Rural Health
Resources by Topic: Health insurance
The Low-Volume Hospital Adjustment Before and During COVID-19
Describes characteristics of rural low-volume hospitals (LVHs) between April 2018 and March 2022. Compares the characteristics and profitability of rural LVHs with other rural prospective payment system (PPS) hospitals before and during the COVID-19 pandemic. Presents data on LVH profitability margins with and without the LVH payment adjustment.
Author(s): Emmaline Keesee, Susie Gurzenda, Kristie Thompson, George Pink
Date: 07/2024
Sponsoring organization: North Carolina Rural Health Research Program
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Describes characteristics of rural low-volume hospitals (LVHs) between April 2018 and March 2022. Compares the characteristics and profitability of rural LVHs with other rural prospective payment system (PPS) hospitals before and during the COVID-19 pandemic. Presents data on LVH profitability margins with and without the LVH payment adjustment.
Author(s): Emmaline Keesee, Susie Gurzenda, Kristie Thompson, George Pink
Date: 07/2024
Sponsoring organization: North Carolina Rural Health Research Program
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Medicare Advantage Enrollees Account for a Rising Share of Inpatient Hospital Days
Describes the growth of Medicare Advantage (MA) as a share of hospital inpatient days between 2015 and 2022. Presents data from hospital cost reports submitted to the Centers for Medicare & Medicaid (CMS) regarding the share of inpatient days attributable to MA compared to traditional Medicare, the percentage of hospitals with more inpatient days from Medicare Advantage than traditional Medicare, and the variation across hospitals within counties. Compares trends in the share of inpatient days for MA enrollees across rural, micropolitan, and metropolitan hospitals.
Author(s): Jamie Godwin, Jeannie Fuglesten Biniek, Zachary Levinson, Tricia Neuman
Date: 07/2024
Sponsoring organization: KFF
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Describes the growth of Medicare Advantage (MA) as a share of hospital inpatient days between 2015 and 2022. Presents data from hospital cost reports submitted to the Centers for Medicare & Medicaid (CMS) regarding the share of inpatient days attributable to MA compared to traditional Medicare, the percentage of hospitals with more inpatient days from Medicare Advantage than traditional Medicare, and the variation across hospitals within counties. Compares trends in the share of inpatient days for MA enrollees across rural, micropolitan, and metropolitan hospitals.
Author(s): Jamie Godwin, Jeannie Fuglesten Biniek, Zachary Levinson, Tricia Neuman
Date: 07/2024
Sponsoring organization: KFF
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MedPAC Data Book: Health Care Spending and the Medicare Program, 2024
Provides an overview of Medicare spending and highlights data on Medicare beneficiary demographics, dual-eligible beneficiaries, quality of care provided through the Medicare program, and other payer liability. Examines settings of care, including rural-specific provider sites, as they relate to spending, access to care, and profit margins. Compares rural and urban beneficiaries and providers throughout. Chart 6-2 addresses rural hospital closures.
Date: 07/2024
Sponsoring organization: Medicare Payment Advisory Commission
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Provides an overview of Medicare spending and highlights data on Medicare beneficiary demographics, dual-eligible beneficiaries, quality of care provided through the Medicare program, and other payer liability. Examines settings of care, including rural-specific provider sites, as they relate to spending, access to care, and profit margins. Compares rural and urban beneficiaries and providers throughout. Chart 6-2 addresses rural hospital closures.
Date: 07/2024
Sponsoring organization: Medicare Payment Advisory Commission
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Positioning Telehealth Policy to Ensure High-Quality, Cost-Effective Care
Presents policy recommendations and suggestions to guide policymakers when considering the future of telehealth. Analyzes peer-reviewed research; government reports; and findings from interviews with payers, providers, provider associations, federal agencies, consumer advocates, technology leaders, policy experts, and other stakeholders. Includes rural references and considerations throughout.
Author(s): Maya Sandalow, Julia Harris, Mikayla Curtis, Marilyn Werber Serafini
Date: 07/2024
Sponsoring organization: Bipartisan Policy Center
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Presents policy recommendations and suggestions to guide policymakers when considering the future of telehealth. Analyzes peer-reviewed research; government reports; and findings from interviews with payers, providers, provider associations, federal agencies, consumer advocates, technology leaders, policy experts, and other stakeholders. Includes rural references and considerations throughout.
Author(s): Maya Sandalow, Julia Harris, Mikayla Curtis, Marilyn Werber Serafini
Date: 07/2024
Sponsoring organization: Bipartisan Policy Center
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How Payment Caps Can Reduce Hospital Prices and Spending: Lessons from the Oregon State Employee Plan
Report discusses how policy changes to state employee insurance plans affected healthcare costs in Oregon. Details Oregon's plan to place payment caps tied to Medicare reimbursement rates and exceptions for rural and Critical Access Hospitals.
Author(s): Roslyn C. Murray, Christopher M. Whaley, Erin C. Fuse Brown, Andrew M. Ryan
Date: 07/2024
Sponsoring organization: Milbank Memorial Fund
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Report discusses how policy changes to state employee insurance plans affected healthcare costs in Oregon. Details Oregon's plan to place payment caps tied to Medicare reimbursement rates and exceptions for rural and Critical Access Hospitals.
Author(s): Roslyn C. Murray, Christopher M. Whaley, Erin C. Fuse Brown, Andrew M. Ryan
Date: 07/2024
Sponsoring organization: Milbank Memorial Fund
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Standing Technical Expert Panel for the Development, Evaluation, and Maintenance of Post-Acute Care (PAC) and Hospice Quality Reporting Program (QRP) Measurement Sets: Summary Report
Describes a December 15, 2023, Technical Expert Panel (TEP) regarding the development of additional cross-setting measures for the Post-Acute Care (PAC) and Hospice Quality Reporting Programs (QRPs), and filling measurement gaps with the Centers for Medicare & Medicaid Services (CMS) Universal Foundation measures. Summarizes TEP comments on adding measures to PAC and Hospice QRPs in four domains: 1) behavioral and mental health, 2) patient experience of care, 3) pain management, and 4) immunization. Covers panelists' discussions on the appropriateness of the existing measure set and potential new measures, setting-specific considerations, data sources, and other topics related to each domain. Includes rural references throughout.
Date: 07/2024
Sponsoring organizations: Abt Associates, Acumen, Centers for Medicare and Medicaid Services
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Describes a December 15, 2023, Technical Expert Panel (TEP) regarding the development of additional cross-setting measures for the Post-Acute Care (PAC) and Hospice Quality Reporting Programs (QRPs), and filling measurement gaps with the Centers for Medicare & Medicaid Services (CMS) Universal Foundation measures. Summarizes TEP comments on adding measures to PAC and Hospice QRPs in four domains: 1) behavioral and mental health, 2) patient experience of care, 3) pain management, and 4) immunization. Covers panelists' discussions on the appropriateness of the existing measure set and potential new measures, setting-specific considerations, data sources, and other topics related to each domain. Includes rural references throughout.
Date: 07/2024
Sponsoring organizations: Abt Associates, Acumen, Centers for Medicare and Medicaid Services
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Estimated Impacts of Multiple Payment Policies on Rural-Serving Home Health Agencies
Describes the estimated impact of three major Medicare home health payment policy changes - implementation of the Patient-Driven Groupings Model (PDGM), revisions to rural add-on payments, and the demonstration and nationwide expansion of the Home Health Value-Based Purchasing (HHVBP) model - on home health agency (HHA) reimbursement for Medicare beneficiaries. Compares the estimated impact of these payment policy changes by HHA rural-serving status, U. S. Census Division, profit status, quality rating, and episode volume.
Author(s): Tracy M. Mroz, Lisa A. Garberson, C. Holly A. Andrilla, Davis G. Patterson
Date: 07/2024
Sponsoring organization: WWAMI Rural Health Research Center
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Describes the estimated impact of three major Medicare home health payment policy changes - implementation of the Patient-Driven Groupings Model (PDGM), revisions to rural add-on payments, and the demonstration and nationwide expansion of the Home Health Value-Based Purchasing (HHVBP) model - on home health agency (HHA) reimbursement for Medicare beneficiaries. Compares the estimated impact of these payment policy changes by HHA rural-serving status, U. S. Census Division, profit status, quality rating, and episode volume.
Author(s): Tracy M. Mroz, Lisa A. Garberson, C. Holly A. Andrilla, Davis G. Patterson
Date: 07/2024
Sponsoring organization: WWAMI Rural Health Research Center
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Disruptors, Essential Services, and Reflections on a Career in Rural Health, with John Supplitt
An episode of the Exploring Rural Health podcast featuring John Supplitt, Senior Director of Rural Health Services for the American Hospital Association. Focuses on the importance of maintaining rural essential services, along with insights from Supplitt's long career in rural health.
Date: 07/2024
Sponsoring organization: Rural Health Information Hub
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An episode of the Exploring Rural Health podcast featuring John Supplitt, Senior Director of Rural Health Services for the American Hospital Association. Focuses on the importance of maintaining rural essential services, along with insights from Supplitt's long career in rural health.
Date: 07/2024
Sponsoring organization: Rural Health Information Hub
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Barriers to Healthcare and Social Service Utilization Among Rural Older Adults Who Use Drugs
Presents a study on the barriers to healthcare and social services access for older adults in rural communities who use drugs. Bases findings on survey results from rural adults over 50 who use drugs on perceived barriers to service utilization. Highlights how barriers such as a lack of transportation, health insurance, and permanent housing correlates with age.
Author(s): Beth Prusaczyk, Sandra Tilmon, Joshua Landman, et al.
Citation: Journal of Applied Gerontology, 43(12), 1977-1984
Date: 06/2024
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Presents a study on the barriers to healthcare and social services access for older adults in rural communities who use drugs. Bases findings on survey results from rural adults over 50 who use drugs on perceived barriers to service utilization. Highlights how barriers such as a lack of transportation, health insurance, and permanent housing correlates with age.
Author(s): Beth Prusaczyk, Sandra Tilmon, Joshua Landman, et al.
Citation: Journal of Applied Gerontology, 43(12), 1977-1984
Date: 06/2024
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Assessing Medicaid Payment Rates and Costs of Caring for the Medicaid Population Residing in Nursing Homes
Explores the relationship between Medicaid per diem payment rates to nursing homes and facilities' costs of providing care to Medicaid patients for facilities with a fiscal year ending on June 30, 2019. Examines the determinants of average cost and payment variations across each state. Presents data by facility-level characteristics, including ownership status, chain affiliation, rural or urban location, and more.
Date: 06/2024
Sponsoring organizations: HHS Office of the Assistant Secretary for Planning and Evaluation, Miami University, RTI International, University of Massachusetts
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Explores the relationship between Medicaid per diem payment rates to nursing homes and facilities' costs of providing care to Medicaid patients for facilities with a fiscal year ending on June 30, 2019. Examines the determinants of average cost and payment variations across each state. Presents data by facility-level characteristics, including ownership status, chain affiliation, rural or urban location, and more.
Date: 06/2024
Sponsoring organizations: HHS Office of the Assistant Secretary for Planning and Evaluation, Miami University, RTI International, University of Massachusetts
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