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Rural Health
Resources by Topic: Accountable Care Organizations

Partnerships to Address Social Needs Across Metropolitan and Non-Metropolitan Prospective Payment System Hospitals and Critical Access Hospitals
Explores the extent to which hospitals partner with community organizations to address population and/or community health needs. Analyzes data from the 2021 American Hospital Association Social Determinants of Health (SDOH) Supplement to describe the number and types of hospital partnerships with community-based organizations. Compares results by hospital type - metropolitan prospective payment system (PPS), Critical Access Hospital (CAH), and non-metropolitan PPS - and by U.S. Census region, ownership status, and accountable care organization (ACO) participation.
Author(s): Whitney E. Zahnd, Khyathi Gadag, Kristin D. Wilson, Keith J. Mueller
Date: 03/2024
Type: Document
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Beneficiary and Clinician Perspectives on Medicare and Other Issues: Findings from 2023 Focus Groups in Select States
Summarizes findings from 24 focus groups of Medicare beneficiaries, Medicare and Medicaid (dual eligible) beneficiaries, and clinicians conducted between May and July 2023, including three virtual focus groups of rural Medicare beneficiaries. Highlights themes that emerged across the focus groups covering Medicare coverage options, access to care, telehealth, organization of care, and prescription drugs.
Date: 02/2024
Type: Document
Sponsoring organizations: Medicare Payment Advisory Commission, NORC at the University of Chicago
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Bridging The Home-Based Primary Care Gap In Rural Areas
Discusses challenges with offering home-based primary care (HBPC) in rural communities for older adults and people with disabilities, notably workforce shortages, insufficient infrastructure, and funding. Offers HBPC redesign suggestions with these challenges in mind, discussing community health workers, technology and telehealth, leveraging community resources and partnerships, training, scope of practice laws, payment models, and infrastructure investments.
Author(s): Ginny Rogers, Montgomery Smith, Jonathan Gonzalez-Smith, Robert S. Saunders
Citation: Health Affairs Forefront
Date: 02/2024
Type: Document
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AHIP Value-Based Care Workgroup
Presentation slides from a January 23, 2024, presentation to the AHIP Value-Based Care Workgroup. Provides an overview of rural healthcare. Discusses rural-relevant engagement and rural value-based care and payment model design considerations. Highlights examples of rural providers successfully participating in value-based payment programs, including Medicare Shared Savings Programs and Accountable Care Organizations (ACOs).
Date: 01/2024
Type: Presentation Slides
Sponsoring organization: Rural Health Value
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Shared Savings Program Fast Facts
Provides summary statistics on the Medicare Shared Savings Program as of January 1, 2024. Offers data on the number of Accountable Care Organizations (ACOs), assigned beneficiaries, total earned shared savings, and quality scores each year since 2012; the number and percent of ACOs in each track; and more. Includes information on ACO participants, including the number of Rural Health Clinics (RHCs) and Critical Access Hospitals (CAHs) participating in the program.
Date: 01/2024
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Evaluation of the Next Generation Accountable Care Organization (NGACO) Model: Final Report
Sixth and final evaluation report on the Next Generation Accountable Care Organization (NGACO) Model. Summarizes findings from across all six performance years (2016-2021) and explores how participating entities responded to the model and how they did or did not achieve model goals. Presents information on cumulative model-wide impacts on Medicare spending, utilization, and quality of care; variations in model outcomes by organization characteristics; spending patterns of beneficiaries served by NGACOs; population health strategies and pathways to reduced spending; lessons learned; and more. The appendices include data on community and beneficiary characteristics, including rurality.
Additional links: Findings at a Glance, Technical Appendices
Date: 01/2024
Type: Document
Sponsoring organizations: Centers for Medicare and Medicaid Services, NORC at the University of Chicago
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Examining Alignment of Community Health Teams' Preferences for Health, Equity, and Spending with State All-payer Waiver Priorities: A Discrete Choice Experiment
Provides an overview of the Vermont All-Payer Model (VAPM) and regional community health teams (CHTs). Analyzes the results of a survey of all 13 Vermont CHTs to describe how VAPM and CHTs interact and how VAPM impacts the priorities and design of community-based CHTs. Examines how community-based CHTs make trade-offs made between health, health equity, and healthcare spending.
Author(s): Eline M. van den Broek-Altenburg, Jamie S. Benson, Adam J. Atherly
Citation: Health Services Research, 59(Suppl.1), e14257
Date: 11/2023
Type: Document
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MedPAC Payment Basics
Series of briefs providing an of Medicare payment systems. Covers payments systems including Accountable Care Organizations (ACO), Critical Access Hospitals (CAH), Federally Qualified Health Centers and Rural Health Clinics, hospital acute inpatient services, and more.
Date: 10/2023
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Medicare Payment Basics: Accountable Care Organizations Payment Systems
Provides an overview of Medicare's Accountable Care Organization (ACO) programs. Discusses the payment mechanics of ACOs, including the maximum shared savings and losses of Medicare Shared Savings Program ACOs by track and level.
Date: 10/2023
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Sustaining Essential Rural Health Services Through Changes in Payment and Related Public Policies
Presentation slides that discuss payment policies and models, Medicare and Medicaid, Accountable Care Organizations (ACOs), commercial plans, value-based care, and more, with data and maps illustrating impacts in specific areas.
Author(s): Keith J. Mueller
Date: 09/2023
Type: Presentation Slides
Sponsoring organizations: Iowa Department of Health Management and Policy, Rural Policy Research Institute
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