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Rural Health Information Hub

Rural Health
Resources by Topic: Service delivery models

Fifth Evaluation Report: Next Generation Accountable Care Organization Model Evaluation
Reports on changes to the Next Generation Accountable Care Organization (NGACO) Model in response to the COVID-19 public health emergency (PHE). Presents information on cumulative model-wide impacts on Medicare spending, utilization, and quality of care, as well as impacts observed in 2020, the model's fifth performance year. The appendices include data on community characteristics, including rurality.
Additional links: Technical Appendices
Date: 11/2022
Sponsoring organizations: Centers for Medicare and Medicaid Services, NORC at the University of Chicago
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CMS Framework for Advancing Health Care in Rural, Tribal, and Geographically Isolated Communities
Report outlines the Centers for Medicare & Medicaid Services (CMS) plan for improving health equity and health outcomes across the U.S. for rural, tribal, and geographically isolated communities. Details a 6 priority framework emphasizing the application of a community-informed geographic lens; the collection and use of standardized data; support for healthcare professionals; the optimization of medical and communication technology; the expansion of access to comprehensive healthcare coverage, benefits, and services and supports; and innovation and value-based care. Highlights examples of activities CMS is undertaking in support of each priority and recent CMS efforts that align with each priority.
Date: 11/2022
Sponsoring organization: Centers for Medicare and Medicaid Services
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Veterans Community Care Program: VA Needs to Strengthen Its Oversight and Improve Data on Its Community Care Network Providers
Describes how the U.S. Department of Veterans Affairs (VA) monitors contractor compliance with the Veterans Community Care Program network adequacy standards and related requirements. Examines the extent to which the VA's contractors are meeting network adequacy standards. Discusses the experiences of VA medical facility officials when scheduling routine appointments for veterans. Offers recommendations to ensure that contractors report complete performance data and increase the accuracy of community provider information.
Additional links: Full Report
Date: 11/2022
Sponsoring organization: Government Accountability Office
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A Global Equity Model (GEM) for the Advancement of Community Health and Health Equity
Provides an overview of existing and emerging payment systems and their roles in promoting community health and health equity. Proposes a global payment model for health systems' inpatient, emergency department (ED), and outpatient sites of care with community health and health equity as its organizing features. Includes information on the Pennsylvania Rural Health Model, the ACO REACH model, and other rural-relevant payment models.
Author(s): Anaeze C. Offodile II, Jason B. Gibbons, Samantha Murrell, Donna Kinzer, Joshua M. Sharfstein
Date: 11/2022
Sponsoring organization: National Academy of Medicine
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Person-Centered Innovation – An Update on the Implementation of the CMS Innovation Center's Strategy
Provides an update on the Centers for Medicare and Medicaid Services' (CMS) Innovation Center's progress in the implementation of the strategy refresh announced in 2021. Describes accomplishments from the first year of implementing the strategy refresh and outlines areas of focus for the upcoming year across the five strategic objectives: driving accountable care, advancing health equity, supporting innovation, addressing affordability, and partnering to achieve healthcare system transformation. Includes information on the Accountable Care Organization Realizing Equity, Access, and Community Health (ACO REACH) Model and the Community Health Access and Rural Transformation (CHART) Model.
Additional links: Supplemental Document
Date: 11/2022
Sponsoring organization: Centers for Medicare and Medicaid Services
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Financial Characteristics of Critical Access Hospitals (CAHs) Participating in Accountable Care Organizations (ACO)
Examines Critical Access Hospital (CAH) participation in Medicare and non-Medicare Accountable Care Organizations (ACOs) in 2019. Compares the organizational and financial characteristics of CAHs across facilities that participate in ACOs and those that do not participate in an ACO. Includes data on profitability, liquidity, outpatient revenue, and Medicare payer mix.
Author(s): Angelina Budko, George Pink, Susie Gurzenda, Ann Howard, Kristin L. Reiter
Date: 11/2022
Sponsoring organization: Flex Monitoring Team
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Virtual Communication Services in Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs)
Provides information for Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs) regarding billing and payment for virtual communication services as established in the 2019 Physician Fee Schedule Final Rule.
Date: 11/2022
Sponsoring organization: Centers for Medicare and Medicaid Services
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October 2022 MACPAC Meeting Transcript
Transcript from the Medicaid and CHIP Payment and Access Commission's (MACPAC) October 2022 meeting. Covers Medicaid race and ethnicity data collection and reporting, improving access to Medicaid coverage and care for adults leaving incarceration, the unwinding of the Public Health Emergency, streamlining the delivery of home- and community-based services, potential recommendations for structuring Disproportionate Share Hospital allotments during economic crises, and more. Includes rural references and considerations throughout.
Date: 10/2022
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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Technical Report of The Maryland Telehealth Study
Presents the results of a study examining the quality and cost of telehealth following its expansion during the COVID-19 pandemic, as well as impact on access to healthcare, alignment with other models of care, and provider and patient satisfaction with a focus on policy impacts in Maryland. Includes findings of a literature review, consumer interviews, behavioral healthcare organization focus groups, and a provider survey.
Date: 10/2022
Sponsoring organizations: NORC at the University of Chicago, The Maryland Health Care Commission
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Assessing Effectiveness of Early Childhood Home Visiting Models Implemented with Tribal Populations
Report assesses the efficacy of early childhood home visiting models for tribal populations. Reviews and assesses home visiting literature, information, and implementation procedures to establish best-practices for American Indian and Alaska Native populations.
Author(s): Rachel Bleiweiss-Sande, Emily Sama-Miller, Carla Chavez, Rebecca Coughlin, Andrea Mraz Esposito
Date: 10/2022
Sponsoring organization: Administration for Children and Families
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