Rural Health
Resources by Topic: Accountable Care Organizations
Financial Characteristics of Critical Access Hospitals (CAHs) Participating in Accountable Care Organizations (ACO)
Examines Critical Access Hospital (CAH) participation in Medicare and non-Medicare Accountable Care Organizations (ACOs) in 2019. Compares the organizational and financial characteristics of CAHs across facilities that participate in ACOs and those that do not participate in an ACO. Includes data on profitability, liquidity, outpatient revenue, and Medicare payer mix.
Author(s): Angelina Budko, George Pink, Susie Gurzenda, Ann Howard, Kristin L. Reiter
Date: 11/2022
Type: Document
Sponsoring organization: Flex Monitoring Team
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Examines Critical Access Hospital (CAH) participation in Medicare and non-Medicare Accountable Care Organizations (ACOs) in 2019. Compares the organizational and financial characteristics of CAHs across facilities that participate in ACOs and those that do not participate in an ACO. Includes data on profitability, liquidity, outpatient revenue, and Medicare payer mix.
Author(s): Angelina Budko, George Pink, Susie Gurzenda, Ann Howard, Kristin L. Reiter
Date: 11/2022
Type: Document
Sponsoring organization: Flex Monitoring Team
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Rural Health System Value-Based Care Innovators Roundtable: Strategies and Insights
Presents findings from interviews with five health systems that include a substantial proportion of rural hospitals and clinics and actively support the transition to value-based care. Covers organizational structure, governance and decision-making, operations, data and communication, contracts, and social determinants of health. Identifies common health system tensions and opportunities to implementing value-based care at rural facilities.
Date: 10/2022
Type: Document
Sponsoring organization: Rural Health Value
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Presents findings from interviews with five health systems that include a substantial proportion of rural hospitals and clinics and actively support the transition to value-based care. Covers organizational structure, governance and decision-making, operations, data and communication, contracts, and social determinants of health. Identifies common health system tensions and opportunities to implementing value-based care at rural facilities.
Date: 10/2022
Type: Document
Sponsoring organization: Rural Health Value
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MaineHealth ACO – Integrating and Using Data to Support Care Delivery
Profiles MaineHealth ACO, a network of 11 hospitals, 353 clinical practices, 18 Rural Health Clinics, and 2 Federally Qualified Health Centers. Describes how MaineHealth ACO integrates clinical and claims data to support care delivery, target patient needs, and reduce costs.
Date: 10/2022
Type: Document
Sponsoring organization: Rural Health Value
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Profiles MaineHealth ACO, a network of 11 hospitals, 353 clinical practices, 18 Rural Health Clinics, and 2 Federally Qualified Health Centers. Describes how MaineHealth ACO integrates clinical and claims data to support care delivery, target patient needs, and reduce costs.
Date: 10/2022
Type: Document
Sponsoring organization: Rural Health Value
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Health Panel Comment Letter – Medicare Shared Savings Program Requirements
Comments offered in response to a July 29, 2022, proposed rule regarding changes to the Medicare Shared Savings Program (SSP) to facilitate more widespread participation in Accountable Care Organizations (ACOs). Discusses how changes will impact rural Medicare beneficiaries, as well as challenges to extending ACOs to all rural counties. Covers advanced interest payments, extended time in one-sided risk, changes to calculating benchmarks, proposals to allow low revenue ACOs to realize shared savings at a lower minimum, a health equity adjustment, and social determinants of health measures.
Date: 09/2022
Type: Document
Sponsoring organization: Rural Policy Research Institute Rural Health Panel
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Comments offered in response to a July 29, 2022, proposed rule regarding changes to the Medicare Shared Savings Program (SSP) to facilitate more widespread participation in Accountable Care Organizations (ACOs). Discusses how changes will impact rural Medicare beneficiaries, as well as challenges to extending ACOs to all rural counties. Covers advanced interest payments, extended time in one-sided risk, changes to calculating benchmarks, proposals to allow low revenue ACOs to realize shared savings at a lower minimum, a health equity adjustment, and social determinants of health measures.
Date: 09/2022
Type: Document
Sponsoring organization: Rural Policy Research Institute Rural Health Panel
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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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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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Trends in Health Disparities of Rural Latinos Pre- and Post-Accountable Care Organization Implementation
Compares diabetes-related hospitalizations among older rural Latino Rural Health Clinic (RHC) patients to those of their White counterparts between 2008 and 2015. Explores whether RHC participation in an Accountable Care Organization reduced diabetes-related hospitalization rates for Latino patients. Presents findings from an analysis of data on 2,683 RHCs nationwide from the Centers for Medicare & Medicaid Services (CMS) and a subset of 516 RHCs in California, Florida, and Texas.
Author(s): Judith Ortiz, Boondaniwon D. Phrathep, Richard Hofler, Chad W. Thomas
Citation: Research in the Sociology of Health Care, 39, 173–187
Date: 03/2022
Type: Document
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Compares diabetes-related hospitalizations among older rural Latino Rural Health Clinic (RHC) patients to those of their White counterparts between 2008 and 2015. Explores whether RHC participation in an Accountable Care Organization reduced diabetes-related hospitalization rates for Latino patients. Presents findings from an analysis of data on 2,683 RHCs nationwide from the Centers for Medicare & Medicaid Services (CMS) and a subset of 516 RHCs in California, Florida, and Texas.
Author(s): Judith Ortiz, Boondaniwon D. Phrathep, Richard Hofler, Chad W. Thomas
Citation: Research in the Sociology of Health Care, 39, 173–187
Date: 03/2022
Type: Document
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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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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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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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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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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 in order 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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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 in order 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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