Rural Health
Resources by Topic: Health insurance
Calendar Year (CY) 2015 Rural Health Clinic (RHC) and Federally Qualified Health Centers (FQHC) Updates: Payment Rate Increases for RHCs and FQHCs Billing Under the All-Inclusive Rate System (AIR), and Urban and Rural Designations for FQHCs Billing Under the AIR
Provides updates for RHCs and FQHCs that are submitting claims to Medicare Administrative Contractors (MACs) for services to Medicare beneficiaries.
Date: 12/2024
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Provides updates for RHCs and FQHCs that are submitting claims to Medicare Administrative Contractors (MACs) for services to Medicare beneficiaries.
Date: 12/2024
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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What to Know About Medicare Coverage of Telehealth
Discusses telehealth use by Medicare patients before, during, and after declaration of the COVID-19 public health emergency. Notes temporary telehealth provisions set to expire December 31, 2024, telehealth provisions made permanent, and trends in use since 2020. Includes rural and urban comparisons of telehealth use since 2020. Discusses payment models for Medicare and Medicare Advantage, current policies related to telehealth, fraud, and the cost of coverage through Medicare.
Author(s): Alex Cottrill, Juliette Cubanski, Tricia Neuman
Date: 10/2024
Type: Document
Sponsoring organization: KFF
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Discusses telehealth use by Medicare patients before, during, and after declaration of the COVID-19 public health emergency. Notes temporary telehealth provisions set to expire December 31, 2024, telehealth provisions made permanent, and trends in use since 2020. Includes rural and urban comparisons of telehealth use since 2020. Discusses payment models for Medicare and Medicare Advantage, current policies related to telehealth, fraud, and the cost of coverage through Medicare.
Author(s): Alex Cottrill, Juliette Cubanski, Tricia Neuman
Date: 10/2024
Type: Document
Sponsoring organization: KFF
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Health Care Transparency: CMS Needs More Information on Hospital Pricing Data Completeness and Accuracy
Provides an overview of the Centers for Medicare & Medicaid Services (CMS) hospital price transparency requirements before and after 2024 updates to the requirements. Describes users' experiences with hospital pricing data before the 2024 updates. Examines CMS's enforcement of hospital price transparency requirements and offers recommendations to CMS regarding the sufficiency and accuracy of the data reported. Table 3 compares CMS enforcement actions by hospitals' rural or urban designation between 2021 and 2023.
Additional links: Full Report
Date: 10/2024
Type: Document
Sponsoring organization: Government Accountability Office
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Provides an overview of the Centers for Medicare & Medicaid Services (CMS) hospital price transparency requirements before and after 2024 updates to the requirements. Describes users' experiences with hospital pricing data before the 2024 updates. Examines CMS's enforcement of hospital price transparency requirements and offers recommendations to CMS regarding the sufficiency and accuracy of the data reported. Table 3 compares CMS enforcement actions by hospitals' rural or urban designation between 2021 and 2023.
Additional links: Full Report
Date: 10/2024
Type: Document
Sponsoring organization: Government Accountability Office
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States Could Better Leverage Coverage and Access Requirements To Promote Maternal Health Care Access in Medicaid Managed Care
Describes challenges to maternal healthcare access. Explores the provider coverage rules and network adequacy standards state Medicaid agencies have set for maternal healthcare in Medicaid managed care. Examines state oversight of quantitative network adequacy standards. Offers recommendations to the Centers for Medicare & Medicaid Services (CMS) to ensure access to pregnancy and postpartum care in Medicaid managed care. Includes rural references throughout.
Additional links: Report in Brief
Date: 09/2024
Type: Document
Sponsoring organization: Office of Inspector General (HHS)
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Describes challenges to maternal healthcare access. Explores the provider coverage rules and network adequacy standards state Medicaid agencies have set for maternal healthcare in Medicaid managed care. Examines state oversight of quantitative network adequacy standards. Offers recommendations to the Centers for Medicare & Medicaid Services (CMS) to ensure access to pregnancy and postpartum care in Medicaid managed care. Includes rural references throughout.
Additional links: Report in Brief
Date: 09/2024
Type: Document
Sponsoring organization: Office of Inspector General (HHS)
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Characteristics of Communities Affected by Critical Access Hospital Mergers
Explores the demographic, socioeconomic, health status, and geographic characteristics of communities served by Critical Access Hospitals (CAHs) that have merged or been acquired. Compares county and hospital characteristics by CAH merger status between 2010 and 2022.
Author(s): Arrianna Marie Planey
Date: 09/2024
Type: Document
Sponsoring organization: Flex Monitoring Team
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Explores the demographic, socioeconomic, health status, and geographic characteristics of communities served by Critical Access Hospitals (CAHs) that have merged or been acquired. Compares county and hospital characteristics by CAH merger status between 2010 and 2022.
Author(s): Arrianna Marie Planey
Date: 09/2024
Type: Document
Sponsoring organization: Flex Monitoring Team
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Health Care Affordability and Medical Debt: Differences by Rurality, Region, and Socio-Demographic Characteristics
Policy brief examining rural/urban differences in health care affordability and medical debt concerns. Features statistics including rates of affordability issues with breakdowns by rural and urban location, and among rural residents with breakdowns by socio-demographic characteristics.
Author(s): Ingrid Jacobson, Katie Rydberg, Mariana Tuttle, et al.
Date: 09/2024
Type: Document
Sponsoring organization: University of Minnesota Rural Health Research Center
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Policy brief examining rural/urban differences in health care affordability and medical debt concerns. Features statistics including rates of affordability issues with breakdowns by rural and urban location, and among rural residents with breakdowns by socio-demographic characteristics.
Author(s): Ingrid Jacobson, Katie Rydberg, Mariana Tuttle, et al.
Date: 09/2024
Type: Document
Sponsoring organization: University of Minnesota Rural Health Research Center
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Leveraging Medicaid to Support Housing and Nutrition in Ohio
Describes the Ohio Medicaid program and the federal Medicaid health-related social needs (HRSN) framework. Discusses how Medicaid coverage in Ohio can cover aspects of housing and nutrition needs as of 2023. Includes county-level map depicting percent of income spent on housing in Ohio as well as examples of programs addressing HRSNs in rural areas.
Author(s): Hailey Akah, Robin Blair-Ackison, Edith Nkenganyi, et al.
Date: 09/2024
Type: Document
Sponsoring organization: Health Policy Institute of Ohio
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Describes the Ohio Medicaid program and the federal Medicaid health-related social needs (HRSN) framework. Discusses how Medicaid coverage in Ohio can cover aspects of housing and nutrition needs as of 2023. Includes county-level map depicting percent of income spent on housing in Ohio as well as examples of programs addressing HRSNs in rural areas.
Author(s): Hailey Akah, Robin Blair-Ackison, Edith Nkenganyi, et al.
Date: 09/2024
Type: Document
Sponsoring organization: Health Policy Institute of Ohio
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Pediatric and Pregnancy-related Visits at Rural Health Clinics in 2018 among Medicaid/CHIP Enrollees in 20 States
Research and policy brief on pediatric and pregnancy-related visits to Rural Health Clinics (RHCs) among Medicaid/CHIP enrollees in 20 states during the year 2018. Provides data, including regional and state comparisons, on rates at which pediatric and pregnancy-related visits took place, medical conditions observed, and services provided. Discusses the role of RHCs in overcoming geographic access barriers.
Author(s): Katherine A. Aherns, Zachariah T. Croll, Yvonne Jonk, John Gale, Heidi O'Connor
Date: 09/2024
Type: Document
Sponsoring organization: Maine Rural Health Research Center
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Research and policy brief on pediatric and pregnancy-related visits to Rural Health Clinics (RHCs) among Medicaid/CHIP enrollees in 20 states during the year 2018. Provides data, including regional and state comparisons, on rates at which pediatric and pregnancy-related visits took place, medical conditions observed, and services provided. Discusses the role of RHCs in overcoming geographic access barriers.
Author(s): Katherine A. Aherns, Zachariah T. Croll, Yvonne Jonk, John Gale, Heidi O'Connor
Date: 09/2024
Type: Document
Sponsoring organization: Maine Rural Health Research Center
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A Snapshot of Sources of Coverage Among Medicare Beneficiaries
Examines the sources of healthcare and supplemental insurance coverage among Medicare beneficiaries in 2022. Presents data on the sources of coverage by beneficiary characteristics, including health status, metropolitan status, and income.
Author(s): Nancy Ochieng, Juliette Cubanski, Tricia Neuman
Date: 09/2024
Type: Document
Sponsoring organization: KFF
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Examines the sources of healthcare and supplemental insurance coverage among Medicare beneficiaries in 2022. Presents data on the sources of coverage by beneficiary characteristics, including health status, metropolitan status, and income.
Author(s): Nancy Ochieng, Juliette Cubanski, Tricia Neuman
Date: 09/2024
Type: Document
Sponsoring organization: KFF
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September 2024 MedPAC Meeting Transcript
Transcript from the Medicare Payment Advisory Commission's (MedPAC) September 2024 meeting. Covers Medicare's overall financial situation, cost-sharing for outpatient services at Critical Access Hospitals, and experiences and challenges of measuring the quality of care provided by rural providers.
Additional links: Cost Sharing for Outpatient Services at Critical Access Hospitals - Presentation Slides, Medicare's Measurement of Rural Provider Quality - Presentation Slides
Date: 09/2024
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Transcript from the Medicare Payment Advisory Commission's (MedPAC) September 2024 meeting. Covers Medicare's overall financial situation, cost-sharing for outpatient services at Critical Access Hospitals, and experiences and challenges of measuring the quality of care provided by rural providers.
Additional links: Cost Sharing for Outpatient Services at Critical Access Hospitals - Presentation Slides, Medicare's Measurement of Rural Provider Quality - Presentation Slides
Date: 09/2024
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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