Rural Health
Resources by Topic: Health insurance
Medicare Could save Billions with Comparable Access for Enrollees If Critical Access Hospital Payments for Swing-Bed Services Were Similar to Those of the Fee-for-Service Prospective Payment System
Describes the use of swing beds for skilled nursing services at Critical Access Hospitals (CAHs) and average daily Medicare reimbursement for these services from 2015 through 2020. Examines data from a sample of 100 CAHs to determine whether Medicare enrollees would have had access to the same skilled nursing services provided by CAHs at alternative facilities within a 35-mile driving distance. Compares the average daily reimbursement for skilled nursing services at CAHs and alternative facilities, as well as the potential savings to Medicare if CAHs were reimbursed for skilled nursing services under the Skilled Nursing Facility (SNF) Prospective Payment System (PPS).
Date: 12/2024
Sponsoring organization: Office of Inspector General (HHS)
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Describes the use of swing beds for skilled nursing services at Critical Access Hospitals (CAHs) and average daily Medicare reimbursement for these services from 2015 through 2020. Examines data from a sample of 100 CAHs to determine whether Medicare enrollees would have had access to the same skilled nursing services provided by CAHs at alternative facilities within a 35-mile driving distance. Compares the average daily reimbursement for skilled nursing services at CAHs and alternative facilities, as well as the potential savings to Medicare if CAHs were reimbursed for skilled nursing services under the Skilled Nursing Facility (SNF) Prospective Payment System (PPS).
Date: 12/2024
Sponsoring organization: Office of Inspector General (HHS)
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Nevada Medicaid Cost Driver Analysis, 2024
Report analyzing 2016-2023 Medicaid data to determine drivers of healthcare costs in Nevada. Data analyzed by plan type, service category, geography, age, and sex.
Date: 12/2024
Sponsoring organization: Nevada Department of Health and Human Services
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Report analyzing 2016-2023 Medicaid data to determine drivers of healthcare costs in Nevada. Data analyzed by plan type, service category, geography, age, and sex.
Date: 12/2024
Sponsoring organization: Nevada Department of Health and Human Services
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December 2024 MedPAC Meeting Transcript
Transcript from the Medicare Payment Advisory Commission's (MedPAC) December 2024 meeting. Covers payment adequacy and updates for physician and other health professional services, hospital inpatient and outpatient services, Rural Emergency Hospitals (REHs), skilled nursing facility services, inpatient rehabilitation facility services, home health services, hospice services, and outpatient dialysis services.
Additional links: Assessing Payment Adequacy and Updating Payments: Hospital Inpatient and Outpatient Services; and Mandated Report on Rural Emergency Hospitals - Presentation Slides, Assessing Payment Adequacy and Updating Payments: Skilled Nursing Facility Services - Presentation Slides
Date: 12/2024
Sponsoring organization: Medicare Payment Advisory Commission
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Transcript from the Medicare Payment Advisory Commission's (MedPAC) December 2024 meeting. Covers payment adequacy and updates for physician and other health professional services, hospital inpatient and outpatient services, Rural Emergency Hospitals (REHs), skilled nursing facility services, inpatient rehabilitation facility services, home health services, hospice services, and outpatient dialysis services.
Additional links: Assessing Payment Adequacy and Updating Payments: Hospital Inpatient and Outpatient Services; and Mandated Report on Rural Emergency Hospitals - Presentation Slides, Assessing Payment Adequacy and Updating Payments: Skilled Nursing Facility Services - Presentation Slides
Date: 12/2024
Sponsoring organization: Medicare Payment Advisory Commission
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Estimating the Effects of the Medicare $2 Drug List on Part D Enrollees
Discusses the Medicare $2 Drug List (M2DL) Model, which would allow Medicare Part D enrollees to purchase monthly drugs for $2 or less. Provides projected financial impact of the model, such as out of pocket (OOP) costs for individual drugs as well as OOP changes for enrollees, with breakdowns by demographic variables, including urban, rural-micropolitan, rural-other, or unclassified location.
Date: 12/2024
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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Discusses the Medicare $2 Drug List (M2DL) Model, which would allow Medicare Part D enrollees to purchase monthly drugs for $2 or less. Provides projected financial impact of the model, such as out of pocket (OOP) costs for individual drugs as well as OOP changes for enrollees, with breakdowns by demographic variables, including urban, rural-micropolitan, rural-other, or unclassified location.
Date: 12/2024
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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Trends in Medicaid and CHIP Telehealth, 2019-2021 Part II: Medicaid and CHIP Telehealth Utilization Trends by Enrollee and Provider Rurality
Explores trends in the use of telehealth among Medicaid and Children's Health Insurance Program (CHIP) enrollees before and during the COVID-19 Public Health Emergency (PHE). Compares trends between rural and urban enrollees, enrollees that reside in primary care Health Professional Shortage Areas (HPSAs), and by providers' rural or urban location.
Author(s): Anupama Warrier, Amelia Whitman, Aiden Lee, et al.
Date: 12/2024
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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Explores trends in the use of telehealth among Medicaid and Children's Health Insurance Program (CHIP) enrollees before and during the COVID-19 Public Health Emergency (PHE). Compares trends between rural and urban enrollees, enrollees that reside in primary care Health Professional Shortage Areas (HPSAs), and by providers' rural or urban location.
Author(s): Anupama Warrier, Amelia Whitman, Aiden Lee, et al.
Date: 12/2024
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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Civil Rights and Disparities in Pediatric Healthcare Access for Racial and Ethnic Minority Families in Arizona
Reports on disparities in pediatric healthcare access and quality experienced by racial and ethnic minority families in Arizona. Discusses primary findings based on testimony heard by the Arizona Advisory Committee to the U.S. Commission on Civil Rights, and provides suggestions to address civil rights concerns related to pediatric healthcare. Includes findings related to insurance, foster youth, healthcare provider shortages, data collection, and bias, among other topics. Discusses rural and tribal health throughout.
Date: 12/2024
Sponsoring organization: U.S. Commission on Civil Rights
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Reports on disparities in pediatric healthcare access and quality experienced by racial and ethnic minority families in Arizona. Discusses primary findings based on testimony heard by the Arizona Advisory Committee to the U.S. Commission on Civil Rights, and provides suggestions to address civil rights concerns related to pediatric healthcare. Includes findings related to insurance, foster youth, healthcare provider shortages, data collection, and bias, among other topics. Discusses rural and tribal health throughout.
Date: 12/2024
Sponsoring organization: U.S. Commission on Civil Rights
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Hospital Margins Rebounded in 2023, But Rural Hospitals and Those With High Medicaid Shares Were Struggling More Than Others
Examines hospital margins for non-federal general short-term hospitals in the U.S. from 2018 through 2023, with a focus on operating margins. Analyzes RAND Hospital Data to explore the extent to which hospitals profited or lost money on patient care and other operating activities. Discusses differences in operating margins by hospital characteristics, including hospital ownership type, commercial share, size, rural or urban location, and Medicare rural payment designation.
Date: 12/2024
Sponsoring organization: KFF
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Examines hospital margins for non-federal general short-term hospitals in the U.S. from 2018 through 2023, with a focus on operating margins. Analyzes RAND Hospital Data to explore the extent to which hospitals profited or lost money on patient care and other operating activities. Discusses differences in operating margins by hospital characteristics, including hospital ownership type, commercial share, size, rural or urban location, and Medicare rural payment designation.
Date: 12/2024
Sponsoring organization: KFF
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Critical Access Hospital Financial Sustainability Guide
Provides guidance and assistance to state Medicare Rural Hospital Flexibility (Flex) Program personnel, leaders of Critical Access Hospitals (CAHs), and others helping CAHs manage long-term financial stability. Presents potential interventions CAHs may use to address ongoing and systemic financial challenges in rural healthcare.
Date: 12/2024
Sponsoring organizations: EideBailly, National Rural Health Resource Center
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Provides guidance and assistance to state Medicare Rural Hospital Flexibility (Flex) Program personnel, leaders of Critical Access Hospitals (CAHs), and others helping CAHs manage long-term financial stability. Presents potential interventions CAHs may use to address ongoing and systemic financial challenges in rural healthcare.
Date: 12/2024
Sponsoring organizations: EideBailly, National Rural Health Resource Center
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Center for Medicare and Medicaid Innovation: 2024 Report to Congress
Reports to Congress on payment and service delivery models and initiatives tested or announced by the Center for Medicare and Medicaid Innovation between October 2022 and September 2024. Includes summaries and updates on multiple rural-relevant models and initiatives, including the Accountable Care Organization Realizing Equity, Access, and Community Health (ACO REACH) Model, the Transforming Maternal Health Model, the Pennsylvania Rural Health Model (PARHM), the Vermont All-Payer Accountable Care Organization Model, and more.
Date: 12/2024
Sponsoring organizations: Centers for Medicare and Medicaid Services, U.S. Department of Health and Human Services
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Reports to Congress on payment and service delivery models and initiatives tested or announced by the Center for Medicare and Medicaid Innovation between October 2022 and September 2024. Includes summaries and updates on multiple rural-relevant models and initiatives, including the Accountable Care Organization Realizing Equity, Access, and Community Health (ACO REACH) Model, the Transforming Maternal Health Model, the Pennsylvania Rural Health Model (PARHM), the Vermont All-Payer Accountable Care Organization Model, and more.
Date: 12/2024
Sponsoring organizations: Centers for Medicare and Medicaid Services, U.S. Department of Health and Human Services
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Ohio Policy Spotlight: School-Based Health Care and Medicaid
Provides an overview of school-based health services in Ohio. Includes county-level data on the percentage of Ohio children enrolled in any public health insurance.
Author(s): Becky Carroll, Sarah Al-Hashemi
Date: 12/2024
Sponsoring organization: Health Policy Institute of Ohio
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Provides an overview of school-based health services in Ohio. Includes county-level data on the percentage of Ohio children enrolled in any public health insurance.
Author(s): Becky Carroll, Sarah Al-Hashemi
Date: 12/2024
Sponsoring organization: Health Policy Institute of Ohio
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