Rural Health
Resources by Topic: Post-acute care
MedPAC Report to the Congress: Medicare Payment Policy: Skilled Nursing Facility Services: Chapter 6
Discusses payment adequacy for skilled nursing facility (SNF) services. Features statistics on SNF care provided by rural hospitals and Critical Access Hospitals (CAHs) via swing beds and Medicare margins for urban, rural, and frontier freestanding SNFs in 2023.
Date: 03/2025
Sponsoring organization: Medicare Payment Advisory Commission
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Discusses payment adequacy for skilled nursing facility (SNF) services. Features statistics on SNF care provided by rural hospitals and Critical Access Hospitals (CAHs) via swing beds and Medicare margins for urban, rural, and frontier freestanding SNFs in 2023.
Date: 03/2025
Sponsoring organization: Medicare Payment Advisory Commission
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MedPAC Report to the Congress: Medicare Payment Policy, 2025
Annual review of Medicare payment policies, with recommendations to Congress. Includes discussion on Medicare payment policies directly affecting rural providers and beneficiaries. Addresses payment adequacy for Medicare fee-for-service payment systems, Medicare Advantage (MA), and Medicare Part D.
Date: 03/2025
Sponsoring organization: Medicare Payment Advisory Commission
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Annual review of Medicare payment policies, with recommendations to Congress. Includes discussion on Medicare payment policies directly affecting rural providers and beneficiaries. Addresses payment adequacy for Medicare fee-for-service payment systems, Medicare Advantage (MA), and Medicare Part D.
Date: 03/2025
Sponsoring organization: Medicare Payment Advisory Commission
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The Association Between Neighborhood Social Vulnerability and Community-Based Rehabilitation after Stroke
Examines the relationship between the timely use of community-based rehabilitation after a stroke and the social determinants of health. Analyzes 6,843 adults enrolled in a post-acute stroke program in North Carolina, with breakdowns according to patient SVI and therapy visits within 90 days of stroke. Includes discussion of rurality as a factor related to access and timely use of care.
Author(s): Shuqi Zhang, Elizabeth R. Mormer, Anna M. Johnson, et al.
Citation: BMC Health Services Research, 25, 55
Date: 01/2025
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Examines the relationship between the timely use of community-based rehabilitation after a stroke and the social determinants of health. Analyzes 6,843 adults enrolled in a post-acute stroke program in North Carolina, with breakdowns according to patient SVI and therapy visits within 90 days of stroke. Includes discussion of rurality as a factor related to access and timely use of care.
Author(s): Shuqi Zhang, Elizabeth R. Mormer, Anna M. Johnson, et al.
Citation: BMC Health Services Research, 25, 55
Date: 01/2025
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Medicare Could save Billions with Comparable Access for Enrollees If Critical Access Hospital Payments for Swing-Bed Services Were Similar to Those of the Fee-for-Service Prospective Payment System
Describes the use of swing beds for skilled nursing services at Critical Access Hospitals (CAHs) and average daily Medicare reimbursement for these services from 2015 through 2020. Examines data from a sample of 100 CAHs to determine whether Medicare enrollees would have had access to the same skilled nursing services provided by CAHs at alternative facilities within a 35-mile driving distance. Compares the average daily reimbursement for skilled nursing services at CAHs and alternative facilities, as well as the potential savings to Medicare if CAHs were reimbursed for skilled nursing services under the Skilled Nursing Facility (SNF) Prospective Payment System (PPS).
Date: 12/2024
Sponsoring organization: Office of Inspector General (HHS)
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Describes the use of swing beds for skilled nursing services at Critical Access Hospitals (CAHs) and average daily Medicare reimbursement for these services from 2015 through 2020. Examines data from a sample of 100 CAHs to determine whether Medicare enrollees would have had access to the same skilled nursing services provided by CAHs at alternative facilities within a 35-mile driving distance. Compares the average daily reimbursement for skilled nursing services at CAHs and alternative facilities, as well as the potential savings to Medicare if CAHs were reimbursed for skilled nursing services under the Skilled Nursing Facility (SNF) Prospective Payment System (PPS).
Date: 12/2024
Sponsoring organization: Office of Inspector General (HHS)
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Associations Between Rural Hospital Closures and Acute and Post-Acute Care Access and Outcomes
Examines the impact of rural hospital closures on hospital and post-acute care (PAC) use and outcomes. Analyzes 32 rural hospital closures and county-level impacts on travel distances, lengths of stay at hospitals, hospital charges, PAC episodes, fall injuries and related mortality and hospitalizations, and population-level hospitalization and death rates. Includes descriptive statistics of 2014-2018 rural hospital closure status.
Author(s): Geoffrey J. Hoffman, Jinkyung Ha, Zhaohui Fan, Jun Li
Citation: Health Services Research
Date: 12/2024
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Examines the impact of rural hospital closures on hospital and post-acute care (PAC) use and outcomes. Analyzes 32 rural hospital closures and county-level impacts on travel distances, lengths of stay at hospitals, hospital charges, PAC episodes, fall injuries and related mortality and hospitalizations, and population-level hospitalization and death rates. Includes descriptive statistics of 2014-2018 rural hospital closure status.
Author(s): Geoffrey J. Hoffman, Jinkyung Ha, Zhaohui Fan, Jun Li
Citation: Health Services Research
Date: 12/2024
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December 2024 MedPAC Meeting Transcript
Transcript from the Medicare Payment Advisory Commission's (MedPAC) December 2024 meeting. Covers payment adequacy and updates for physician and other health professional services, hospital inpatient and outpatient services, Rural Emergency Hospitals (REHs), skilled nursing facility services, inpatient rehabilitation facility services, home health services, hospice services, and outpatient dialysis services.
Additional links: Assessing Payment Adequacy and Updating Payments: Hospital Inpatient and Outpatient Services; and Mandated Report on Rural Emergency Hospitals - Presentation Slides, Assessing Payment Adequacy and Updating Payments: Skilled Nursing Facility Services - Presentation Slides
Date: 12/2024
Sponsoring organization: Medicare Payment Advisory Commission
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Transcript from the Medicare Payment Advisory Commission's (MedPAC) December 2024 meeting. Covers payment adequacy and updates for physician and other health professional services, hospital inpatient and outpatient services, Rural Emergency Hospitals (REHs), skilled nursing facility services, inpatient rehabilitation facility services, home health services, hospice services, and outpatient dialysis services.
Additional links: Assessing Payment Adequacy and Updating Payments: Hospital Inpatient and Outpatient Services; and Mandated Report on Rural Emergency Hospitals - Presentation Slides, Assessing Payment Adequacy and Updating Payments: Skilled Nursing Facility Services - Presentation Slides
Date: 12/2024
Sponsoring organization: Medicare Payment Advisory Commission
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October 2024 MedPAC Meeting Transcript
Transcript from the Medicare Payment Advisory Commission's (MedPAC) October 2024 meeting. Covers an analysis of Medicare beneficiaries in nursing homes, findings from MedPAC's annual beneficiary and provider focus groups, supplemental benefits in Medicare Advantage, a work plan for a mandated final report on the impact of recent changes to the home health prospective payment system, and initial estimates of home health care use among Medicare Advantage enrollees. Includes rural references throughout.
Additional links: Medicare Beneficiaries in Nursing Homes - Presentation Slides
Date: 10/2024
Sponsoring organization: Medicare Payment Advisory Commission
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Transcript from the Medicare Payment Advisory Commission's (MedPAC) October 2024 meeting. Covers an analysis of Medicare beneficiaries in nursing homes, findings from MedPAC's annual beneficiary and provider focus groups, supplemental benefits in Medicare Advantage, a work plan for a mandated final report on the impact of recent changes to the home health prospective payment system, and initial estimates of home health care use among Medicare Advantage enrollees. Includes rural references throughout.
Additional links: Medicare Beneficiaries in Nursing Homes - Presentation Slides
Date: 10/2024
Sponsoring organization: Medicare Payment Advisory Commission
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Medicare Payment Basics: Skilled Nursing Facility Services Payment System
Overview of Medicare payments for skilled nursing and rehabilitation services. Describes what constitutes a skilled nursing facility and how small, rural hospitals and Critical Access Hospitals (CAHs) may be used to provide these services with CMS approval. Compares Medicare daily base rates for urban and rural skilled nursing facilities.
Date: 10/2024
Sponsoring organization: Medicare Payment Advisory Commission
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Overview of Medicare payments for skilled nursing and rehabilitation services. Describes what constitutes a skilled nursing facility and how small, rural hospitals and Critical Access Hospitals (CAHs) may be used to provide these services with CMS approval. Compares Medicare daily base rates for urban and rural skilled nursing facilities.
Date: 10/2024
Sponsoring organization: Medicare Payment Advisory Commission
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Medicare Payment Basics: Inpatient Rehabilitation Facilities Payment System
Overview of Medicare's payment system for inpatient rehabilitation services in freestanding facilities or within acute care hospitals. Demonstrates how payment rates are adjusted to account for certain facility characteristics, including facilities in rural areas.
Date: 10/2024
Sponsoring organization: Medicare Payment Advisory Commission
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Overview of Medicare's payment system for inpatient rehabilitation services in freestanding facilities or within acute care hospitals. Demonstrates how payment rates are adjusted to account for certain facility characteristics, including facilities in rural areas.
Date: 10/2024
Sponsoring organization: Medicare Payment Advisory Commission
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Nebraska - Breaking the Pattern: Driving Initiatives to Safely Transition Patients Across the Care Continuum
Discusses challenges of discharging hospitalized patients in Nebraska to post-acute care. Provides data on patients awaiting discharge, reasons for delay, impact of Medicare advantage, and possible solutions. Includes county-level information on availability of long-term care or assisted living facilities and discusses impact on rural areas.
Date: 09/2024
Sponsoring organization: Nebraska Hospital Association
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Discusses challenges of discharging hospitalized patients in Nebraska to post-acute care. Provides data on patients awaiting discharge, reasons for delay, impact of Medicare advantage, and possible solutions. Includes county-level information on availability of long-term care or assisted living facilities and discusses impact on rural areas.
Date: 09/2024
Sponsoring organization: Nebraska Hospital Association
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