Rural Health
Resources by Topic: Accountable Care Organizations
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
Sponsoring organizations: Centers for Medicare and Medicaid Services, NORC at the University of Chicago
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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
Sponsoring organizations: Centers for Medicare and Medicaid Services, NORC at the University of Chicago
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Frontline Presence, Building Trust, Emergency Preparedness, and Lessons Learned: Q&A with Dr. Tim Putnam
An interview with Tim Putnam sharing rural health leadership insights from his experiences as a rural hospital CEO, a member of a White House task force, and in an academic healthcare policy position.
Author(s): Kay Miller Temple
Citation: Rural Monitor
Date: 01/2024
Sponsoring organization: Rural Health Information Hub
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An interview with Tim Putnam sharing rural health leadership insights from his experiences as a rural hospital CEO, a member of a White House task force, and in an academic healthcare policy position.
Author(s): Kay Miller Temple
Citation: Rural Monitor
Date: 01/2024
Sponsoring organization: Rural Health Information Hub
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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
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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
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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
Sponsoring organization: Medicare Payment Advisory Commission
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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
Sponsoring organization: Medicare Payment Advisory Commission
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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
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
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
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
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
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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
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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 underserved areas.
Author(s): Purva Rawal, Douglas Jacobs, Elizabeth Fowler, Meena Seshamani
Citation: Health Affairs Forefront
Date: 07/2023
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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 underserved areas.
Author(s): Purva Rawal, Douglas Jacobs, Elizabeth Fowler, Meena Seshamani
Citation: Health Affairs Forefront
Date: 07/2023
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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
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
Sponsoring organization: Rural Policy Research Institute
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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
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
Sponsoring organizations: Centers for Medicare and Medicaid Services, NORC at the University of Chicago
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