of the relative completeness of MA encounter data and other data sources; Medicare coverage and payments for medical software; alternate approaches to lower Medicare payment rates for select conditions in inpatient rehabilitation facilities; and Medicare's Acute Hospital Care at Home program. Includes rural references throughout.
Additional links: Executive Summary
Date: 06/2024
Sponsoring organization: Medicare Payment Advisory Commission
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Evaluates Medicare payment issues and provides recommendations to the U.S. Congress. Covers approaches for updating fee-for-service (FFS) Medicare's physician fee schedule (PFS) payments and incentivizing participation in alternative payment models; provider networks and prior authorization in Medicare Advantage (MA) plans; an assessment of the relative completeness of MA encounter data and other data sources; Medicare coverage and payments for medical software; alternate approaches to lower Medicare payment rates for select conditions in inpatient rehabilitation facilities; and Medicare's Acute Hospital Care at Home program. Includes rural references throughout.
Additional links: Executive Summary
Date: 06/2024
Sponsoring organization: Medicare Payment Advisory Commission
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Report to Congress on Medicaid and CHIP, June 2024
Semi-annual report to Congress from the Medicaid and CHIP Payment and Access Commission (MACPAC). Covers recommendations for increased transparency in Medicaid and CHIP financing, tools for optimizing state Medicaid agency contracts (SMACs), enrollment trends in Medicare Savings Programs (MSPs), and demographic data collection in Medicaid. Includes rural references throughout.
Date: 06/2024
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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Semi-annual report to Congress from the Medicaid and CHIP Payment and Access Commission (MACPAC). Covers recommendations for increased transparency in Medicaid and CHIP financing, tools for optimizing state Medicaid agency contracts (SMACs), enrollment trends in Medicare Savings Programs (MSPs), and demographic data collection in Medicaid. Includes rural references throughout.
Date: 06/2024
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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Health Insurance Coverage and Access to Care among American Indians and Alaska Natives: Recent Trends and Key Challenges
Issue brief presenting data on rates of insurance coverage, Medicaid coverage, and access to healthcare for American Indians and Alaska Natives (AI/AN) using American Community Survey data. Discusses the impacts of health disparities, coverage expansions under the Affordable Care Act, and state Medicaid expansions on AI/AN populations.
Date: 06/2024
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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Issue brief presenting data on rates of insurance coverage, Medicaid coverage, and access to healthcare for American Indians and Alaska Natives (AI/AN) using American Community Survey data. Discusses the impacts of health disparities, coverage expansions under the Affordable Care Act, and state Medicaid expansions on AI/AN populations.
Date: 06/2024
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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Improving Access to Affordable and Equitable Health Coverage: A Review from 2010 to 2024
An issue brief that provides commentary and data on how the Affordable Care Act (ACA) has impacted access to health insurance coverage. Provides uninsurance rates by demographic groups and discusses the effect of the ACA on rural areas.
Author(s): Thomas Buchmueller, Amelia Whitman, Christie Peters, Nancy De Lew
Date: 06/2024
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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An issue brief that provides commentary and data on how the Affordable Care Act (ACA) has impacted access to health insurance coverage. Provides uninsurance rates by demographic groups and discusses the effect of the ACA on rural areas.
Author(s): Thomas Buchmueller, Amelia Whitman, Christie Peters, Nancy De Lew
Date: 06/2024
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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Reimagining Rural Health Equity: Understanding Disparities and Orienting Policy, Practice, and Research in Rural America
Commentary piece discussing public health disparities and disadvantage in rural areas. Proposes five principles for policy, research, and practice in support of health equity. Includes coverage of rural leadership and assets, rural characteristics, and the value of rural-specific interventions, among other topics.
Author(s): Anne N. Sosin, Elizabeth A. Carpenter-Song
Citation: Health Affairs, 43(6), 791-797
Date: 06/2024
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Commentary piece discussing public health disparities and disadvantage in rural areas. Proposes five principles for policy, research, and practice in support of health equity. Includes coverage of rural leadership and assets, rural characteristics, and the value of rural-specific interventions, among other topics.
Author(s): Anne N. Sosin, Elizabeth A. Carpenter-Song
Citation: Health Affairs, 43(6), 791-797
Date: 06/2024
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MedPAC Comment on CMS's Proposed Rule on the Hospital Inpatient PPS and the Long-term Care Hospital PPS for FY 2025
Comments on a May 2, 2024, Federal Register proposed rule revising the hospital inpatient and long-term care hospital (LTCH) prospective payment systems (PPS). Discusses proposals on rate-setting in both the inpatient prospective payment systems (IPPS) and LTCH PPS; the Transforming Episode Accountability Model (TEAM), including the definition of rural hospitals eligible to participate in a lower-risk track; new payments to small, independent hospitals that establish and maintain a 6-month buffer supply of essential medicines; updates to wage index values and policies; and updates to outlier reconciliation thresholds.
Date: 06/2024
Sponsoring organization: Medicare Payment Advisory Commission
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Comments on a May 2, 2024, Federal Register proposed rule revising the hospital inpatient and long-term care hospital (LTCH) prospective payment systems (PPS). Discusses proposals on rate-setting in both the inpatient prospective payment systems (IPPS) and LTCH PPS; the Transforming Episode Accountability Model (TEAM), including the definition of rural hospitals eligible to participate in a lower-risk track; new payments to small, independent hospitals that establish and maintain a 6-month buffer supply of essential medicines; updates to wage index values and policies; and updates to outlier reconciliation thresholds.
Date: 06/2024
Sponsoring organization: Medicare Payment Advisory Commission
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Sources of Federal Funding for Health Care Facilities: Frequently Asked Questions
Provides an overview of how the federal government supports healthcare facilities, with a focus on hospitals. Discusses how Medicare and Medicaid pay acute care hospitals and for services rendered to beneficiaries and enrollees, as well as other payments these programs make. Identifies federal grants, loans, and technical assistance programs that can support health facilities. Describes how federal agencies, including the Health Resources and Services Administration (HRSA) and the U.S. Department of Agriculture (USDA), have supported healthcare facilities during emergencies.
Date: 06/2024
Sponsoring organization: Congressional Research Service
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Provides an overview of how the federal government supports healthcare facilities, with a focus on hospitals. Discusses how Medicare and Medicaid pay acute care hospitals and for services rendered to beneficiaries and enrollees, as well as other payments these programs make. Identifies federal grants, loans, and technical assistance programs that can support health facilities. Describes how federal agencies, including the Health Resources and Services Administration (HRSA) and the U.S. Department of Agriculture (USDA), have supported healthcare facilities during emergencies.
Date: 06/2024
Sponsoring organization: Congressional Research Service
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Veterans Health Care: Opportunities Exist to Improve Assessment of Network Adequacy for Mental Health
Provides an overview of the U.S. Department of Veterans Affairs (VA) Community Care Networks (CCN) program and how the VA and contractors develop and maintain mental health provider networks. Describes how the VA assesses the adequacy of the CCN mental health provider networks. Examines the extent to which the VA collects information on the factors that contribute to scheduling timeliness challenges for community care appointments, including for mental health appointments. Presents data on the percentage of CCN mental health claims that were within drive-time and appointment-availability standards between April 2022 and March 2023 by CCN region, rurality, and care setting.
Additional links: Full Report
Date: 06/2024
Sponsoring organization: Government Accountability Office
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Provides an overview of the U.S. Department of Veterans Affairs (VA) Community Care Networks (CCN) program and how the VA and contractors develop and maintain mental health provider networks. Describes how the VA assesses the adequacy of the CCN mental health provider networks. Examines the extent to which the VA collects information on the factors that contribute to scheduling timeliness challenges for community care appointments, including for mental health appointments. Presents data on the percentage of CCN mental health claims that were within drive-time and appointment-availability standards between April 2022 and March 2023 by CCN region, rurality, and care setting.
Additional links: Full Report
Date: 06/2024
Sponsoring organization: Government Accountability Office
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Medicare Claims Processing Manual Chapter 4 - Part B Hospital (Including Inpatient Hospital Part B and OPPS)
Outlines rules and regulations for processing Medicare Part B hospital claims. Covers special rules for Critical Access Hospital outpatient billing, hospital-based Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs) billing for non-RHC/FQHC services, and payment adjustments for Rural Emergency Hospitals (REHs).
Date: 06/2024
Sponsoring organization: Centers for Medicare and Medicaid Services
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Outlines rules and regulations for processing Medicare Part B hospital claims. Covers special rules for Critical Access Hospital outpatient billing, hospital-based Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs) billing for non-RHC/FQHC services, and payment adjustments for Rural Emergency Hospitals (REHs).
Date: 06/2024
Sponsoring organization: Centers for Medicare and Medicaid Services
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Rural Emergency Hospitals
Provides an overview of the Rural Emergency Hospital (REH) program and the statutory requirements for facilities seeking REH designation. Outlines state laws that established REH licensure.
Date: 06/2024
Sponsoring organization: National Conference of State Legislatures
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Provides an overview of the Rural Emergency Hospital (REH) program and the statutory requirements for facilities seeking REH designation. Outlines state laws that established REH licensure.
Date: 06/2024
Sponsoring organization: National Conference of State Legislatures
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