Rural Health
Resources by Topic: Health insurance
QPP 2021: Participation Results At-a-Glance
Provides an overview of the results of the Quality Payment Program (QPP) for the 2021 performance year. Highlights mean and median final scores in the Merit-based Incentive Payment System (MIPS) for small practices and compares results to those in 2020.
Date: 06/2023
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Provides an overview of the results of the Quality Payment Program (QPP) for the 2021 performance year. Highlights mean and median final scores in the Merit-based Incentive Payment System (MIPS) for small practices and compares results to those in 2020.
Date: 06/2023
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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MedPAC Comment on CMS's Proposed Rule on the Hospital Inpatient PPS for FY 2024
Comments on a May 1, 2023, Federal Register proposed rule revising the hospital inpatient and long-term care hospital (LTCH) prospective payment systems (PPS). Offers comments on future hospital safety-net policies, including a potential safety-net adjustment for Medicare inpatient hospital payments; a potential health equity adjustment bonus to the hospital value-based purchasing program; recent case law on rural reclassification and estimated implications; and supplemental uncompensated care payments to Puerto Rico.
Date: 06/2023
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Comments on a May 1, 2023, Federal Register proposed rule revising the hospital inpatient and long-term care hospital (LTCH) prospective payment systems (PPS). Offers comments on future hospital safety-net policies, including a potential safety-net adjustment for Medicare inpatient hospital payments; a potential health equity adjustment bonus to the hospital value-based purchasing program; recent case law on rural reclassification and estimated implications; and supplemental uncompensated care payments to Puerto Rico.
Date: 06/2023
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Medicare Accountable Care Organizations: Presence in Rural America
Presentation slides from a June 6, 2023, webinar for the Rural Northern Border Healthcare Support Technical Assistance Center. Provides an overview of the Medicare Shared Savings Program, including the composition of program participants in 2023, the spread of Accountable Care Organizations (ACOs) in rural counties, and the federal and state policy landscape. Details changes to the Shared Savings Program for 2024.
Author(s): Keith J. Mueller
Date: 06/2023
Type: Presentation Slides
Sponsoring organization: Rural Policy Research Institute
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Presentation slides from a June 6, 2023, webinar for the Rural Northern Border Healthcare Support Technical Assistance Center. Provides an overview of the Medicare Shared Savings Program, including the composition of program participants in 2023, the spread of Accountable Care Organizations (ACOs) in rural counties, and the federal and state policy landscape. Details changes to the Shared Savings Program for 2024.
Author(s): Keith J. Mueller
Date: 06/2023
Type: Presentation Slides
Sponsoring organization: Rural Policy Research Institute
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Diabetes Prevalence and Monitoring in Nonmetropolitan and Metropolitan Areas Within a Commercially Insured U.S. Population
Explores the prevalence of diabetes in metro and nonmetro areas. Draws data from commercial insurance enrollees and compares rates of diabetes testing and outcomes by rurality.
Author(s): Lindsey R. Hammerslag, Jeffery Talbert
Date: 06/2023
Type: Document
Sponsoring organization: Rural and Underserved Health Research Center
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Explores the prevalence of diabetes in metro and nonmetro areas. Draws data from commercial insurance enrollees and compares rates of diabetes testing and outcomes by rurality.
Author(s): Lindsey R. Hammerslag, Jeffery Talbert
Date: 06/2023
Type: Document
Sponsoring organization: Rural and Underserved Health Research Center
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MedPAC Comment on CMS's Proposed Rule on the Payment System for Inpatient Psychiatric Facilities for FY 2024
Comment on an April 4, 2023, Federal Register proposed rule revising the Inpatient Psychiatric Facility Prospective Payment System (IPF PPS) for fiscal year 2024. Includes a discussion of rural IPF PPS payment adjustments.
Date: 06/2023
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Comment on an April 4, 2023, Federal Register proposed rule revising the Inpatient Psychiatric Facility Prospective Payment System (IPF PPS) for fiscal year 2024. Includes a discussion of rural IPF PPS payment adjustments.
Date: 06/2023
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Training the Primary Care Workforce to Deliver Team-Based Care in Underserved Areas: The Teaching Health Center Program
Provides an overview of the Teaching Health Center Graduate Medical Education (THCGME) program. Describes the THCGME program's outcomes in training primary care medical and dental providers, the practice settings of THCGME family medicine graduates, and services provided by program graduates. Profiles four THCGME programs, including three programs that serve tribal or rural areas. Discusses challenges facing Teaching Health Centers, proposed solutions, and key takeaways and recommendations for policymakers.
Author(s): Emily Hawes, Jacob Rains, Candice Chen, Erin Fraher
Date: 06/2023
Type: Document
Sponsoring organization: Milbank Memorial Fund
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Provides an overview of the Teaching Health Center Graduate Medical Education (THCGME) program. Describes the THCGME program's outcomes in training primary care medical and dental providers, the practice settings of THCGME family medicine graduates, and services provided by program graduates. Profiles four THCGME programs, including three programs that serve tribal or rural areas. Discusses challenges facing Teaching Health Centers, proposed solutions, and key takeaways and recommendations for policymakers.
Author(s): Emily Hawes, Jacob Rains, Candice Chen, Erin Fraher
Date: 06/2023
Type: Document
Sponsoring organization: Milbank Memorial Fund
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Rural Disparities in the Quality of Clinical Care Are Notable and Larger for Males
Explores the differences in healthcare quality among male and female Medicare Advantage beneficiaries in rural and urban areas. Breaks down data by gender, treatment received, treatment outcomes, and rural versus urban location, among other measures.
Author(s): Sarah MacCarthy, Marc N. Elliott, Steven C. Martino, et al.
Citation: Journal of Rural Health, 39(3), 636-642
Date: 06/2023
Type: Document
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Explores the differences in healthcare quality among male and female Medicare Advantage beneficiaries in rural and urban areas. Breaks down data by gender, treatment received, treatment outcomes, and rural versus urban location, among other measures.
Author(s): Sarah MacCarthy, Marc N. Elliott, Steven C. Martino, et al.
Citation: Journal of Rural Health, 39(3), 636-642
Date: 06/2023
Type: Document
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Medicare Claims Processing Manual: Chapter 9 - Rural Health Clinics/Federally Qualified Health Centers
Describes the differences between Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs). Identifies the rules and regulations for processing Medicare claims.
Date: 06/2023
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Describes the differences between Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs). Identifies the rules and regulations for processing Medicare claims.
Date: 06/2023
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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State Medicaid Telehealth Coverage Policy Decisions Since the COVID-19 Public Health Emergency
Describes changes to state Medicaid telehealth policy flexibilities and/or new policies enacted during the COVID-19 PHE as of April–May 2022. Focuses on flexibilities that were rolled back, as well as those made permanent in whole or in part. Examines the decision-making processes behind Medicaid telehealth policy changes. Summarizes findings from guided discussions with state Medicaid representatives across four domains: 1) state attitudes and perspectives on telehealth and telehealth policies; 2) state telehealth policy decision-making processes; 3) states' future plans for telehealth; and 4) challenges and lessons learned. Outlines potential opportunities for the future of telehealth. Includes rural references throughout.
Additional links: Executive Summary
Author(s): Peggy G. Chen, Sara E. Heins, Stephanie Dellva
Date: 05/2023
Type: Document
Sponsoring organizations: HHS Office of the Assistant Secretary for Planning and Evaluation, RAND Corporation
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Describes changes to state Medicaid telehealth policy flexibilities and/or new policies enacted during the COVID-19 PHE as of April–May 2022. Focuses on flexibilities that were rolled back, as well as those made permanent in whole or in part. Examines the decision-making processes behind Medicaid telehealth policy changes. Summarizes findings from guided discussions with state Medicaid representatives across four domains: 1) state attitudes and perspectives on telehealth and telehealth policies; 2) state telehealth policy decision-making processes; 3) states' future plans for telehealth; and 4) challenges and lessons learned. Outlines potential opportunities for the future of telehealth. Includes rural references throughout.
Additional links: Executive Summary
Author(s): Peggy G. Chen, Sara E. Heins, Stephanie Dellva
Date: 05/2023
Type: Document
Sponsoring organizations: HHS Office of the Assistant Secretary for Planning and Evaluation, RAND Corporation
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Interoperability among Hospitals Treating Populations That Have Been Marginalized
Examines how hospitals that serve more marginalized patients engage with interoperability. Compares the percentage of hospitals supporting interoperable exchange and participating in national networks by hospital characteristics, including Critical Access Hospital (CAH) designation and rural-urban status.
Author(s): Jordan Everson, Vaishali Patel, Andrew W. Bazemore, Robert L. Phillips
Citation: Health Services Research, 58(4), 853-864
Date: 05/2023
Type: Document
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Examines how hospitals that serve more marginalized patients engage with interoperability. Compares the percentage of hospitals supporting interoperable exchange and participating in national networks by hospital characteristics, including Critical Access Hospital (CAH) designation and rural-urban status.
Author(s): Jordan Everson, Vaishali Patel, Andrew W. Bazemore, Robert L. Phillips
Citation: Health Services Research, 58(4), 853-864
Date: 05/2023
Type: Document
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