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Rural Health
Resources by Topic: Accountable Care Organizations

Synthesis of Evaluation Results across 21 Medicare Models, 2012-2020
Summarizes results from evaluations of 21 Centers for Medicare & Medicaid (CMS) Innovation Center models. Examines measures related to gross and net Medicare spending, utilization, and quality of care. Identifies themes among models with similar participant types and interventions used. Offers considerations for acute or specialty care and targeted populations models and prevention and population management models.
Additional links: Findings at a Glance, Synthesis of Evaluation Results Across 21 Medicare Models Slides, Transcript, Webinar Recording
Date: 07/2022
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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MedPAC Data Book: Health Care Spending and the Medicare Program, 2022
Provides an overview of Medicare spending and highlights data on Medicare beneficiary demographics, dual-eligible beneficiaries, quality of care provided through the Medicare program, and other payer liability. Examines settings of care, including rural specific provider sites, as they relate to spending, access to care, and profit margins. Compares rural and urban beneficiaries and providers throughout. Chart 6-2 addresses rural hospital closures.
Date: 07/2022
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Environmental Scan on Issues Related to the Development of Population-Based Total Cost of Care (TCOC) Models in the Broader Context of Alternative Payment Models (APMs) and Physician-Focused Payment Models (PFPMs)
Presents results of an environmental scan regarding population-based total cost of care (TCOC) payment models and the role these models can play in optimizing health care delivery and value-based transformation in the context of alternative payment models (APMs) and physician-focused payment models (PFPMs). Provides an overview of TCOC payment models, relevant performance and outcome measures used in reporting and evaluation, findings from research related to population-based models and programs that seek to reduce TCOC, barriers and challenges related to implementing population-based TCOC models, and opportunities for improving and optimizing efforts to develop and implement these models. Highlights rural considerations and examples throughout.
Date: 03/2022
Type: Document
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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Vermont's All-Payer Accountable Care Organization Model: Mt. Ascutney Hospital and Health Center's Experience
Profiles Mt. Ascutney Hospital and Health Center (MAHHC), a Critical Access Hospital and health center partnership in central Vermont. Describes how MAHHC provides care differently as a participant in the OneCare Vermont accountable care organization (ACO). Discusses how MAHHC adapted healthcare delivery during the COVID-19 pandemic. Highlights challenges and financial implications of MAHHC's participation in OneCare Vermont.
Date: 03/2022
Type: Document
Sponsoring organization: Rural Health Value
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Medicare Payment Basics: Accountable Care Organizations Payment Systems
Provides an overview of the payment mechanisms associated with Medicare's Accountable Care Organization (ACO) programs: the Medicare Shared Savings Program (MSSP), and the Next Generation ACO demonstration. Discusses temporary changes for ACOs during the COVID-19 public health emergency.
Date: 11/2021
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Fourth Evaluation Report: Next Generation Accountable Care Organization Model Evaluation
Reports on implementation experiences and outcomes for 41 Next Generation Accountable Care Organizations (NGACOs) that participated in the model in the 2019 performance year. Evaluates findings of the model to date by NGACO cohort. Also presents information on model-wide, cohort-level, and NGACO-level impacts on Medicare spending, utilization, and quality of care. Includes information on the extent to which NGACOs served rural areas.
Additional links: Findings at a Glance, Technical Appendices
Date: 10/2021
Type: Document
Sponsoring organizations: Centers for Medicare and Medicaid Services, NORC at the University of Chicago
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Addressing Health-Related Social Needs to Improve Rural Health: Ideas to Action
Identifies strategies for building community and regional systems of care to better address the social needs of patients and inform the design of community-level rural health transformation initiatives, pilots, or demonstrations in rural Maine. Examines existing literature and evidence from similar initiatives in Vermont, Idaho, and Oregon, and highlights key observations. Describes key components of a demonstration designed to build, implement, and test strategies for aligning health, social service, and other systems to address to advance whole-person care.
Author(s): Andrew F. Coburn, Deborah A. Deatrick
Date: 09/2021
Type: Document
Sponsoring organizations: Maine Rural Health Action Network, New England Rural Health Association
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MedPAC Comment on CMS's Proposed Rule on the Physician Fee Schedule and Other Revisions to Part B for CY 2022
Comment on a July 23, 2021, Federal Register proposed rule revising the physician fee schedule to improve payment systems for physicians and other Medicare Part B revisions. Includes a discussion of the expansion of telehealth service coverage after the COVID-19 public health emergency, as well as reimbursement rates to Rural Health Clinics and Federally Qualified Health Centers for telehealth mental health services.
Date: 09/2021
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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CMS Innovation Center COVID-19 Flexibilities
Shares flexibilities and adjustments to current and future Center for Medicare and Medicaid Innovation (CMMI) models in response to the COVID-19 public health emergency. Addresses changes related to financial methodologies, quality reporting, and model timelines.
Additional links: CMS Model Flexibilities Table
Date: 09/2021
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Evaluation of the Vermont All-Payer Accountable Care Organization Model: First Evaluation Report
Evaluates the first two performance years of the Vermont All-Payer Accountable Care Organization Model (VTAPM), which aims to assess whether scaling an Accountable Care Organization (ACO) across all payers in the state can reduce program expenditures while preserving or improving care quality. Discusses the implementation of the model, provider engagement, efforts to address population health goals; characteristics of participating hospitals, practitioners, and beneficiaries; and the model's impacts on Medicare spending, utilization, and quality of care. Includes information on hospital and provider participation in rural counties and unique challenges for rural Critical Access Hospitals.
Additional links: Findings at a Glance, Technical Appendices
Date: 08/2021
Type: Document
Sponsoring organizations: Centers for Medicare and Medicaid Services, NORC at the University of Chicago
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