Rural Health
Resources by Topic: Service delivery models
Report to Congress on Medicaid and CHIP, June 2023
Semi-annual report to Congress from the Medicaid and CHIP Payment and Access Commission (MACPAC). Covers recommendations on disproportionate share hospital (DSH) payments, care integration for people who are dually eligible for Medicaid and Medicare, access to Medicaid coverage for adults leaving incarceration, and barriers to Medicaid home- and community-based services (HCBS). Includes rural references throughout.
Date: 06/2023
Type: Document
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 on disproportionate share hospital (DSH) payments, care integration for people who are dually eligible for Medicaid and Medicare, access to Medicaid coverage for adults leaving incarceration, and barriers to Medicaid home- and community-based services (HCBS). Includes rural references throughout.
Date: 06/2023
Type: Document
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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Expansion of Telehealth Availability for Mental Health Care After State-Level Policy Changes From 2019 to 2022
Explores mental health access associated with state-level telehealth policy changes due to COVID-19. Highlights disparities in mental health via telehealth access before and after COVID-related policy changes and details access rates in counties based on race and rurality, among other measures.
Author(s): Ryan K. McBain, Megan S. Schuler, Nabeel Qureshi, et al.
Citation: JAMA Network Open, 6(6), e2318045
Date: 06/2023
Type: Document
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Explores mental health access associated with state-level telehealth policy changes due to COVID-19. Highlights disparities in mental health via telehealth access before and after COVID-related policy changes and details access rates in counties based on race and rurality, among other measures.
Author(s): Ryan K. McBain, Megan S. Schuler, Nabeel Qureshi, et al.
Citation: JAMA Network Open, 6(6), e2318045
Date: 06/2023
Type: Document
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Medicare Accountable Care Organizations: Presence in Rural America
Presentation slides from a June 6, 2023, webinar for the Rural Northern Border Healthcare Support Technical Assistance Center. Provides an overview of the Medicare Shared Savings Program, including the composition of program participants in 2023, the spread of Accountable Care Organizations (ACOs) in rural counties, and the federal and state policy landscape. Details changes to the Shared Savings Program for 2024.
Author(s): Keith J. Mueller
Date: 06/2023
Type: Presentation Slides
Sponsoring organization: Rural Policy Research Institute
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Presentation slides from a June 6, 2023, webinar for the Rural Northern Border Healthcare Support Technical Assistance Center. Provides an overview of the Medicare Shared Savings Program, including the composition of program participants in 2023, the spread of Accountable Care Organizations (ACOs) in rural counties, and the federal and state policy landscape. Details changes to the Shared Savings Program for 2024.
Author(s): Keith J. Mueller
Date: 06/2023
Type: Presentation Slides
Sponsoring organization: Rural Policy Research Institute
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State Medicaid Telehealth Coverage Policy Decisions Since the COVID-19 Public Health Emergency
Describes changes to state Medicaid telehealth policy flexibilities and/or new policies enacted during the COVID-19 PHE as of April–May 2022. Focuses on flexibilities that were rolled back, as well as those made permanent in whole or in part. Examines the decision-making processes behind Medicaid telehealth policy changes. Summarizes findings from guided discussions with state Medicaid representatives across four domains: 1) state attitudes and perspectives on telehealth and telehealth policies; 2) state telehealth policy decision-making processes; 3) states' future plans for telehealth; and 4) challenges and lessons learned. Outlines potential opportunities for the future of telehealth. Includes rural references throughout.
Additional links: Executive Summary
Author(s): Peggy G. Chen, Sara E. Heins, Stephanie Dellva
Date: 05/2023
Type: Document
Sponsoring organizations: HHS Office of the Assistant Secretary for Planning and Evaluation, RAND Corporation
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Describes changes to state Medicaid telehealth policy flexibilities and/or new policies enacted during the COVID-19 PHE as of April–May 2022. Focuses on flexibilities that were rolled back, as well as those made permanent in whole or in part. Examines the decision-making processes behind Medicaid telehealth policy changes. Summarizes findings from guided discussions with state Medicaid representatives across four domains: 1) state attitudes and perspectives on telehealth and telehealth policies; 2) state telehealth policy decision-making processes; 3) states' future plans for telehealth; and 4) challenges and lessons learned. Outlines potential opportunities for the future of telehealth. Includes rural references throughout.
Additional links: Executive Summary
Author(s): Peggy G. Chen, Sara E. Heins, Stephanie Dellva
Date: 05/2023
Type: Document
Sponsoring organizations: HHS Office of the Assistant Secretary for Planning and Evaluation, RAND Corporation
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Rural Health Challenges and Opportunities
Presentation slides discussing rural health challenges, including access and affordability, poor health, and underlying factors driving the stress on rural health systems. Outlines policy opportunities to improve affordability and create incentives for improved health.
Author(s): Timothy McBride
Date: 05/2023
Type: Document
Sponsoring organizations: Center for Advancing Health Services, Policy and Economics Research, RUPRI Center for Rural Health Policy Analysis
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Presentation slides discussing rural health challenges, including access and affordability, poor health, and underlying factors driving the stress on rural health systems. Outlines policy opportunities to improve affordability and create incentives for improved health.
Author(s): Timothy McBride
Date: 05/2023
Type: Document
Sponsoring organizations: Center for Advancing Health Services, Policy and Economics Research, RUPRI Center for Rural Health Policy Analysis
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2023 National Survey on MIH-CP Programs
Results of a February 2023 survey of approximately 400 emergency medical services (EMS) agencies nationwide that have launched mobile integrated healthcare and community paramedicine (MIH-CP) programs. Features statistics on nontraditional services offered, and programs by demographic region served, with breakdowns by 3 levels of population density.
Date: 05/2023
Type: Document
Sponsoring organization: National Association of Emergency Medical Technicians
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Results of a February 2023 survey of approximately 400 emergency medical services (EMS) agencies nationwide that have launched mobile integrated healthcare and community paramedicine (MIH-CP) programs. Features statistics on nontraditional services offered, and programs by demographic region served, with breakdowns by 3 levels of population density.
Date: 05/2023
Type: Document
Sponsoring organization: National Association of Emergency Medical Technicians
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Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs): CMS Flexibilities to Fight COVID-19
Outlines specific regulatory waivers and Medicare flexibilities for Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs) issued in response to the COVID-19 pandemic. Includes information on payments for telehealth services, COVID-19 vaccines, therapeutics, and more. Identifies whether each waiver or flexibility was terminated, ended at the conclusion of the public health emergency, was extended, or became permanent.
Date: 05/2023
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Outlines specific regulatory waivers and Medicare flexibilities for Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs) issued in response to the COVID-19 pandemic. Includes information on payments for telehealth services, COVID-19 vaccines, therapeutics, and more. Identifies whether each waiver or flexibility was terminated, ended at the conclusion of the public health emergency, was extended, or became permanent.
Date: 05/2023
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Integrating Behavioral Health and Primary Care in Rural America
Recording of a May 2023 webinar discussing behavioral health and primary care integration in rural areas. Explores the importance of integration in rural areas, the barriers to integration, and opportunities for policies that can improve access to care. Features opening remarks from Tom Morris, Associate Administrator for Rural Health Policy at the Health Resources and Services Administration (HRSA), and a panel of providers from Missouri, New Hampshire, and Texas. Transcript available in the video description.
Date: 05/2023
Type: Video/Multimedia
Sponsoring organization: Bipartisan Policy Center
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Recording of a May 2023 webinar discussing behavioral health and primary care integration in rural areas. Explores the importance of integration in rural areas, the barriers to integration, and opportunities for policies that can improve access to care. Features opening remarks from Tom Morris, Associate Administrator for Rural Health Policy at the Health Resources and Services Administration (HRSA), and a panel of providers from Missouri, New Hampshire, and Texas. Transcript available in the video description.
Date: 05/2023
Type: Video/Multimedia
Sponsoring organization: Bipartisan Policy Center
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Patient-Centered Care Through Nurse Practitioner–Led Integrated Behavioral Health: A Case Study
Examines the implementation of a nurse practitioner-led interprofessional team-based behavioral healthcare delivery model in 5 rural or medically underserved clinics in Texas from July 1, 2020, through December 31, 2021. Analyzes the first year of implementation of the delivery model utilizing multiple data sources, with a focus on barriers to implementation, challenges to sustainability, and successes.
Author(s): Cindy Weston, Elizabeth Wells-Beede, Alice Salazar, et al.
Citation: Public Health Reports, 138(1)
Date: 05/2023
Type: Document
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Examines the implementation of a nurse practitioner-led interprofessional team-based behavioral healthcare delivery model in 5 rural or medically underserved clinics in Texas from July 1, 2020, through December 31, 2021. Analyzes the first year of implementation of the delivery model utilizing multiple data sources, with a focus on barriers to implementation, challenges to sustainability, and successes.
Author(s): Cindy Weston, Elizabeth Wells-Beede, Alice Salazar, et al.
Citation: Public Health Reports, 138(1)
Date: 05/2023
Type: Document
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Community Health Centers Seek to Prepare Medicaid Beneficiaries, and Themselves, for the Risks Ahead
Explores how Federally Qualified Health Centers (FQHCs), including an FQHC serving rural North Carolina, are helping Medicaid beneficiaries stay enrolled or find alternate coverage during the post-COVID-19 redetermination process. Describes how operations of these FQHCs have been changed by funding from the Coronavirus Aid, Relief, and Economic Security (CARES) Act and pandemic-related regulatory flexibilities.
Date: 05/2023
Type: Document
Sponsoring organization: Commonwealth Fund
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Explores how Federally Qualified Health Centers (FQHCs), including an FQHC serving rural North Carolina, are helping Medicaid beneficiaries stay enrolled or find alternate coverage during the post-COVID-19 redetermination process. Describes how operations of these FQHCs have been changed by funding from the Coronavirus Aid, Relief, and Economic Security (CARES) Act and pandemic-related regulatory flexibilities.
Date: 05/2023
Type: Document
Sponsoring organization: Commonwealth Fund
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