Rural Health
Resources by Topic: Health insurance
Synthesis of Evaluation Results across 21 Medicare Models, 2012-2020
Summarizes results from evaluations of 21 Centers for Medicare & Medicaid (CMS) Innovation Center models. Examines measures related to gross and net Medicare spending, utilization, and quality of care. Identifies themes among models with similar participant types and interventions used. Offers considerations for acute or specialty care and targeted populations models and prevention and population management models.
Additional links: Findings at a Glance, Synthesis of Evaluation Results Across 21 Medicare Models Slides, Transcript, Webinar Recording
Date: 07/2022
Sponsoring organization: Centers for Medicare and Medicaid Services
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Summarizes results from evaluations of 21 Centers for Medicare & Medicaid (CMS) Innovation Center models. Examines measures related to gross and net Medicare spending, utilization, and quality of care. Identifies themes among models with similar participant types and interventions used. Offers considerations for acute or specialty care and targeted populations models and prevention and population management models.
Additional links: Findings at a Glance, Synthesis of Evaluation Results Across 21 Medicare Models Slides, Transcript, Webinar Recording
Date: 07/2022
Sponsoring organization: Centers for Medicare and Medicaid Services
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The Association Between Primary Care Use and Potentially-Preventable Hospitalization Among Dual Eligibles Age 65 and Over
Examines the relationship between primary care and ambulatory care sensitive condition (ACSC) hospitalization among people age 65 and older who are dually-enrolled in Medicare and Medicaid. Features statistics with breakdowns by urban or rural location.
Author(s): N. Loren Oh, Andrew J. Potter, Lindsay M. Sabik, et al.
Citation: BMC Health Services Research, 22(927)
Date: 07/2022
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Examines the relationship between primary care and ambulatory care sensitive condition (ACSC) hospitalization among people age 65 and older who are dually-enrolled in Medicare and Medicaid. Features statistics with breakdowns by urban or rural location.
Author(s): N. Loren Oh, Andrew J. Potter, Lindsay M. Sabik, et al.
Citation: BMC Health Services Research, 22(927)
Date: 07/2022
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Report to Congress: Unified Payment for Medicare-Covered Post-Acute Care
Presents a prototype for a Unified Post-acute Care (PAC) prospective payment system (PPS) that would set payment for PAC services on the basis of the clinical characteristics of the patient rather than the type of provider. Details the structure of the prototype and the data used in the analyses to design and calibrate the PPS. Explores key considerations for unifying PAC payment, such as cost-sharing and value-based payment. Includes data on PAC provider characteristics, including facility size and rural status, as well as rural payment adjustments.
Additional links: Appendices
Author(s): Benjamin Silver, Anne Deutsch, Nicole Coomer, et al.
Date: 07/2022
Sponsoring organizations: Centers for Medicare and Medicaid Services, RTI International
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Presents a prototype for a Unified Post-acute Care (PAC) prospective payment system (PPS) that would set payment for PAC services on the basis of the clinical characteristics of the patient rather than the type of provider. Details the structure of the prototype and the data used in the analyses to design and calibrate the PPS. Explores key considerations for unifying PAC payment, such as cost-sharing and value-based payment. Includes data on PAC provider characteristics, including facility size and rural status, as well as rural payment adjustments.
Additional links: Appendices
Author(s): Benjamin Silver, Anne Deutsch, Nicole Coomer, et al.
Date: 07/2022
Sponsoring organizations: Centers for Medicare and Medicaid Services, RTI International
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Self-Employed Workers Are Less Likely To Have Health Insurance Than Those Employed by Private Firms, Governments
Examines nonmetropolitan health insurance coverage in 2018 among working age adults (26-64 years old) who are self-employed, otherwise employed, unemployed, and those not in the labor force. Includes a bar chart showing metro compared to nonmetro coverage by employment status for the following types of health insurance: none, employer-based, direct-purchase, and public.
Author(s): Elizabeth A. Dobis, Jessica E. Todd
Citation: Amber Waves
Date: 07/2022
Sponsoring organization: USDA Economic Research Service
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Examines nonmetropolitan health insurance coverage in 2018 among working age adults (26-64 years old) who are self-employed, otherwise employed, unemployed, and those not in the labor force. Includes a bar chart showing metro compared to nonmetro coverage by employment status for the following types of health insurance: none, employer-based, direct-purchase, and public.
Author(s): Elizabeth A. Dobis, Jessica E. Todd
Citation: Amber Waves
Date: 07/2022
Sponsoring organization: USDA Economic Research Service
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Rural Illinois in Numbers: Content-Valid Indicators for Governance
Reports on quality of life (QOL) measures in Illinois such as economic conditions, access to healthcare, educational attainment, crime rates, and more. Includes metro versus nonmetro comparisons using data spanning from 2000 to 2020.
Author(s): Adee Athiyaman
Date: 06/2022
Sponsoring organization: Illinois Institute for Rural Affairs
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Reports on quality of life (QOL) measures in Illinois such as economic conditions, access to healthcare, educational attainment, crime rates, and more. Includes metro versus nonmetro comparisons using data spanning from 2000 to 2020.
Author(s): Adee Athiyaman
Date: 06/2022
Sponsoring organization: Illinois Institute for Rural Affairs
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MedPAC Comment on CMS's Proposed Rule on the Hospital Inpatient PPS and the Long-term Care Hospital PPS for FY 2023
Comments on a May 10, 2022, Federal Register proposed rule revising the hospital inpatient and long-term care hospital (LTCH) prospective payment systems (PPS). Discusses proposals on rate-setting in both the inpatient prospective payment systems (IPPS) and LTCH PPS, promoting stability in the IPPS and LTCH PPS, creating a permanent supplemental payment for Puerto Rico and Indian Health Service (IHS) hospitals, establishing a payment adjustment for domestic N95 respirators, adding new measures to the LTCH quality reporting program, and establishing overarching principles for measuring equity and health care quality disparities across CMS quality programs.
Date: 06/2022
Sponsoring organization: Medicare Payment Advisory Commission
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Comments on a May 10, 2022, Federal Register proposed rule revising the hospital inpatient and long-term care hospital (LTCH) prospective payment systems (PPS). Discusses proposals on rate-setting in both the inpatient prospective payment systems (IPPS) and LTCH PPS, promoting stability in the IPPS and LTCH PPS, creating a permanent supplemental payment for Puerto Rico and Indian Health Service (IHS) hospitals, establishing a payment adjustment for domestic N95 respirators, adding new measures to the LTCH quality reporting program, and establishing overarching principles for measuring equity and health care quality disparities across CMS quality programs.
Date: 06/2022
Sponsoring organization: Medicare Payment Advisory Commission
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Insurance Type Is the Top Predictor of Telehealth Use as Adoption Levels Off Long-Term
Brief presenting data on rates of outpatient telehealth use by encounter type, rural and metro location, and insurance type based on provider-reported 2020 data from Cosmos.
Author(s): Christopher Alban, Alissa MacGibbon, Tim Keogh, et al.
Date: 06/2022
Sponsoring organization: Epic Research
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Brief presenting data on rates of outpatient telehealth use by encounter type, rural and metro location, and insurance type based on provider-reported 2020 data from Cosmos.
Author(s): Christopher Alban, Alissa MacGibbon, Tim Keogh, et al.
Date: 06/2022
Sponsoring organization: Epic Research
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MedPAC Report to the Congress: Medicare and the Health Care Delivery System, June 2022
Evaluates Medicare payment issues and provides recommendations to the U.S. Congress. Chapter 2 presents a report on access to care for beneficiaries in Medically Underserved Areas (MUAs), who are dually eligible for Medicare and Medicaid, or have multiple chronic conditions. Also includes chapters on alternative payment models, safety net providers, the cost of drugs covered under Medicare Part B, the accuracy of Medicare Advantage payments, the alignment of fee-for-service payment rates across ambulatory settings, and segmentation in the stand-alone Part D plan market.
Date: 06/2022
Sponsoring organization: Medicare Payment Advisory Commission
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Evaluates Medicare payment issues and provides recommendations to the U.S. Congress. Chapter 2 presents a report on access to care for beneficiaries in Medically Underserved Areas (MUAs), who are dually eligible for Medicare and Medicaid, or have multiple chronic conditions. Also includes chapters on alternative payment models, safety net providers, the cost of drugs covered under Medicare Part B, the accuracy of Medicare Advantage payments, the alignment of fee-for-service payment rates across ambulatory settings, and segmentation in the stand-alone Part D plan market.
Date: 06/2022
Sponsoring organization: Medicare Payment Advisory Commission
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Report to Congress on Medicaid and CHIP, June 2022
Semi-annual report to Congress from the Medicaid and CHIP Payment and Access Commission (MACPAC). Discusses access to care, the oversight and transparency of managed care directed payments, access to vaccines for adult Medicaid beneficiaries, how Medicaid policy can be used to support the adoption of health IT among behavioral health providers, care integration for people who are dually eligible for Medicaid and Medicare, and advancing health equity in Medicaid. Includes rural references throughout.
Date: 06/2022
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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Semi-annual report to Congress from the Medicaid and CHIP Payment and Access Commission (MACPAC). Discusses access to care, the oversight and transparency of managed care directed payments, access to vaccines for adult Medicaid beneficiaries, how Medicaid policy can be used to support the adoption of health IT among behavioral health providers, care integration for people who are dually eligible for Medicaid and Medicare, and advancing health equity in Medicaid. Includes rural references throughout.
Date: 06/2022
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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State Innovation Model Testing Awards from the Centers for Medicare & Medicaid Services Innovation Center: Highlighting Rural Focus
Summarizes the activities and accomplishments of rural-specific State Innovation Models (SIM) in 11 states: Arkansas, Colorado, Idaho, Iowa, Maine, Michigan, Minnesota, New York, Ohio, Oregon, and Vermont. Describes the SIM initiative, which began in 2012 to support states committed to designing and testing strategies for payment model and delivery system reform.
Date: 06/2022
Sponsoring organization: Rural Health Value
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Summarizes the activities and accomplishments of rural-specific State Innovation Models (SIM) in 11 states: Arkansas, Colorado, Idaho, Iowa, Maine, Michigan, Minnesota, New York, Ohio, Oregon, and Vermont. Describes the SIM initiative, which began in 2012 to support states committed to designing and testing strategies for payment model and delivery system reform.
Date: 06/2022
Sponsoring organization: Rural Health Value
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