Rural Health
Resources by Topic: Health insurance
Certified Community Behavioral Health Clinics Demonstration Program: Report to Congress, 2023
Provides an overview of the Certified Community Behavioral Health Clinic (CCBHC) demonstration. Describes changes in the quality of care during the first four years of the demonstration for states with available quality measures, as well as quality bonus payments states made to CCBHCs based on quality measure performance. Builds on findings on demonstration implementation, quality improvement, and costs outlined in previous evaluation reports, focusing on data collected since spring 2022.
Date: 07/2024
Type: Document
Sponsoring organizations: HHS Office of the Assistant Secretary for Planning and Evaluation, Mathematica, RAND Corporation
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Provides an overview of the Certified Community Behavioral Health Clinic (CCBHC) demonstration. Describes changes in the quality of care during the first four years of the demonstration for states with available quality measures, as well as quality bonus payments states made to CCBHCs based on quality measure performance. Builds on findings on demonstration implementation, quality improvement, and costs outlined in previous evaluation reports, focusing on data collected since spring 2022.
Date: 07/2024
Type: Document
Sponsoring organizations: HHS Office of the Assistant Secretary for Planning and Evaluation, Mathematica, RAND Corporation
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Disability and Independence in Rural America: White Paper
Provides an overview of disability and independence in rural America. Describes disability prevalence in rural areas and U.S. Department of Health and Human Services (HHS) programs for people with disabilities. Outlines key considerations for rural disability services, including access, Medicaid and Medicare coverage, workforce, and telehealth and technology. Highlights themes that emerged during the September 2023 National Advisory Committee on Rural Health and Human Service (NACRHHS) meeting regarding areas for disability and independence policy improvement. Appendix A summarizes NACRHHS subcommittee site visits of two organizations serving rural Colorado residents.
Date: 07/2024
Type: Document
Sponsoring organization: National Advisory Committee on Rural Health and Human Services
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Provides an overview of disability and independence in rural America. Describes disability prevalence in rural areas and U.S. Department of Health and Human Services (HHS) programs for people with disabilities. Outlines key considerations for rural disability services, including access, Medicaid and Medicare coverage, workforce, and telehealth and technology. Highlights themes that emerged during the September 2023 National Advisory Committee on Rural Health and Human Service (NACRHHS) meeting regarding areas for disability and independence policy improvement. Appendix A summarizes NACRHHS subcommittee site visits of two organizations serving rural Colorado residents.
Date: 07/2024
Type: Document
Sponsoring organization: National Advisory Committee on Rural Health and Human Services
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Variation in Dentist Participation Between Dental Medicaid Managed Care Organizations
Examines the variation in Medicaid managed care organization (MCO) participation among private practice dentists in Iowa. Describes factors associated with Medicaid MCO participation, including dentists' personal and practice characteristics, including practice type, rural or urban location, and dental Health Professional Shortage Area (HPSA) designation.
Author(s): Pamela C. Nwachukwu, Peter C. Damiano, Steven Levy, et al.
Citation: Journal of Public Health Dentistry,
Date: 07/2024
Type: Document
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Examines the variation in Medicaid managed care organization (MCO) participation among private practice dentists in Iowa. Describes factors associated with Medicaid MCO participation, including dentists' personal and practice characteristics, including practice type, rural or urban location, and dental Health Professional Shortage Area (HPSA) designation.
Author(s): Pamela C. Nwachukwu, Peter C. Damiano, Steven Levy, et al.
Citation: Journal of Public Health Dentistry,
Date: 07/2024
Type: Document
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The Low-Volume Hospital Adjustment Before and During COVID-19
Describes characteristics of rural low-volume hospitals (LVHs) between April 2018 and March 2022. Compares the characteristics and profitability of rural LVHs with other rural prospective payment system (PPS) hospitals before and during the COVID-19 pandemic. Presents data on LVH profitability margins with and without the LVH payment adjustment.
Author(s): Emmaline Keesee, Susie Gurzenda, Kristie Thompson, George Pink
Date: 07/2024
Type: Document
Sponsoring organization: North Carolina Rural Health Research Program
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Describes characteristics of rural low-volume hospitals (LVHs) between April 2018 and March 2022. Compares the characteristics and profitability of rural LVHs with other rural prospective payment system (PPS) hospitals before and during the COVID-19 pandemic. Presents data on LVH profitability margins with and without the LVH payment adjustment.
Author(s): Emmaline Keesee, Susie Gurzenda, Kristie Thompson, George Pink
Date: 07/2024
Type: Document
Sponsoring organization: North Carolina Rural Health Research Program
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Medicare Advantage Enrollees Account for a Rising Share of Inpatient Hospital Days
Describes the growth of Medicare Advantage (MA) as a share of hospital inpatient days between 2015 and 2022. Presents data from hospital cost reports submitted to the Centers for Medicare & Medicaid (CMS) regarding the share of inpatient days attributable to MA compared to traditional Medicare, the percentage of hospitals with more inpatient days from Medicare Advantage than traditional Medicare, and the variation across hospitals within counties. Compares trends in the share of inpatient days for MA enrollees across rural, micropolitan, and metropolitan hospitals.
Author(s): Jamie Godwin, Jeannie Fuglesten Biniek, Zachary Levinson, Tricia Neuman
Date: 07/2024
Type: Document
Sponsoring organization: KFF
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Describes the growth of Medicare Advantage (MA) as a share of hospital inpatient days between 2015 and 2022. Presents data from hospital cost reports submitted to the Centers for Medicare & Medicaid (CMS) regarding the share of inpatient days attributable to MA compared to traditional Medicare, the percentage of hospitals with more inpatient days from Medicare Advantage than traditional Medicare, and the variation across hospitals within counties. Compares trends in the share of inpatient days for MA enrollees across rural, micropolitan, and metropolitan hospitals.
Author(s): Jamie Godwin, Jeannie Fuglesten Biniek, Zachary Levinson, Tricia Neuman
Date: 07/2024
Type: Document
Sponsoring organization: KFF
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Proposed CY 2025 Medicare Physician Fee Schedule: Fact Sheet
Fact sheet covering proposed Centers for Medicare & Medicaid Services (CMS) telehealth policy changes for 2025 as outlined in the calendar year (CY) 2025 Physician Fee Schedule proposed rule. Covers proposals related to audio-only telehealth; eligible services that can be delivered by telehealth; frequency limitations for inpatient visits, nursing facilities, and critical care consults; direct supervision through the use of live video; payment to Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs); opioid treatment programs; and more.
Date: 07/2024
Type: Document
Sponsoring organization: Center for Connected Health Policy: The National Telehealth Policy Resource Center
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Fact sheet covering proposed Centers for Medicare & Medicaid Services (CMS) telehealth policy changes for 2025 as outlined in the calendar year (CY) 2025 Physician Fee Schedule proposed rule. Covers proposals related to audio-only telehealth; eligible services that can be delivered by telehealth; frequency limitations for inpatient visits, nursing facilities, and critical care consults; direct supervision through the use of live video; payment to Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs); opioid treatment programs; and more.
Date: 07/2024
Type: Document
Sponsoring organization: Center for Connected Health Policy: The National Telehealth Policy Resource Center
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MedPAC Data Book: Health Care Spending and the Medicare Program, 2024
Provides an overview of Medicare spending and highlights data on Medicare beneficiary demographics, dual-eligible beneficiaries, quality of care provided through the Medicare program, and other payer liability. Examines settings of care, including rural-specific provider sites, as they relate to spending, access to care, and profit margins. Compares rural and urban beneficiaries and providers throughout. Chart 6-2 addresses rural hospital closures.
Date: 07/2024
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Provides an overview of Medicare spending and highlights data on Medicare beneficiary demographics, dual-eligible beneficiaries, quality of care provided through the Medicare program, and other payer liability. Examines settings of care, including rural-specific provider sites, as they relate to spending, access to care, and profit margins. Compares rural and urban beneficiaries and providers throughout. Chart 6-2 addresses rural hospital closures.
Date: 07/2024
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Positioning Telehealth Policy to Ensure High-Quality, Cost-Effective Care
Presents policy recommendations and suggestions to guide policymakers when considering the future of telehealth. Analyzes peer-reviewed research; government reports; and findings from interviews with payers, providers, provider associations, federal agencies, consumer advocates, technology leaders, policy experts, and other stakeholders. Includes rural references and considerations throughout.
Author(s): Maya Sandalow, Julia Harris, Mikayla Curtis, Marilyn Werber Serafini
Date: 07/2024
Type: Document
Sponsoring organization: Bipartisan Policy Center
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Presents policy recommendations and suggestions to guide policymakers when considering the future of telehealth. Analyzes peer-reviewed research; government reports; and findings from interviews with payers, providers, provider associations, federal agencies, consumer advocates, technology leaders, policy experts, and other stakeholders. Includes rural references and considerations throughout.
Author(s): Maya Sandalow, Julia Harris, Mikayla Curtis, Marilyn Werber Serafini
Date: 07/2024
Type: Document
Sponsoring organization: Bipartisan Policy Center
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How Payment Caps Can Reduce Hospital Prices and Spending: Lessons from the Oregon State Employee Plan
Report discusses how policy changes to state employee insurance plans affected healthcare costs in Oregon. Details Oregon's plan to place payment caps tied to Medicare reimbursement rates and exceptions for rural and Critical Access Hospitals.
Author(s): Roslyn C. Murray, Christopher M. Whaley, Erin C. Fuse Brown, Andrew M. Ryan
Date: 07/2024
Type: Document
Sponsoring organization: Milbank Memorial Fund
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Report discusses how policy changes to state employee insurance plans affected healthcare costs in Oregon. Details Oregon's plan to place payment caps tied to Medicare reimbursement rates and exceptions for rural and Critical Access Hospitals.
Author(s): Roslyn C. Murray, Christopher M. Whaley, Erin C. Fuse Brown, Andrew M. Ryan
Date: 07/2024
Type: Document
Sponsoring organization: Milbank Memorial Fund
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CY 2025 Medicare Hospital Outpatient Prospective Payment System and Ambulatory Surgical Center Payment System Proposed Rule (CMS 1809-P)
Fact sheet providing an overview of the Centers for Medicare & Medicaid Services (CMS) proposed rule regarding updates and changes to the Medicare payments for hospital outpatient and Ambulatory Surgical Center (ASC) services for calendar year 2025. Summarizes provisions regarding changes to Intensive Outpatient Program (IOP) and partial hospital program rate setting; a proposal to include an add-on payment to the Medicare outpatient hospital all-inclusive rate (AIR) for certain high-cost drugs for people with Medicare who receive care at Indian Health Service (IHS) or tribal hospitals; updates to the Hospital Outpatient Quality Reporting (OQR), Ambulatory Surgical Center Quality Reporting (ASCQR), and Rural Emergency Hospital Quality Reporting (REHQR) Programs; a proposal for new Conditions of Participation (CoPs) for hospitals and Critical Access Hospitals (CAHs) for obstetrical services; Medicaid and CHIP continuous eligibility; Medicaid clinic services "four walls" exceptions; and more.
Date: 07/2024
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Fact sheet providing an overview of the Centers for Medicare & Medicaid Services (CMS) proposed rule regarding updates and changes to the Medicare payments for hospital outpatient and Ambulatory Surgical Center (ASC) services for calendar year 2025. Summarizes provisions regarding changes to Intensive Outpatient Program (IOP) and partial hospital program rate setting; a proposal to include an add-on payment to the Medicare outpatient hospital all-inclusive rate (AIR) for certain high-cost drugs for people with Medicare who receive care at Indian Health Service (IHS) or tribal hospitals; updates to the Hospital Outpatient Quality Reporting (OQR), Ambulatory Surgical Center Quality Reporting (ASCQR), and Rural Emergency Hospital Quality Reporting (REHQR) Programs; a proposal for new Conditions of Participation (CoPs) for hospitals and Critical Access Hospitals (CAHs) for obstetrical services; Medicaid and CHIP continuous eligibility; Medicaid clinic services "four walls" exceptions; and more.
Date: 07/2024
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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