Rural Health
Resources by Topic: Health insurance
How Regional Partnerships Bolster Rural Hospitals
Explores how Critical Access Hospitals (CAHs) and other rural providers partner to overcome challenges. Profiles six regional partnerships that address staffing, quality improvement, contracts with payers, value-based payment, and community development. Offers lessons learned that could inform policy changes to strengthen rural providers.
Author(s): Martha Hostetter, Sarah Klein
Date: 05/2023
Type: Document
Sponsoring organization: Commonwealth Fund
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Explores how Critical Access Hospitals (CAHs) and other rural providers partner to overcome challenges. Profiles six regional partnerships that address staffing, quality improvement, contracts with payers, value-based payment, and community development. Offers lessons learned that could inform policy changes to strengthen rural providers.
Author(s): Martha Hostetter, Sarah Klein
Date: 05/2023
Type: Document
Sponsoring organization: Commonwealth Fund
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340B Drug Discount Program: Information about Hospitals That Received an Eligibility Exception as a Result of COVID-19
Provides an overview of a provision of the Consolidated Appropriations Act, 2022, that allowed hospitals to request an exception to the disproportionate share hospital (DSH) percentage eligibility requirement if they were unable to meet it due to the COVID-19 pandemic. Explores the exception process and provides information on hospitals that received the exception. Discusses the amount of 340B drug purchases and discounts that excepted hospitals indicated they had in 2020 and 2021; the extent to which excepted hospitals indicated providing discounts on 340B drugs to low-income, uninsured patients; and results of the Health Resources and Services Administration's audits and oversight activities to assess program compliance.
Additional links: Full Report
Date: 05/2023
Type: Document
Sponsoring organization: Government Accountability Office
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Provides an overview of a provision of the Consolidated Appropriations Act, 2022, that allowed hospitals to request an exception to the disproportionate share hospital (DSH) percentage eligibility requirement if they were unable to meet it due to the COVID-19 pandemic. Explores the exception process and provides information on hospitals that received the exception. Discusses the amount of 340B drug purchases and discounts that excepted hospitals indicated they had in 2020 and 2021; the extent to which excepted hospitals indicated providing discounts on 340B drugs to low-income, uninsured patients; and results of the Health Resources and Services Administration's audits and oversight activities to assess program compliance.
Additional links: Full Report
Date: 05/2023
Type: Document
Sponsoring organization: Government Accountability Office
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Evaluation of the Home Health Value-Based Purchasing (HHVBP) Model: Sixth Annual Report
Evaluates the Home Health Value-Based Purchasing (HHVBP) Model, which tests the impact of providing financial incentives to home health agencies in nine states: Arizona, Florida, Iowa, Massachusetts, Maryland, Nebraska, North Carolina, Tennessee, and Washington. Reports on the experiences of home health agencies and patients through 2021, the sixth performance year of the HHVBP Model, and the fourth and final year that agencies in the nine original HHVBP states received a payment adjustment. Examines the impacts of the HHVBP Model on Medicare expenditures, healthcare utilization, quality of care and patient experience, and agency operations. Includes data on rural HHVBP beneficiaries.
Additional links: Findings at a Glance, Technical Appendices
Author(s): Alyssa Pozniak, Marc Turenne, Eric Lammers, et al.
Date: 05/2023
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Evaluates the Home Health Value-Based Purchasing (HHVBP) Model, which tests the impact of providing financial incentives to home health agencies in nine states: Arizona, Florida, Iowa, Massachusetts, Maryland, Nebraska, North Carolina, Tennessee, and Washington. Reports on the experiences of home health agencies and patients through 2021, the sixth performance year of the HHVBP Model, and the fourth and final year that agencies in the nine original HHVBP states received a payment adjustment. Examines the impacts of the HHVBP Model on Medicare expenditures, healthcare utilization, quality of care and patient experience, and agency operations. Includes data on rural HHVBP beneficiaries.
Additional links: Findings at a Glance, Technical Appendices
Author(s): Alyssa Pozniak, Marc Turenne, Eric Lammers, et al.
Date: 05/2023
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Barriers to Mental Health Care: Improving Provider Directory Accuracy to Reduce the Prevalence of Ghost Networks
Recording of a May 3, 2023, hearing of the U.S. Senate Committee on Finance regarding inaccurate healthcare provider directories that impede access to mental healthcare. Features testimony from Robert L. Trestman, Professor and Chair of Behavioral Medicine at the Carilion Clinic and Virginia Tech Carilion School of Medicine, on access to care in rural Virginia.
Additional links: Robert L. Trestman, American Psychiatric Association - Testimony
Date: 05/2023
Type: Document
Sponsoring organization: Senate Committee on Finance
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Recording of a May 3, 2023, hearing of the U.S. Senate Committee on Finance regarding inaccurate healthcare provider directories that impede access to mental healthcare. Features testimony from Robert L. Trestman, Professor and Chair of Behavioral Medicine at the Carilion Clinic and Virginia Tech Carilion School of Medicine, on access to care in rural Virginia.
Additional links: Robert L. Trestman, American Psychiatric Association - Testimony
Date: 05/2023
Type: Document
Sponsoring organization: Senate Committee on Finance
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Medicaid in Midlife: A Profile of Enrollees Ages 50 to 64
Provides an overview of Medicaid eligibility requirements for adults aged 50-64. Presents data on demographic characteristics of Medicaid beneficiaries in this age group, including race and ethnicity, gender, age, geography, and disability.
Author(s): James McSpadden, Sari Siegel
Date: 05/2023
Type: Document
Sponsoring organization: AARP Public Policy Institute
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Provides an overview of Medicaid eligibility requirements for adults aged 50-64. Presents data on demographic characteristics of Medicaid beneficiaries in this age group, including race and ethnicity, gender, age, geography, and disability.
Author(s): James McSpadden, Sari Siegel
Date: 05/2023
Type: Document
Sponsoring organization: AARP Public Policy Institute
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Guidance for the Expiration of the COVID-19 Public Health Emergency (PHE)
Outlines the emergency waivers related to the minimum health and safety requirements for long-term care and acute continuing care providers that are expiring at the end of the COVID-19 public health emergency (PHE). Describes the timelines for certain regulatory requirements issued during the PHE through interim final rules.
Date: 05/2023
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Outlines the emergency waivers related to the minimum health and safety requirements for long-term care and acute continuing care providers that are expiring at the end of the COVID-19 public health emergency (PHE). Describes the timelines for certain regulatory requirements issued during the PHE through interim final rules.
Date: 05/2023
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Access to Maternity Providers: Midwives and Birth Centers
Provides an overview of the role of certified nurse-midwives and birth centers in Medicaid and how beneficiaries use these services. Describes policy issues and barriers to expanding access to midwives and birth centers, including payment policies; contracting with managed care organizations; licensure, certification, and accreditation; scope of practice; and limited supply. Includes rural considerations throughout.
Date: 05/2023
Type: Document
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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Provides an overview of the role of certified nurse-midwives and birth centers in Medicaid and how beneficiaries use these services. Describes policy issues and barriers to expanding access to midwives and birth centers, including payment policies; contracting with managed care organizations; licensure, certification, and accreditation; scope of practice; and limited supply. Includes rural considerations throughout.
Date: 05/2023
Type: Document
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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Frequently Asked Questions: CMS Waivers, Flexibilities, and the End of the COVID-19 Public Health Emergency
Provides information related to COVID-19 flexibilities after the end of the COVID-19 public health emergency (PHE) that expired May 11, 2023. Addresses issues impacting Medicare, Medicaid, the Children's Health Insurance Program (CHIP), and private insurance including concerns related to COVID-19 vaccines and treatment, telehealth, and more. Includes information about which changes have ended, as well as end dates for those that extend after the PHE.
Date: 05/2023
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Provides information related to COVID-19 flexibilities after the end of the COVID-19 public health emergency (PHE) that expired May 11, 2023. Addresses issues impacting Medicare, Medicaid, the Children's Health Insurance Program (CHIP), and private insurance including concerns related to COVID-19 vaccines and treatment, telehealth, and more. Includes information about which changes have ended, as well as end dates for those that extend after the PHE.
Date: 05/2023
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Evaluation of the Maternal Opioid Misuse (MOM) Model Second Annual Report (Implementation Year 1)
Provides an overview of the Maternal Opioid Misuse Model, which provides evidence-based integrated care and care coordination for pregnant and postpartum Medicaid beneficiaries with opioid use disorder (OUD). Describes activities MOM Model awardees undertook during the MOM Model's first implementation year, July 1, 2021–June 30, 2022. Discusses barriers pregnant and postpartum people with OUD face in accessing high-quality, continuous care, specifically in rural areas.
Additional links: Findings at a Glance
Date: 04/2023
Type: Document
Sponsoring organizations: Centers for Medicare and Medicaid Services, Insight Policy Research
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Provides an overview of the Maternal Opioid Misuse Model, which provides evidence-based integrated care and care coordination for pregnant and postpartum Medicaid beneficiaries with opioid use disorder (OUD). Describes activities MOM Model awardees undertook during the MOM Model's first implementation year, July 1, 2021–June 30, 2022. Discusses barriers pregnant and postpartum people with OUD face in accessing high-quality, continuous care, specifically in rural areas.
Additional links: Findings at a Glance
Date: 04/2023
Type: Document
Sponsoring organizations: Centers for Medicare and Medicaid Services, Insight Policy Research
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Closed, Converted, Merged, and New Hospitals with Medicare Rural Designations: January 2018-November 2022
Provides an overview of four Medicare rural hospital designations - Critical Access Hospital, Low-Volume Hospital, Medicare Dependent Hospital, and Sole Community Hospital - and factors related to financial distress that these designations are intended to address. Explores the number of rural-designated hospitals that have closed, merged, converted, or opened between January 2018-November 2022 and compares the number of rural-designated hospitals with the number of non-designated hospitals. Outlines considerations for Congress regarding policy options for rural hospitals and access to healthcare services in rural areas.
Date: 04/2023
Type: Document
Sponsoring organization: Congressional Research Service
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Provides an overview of four Medicare rural hospital designations - Critical Access Hospital, Low-Volume Hospital, Medicare Dependent Hospital, and Sole Community Hospital - and factors related to financial distress that these designations are intended to address. Explores the number of rural-designated hospitals that have closed, merged, converted, or opened between January 2018-November 2022 and compares the number of rural-designated hospitals with the number of non-designated hospitals. Outlines considerations for Congress regarding policy options for rural hospitals and access to healthcare services in rural areas.
Date: 04/2023
Type: Document
Sponsoring organization: Congressional Research Service
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