Rural Health
Resources by Topic: Accountable Care Organizations
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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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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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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Rural Health: Pathway to Progress
Presents insights and perspectives from four rural healthcare leaders. Describes strategies for overcoming workforce challenges, increasing access to specialty care, and addressing cost pressures. Requires registration to download.
Date: 09/2023
Type: Document
Sponsoring organization: Reuters Events
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Presents insights and perspectives from four rural healthcare leaders. Describes strategies for overcoming workforce challenges, increasing access to specialty care, and addressing cost pressures. Requires registration to download.
Date: 09/2023
Type: Document
Sponsoring organization: Reuters Events
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Health Panel Comment Letter - 2024 Physician Fee Schedule and Medicare Part B Proposed Rule
Comments offered in response to a July 13, 2023, Federal Register proposed rule revising the Medicare Physician Fee Schedule. Includes discussions on telehealth services, services addressing health-related social needs, advancing access to behavioral health services, Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs), and the Medicare Shared Savings Program.
Date: 09/2023
Type: Document
Sponsoring organization: Rural Policy Research Institute Rural Health Panel
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Comments offered in response to a July 13, 2023, Federal Register proposed rule revising the Medicare Physician Fee Schedule. Includes discussions on telehealth services, services addressing health-related social needs, advancing access to behavioral health services, Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs), and the Medicare Shared Savings Program.
Date: 09/2023
Type: Document
Sponsoring organization: Rural Policy Research Institute Rural Health Panel
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MedPAC Comment on CMS's Proposed Rule on the Physician Prospective Payment System for FY 2024
Comment on the August 7, 2023, Federal Register proposed rule revising the physician fee schedule to improve payment systems for physicians and other Medicare Part B revisions. Includes discussions on payment rates for Medicare telehealth services; the Medicare Shared Savings Program, including regional adjustments; incorporating Medicare Advantage data into public reporting; and more.
Date: 09/2023
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Comment on the August 7, 2023, Federal Register proposed rule revising the physician fee schedule to improve payment systems for physicians and other Medicare Part B revisions. Includes discussions on payment rates for Medicare telehealth services; the Medicare Shared Savings Program, including regional adjustments; incorporating Medicare Advantage data into public reporting; and more.
Date: 09/2023
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Who's Accountable? Low-Value Care Received By Medicare Beneficiaries Outside Of Their Attributed Health Systems
Examines how much low-volume care and health system spending can be attributed to fee-for-service Medicare beneficiaries aged 65-years-old and older receiving care outside of the health system between 2017-2018. Explores beneficiary and health system factors associated with receiving the thirty most common low-value services, including beneficiaries' rurality and whether the low-value services originated from primary care physicians or specialists.
Author(s): Ishani Ganguli, Maia L. Crawford, Benjamin Usadi, et al.
Citation: Health Affairs, 42(8), 1128-1139
Date: 08/2023
Type: Document
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Examines how much low-volume care and health system spending can be attributed to fee-for-service Medicare beneficiaries aged 65-years-old and older receiving care outside of the health system between 2017-2018. Explores beneficiary and health system factors associated with receiving the thirty most common low-value services, including beneficiaries' rurality and whether the low-value services originated from primary care physicians or specialists.
Author(s): Ishani Ganguli, Maia L. Crawford, Benjamin Usadi, et al.
Citation: Health Affairs, 42(8), 1128-1139
Date: 08/2023
Type: Document
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Building On CMS's Accountable Care Vision To Improve Care For Medicare Beneficiaries
Describes progress the Centers for Medicare & Medicaid Services (CMS) has made to date in its accountable care strategy. Outlines areas that CMS is exploring to accelerate the growth of and access to accountable care organizations (ACOs) that can support improved care and quality for beneficiaries, especially those in rural and underserved areas. Covers aligning the testing of ACO models and features with the Shared Savings Program (SSP), growth in the SSP, and using ACOs to reach more underserved populations and promote health equity.
Author(s): Purva Rawal, Douglas Jacobs, Elizabeth Fowler, Meena Seshamani
Citation: Health Affairs Forefront
Date: 07/2023
Type: Document
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Describes progress the Centers for Medicare & Medicaid Services (CMS) has made to date in its accountable care strategy. Outlines areas that CMS is exploring to accelerate the growth of and access to accountable care organizations (ACOs) that can support improved care and quality for beneficiaries, especially those in rural and underserved areas. Covers aligning the testing of ACO models and features with the Shared Savings Program (SSP), growth in the SSP, and using ACOs to reach more underserved populations and promote health equity.
Author(s): Purva Rawal, Douglas Jacobs, Elizabeth Fowler, Meena Seshamani
Citation: Health Affairs Forefront
Date: 07/2023
Type: Document
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Rural Health Policy Landscape: Implications for Addressing Behavioral Health
Presentation slides from a July 22, 2023, presentation at the 48th Annual Rural Social Work Conference. Provides an overview of the federal, state, and commercial insurance policy landscapes regarding healthcare value and payment. Offers policy recommendations related to rural behavioral health.
Author(s): Keith J. Mueller
Date: 07/2023
Type: Document
Sponsoring organization: Rural Policy Research Institute
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Presentation slides from a July 22, 2023, presentation at the 48th Annual Rural Social Work Conference. Provides an overview of the federal, state, and commercial insurance policy landscapes regarding healthcare value and payment. Offers policy recommendations related to rural behavioral health.
Author(s): Keith J. Mueller
Date: 07/2023
Type: Document
Sponsoring organization: Rural Policy Research Institute
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MedPAC Data Book: Health Care Spending and the Medicare Program, 2023
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: 07/2023
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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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: 07/2023
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Evaluation of the Vermont All-Payer Accountable Care Organization Model: Third Evaluation Report
Evaluates the first four and a half 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. Describes trends in substance use disorder diagnosis and treatment for Medicaid members. Outlines challenges and lessons learned, as well as areas for future research.
Additional links: Findings at a Glance, Technical Appendices
Date: 07/2023
Type: Document
Sponsoring organizations: Centers for Medicare and Medicaid Services, NORC at the University of Chicago
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Evaluates the first four and a half 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. Describes trends in substance use disorder diagnosis and treatment for Medicaid members. Outlines challenges and lessons learned, as well as areas for future research.
Additional links: Findings at a Glance, Technical Appendices
Date: 07/2023
Type: Document
Sponsoring organizations: Centers for Medicare and Medicaid Services, NORC at the University of Chicago
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