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Resources by Topic: Health insurance

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
Type: Document
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Merit-based Incentive Payment System (MIPS) 2024 Small Practice Eligibility and Participation Frequently Asked Questions
Provides answers to frequently asked questions regarding small practice participation and eligibility for the Merit-based Incentive Payment System (MIPS) for the 2024 performance year. Covers individual and group eligibility, the low-volume threshold, changes to group composition during the performance year, and more.
Date: 03/2024
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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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
Type: Document
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Breast Cancer Screening among Medicare Advantage Enrollees with Dementia
Compares rates of mammogram screening among screening-eligible women with Alzheimer's disease and related dementias (ADRD) using 2012-2019 Medicare Current Beneficiary Survey data. Compares screening rates of Medicare Advantage and fee-for-service Medicare enrollees, with data breakdowns by race and ethnicity, rural versus urban status, and more. Identifies potential risks related to over-screening.
Author(s): Eli Raver, Wendy Y. Xu, Jean Jung, Sunmin Lee
Citation: BMC Health Services Research, 24, 283
Date: 03/2024
Type: Document
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Use of In-Network Insurance Benefits Is Critical for Improving Retention in Telehealth-Based Buprenorphine Treatment
Evaluated 3,842 patients in an opioid use disorder (OUD) telehealth company to identify associations in insurance status and treatment program retention. Patient characteristic data includes breakdown by urbanicity, age, gender, race and ethnicity, buprenorphine status, and more.
Author(s): Arthur Robin Williams, Christopher Row, Lexie Minarik, et al.
Citation: Health Affairs Scholar, 2(3)
Date: 03/2024
Type: Document
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Inflation Reduction Act Research Series: Projected Impacts for Rural Medicare Enrollees
Provides an overview of how the Inflation Reduction Act (IRA) is intended to improve prescription drug affordability for Medicare enrollees. Describes Medicare enrollment in rural areas and rural residents' health status and access to care. Outlines the projected impact of drug-related IRA provisions for rural Medicare beneficiaries, including the expansion of financial assistance through the low-income subsidy program, out-of-pocket spending caps for insulin, changes in Part D benefit design, and more.
Date: 03/2024
Type: Document
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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Catalog of Value-Based Initiatives for Rural Providers
Summarizes rural-relevant, value-based programs currently or recently implemented by the U.S. Department of Health and Human Services (HHS), including the Centers for Medicare and Medicaid Services (CMS) and the CMS Innovation Center. Designed to help rural healthcare leaders identify HHS value-based programs that are suitable for rural participation. Contains descriptions of each demonstration and provides direct links to the corresponding agency web page.
Date: 03/2024
Type: Document
Sponsoring organization: Rural Health Value
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Rural Health Research Recap: Post-Acute Care in Rural Areas: The Role of Swing Beds and Nursing Homes
Offers statistics on availability of post-acute care in rural areas through skilled nursing facilities, home health agencies, hospice, inpatient rehabilitation facilities, and swing beds. Includes sections on prospective payment system and cost-based reimbursement, and provides statistics on the proportion of nursing home closures in metropolitan and nonmetropolitan areas from 2008-2018.
Author(s): Per Ostmo
Date: 03/2024
Type: Document
Sponsoring organization: Rural Health Research Gateway
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Merit-Based Incentive Payment System (MIPS): 2024 Improvement Activities Performance Category Quick Start Guide
Provides an overview of Merit-based Incentive Payment System (MIPS) requirements, data collection, and data submission for the improvement activities performance category for the 2024 performance year. Includes information about special status scoring for small practices and clinicians located in a rural or Health Professional Shortage Area.
Date: 03/2024
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Merit-Based Incentive Payment System (MIPS): 2023 Opt-in and Voluntary Reporting Election Process Guide
Discusses the eligibility of clinicians, groups, and Alternative Payment Model (APM) participants that exceed some low-volume threshold criteria to opt-in to the Merit-Based Incentive Payment System (MIPS) and the APM Performance Pathway (APP) for the 2023 performance period. Compares opting in and voluntarily reporting MIPS data and provides an overview of the election process.
Date: 03/2024
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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