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Resources by Topic: Health insurance

Hospital Outpatient Prospective Payment System (OPPS): Remedy for the 340B-Acquired Drug Payment Policy for Calendar Years 2018-2022 Final Rule (CMS 1793-F)
Fact sheet providing an overview of the Centers for Medicare & Medicaid Services (CMS) final rule describing the agency's actions to remedy payment cuts to certain hospitals that participate in the 340B Drug Pricing Program from 2018-2022 that were declared unlawful by the Supreme Court's decision in American Hospital Association v. Becerra, 142 S. Ct. 1896 (2022). Details the one-time lump sum payments to affected 340B covered entities to what they would have been paid had the 340B payment cuts not been applied, as well as a 0.5% payment reduction on future non-drug item and service payments to maintain budget neutrality beginning in calendar year 2026.
Date: 11/2023
Sponsoring organization: Centers for Medicare & Medicaid Services
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MBQIP Quality Measures National Annual Report - 2022
Summarizes quality measure reporting rates and performance among Critical Access Hospitals (CAHs) in 2022. Presents data on the four Medicare Beneficiary Quality Improvement Project (MBQIP) domains: patient safety/inpatient, outpatient, patient engagement, and care transitions.
Author(s): Megan Lahr, Alyssa Furukawa, Madeleine Pick, Robert Barclay
Date: 10/2023
Sponsoring organization: Flex Monitoring Team
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Rural Health Policy for the Next Decade: Changes are Upon Us
Presentation slides that discuss the future of rural health policy, with a focus on the comprehensive community wealth approach, healthcare modalities and sites of care, and healthcare payment models, including Medicare Advantage.
Author(s): Keith J. Mueller
Date: 10/2023
Sponsoring organizations: Iowa College of Public Health, Rural Policy Research Institute
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Medicare: Performance-Based and Geographic Adjustments to Physician Payments
Statement to the U.S. House of Representatives Committee on Energy and Commerce, Subcommittee on Health, summarizing the Government Accountability Organization's (GAO) 2021 reports on the Quality Payment Program and the two tracks it established to incentivize Medicare providers and its 2022 report on geographic adjustments to physician payments. Includes information on the participation of providers in rural and underserved areas in Advanced Alternative Payment Models (APMs) and the challenges these providers face in transitioning to APMs.
Additional links: Full Report
Date: 10/2023
Sponsoring organization: Government Accountability Office
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October 2023 MedPAC Meeting Transcript
Transcript from the Medicare Payment Advisory Commission's (MedPAC) October 2023 meeting. Covers updates to Medicare payment rates for clinician services, staffing ratios and turnover rates in nursing facilities, an alternative method to establish Medicare payments for select conditions treated in inpatient rehabilitation facilities, and a work plan relating to generic drug prices under Medicare Part D. Includes rural references and considerations throughout.
Date: 10/2023
Sponsoring organization: Medicare Payment Advisory Commission
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Telehealth and the Future of Health Care Access in California
Fact sheet offering an overview of telehealth use in California in 2022. Discusses patterns of use by insurance status, age, income, race and ethnicity, language, and geography including rurality.
Additional links: Infographic
Author(s): Sean Tan
Date: 10/2023
Sponsoring organization: UCLA Center for Health Policy Research
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CMS Native American Contacts
Features Centers for Medicare and Medicaid Services contacts for personnel in the Division of Tribal Affairs and the contacts responsible for the different Indian Health Services areas.
Date: 10/2023
Sponsoring organization: Centers for Medicare & Medicaid Services
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Findings from the National Agricultural Workers Survey (NAWS) 2021-2022: A Demographic and Employment Profile of United States Crop Workers
Reports on demographic and employment characteristics of hired agricultural workers in the United States. Includes data on health insurance and healthcare access, as well as information on social determinants of health such as income, education level, language skills, housing, and digital device access. Based on data collected from face-to-face interviews with 2,598 crop farmworkers conducted between September 29, 2020 and October 1, 2022.
Date: 09/2023
Sponsoring organization: U.S. Department of Labor
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Sociodemographic Inequities in Telemedicine Use Among US Patients Initiating Treatment in Community Cancer Centers During the Ongoing COVID-19 Pandemic, 2020-2022
Evaluates demographic factors associated with use of telehealth within 90 days after starting cancer treatment during the COVID-19 pandemic, utilizing March 2020-March 2023 data of 36,993 cancer patients. Includes data on telehealth inequities by race and ethnicity, insurance, socioeconomic status, rurality, and more.
Author(s): Jenny S. Guadamuz, Xiaoliang Wang, Trevor J. Royce, Gregory S. Calip
Citation: JCO Oncology Practice, 19(12), 1206-1214
Date: 09/2023
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Environmental Scan on Encouraging Rural Participation in Population-Based TCOC Models
Presents results of an environmental scan regarding population-based total cost of care (PB-TCOC) payment models and encouraging rural participation in these models. Describes challenges affecting rural patients and providers; opportunities for alternative payment models (APMs) and PB-TCOC models to address challenges in rural areas; trends in rural providers' participation in APMs; driving care delivery transformation in rural providers, including models that include or target rural participants in their model designs; leveraging financial incentives to improve rural health care; adoption and use of health information technology, including telehealth and data analytics among rural providers; and the measurement of rural providers' performance in APMs.
Date: 09/2023
Sponsoring organizations: HHS Office of the Assistant Secretary for Planning and Evaluation, NORC at the University of Chicago
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