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Rural Health
Resources by Topic: Accountable Care Organizations

Continuing on the Road to Value
Slides presented at the Indiana Rural Health Association's Annual Public Policy Forum in 2021. Discusses management methods and policy initiatives for transitioning hospitals to value-based care. Includes information on the Community Health Access and Rural Transformation (CHART) Model, Accountable Care Organization (ACO) Pathways to Success, and global budgeting.
Author(s): Keith J. Mueller
Date: 01/2021
Type: Presentation Slides
Sponsoring organization: Rural Policy Research Institute
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Care Transformation Toolkit
Provides an overview of common approaches and best practices Medicare Accountable Care Organizations (ACOs) utilize to improve healthcare quality, lower healthcare costs, and enhance patient experiences. Describes ACO programs designed to use telehealth to expand access to care and improve efficiency, support high-risk beneficiaries through home visits, and provide timely access to skilled nursing care through Medicare waivers. Discusses lessons learned, options available to ACOs, and possible implementation challenges.
Date: 01/2021
Type: Document
Sponsoring organizations: Centers for Medicare and Medicaid Services, Mathematica
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MedPAC Comment on CMS's Proposed Rule on the Physician Fee Schedule and Other Revisions to Part B for CY 2021
Comment on an August 17, 2020 Federal Register proposed rule revising the physician fee schedule to improve payment systems for physicians and other Medicare Part B revisions. Includes a discussion of COVID-19-related telehealth expansion.
Date: 10/2020
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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State Support to Rural Hospitals Fact Sheet
Overview of the Small Rural Hospital Improvement Program (SHIP) and the Medicare Rural Hospital Flexibility (Flex) program supporting rural hospitals and Critical Access Hospitals. Highlights with data the impact of these programs on a national level.
Date: 10/2020
Type: Document
Sponsoring organization: Health Resources and Services Administration
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Building Capacity for Value
Slides presented at the 2020 Nebraska Rural Health Conference describing the evolution of value-based care. Discusses different approaches to value-based care transformation, including the Medicare Shared Savings Program Accountable Care Organizations and global budgeting. Presents management and leadership strategies to navigate future changes while meeting community health needs.
Author(s): Karla Weng
Date: 09/2020
Type: Presentation Slides
Sponsoring organization: Rural Health Value
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Third Evaluation Report: Next Generation Accountable Care Organization Model Evaluation
Reports on implementation experiences and outcomes for 50 Next Generation Accountable Care Organizations (NGACOs) that participated in the model in the 2018 performance year. Also evaluates findings of the model to date, from NGACOs entering the model in 2016, 2017, and 2018. Includes information on the extent to which NGACOs served rural areas.
Additional links: CMS Perspective, October 2020, Findings at a Glance, Technical Appendices
Date: 09/2020
Type: Document
Sponsoring organizations: Centers for Medicare and Medicaid Services, NORC at the University of Chicago
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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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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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April 2020 MedPAC Meeting Transcript
Transcript from the Medicare Payment Advisory Commission's (MedPAC) April 2020 meeting. Covers value-based payment in Medicare, challenges in maintaining and increasing savings from accountable care organizations, incentives in Medicare Part D, the Medicare Advantage quality bonus program, and Medicare's end-stage renal disease (ESRD) prospective payment system. Includes a discussion of ESRD payment adjustments for rural and low-volume providers.
Date: 04/2020
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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