Rural Health
Resources by Topic: Accountable Care Organizations
RHCs & the Medicare Shared Savings Program - What You Need to Know
Recording of a March 7, 2023, webinar providing an overview of the transition to value-based care, Accountable Care Organizations, and the Medicare Shared Savings Program. Discusses considerations for Rural Health Clinic participation in the Shared Savings Program. Part of the Rural Health Clinic Technical Assistance Series.
Additional links: Presentation Slides, Transcript
Date: 03/2023
Sponsoring organization: National Association of Rural Health Clinics
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Recording of a March 7, 2023, webinar providing an overview of the transition to value-based care, Accountable Care Organizations, and the Medicare Shared Savings Program. Discusses considerations for Rural Health Clinic participation in the Shared Savings Program. Part of the Rural Health Clinic Technical Assistance Series.
Additional links: Presentation Slides, Transcript
Date: 03/2023
Sponsoring organization: National Association of Rural Health Clinics
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Center for Medicare & Medicaid Innovation Initiatives to Address Rural Health and Health Disparities
Policy brief describing three national Center for Medicare & Medicaid Innovation (CMMI) value-based initiatives that allow providers to work toward health equity. Provides policy recommendations to design and refine programs to engage rural providers.
Author(s): Andrea Mitchell, Alyssa Meller, Hunter Nostrant
Date: 02/2023
Sponsoring organization: National Rural Health Association
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Policy brief describing three national Center for Medicare & Medicaid Innovation (CMMI) value-based initiatives that allow providers to work toward health equity. Provides policy recommendations to design and refine programs to engage rural providers.
Author(s): Andrea Mitchell, Alyssa Meller, Hunter Nostrant
Date: 02/2023
Sponsoring organization: National Rural Health Association
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Evaluation of the Vermont All-Payer Accountable Care Organization Model: Second Evaluation Report
Evaluates the first three 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 changes to the model's design in response to the COVID-19 public health emergency and how COVID-19 and a cyberattack impacted healthcare utilization. Includes information on hospital and provider participation in rural areas and limited participation by Critical Access Hospitals.
Additional links: Findings at a Glance, Technical Appendices
Date: 12/2022
Sponsoring organizations: Centers for Medicare and Medicaid Services, NORC at the University of Chicago
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Evaluates the first three 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 changes to the model's design in response to the COVID-19 public health emergency and how COVID-19 and a cyberattack impacted healthcare utilization. Includes information on hospital and provider participation in rural areas and limited participation by Critical Access Hospitals.
Additional links: Findings at a Glance, Technical Appendices
Date: 12/2022
Sponsoring organizations: Centers for Medicare and Medicaid Services, NORC at the University of Chicago
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Fifth Evaluation Report: Next Generation Accountable Care Organization Model Evaluation
Reports on changes to the Next Generation Accountable Care Organization (NGACO) Model in response to the COVID-19 public health emergency (PHE). Presents information on cumulative model-wide impacts on Medicare spending, utilization, and quality of care, as well as impacts observed in 2020, the model's fifth performance year. The appendices include data on community characteristics, including rurality.
Additional links: Technical Appendices
Date: 11/2022
Sponsoring organizations: Centers for Medicare and Medicaid Services, NORC at the University of Chicago
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Reports on changes to the Next Generation Accountable Care Organization (NGACO) Model in response to the COVID-19 public health emergency (PHE). Presents information on cumulative model-wide impacts on Medicare spending, utilization, and quality of care, as well as impacts observed in 2020, the model's fifth performance year. The appendices include data on community characteristics, including rurality.
Additional links: Technical Appendices
Date: 11/2022
Sponsoring organizations: Centers for Medicare and Medicaid Services, NORC at the University of Chicago
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A Global Equity Model (GEM) for the Advancement of Community Health and Health Equity
Provides an overview of existing and emerging payment systems and their roles in promoting community health and health equity. Proposes a global payment model for health systems' inpatient, emergency department (ED), and outpatient sites of care with community health and health equity as its organizing features. Includes information on the Pennsylvania Rural Health Model, the ACO REACH model, and other rural-relevant payment models.
Author(s): Anaeze C. Offodile II, Jason B. Gibbons, Samantha Murrell, Donna Kinzer, Joshua M. Sharfstein
Date: 11/2022
Sponsoring organization: National Academy of Medicine
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Provides an overview of existing and emerging payment systems and their roles in promoting community health and health equity. Proposes a global payment model for health systems' inpatient, emergency department (ED), and outpatient sites of care with community health and health equity as its organizing features. Includes information on the Pennsylvania Rural Health Model, the ACO REACH model, and other rural-relevant payment models.
Author(s): Anaeze C. Offodile II, Jason B. Gibbons, Samantha Murrell, Donna Kinzer, Joshua M. Sharfstein
Date: 11/2022
Sponsoring organization: National Academy of Medicine
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Person-Centered Innovation – An Update on the Implementation of the CMS Innovation Center's Strategy
Provides an update on the Centers for Medicare and Medicaid Services' (CMS) Innovation Center's progress in the implementation of the strategy refresh announced in 2021. Describes accomplishments from the first year of implementing the strategy refresh and outlines areas of focus for the upcoming year across the five strategic objectives: driving accountable care, advancing health equity, supporting innovation, addressing affordability, and partnering to achieve healthcare system transformation. Includes information on the Accountable Care Organization Realizing Equity, Access, and Community Health (ACO REACH) Model and the Community Health Access and Rural Transformation (CHART) Model.
Additional links: Supplemental Document
Date: 11/2022
Sponsoring organization: Centers for Medicare and Medicaid Services
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Provides an update on the Centers for Medicare and Medicaid Services' (CMS) Innovation Center's progress in the implementation of the strategy refresh announced in 2021. Describes accomplishments from the first year of implementing the strategy refresh and outlines areas of focus for the upcoming year across the five strategic objectives: driving accountable care, advancing health equity, supporting innovation, addressing affordability, and partnering to achieve healthcare system transformation. Includes information on the Accountable Care Organization Realizing Equity, Access, and Community Health (ACO REACH) Model and the Community Health Access and Rural Transformation (CHART) Model.
Additional links: Supplemental Document
Date: 11/2022
Sponsoring organization: Centers for Medicare and Medicaid Services
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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
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
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
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
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
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
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
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
Sponsoring organization: Rural Policy Research Institute Rural Health Panel
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