Rural Health
Resources by Topic: Health insurance
Evaluation of the Primary Care First Model: Second Annual Report
Provides an overview of the Primary Care First (PCF) model, which aims to enhance primary care and move primary care practitioners toward value-based payment. Describes the PCF model implementation experiences for Cohort 1 and Cohort 2 practices. Explores the preliminary impact of the PCF Model on acute hospitalizations and Medicare Part A and B expenditures relative to a comparison group. Estimates the impacts of the model on a set of seven leading indicators to provide an early assessment of whether care delivery changes are resulting in meaningful early outcome changes. Highlights implications from this report for the Primary Care First model and future models.
Additional links: Findings at a Glance
Date: 02/2024
Sponsoring organizations: Centers for Medicare and Medicaid Services, Mathematica
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Provides an overview of the Primary Care First (PCF) model, which aims to enhance primary care and move primary care practitioners toward value-based payment. Describes the PCF model implementation experiences for Cohort 1 and Cohort 2 practices. Explores the preliminary impact of the PCF Model on acute hospitalizations and Medicare Part A and B expenditures relative to a comparison group. Estimates the impacts of the model on a set of seven leading indicators to provide an early assessment of whether care delivery changes are resulting in meaningful early outcome changes. Highlights implications from this report for the Primary Care First model and future models.
Additional links: Findings at a Glance
Date: 02/2024
Sponsoring organizations: Centers for Medicare and Medicaid Services, Mathematica
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Pre-Rulemaking Measure Review Measures Under Consideration: 2023 Recommendations Report
Reviews the 42 pre-rulemaking quality measures the Battelle's Partnership for Quality Measurement (PQM) considered during the 2023-2024 Pre-Rulemaking Measure Review (PRMR) cycle. Discusses measures for clinician, hospital, and post-acute care/long-term care programs. Includes rural references and considerations throughout.
Date: 02/2024
Sponsoring organization: Partnership for Quality Measurement
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Reviews the 42 pre-rulemaking quality measures the Battelle's Partnership for Quality Measurement (PQM) considered during the 2023-2024 Pre-Rulemaking Measure Review (PRMR) cycle. Discusses measures for clinician, hospital, and post-acute care/long-term care programs. Includes rural references and considerations throughout.
Date: 02/2024
Sponsoring organization: Partnership for Quality Measurement
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Medicare Ground Ambulance Data Collection System (GADCS): Rural and Super Rural Organizations Tip Sheet
Covers 6 Ground Ambulance Data Collection System (GADCS) tips and common reporting scenarios for ground ambulance organizations serving rural and super rural areas. Intended to help highlight geographic differences in costs, revenues, and services.
Date: 02/2024
Sponsoring organization: Centers for Medicare and Medicaid Services
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Covers 6 Ground Ambulance Data Collection System (GADCS) tips and common reporting scenarios for ground ambulance organizations serving rural and super rural areas. Intended to help highlight geographic differences in costs, revenues, and services.
Date: 02/2024
Sponsoring organization: Centers for Medicare and Medicaid Services
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Integrated Care for Kids (InCK) Model: Evaluation Report 2
Presents findings from the first year of the implementation of the Integrated Care for Kids (InCK) Model, which aims to improve health outcomes for Medicaid-enrolled children with complex physical and behavioral health needs. Provides an overview of the InCK Model and profiles each InCK award recipient's model, community context, approach to assessing beneficiary needs, and alternative payment model design. Identifies models serving rural areas and service gaps in these areas.
Additional links: Findings at a Glance
Date: 02/2024
Sponsoring organizations: Abt Associates, Centers for Medicare and Medicaid Services
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Presents findings from the first year of the implementation of the Integrated Care for Kids (InCK) Model, which aims to improve health outcomes for Medicaid-enrolled children with complex physical and behavioral health needs. Provides an overview of the InCK Model and profiles each InCK award recipient's model, community context, approach to assessing beneficiary needs, and alternative payment model design. Identifies models serving rural areas and service gaps in these areas.
Additional links: Findings at a Glance
Date: 02/2024
Sponsoring organizations: Abt Associates, Centers for Medicare and Medicaid Services
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Access in Brief: Adults with Intellectual Disabilities and Developmental Disabilities
Issue brief examining access to Medicaid coverage for adults with intellectual or developmental disabilities (ID/DD), using data for fiscal years 2017-2018. Compares characteristics of adult Medicaid beneficiaries with ID/DD across racial and ethnic groups and by Medicaid-only or dually eligible status. Includes a section on home and community-based services and features demographics including breakdowns by rural or urban residence.
Date: 02/2024
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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Issue brief examining access to Medicaid coverage for adults with intellectual or developmental disabilities (ID/DD), using data for fiscal years 2017-2018. Compares characteristics of adult Medicaid beneficiaries with ID/DD across racial and ethnic groups and by Medicaid-only or dually eligible status. Includes a section on home and community-based services and features demographics including breakdowns by rural or urban residence.
Date: 02/2024
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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Unrelenting Pressure Pushes Rural Safety Net Crisis Into Uncharted Territory
Examines financial and operational metrics for rural hospitals. Discusses the growth of Medicare Advantage (MA) enrollment in rural communities between 2019 and 2023, the impact of MA on rural hospital reimbursement, how the Rural Emergency Hospital (REH) designation can provide a path forward for some rural facilities, and the discontinuation of obstetrics and chemotherapy services at rural hospitals since 2011. Includes the percentage of rural hospitals in each state vulnerable to closure and nine factors significantly associated with rural hospital vulnerability.
Date: 02/2024
Sponsoring organization: Chartis Center for Rural Health
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Examines financial and operational metrics for rural hospitals. Discusses the growth of Medicare Advantage (MA) enrollment in rural communities between 2019 and 2023, the impact of MA on rural hospital reimbursement, how the Rural Emergency Hospital (REH) designation can provide a path forward for some rural facilities, and the discontinuation of obstetrics and chemotherapy services at rural hospitals since 2011. Includes the percentage of rural hospitals in each state vulnerable to closure and nine factors significantly associated with rural hospital vulnerability.
Date: 02/2024
Sponsoring organization: Chartis Center for Rural Health
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State Medicaid & CHIP Telehealth Toolkit
Toolkit to support state policymakers in expanding the use of telehealth to deliver Medicaid and Children's Health Insurance Program (CHIP) services. Provides information on telehealth flexibilities under Medicaid and CHIP; billing best practices; strategies for telehealth in value-based care; best practices from states during the COVID-19 public health emergency; strategies to promote the delivery of accessible and culturally competent care via telehealth; evaluation strategies to understand how telehealth affects quality, outcomes, and cost, and more. Offers state policy and operational considerations; information about common telehealth modalities; frequently asked questions for states to consider as they explore whether to expand the use of telehealth; Medicaid managed care and fee-for-service state checklists; and other planning tools. Includes information about using telehealth to deliver services to medically underserved and rural communities, older adults, and other specific populations.
Date: 02/2024
Sponsoring organization: Centers for Medicare and Medicaid Services
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Toolkit to support state policymakers in expanding the use of telehealth to deliver Medicaid and Children's Health Insurance Program (CHIP) services. Provides information on telehealth flexibilities under Medicaid and CHIP; billing best practices; strategies for telehealth in value-based care; best practices from states during the COVID-19 public health emergency; strategies to promote the delivery of accessible and culturally competent care via telehealth; evaluation strategies to understand how telehealth affects quality, outcomes, and cost, and more. Offers state policy and operational considerations; information about common telehealth modalities; frequently asked questions for states to consider as they explore whether to expand the use of telehealth; Medicaid managed care and fee-for-service state checklists; and other planning tools. Includes information about using telehealth to deliver services to medically underserved and rural communities, older adults, and other specific populations.
Date: 02/2024
Sponsoring organization: Centers for Medicare and Medicaid Services
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2024 Rural Advocacy Agenda
Outlines the American Hospital Association's federal policy priorities for rural hospitals in 2024. Offers recommendations in the areas of commercial insurer accountability, flexible payment options, reimbursement, workforce, and the 340B program.
Date: 02/2024
Sponsoring organization: American Hospital Association
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Outlines the American Hospital Association's federal policy priorities for rural hospitals in 2024. Offers recommendations in the areas of commercial insurer accountability, flexible payment options, reimbursement, workforce, and the 340B program.
Date: 02/2024
Sponsoring organization: American Hospital Association
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Medicare Enrollees and the Part D Drug Benefit: Improving Financial Protection through the Low- Income Subsidy
Provides an overview of the Medicare Part D Low-Income Subsidy (LIS) program, which covers some or all Part D drug costs. Presents estimates of number of Medicare Part D enrollees who received LIS in 2020 and their characteristics, as well as Medicare beneficiaries who did and did not have prescription drug coverage but who appear to be eligible for LIS based on income and resources. Compares Medicare enrollees demographic, financial, health status, and healthcare utilization characteristics, including rurality.
Author(s): Yevgeniy Feyman, Joel Ruhter, Kenneth Finegold, et al.
Date: 02/2024
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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Provides an overview of the Medicare Part D Low-Income Subsidy (LIS) program, which covers some or all Part D drug costs. Presents estimates of number of Medicare Part D enrollees who received LIS in 2020 and their characteristics, as well as Medicare beneficiaries who did and did not have prescription drug coverage but who appear to be eligible for LIS based on income and resources. Compares Medicare enrollees demographic, financial, health status, and healthcare utilization characteristics, including rurality.
Author(s): Yevgeniy Feyman, Joel Ruhter, Kenneth Finegold, et al.
Date: 02/2024
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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Rural Cancer Disparities from Oklahoma Cancer and Vital Records Registries 2016-2020
Evaluates cancer disparities in Oklahoma counties using 2016-2020 Oklahoma State Department of Health data, with breakdowns by urban, large rural, and small rural setting. Provides statistics, including population characteristics, on cancer incidence, specific cancers, mortality, and stage of diagnosis. Highlights concerns related to insurance coverage, cancer screening, and treatment in rural areas.
Author(s): Janis E. Campbell, Ayesha B. Sambo, Lauri A. Hunsucker, Stephanie F. Pharr, Mark P. Doescher
Citation: Cancer Epidemiology, 88, 102512
Date: 02/2024
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Evaluates cancer disparities in Oklahoma counties using 2016-2020 Oklahoma State Department of Health data, with breakdowns by urban, large rural, and small rural setting. Provides statistics, including population characteristics, on cancer incidence, specific cancers, mortality, and stage of diagnosis. Highlights concerns related to insurance coverage, cancer screening, and treatment in rural areas.
Author(s): Janis E. Campbell, Ayesha B. Sambo, Lauri A. Hunsucker, Stephanie F. Pharr, Mark P. Doescher
Citation: Cancer Epidemiology, 88, 102512
Date: 02/2024
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