Rural Health
Resources by Topic: Health insurance
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
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
Sponsoring organization: Government Accountability Office
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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
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
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.
Author(s): James McSpadden, Sari Siegel
Date: 05/2023
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.
Author(s): James McSpadden, Sari Siegel
Date: 05/2023
Sponsoring organization: AARP Public Policy Institute
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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
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
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
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
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
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
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
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
Sponsoring organization: Congressional Research Service
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Medicaid: Characteristics of and Expenditures for Adults with Intellectual or Developmental Disabilities
Describes the health and demographic characteristics of adults with intellectual or developmental disabilities (I/DD) enrolled in Medicaid home- and community-based programs in 2019 in six states: Colorado, Florida, Georgia, Indiana, Oklahoma, and South Dakota. Examines average per-beneficiary healthcare expenditures for I/DD beneficiaries in these states. Highlights the percentage of I/DD beneficiaries in rural areas of each state.
Additional links: Full Report
Date: 04/2023
Sponsoring organization: Government Accountability Office
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Describes the health and demographic characteristics of adults with intellectual or developmental disabilities (I/DD) enrolled in Medicaid home- and community-based programs in 2019 in six states: Colorado, Florida, Georgia, Indiana, Oklahoma, and South Dakota. Examines average per-beneficiary healthcare expenditures for I/DD beneficiaries in these states. Highlights the percentage of I/DD beneficiaries in rural areas of each state.
Additional links: Full Report
Date: 04/2023
Sponsoring organization: Government Accountability Office
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April 2023 MACPAC Meeting Transcript
Transcript from the Medicaid and CHIP Payment and Access Commission's (MACPAC) April 2023 meeting. Covers automatic adjustments to Disproportionate Share Hospital (DSH) allotments, DSH third-party payer policy, integrating care for dually eligible beneficiaries, access to Medicaid coverage and care for adults leaving incarceration, adult access to covered dental benefits, access to home- and community-based services, and an update on the COVID-19 public health emergency (PHE) unwinding. Includes rural references and considerations throughout.
Date: 04/2023
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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Transcript from the Medicaid and CHIP Payment and Access Commission's (MACPAC) April 2023 meeting. Covers automatic adjustments to Disproportionate Share Hospital (DSH) allotments, DSH third-party payer policy, integrating care for dually eligible beneficiaries, access to Medicaid coverage and care for adults leaving incarceration, adult access to covered dental benefits, access to home- and community-based services, and an update on the COVID-19 public health emergency (PHE) unwinding. Includes rural references and considerations throughout.
Date: 04/2023
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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April 2023 MedPAC Meeting Transcript
Transcript from the Medicare Payment Advisory Commission's (MedPAC) April 2023 meeting. Covers high prices of drugs covered under Medicare Part B, draft recommendations for reforming Medicare's wage index systems, aligning fee-for-service payment rates across ambulatory settings, leveraging Medicare policies to address social determinants of health, assessing post-sale rebates for prescription drugs in Medicare Part D, and assessing the need for Medicare safety net payments for skilled nursing facilities and home health agencies. Features discussions on draft reports regarding a prototype design for a post-acute care prospective payment system, telehealth in Medicare, and behavioral health in Medicare. Includes rural references throughout.
Date: 04/2023
Sponsoring organization: Medicare Payment Advisory Commission
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Transcript from the Medicare Payment Advisory Commission's (MedPAC) April 2023 meeting. Covers high prices of drugs covered under Medicare Part B, draft recommendations for reforming Medicare's wage index systems, aligning fee-for-service payment rates across ambulatory settings, leveraging Medicare policies to address social determinants of health, assessing post-sale rebates for prescription drugs in Medicare Part D, and assessing the need for Medicare safety net payments for skilled nursing facilities and home health agencies. Features discussions on draft reports regarding a prototype design for a post-acute care prospective payment system, telehealth in Medicare, and behavioral health in Medicare. Includes rural references throughout.
Date: 04/2023
Sponsoring organization: Medicare Payment Advisory Commission
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