Rural Health
Resources by Topic: Health insurance
Identifying Rural Health Clinics Within the Transformed Medicaid Statistical Information System (T-MSIS) Analytic Files
Provides an overview and history of the Rural Health Clinic (RHC) Program and the services provided to Medicaid recipients. Examines the methodology for locating RHC encounters within Medicaid claims files utilizing the Transformed Statistical Information System (T-MSIS) Analytic Files.
Author(s): Katherine Ahrens, Zachariah Croll, Yvonne Jonk, John Gale, Heidi O'Connor
Date: 03/2024
Sponsoring organization: Maine Rural Health Research Center
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Provides an overview and history of the Rural Health Clinic (RHC) Program and the services provided to Medicaid recipients. Examines the methodology for locating RHC encounters within Medicaid claims files utilizing the Transformed Statistical Information System (T-MSIS) Analytic Files.
Author(s): Katherine Ahrens, Zachariah Croll, Yvonne Jonk, John Gale, Heidi O'Connor
Date: 03/2024
Sponsoring organization: Maine Rural Health Research Center
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The State of Georgia's Healthcare System
Fact sheet on income-based gaps in healthcare coverage in Georgia. Provides county-level maps and data on areas with the most significant coverage gaps, economic impacts of uninsured population, rural hospital and provider shortages, and more.
Date: 03/2024
Sponsoring organization: Georgia Budget & Policy Institute (GBPI)
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Fact sheet on income-based gaps in healthcare coverage in Georgia. Provides county-level maps and data on areas with the most significant coverage gaps, economic impacts of uninsured population, rural hospital and provider shortages, and more.
Date: 03/2024
Sponsoring organization: Georgia Budget & Policy Institute (GBPI)
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March 2024 MedPAC Meeting Transcript
Transcript from the Medicare Payment Advisory Commission's (MedPAC) March 2024 meeting. Covers proposed approaches and research topics related to evaluating rural hospital and clinician payment policies, an assessment of the completeness of Medicare Advantage (MA) encounter data and other sources of information about MA enrollees' healthcare utilization, a preliminary analysis of MA quality, the Acute Hospital Care at Home program, and Medicare inpatient psychiatric service trends and issues.
Additional links: Rural Hospital and Clinician Payment Policy: A Workplan for 2024–2025 - Presentation Slides
Date: 03/2024
Sponsoring organization: Medicare Payment Advisory Commission
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Transcript from the Medicare Payment Advisory Commission's (MedPAC) March 2024 meeting. Covers proposed approaches and research topics related to evaluating rural hospital and clinician payment policies, an assessment of the completeness of Medicare Advantage (MA) encounter data and other sources of information about MA enrollees' healthcare utilization, a preliminary analysis of MA quality, the Acute Hospital Care at Home program, and Medicare inpatient psychiatric service trends and issues.
Additional links: Rural Hospital and Clinician Payment Policy: A Workplan for 2024–2025 - Presentation Slides
Date: 03/2024
Sponsoring organization: Medicare Payment Advisory Commission
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Report to Congress on Medicaid and CHIP, March 2024
Reports on three aspects of Medicaid of interest to Congress: 1) improving the Medicaid beneficiary experience through Medical Care Advisory Committees (MCACs) and federal government actions to aid states, 2) increasing the transparency and improving the monitoring of the denials and appeals process in Medicaid managed care, and 3) reviewing hospital payment policy for the nation's safety-net hospitals. Chapter 3 examines the relationship between disproportionate share hospital (DSH) allotments to states and the number of uninsured individuals, the amounts and sources of hospitals' uncompensated care costs, and the number of hospitals with high levels of uncompensated care that also provide essential community services. Table 3-1 details DSH spending for urban and rural hospitals and for Critical Access Hospitals.
Date: 03/2024
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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Reports on three aspects of Medicaid of interest to Congress: 1) improving the Medicaid beneficiary experience through Medical Care Advisory Committees (MCACs) and federal government actions to aid states, 2) increasing the transparency and improving the monitoring of the denials and appeals process in Medicaid managed care, and 3) reviewing hospital payment policy for the nation's safety-net hospitals. Chapter 3 examines the relationship between disproportionate share hospital (DSH) allotments to states and the number of uninsured individuals, the amounts and sources of hospitals' uncompensated care costs, and the number of hospitals with high levels of uncompensated care that also provide essential community services. Table 3-1 details DSH spending for urban and rural hospitals and for Critical Access Hospitals.
Date: 03/2024
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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MedPAC Report to the Congress: Medicare Payment Policy: Mandated Report: Rural Emergency Hospitals: Chapter 15
Provides an overview of the Rural Emergency Hospital (REH) designation. Discusses the evolution of Medicare's support for rural hospitals through payment policies and the impact of declining inpatient volumes on rural hospitals' financial sustainability. Describes the characteristics of hospitals that converted to REH status in 2023, the first year of the designation.
Date: 03/2024
Sponsoring organization: Medicare Payment Advisory Commission
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Provides an overview of the Rural Emergency Hospital (REH) designation. Discusses the evolution of Medicare's support for rural hospitals through payment policies and the impact of declining inpatient volumes on rural hospitals' financial sustainability. Describes the characteristics of hospitals that converted to REH status in 2023, the first year of the designation.
Date: 03/2024
Sponsoring organization: Medicare Payment Advisory Commission
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MedPAC Report to the Congress: Medicare Payment Policy, 2024
Annual review of Medicare payment policies, with recommendations to Congress. Includes discussion on Medicare payment policies directly affecting rural providers and beneficiaries. Addresses payment adequacy for Medicare fee-for-service payment systems, Medicare Advantage (MA), and Medicare Part D. Includes two mandated reports on special needs plans for beneficiaries dually eligible for Medicare and Medicaid and the Rural Emergency Hospital (REH) designation.
Date: 03/2024
Sponsoring organization: Medicare Payment Advisory Commission
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Annual review of Medicare payment policies, with recommendations to Congress. Includes discussion on Medicare payment policies directly affecting rural providers and beneficiaries. Addresses payment adequacy for Medicare fee-for-service payment systems, Medicare Advantage (MA), and Medicare Part D. Includes two mandated reports on special needs plans for beneficiaries dually eligible for Medicare and Medicaid and the Rural Emergency Hospital (REH) designation.
Date: 03/2024
Sponsoring organization: Medicare Payment Advisory Commission
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Generic Drug Utilization and Spending Among Medicare Part D Enrollees in 2022
Issue brief on prescriptions for generic drugs filled by Medicare Part D enrollees using 2022 Part D prescription drug event (PDE) data. Covers commonly used prescription drugs, costs, and conditions treated, and includes data breakdowns by plan type, race and ethnicity, and level of rurality throughout. Discusses formulary design to improve access by promoting affordability and reducing confusion among enrollees.
Author(s): Yevgeniy Feyman, Bisma Sayed, Kenneth Finegold, et al.
Date: 03/2024
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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Issue brief on prescriptions for generic drugs filled by Medicare Part D enrollees using 2022 Part D prescription drug event (PDE) data. Covers commonly used prescription drugs, costs, and conditions treated, and includes data breakdowns by plan type, race and ethnicity, and level of rurality throughout. Discusses formulary design to improve access by promoting affordability and reducing confusion among enrollees.
Author(s): Yevgeniy Feyman, Bisma Sayed, Kenneth Finegold, et al.
Date: 03/2024
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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2024 National Impact Assessment of the Centers for Medicare & Medicaid Services (CMS) Quality Measures Report
Evaluates the quality measures used across 26 Centers for Medicare & Medicaid Services (CMS) quality reporting programs. Explores whether quality measure scores during the COVID-19 public health emergency (2020-2021) differed from expected trends. Analyzes how urban and rural residents performed at a national level in order to inform future quality measure development. Provides statistics concerning participation and performance within Medicare quality reporting programs, including statistics specific to rural populations and facilities.
Additional links: Appendices ZIP File
Date: 03/2024
Sponsoring organization: Centers for Medicare and Medicaid Services
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Evaluates the quality measures used across 26 Centers for Medicare & Medicaid Services (CMS) quality reporting programs. Explores whether quality measure scores during the COVID-19 public health emergency (2020-2021) differed from expected trends. Analyzes how urban and rural residents performed at a national level in order to inform future quality measure development. Provides statistics concerning participation and performance within Medicare quality reporting programs, including statistics specific to rural populations and facilities.
Additional links: Appendices ZIP File
Date: 03/2024
Sponsoring organization: Centers for Medicare and Medicaid Services
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Rural–Urban Differences in Out-of-Network Treatment Initiation and Engagement Rates for Substance Use Disorders
Explores disparities in access to substance use disorder treatments among privately insured individuals in rural and urban areas between 2016-2018. Compares rates of initial and ongoing treatment for alcohol use disorder, opioid use disorder, and other drug use disorders overall and from out-of-network providers for urban and rural patients.
Author(s): Eli Raver, Sheldon M. Retchin, Yiting Li, Andrew D. Carlo, Wendy Y. Xu
Citation: Health Services Research
Date: 03/2024
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Explores disparities in access to substance use disorder treatments among privately insured individuals in rural and urban areas between 2016-2018. Compares rates of initial and ongoing treatment for alcohol use disorder, opioid use disorder, and other drug use disorders overall and from out-of-network providers for urban and rural patients.
Author(s): Eli Raver, Sheldon M. Retchin, Yiting Li, Andrew D. Carlo, Wendy Y. Xu
Citation: Health Services Research
Date: 03/2024
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Nonmetropolitan Premiums, Issuer Participation, and Enrollment in Health Insurance Marketplaces in 2022
Policy brief describing differences in unsubsidized and net-of-subsidy premiums in 2022 between nonmetropolitan and metropolitan counties in Health Insurance Marketplace plan design and availability. Features statistics with breakdowns by metropolitan, micropolitan, and noncore areas.
Author(s): Abigail Barker, Ayushi Shrivastava, Eliot Jost, Timothy McBride, Keith Mueller
Date: 03/2024
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Policy brief describing differences in unsubsidized and net-of-subsidy premiums in 2022 between nonmetropolitan and metropolitan counties in Health Insurance Marketplace plan design and availability. Features statistics with breakdowns by metropolitan, micropolitan, and noncore areas.
Author(s): Abigail Barker, Ayushi Shrivastava, Eliot Jost, Timothy McBride, Keith Mueller
Date: 03/2024
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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