Rural Health
Resources by Topic: Health insurance
Medicare Program: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems and Quality Reporting Programs; Organ Acquisition; Rural Emergency Hospitals: Payment Policies, Conditions of Participation, Provider Enrollment, Physician Self-Referral; New Service Category for Hospital Outpatient Department Prior Authorization Process; Overall Hospital Quality Star Rating; COVID-19
Establishes the Rural Emergency Hospital (REH) provider type. Outlines REH payment policy, Conditions of Participation (CoPs), quality measures, and enrollment policy. Outlines changes to the Critical Access Hospitals (CAH) CoPs regarding location and distance requirements, patient's rights requirements, and flexibilities for CAHs that are part of a larger health system. Among other things, this rule also revises the Medicare Hospital Outpatient Prospective Payment System (OPPS) and Medicare Ambulatory Surgical Center (ACS) payment system for calendar year 2023 and finalizes provisions included in the COVID-19 interim final rules.
Additional links: Fact Sheet
Date: 11/2022
Sponsoring organization: Centers for Medicare and Medicaid Services
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Establishes the Rural Emergency Hospital (REH) provider type. Outlines REH payment policy, Conditions of Participation (CoPs), quality measures, and enrollment policy. Outlines changes to the Critical Access Hospitals (CAH) CoPs regarding location and distance requirements, patient's rights requirements, and flexibilities for CAHs that are part of a larger health system. Among other things, this rule also revises the Medicare Hospital Outpatient Prospective Payment System (OPPS) and Medicare Ambulatory Surgical Center (ACS) payment system for calendar year 2023 and finalizes provisions included in the COVID-19 interim final rules.
Additional links: Fact Sheet
Date: 11/2022
Sponsoring organization: Centers for Medicare and Medicaid Services
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CY 2023 Medicare Hospital Outpatient Prospective Payment System and Ambulatory Surgical Center Payment System Final Rule (CMS 1772-FC) Rural Emergency Hospitals — New Medicare Provider Type
Provides an overview of Rural Emergency Hospitals, a Medicare provider type established by the Consolidated Appropriations Act, 2021. Details key policies outlined in the Calendar Year 2023 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System Final Rule, including payment policies, conditions of participation, REH provider enrollment, and exceptions to the physician self-referral law.
Date: 11/2022
Sponsoring organization: Centers for Medicare and Medicaid Services
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Provides an overview of Rural Emergency Hospitals, a Medicare provider type established by the Consolidated Appropriations Act, 2021. Details key policies outlined in the Calendar Year 2023 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System Final Rule, including payment policies, conditions of participation, REH provider enrollment, and exceptions to the physician self-referral law.
Date: 11/2022
Sponsoring organization: Centers for Medicare and Medicaid Services
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Financial Characteristics of Critical Access Hospitals (CAHs) Participating in Accountable Care Organizations (ACO)
Examines Critical Access Hospital (CAH) participation in Medicare and non-Medicare Accountable Care Organizations (ACOs) in 2019. Compares the organizational and financial characteristics of CAHs across facilities that participate in ACOs and those that do not participate in an ACO. Includes data on profitability, liquidity, outpatient revenue, and Medicare payer mix.
Author(s): Angelina Budko, George Pink, Susie Gurzenda, Ann Howard, Kristin L. Reiter
Date: 11/2022
Sponsoring organization: Flex Monitoring Team
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Examines Critical Access Hospital (CAH) participation in Medicare and non-Medicare Accountable Care Organizations (ACOs) in 2019. Compares the organizational and financial characteristics of CAHs across facilities that participate in ACOs and those that do not participate in an ACO. Includes data on profitability, liquidity, outpatient revenue, and Medicare payer mix.
Author(s): Angelina Budko, George Pink, Susie Gurzenda, Ann Howard, Kristin L. Reiter
Date: 11/2022
Sponsoring organization: Flex Monitoring Team
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Virtual Communication Services in Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs)
Provides information for Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs) regarding billing and payment for virtual communication services as established in the 2019 Physician Fee Schedule Final Rule.
Date: 11/2022
Sponsoring organization: Centers for Medicare and Medicaid Services
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Provides information for Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs) regarding billing and payment for virtual communication services as established in the 2019 Physician Fee Schedule Final Rule.
Date: 11/2022
Sponsoring organization: Centers for Medicare and Medicaid Services
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2022 Georgia State of the State: Maternal and Infant Health Report
Summarizes data and evidence regarding maternal and infant health indicators in Georgia. Offers recommendations for further improving the health of mothers and babies. Includes statistics related to fetal, infant, and maternal health in Georgia with breakdowns by demographics and rural or nonrural locations.
Date: 10/2022
Sponsoring organization: Healthy Mothers, Healthy Babies Coalition of Georgia
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Summarizes data and evidence regarding maternal and infant health indicators in Georgia. Offers recommendations for further improving the health of mothers and babies. Includes statistics related to fetal, infant, and maternal health in Georgia with breakdowns by demographics and rural or nonrural locations.
Date: 10/2022
Sponsoring organization: Healthy Mothers, Healthy Babies Coalition of Georgia
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October 2022 MACPAC Meeting Transcript
Transcript from the Medicaid and CHIP Payment and Access Commission's (MACPAC) October 2022 meeting. Covers Medicaid race and ethnicity data collection and reporting, improving access to Medicaid coverage and care for adults leaving incarceration, the unwinding of the Public Health Emergency, streamlining the delivery of home- and community-based services, potential recommendations for structuring Disproportionate Share Hospital allotments during economic crises, and more. Includes rural references and considerations throughout.
Date: 10/2022
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) October 2022 meeting. Covers Medicaid race and ethnicity data collection and reporting, improving access to Medicaid coverage and care for adults leaving incarceration, the unwinding of the Public Health Emergency, streamlining the delivery of home- and community-based services, potential recommendations for structuring Disproportionate Share Hospital allotments during economic crises, and more. Includes rural references and considerations throughout.
Date: 10/2022
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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The Impact of Medicare Shared Savings Program Participation on Hospital Financial Performance: An Event-Study Analysis
Examines the effects of hospitals' participation in the Medicare Shared Savings Program (MSSP) on their financial performance. Compares within-hospital changes over time between MSSP and non-MSSP hospitals. Includes a comparison of the effects of MSSP participation between Critical Access Hospitals (CAHs) and non-CAHs.
Author(s): Huang Huang, Fred Ullrich, A. Clinton MacKinney, Keith Mueller
Citation: Health Services Research, 2022
Date: 10/2022
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Examines the effects of hospitals' participation in the Medicare Shared Savings Program (MSSP) on their financial performance. Compares within-hospital changes over time between MSSP and non-MSSP hospitals. Includes a comparison of the effects of MSSP participation between Critical Access Hospitals (CAHs) and non-CAHs.
Author(s): Huang Huang, Fred Ullrich, A. Clinton MacKinney, Keith Mueller
Citation: Health Services Research, 2022
Date: 10/2022
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Teledentistry Trends in the United States During the COVID-19 Pandemic
Reviews the use of teledentistry during and following the COVID-19 pandemic in California, Maine, Pennsylvania, and Wisconsin, and examines reimbursement issues and supports needed to enhance dental care in a post-COVID-19 world. Mentions rural throughout.
Author(s): Miranda Werts, Prashanta Patel, Elizabeth Mertz
Date: 10/2022
Sponsoring organization: Oral Health Workforce Research Center
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Reviews the use of teledentistry during and following the COVID-19 pandemic in California, Maine, Pennsylvania, and Wisconsin, and examines reimbursement issues and supports needed to enhance dental care in a post-COVID-19 world. Mentions rural throughout.
Author(s): Miranda Werts, Prashanta Patel, Elizabeth Mertz
Date: 10/2022
Sponsoring organization: Oral Health Workforce Research Center
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Federal Policy & Telehealth: What to be Aware of Going Forward
Webinar describing the telehealth policy landscape following the COVID-19 pandemic and the associated public health emergency, highlighting federal policy issues as of October 2022. Describes policy flexibilities, Medicare telehealth during the pandemic, and research initiatives examining telehealth.
Additional links: Presentation Slide Deck
Date: 10/2022
Sponsoring organization: Center for Connected Health Policy: The National Telehealth Policy Resource Center
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Webinar describing the telehealth policy landscape following the COVID-19 pandemic and the associated public health emergency, highlighting federal policy issues as of October 2022. Describes policy flexibilities, Medicare telehealth during the pandemic, and research initiatives examining telehealth.
Additional links: Presentation Slide Deck
Date: 10/2022
Sponsoring organization: Center for Connected Health Policy: The National Telehealth Policy Resource Center
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The Future of Telehealth After COVID-19: New Opportunities and Challenges
Provides an overview of the current evidence regarding telehealth's impact on equitable access to care and on quality of care, patient outcomes, and cost. Describes the COVID-19 pandemic-related regulatory flexibilities for mental health and substance use disorder services. Discusses the importance of telehealth on primary and specialty care during the public health emergency (PHE). Offers recommendations for Medicare telehealth policies to promote better outcomes for Medicare beneficiaries and value for the Medicare program.
Additional links: Medicare Telehealth Utilization and Spending Impacts 2019-2021, Webinar Recording
Author(s): Julia Harris, Sabah Bhatnagar, Brady Newell, et al.
Date: 10/2022
Sponsoring organization: Bipartisan Policy Center
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Provides an overview of the current evidence regarding telehealth's impact on equitable access to care and on quality of care, patient outcomes, and cost. Describes the COVID-19 pandemic-related regulatory flexibilities for mental health and substance use disorder services. Discusses the importance of telehealth on primary and specialty care during the public health emergency (PHE). Offers recommendations for Medicare telehealth policies to promote better outcomes for Medicare beneficiaries and value for the Medicare program.
Additional links: Medicare Telehealth Utilization and Spending Impacts 2019-2021, Webinar Recording
Author(s): Julia Harris, Sabah Bhatnagar, Brady Newell, et al.
Date: 10/2022
Sponsoring organization: Bipartisan Policy Center
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