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Rural Health
Resources by Topic: Accountable Care Organizations

Evaluation of the Accountable Care Organization Investment Model: Final Report
Examines the ACO Investment Model (AIM) over three performance years. AIM tested the use of prepaid shared savings to encourage new ACOs to form in rural and underserved areas and to encourage current Medicare Shared Savings Program ACOs to transition to arrangements with greater financial risk. Reports on AIM results related to ACO formation, risk-taking, and sustainability, including the impact of rurality. Also discusses impacts on healthcare costs, utilization, and quality of care.
Additional links: Appendices, CMS Perspective Report, Findings at a Glance
Date: 09/2020
Type: Document
Sponsoring organizations: Abt Associates, Centers for Medicare and Medicaid Services
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Community Health Access and Rural Transformation (CHART) Model: CCHP Fact Sheet
Provides an overview of the Community Health Access and Rural Transformation (CHART) Model. Discusses the model's two tracks, the Community Transformation Track or the ACO Transformation Track, and the implementation timeline. Includes information on what the CHART Model may mean for telehealth use in rural communities.
Date: 08/2020
Type: Document
Sponsoring organization: Center for Connected Health Policy: The National Telehealth Policy Resource Center
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Community Health Access and Rural Transformation (CHART) Model Overview Webinar
Recording of an August 18, 2020, webinar that provides an overview of the Community Health Access and Rural Transformation (CHART) Model and its two tracks. Includes information on objectives, eligible participants and their roles, payment options, and timeline for each track.
Additional links: Presentation Slides
Date: 08/2020
Type: Video/Multimedia
Sponsoring organization: Centers for Medicare and Medicaid Services
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Community Health Access and Rural Transformation (CHART) Model Fact Sheet
Provides an overview of the Community Health Access and Rural Transformation (CHART) Model, which aims to increase financial stability for rural providers, provide operational and regulatory flexibility for rural providers, and enhance Medicare and Medicaid beneficiaries' access to health care services. Describes the two tracks available in the model, and outlines the model implementation time.
Date: 08/2020
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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MedPAC Comment on CMS's Interim Final Rule on Policy and Regulatory Revisions in Response to the COVID-19 Public Health Emergency
Comments on a May 8, 2020, Federal Register interim final rule addressing flexibilities for providers in response to the COVID-19 public health emergency. Discusses payments for audio-only telehealth services, expanded reporting requirements for nursing homes related to COVID-19, and adjustments to the Medicare Shared Savings Program methodology.
Date: 06/2020
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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MedPAC Report to the Congress: Medicare and the Health Care Delivery System, June 2020
Evaluates Medicare payment issues and offers recommendations to the U.S. Congress. Includes chapters on value-based payment in Medicare, Accountable Care Organizations (ACOs), the Medicare Advantage quality bonus program, the impact of changes in the 21st Century Cures Act to risk adjustment for Medicare Advantage enrollees, Medicare Part D, separately payable drugs in the hospital outpatient prospective payment system, and the Medicare end-stage renal disease prospective payment system. Examines the current payment policy for low-volume and rural dialysis facilities and proposes changes.
Additional links: Executive Summary
Date: 06/2020
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Rural Hospital Participation in Medicare Accountable Care Organizations
Report explores the rates of rural hospital participation in Medicare Shared Savings Program (SSP) Accountable Care Organizations (ACOs). Details some of the factors that correspond to participation and compares rates by region and by rural status.
Date: 04/2020
Type: Document
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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How to Better Support Small Physician-led Accountable Care Organizations: Recent Program Updates, Challenges, and Policy Implications
Describes the strategies of successful small physician-led Accountable Care Organizations (ACOs). Discusses how policy changes contribute to the opportunities and challenges for these ACOs. Explores how "ACO Enablers" aid small ACOs in participating in risk-bearing models. Includes a brief discussion of how the ACO Investment Model program supported ACOs in rural and underserved areas with access to capital.
Author(s): Jonathan Gonzalez-Smith, Hannah Crook, Elizabeth Singletary, William Bleser, Robert Saunders
Date: 02/2020
Type: Document
Sponsoring organizations: Duke Margolis Center for Health Policy, Robert Wood Johnson Foundation
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Second Evaluation Report: Next Generation Accountable Care Organization Model Evaluation
Reports on the impact of the Next Generation Accountable Care Organization model in 2016 and 2017, with information on the full sample of 46 participating NGACOs. Provides information on the models' impact on gross and net Medicare spending. The appendices include data on community characteristics, including rurality.
Additional links: Findings at a Glance, Technical Appendices
Date: 01/2020
Type: Document
Sponsoring organizations: Centers for Medicare and Medicaid Services, NORC at the University of Chicago
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The Rural Health Care Coordination Network Partnership Program: South East Rural Physicians Alliance
Describes and examines the impact of a care coordination program developed by the South East Rural Physicians Alliance-Independent Physician Association located in Nebraska. Program focuses on clinic-based care coordination for high-risk patients with diagnosed diabetes or congestive heart failure. Funded under the Rural Health Care Coordination Network Partnership Grant Program from 2015-2018.
Date: 2020
Type: Document
Sponsoring organizations: NORC Walsh Center for Rural Health Analysis, University of Minnesota Rural Health Research Center
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