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Rural Health
Resources by Topic: Health insurance

The Impact of State Medicaid Expansion Under the Affordable Care Act on Health Insurance Coverage at the County Level
Compares health insurance coverage in 2013, prior to the Affordable Care Act, and in 2015. Includes data on health insurance coverage for metropolitan and nonmetro counties. Discusses the impact of Medicaid expansion on health insurance coverage.
Author(s): Danielle C. Rhubart
Date: 12/2016
Sponsoring organization: Carsey School of Public Policy
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Evaluation of Hospital-Setting HCIA Awards: Third Annual Report, Final
Third and final report evaluating 10 Health Care Innovation Awards Round One projects undertaken in a hospital inpatient or emergency department. Presents awardee-specific information on program impact and lessons learned. Includes projects that involved Critical Access Hospitals and other rural hospitals. Includes projects focused on improved care for sepsis and projects using remote electronic intensive care unit (eICU) services.
Additional links: Addendum, March 2017
Date: 11/2016
Sponsoring organizations: Abt Associates, Centers for Medicare and Medicaid Services
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MBQIP Quality Measure Trends, 2011-2016
Examines trends in 37 Medicare Beneficiary Quality Improvement Project (MBQIP) quality measures from 2011 to 2016. Groups Critical Access Hospitals (CAHs) within 45 State Flex Programs into five regions, and organizes data into tables and figures which allow in-depth comparisons of the national, regional, and state trends for each MBQIP measure. Presents findings across five quality measure domains: patient engagement, care transitions, outpatient, inpatient, and patient safety.
Author(s): Tami Swenson, Michelle Casey
Date: 11/2016
Sponsoring organization: Flex Monitoring Team
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Federal Requirement for Physician Supervision of CRNAs
Discusses the federal requirement affecting participation in the Medicare program by Critical Access Hospitals (CAHs) or Ambulatory Surgical Centers (ASCs) regarding physician supervision of Certified Registered Nurse Anesthetists (CRNAs). Addresses the conditions for states to opt out of the physician supervision Medicare rule if they meet certain conditions and the research comparing the outcomes between states that opt-out and those that do not.
Author(s): Steve Barnett, John H Everett, Pat Schou
Date: 11/2016
Sponsoring organization: National Rural Health Association
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Freestanding Emergency Departments: An Alternative Model for Rural Communities
Describes the freestanding emergency department (FSED) model as an option for rural communities that can no longer support inpatient services. Looks at both hospital-based and independent FSEDs, examines financial viability of the model, and features rural FSEDs in Illinois and Arizona.
Author(s): Jenn Lukens
Citation: Rural Monitor
Date: 11/2016
Sponsoring organization: Rural Health Information Hub
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Impact of Race/Ethnicity and Socioeconomic Status on Risk-Adjusted Readmission Rates: Implications for the Hospital Readmissions Reduction Program
Examines what would happen to hospitals' excess readmission ratios and potential penalties if socioeconomic status and race/ethnicity were added to the Centers for Medicare & Medicaid Services risk-adjustment algorithm. Includes information on potential change in penalties for metropolitan, micropolitan, and nonmetro hospitals.
Author(s): Grant R. Martsolf, Marguerite L. Barrett, Audrey J. Weiss, et al.
Citation: Inquiry, 53
Date: 10/2016
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Health Insurance CO-OPs: Product Availability and Premiums in Rural Counties
Describes the role of CO-OPs, their regional distribution, and national prevalence in rural and urban counties. Compares the number of products available in counties with and without CO-OP plans in 2014 and 2015.
Author(s): Erika C. Ziller, Zachariah Croll, Andrew F. Coburn
Date: 10/2016
Sponsoring organization: Maine Rural Health Research Center
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The Impact of the Low Volume Hospital (LVH) Program on the Viability of Small, Rural Hospitals
Compares rural low volume hospitals (LVH) with non-LVH (Inpatient Prospective Payment System) hospitals. Discusses the financial impact of removing the LVH program and returning to the 2005 LVH classification and payment adjustment, and the effect this will have on Medicare beneficiaries.
Author(s): Rebecca G. Whitaker, G. Mark Holmes, George H. Pink
Date: 10/2016
Sponsoring organization: North Carolina Rural Health Research Program
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Aging in Rural and Frontier Oregon: Challenges Facing Rural and Frontier Home Health Agencies
Provides an overview of the services and challenges affecting home health agencies offering assistance to the aging population in rural Oregon by county. Includes discussion on healthcare access, home health agency regulation and reimbursement, recruitment and retention of healthcare providers, and physician compliance.
Author(s): Callie Walsh-Bailey, Jamie Horst
Date: 09/2016
Sponsoring organization: Oregon Office of Rural Health
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Findings from the Field: Medicaid Delivery Systems and Access to Care in Four States in Year Three of the ACA
Explores the experiences of four states that participated in Medicaid expansion as part of the Patient Protection and Affordable Care Act (ACA): Colorado, Connecticut, Kentucky, and Washington. Examines what each state is doing to transition, from outreach and enrollment activities, to improving delivery systems and access to care. Contains rural-specific content and information on how the states are dealing with the expanded Medicaid population. Addresses how Community Health Centers have responded to the Medicaid expansion.
Author(s): Samantha Artiga, Robin Rudowitz, Jennifer Tolbert, Julia Paradise, Melissa Majerol
Date: 09/2016
Sponsoring organization: KFF
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