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Rural Health
Resources by Topic: Post-acute care

Understanding Adaptations in the Veteran Health Administration's Transitions Nurse Program: Refining Methodology and Pragmatic Implications for Scale-up
Highlights a study on adaptations to the rural Transitions Nurse Program (TNP) in Veterans Health Administration facilities. Focuses on TNP sites and discusses the adaptations and lessons learned from each.
Author(s): Michaela S. McCarthy, Lexus L. Ujano-De Motta, Mary A. Nunnery, et al.
Citation: Implementation Science, 16, 71
Date: 07/2021
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MedPAC Report to the Congress: Medicare Payment Policy, 2021
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 healthcare facilities and services, improving Medicare payment for post-acute care, Medicare Advantage, Medicare Part D, and the impact of healthcare provider consolidation. Contains information on the effects of the COVID-19 pandemic on Medicare beneficiary healthcare access, mortality, and service use. Presents an option for Medicare's coverage of telehealth beyond the public health emergency.
Date: 03/2021
Sponsoring organization: Medicare Payment Advisory Commission
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January 2021 MedPAC Meeting Transcript
Transcript from the Medicare Payment Advisory Commission's (MedPAC) January 2021 meeting. Features a discussion on the expansion of telehealth in Medicare. Also covers payment adequacy and updates for hospital inpatient and outpatient services and the mandated report expanding the post-acute care transfer policy to hospice, physician and other health professional services, ambulatory surgical center services, outpatient dialysis services, hospice services, skilled nursing facility services, home health agency services, inpatient rehabilitation facility services, long-term care hospital services, and CMMI's development and implementation of alternative payment models.
Date: 01/2021
Sponsoring organization: Medicare Payment Advisory Commission
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Medicare Severe Wound Care: Spending Declines May Reflect Site of Care Changes; Limited Information Is Available on Quality
Reports on an analysis of where Medicare beneficiaries received care for severe wounds in 2018 and Medicare payment for these services. Provides an overview of the implementation of a dual payment system for long-term care hospitals in 2016, and examines how the dual payment system affected the availability and quality of severe wound care for Medicare beneficiaries. Includes data on severe wound care by facility type in addition to Medicare spending by urban and rural location.
Additional links: Full Report
Date: 01/2021
Sponsoring organization: Government Accountability Office
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Frontier Community Health Integration Project (FCHIP) Demonstration Evaluation: Final Evaluation Report
Presents findings from an evaluation of the Frontier Community Health Integration Project (FCHIP) Demonstration. Describes the three possible interventions, including their impact, progress and accomplishments, challenges, and lessons learned. Identifies commonalities that emerged across the FCHIP interventions that may inform future demonstrations among rural healthcare providers.
Additional links: Findings At-A-Glance
Date: 11/2020
Sponsoring organizations: Centers for Medicare and Medicaid Services, RTI International
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MedPAC Comment on CMS's Proposed Rule on the Inpatient Rehabilitation Facility PPS for FY 2021
Comments on an April 21, 2020, Federal Register proposed rule addressing updates to the prospective payment system for inpatient rehabilitation facilities (IRFs) for fiscal year 2021. Includes comments on the adoption of the Office of Management and Budget's geographic area delineations to determine wage index values.
Date: 05/2020
Sponsoring organization: Medicare Payment Advisory Commission
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Estimated Reduction in CAH Profitability from Loss of Cost-Based Reimbursement for Swing Beds
Examines the impact of proposed legislation recommending changes to swing bed reimbursements for Critical Access Hospitals (CAHs) from cost-based to the Skilled Nursing Facility Prospective Payment System (SNF PPS). Estimates CAH profitability using reimbursement formulas from Medicare cost reports and discusses the characteristics of CAHs most affected by a change in swing bed reimbursement.
Author(s): Drake M. Broussard, Kristin L. Reiter
Date: 05/2020
Sponsoring organization: North Carolina Rural Health Research Program
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MedPAC Report to the Congress: Medicare Payment Policy, 2020
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 healthcare facilities and services, improving Medicare payment for post-acute care, Medicare Advantage, Medicare Part D, and the impact of healthcare provider consolidation.
Date: 03/2020
Sponsoring organization: Medicare Payment Advisory Commission
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Assessment of Rural-Urban Differences in Postacute Care Utilization and Outcomes Among Older US Adults
Results of a study of 2,044,231 Medicare beneficiaries who were hospitalized in 2011-2015 for pneumonia, stroke, heart failure, hip fracture, or COPD. Examines the frequency, type, and duration of postacute care, as well as readmission and mortality rates in people discharged to a community or to postacute care. Features statistics with breakdowns by urban area, rural community adjacent to urban area, or rural community nonadjacent to urban area.
Author(s): Cyrus M. Kosar, Lacey Loomer, Nasim B. Ferdows, et al.
Citation: JAMA Network Open, 3(1)
Date: 01/2020
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Report to Congress: Demonstration Project on Community Health Integration Models in Certain Rural Counties - Final Report
Presents findings from the Frontier Community Health Integration Project Demonstration (FCHIP) over the 3-year project period. Shares results for the 10 participating Critical Access Hospitals in three states: North Dakota, Montana, and Nevada. The demonstration focused on interventions addressing ambulance services, skilled nursing facility/nursing facility beds, and telehealth. Offers recommendations for legislative and administrative action.
Date: 2020
Sponsoring organization: U.S. Department of Health and Human Services
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