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Rural Health Information Hub

Rural Health
Resources by Topic: Health insurance

High-Functioning Rural Medicare ACOs – A Qualitative Review
Describes the success factors common to high-performing Accountable Care Organizations (ACOs) based in rural areas of New York, Maine, Missouri and Arkansas, and New Hampshire. Examines these organizations' governance, ACO history, operations, finances, population health, and lessons learned.
Author(s): Thomas Vaughn, Keith Mueller, Clinton MacKinney
Date: 02/2021
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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CMS Needs to Implement Risk-Based Oversight of Puerto Rico's Procurement Process
Report details the lack of oversight by Centers for Medicare and Medicaid Services (CMS) of contractors hired to facilitate Puerto Rico's Medicaid program. Discusses Puerto Rico's Medicaid procurement process and outlines the risk of fraud, waste, and abuse of funds due to lack oversight.
Additional links: Full Report
Date: 02/2021
Sponsoring organization: Government Accountability Office
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Medicaid's Role in Health Care for American Indians and Alaska Natives
Provides an overview of the federal government's role in providing healthcare to American Indians and Alaska Natives (AI/AN). Discusses AI/AN demographics, economic and health disparities, and access to healthcare and insurance coverage. Describes the structure of the Indian Health Service (IHS), services provided, and IHS financing and spending. Highlights special rules and protections that apply to AI/AN Medicaid beneficiaries. Presents a series of policy issues that have been raised regarding the Medicaid and IHS relationship, as well as opportunities for improving Medicaid's role in providing healthcare to AI/AN populations.
Date: 02/2021
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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MBQIP Quality Measures National Annual Report - 2019
Summarizes quality measure reporting rates and performance among Critical Access Hospitals (CAHs) in 2019. 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, Madeleine Pick, Tongtan Chantarat, Nathan Bean, Ira Moscovice
Date: 02/2021
Sponsoring organization: Flex Monitoring Team
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Health System Challenges for Critical Access Hospitals: Findings from a National Survey of CAH Executives
Results of a 2019 survey of 174 respondents, examining challenges including uncompensated care, affordability of health insurance, patients seeking care beyond their local hospital, and prescription drug prices. Intended to help rural health policymakers in development of strategies to maintain Critical Access Hospital viability and access to healthcare in rural communities.
Author(s): Sharita Thomas, Kristie Thompson, Kathleen Knocke, George Pink
Date: 02/2021
Sponsoring organization: North Carolina Rural Health Research Program
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Medicaid and CHIP in the U.S. Virgin Islands
Summarizes key requirements and design features of Medicaid and the State Children's Health Insurance Program (CHIP) in the U.S. Virgin Islands. Features statistics on program costs from fiscal years 2011-2019, with breakdowns by federal spending and U.S. Virgin Islands spending.
Date: 02/2021
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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Medicaid and CHIP in the Commonwealth of the Northern Mariana Islands
Summarizes key requirements and design features of Medicaid and the State Children's Health Insurance Program (CHIP) in the Northern Mariana Islands. Features statistics on program costs from fiscal years 2011-2019, with breakdowns by federal spending and Northern Mariana Islands spending.
Date: 02/2021
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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MBQIP Fundamentals Guide for State Flex Programs
Provides information about the history and status of the Medicare Beneficiary Quality Improvement Project (MBQIP). Developed for the benefit of Flex Program personnel and subcontractors and includes resources to support their work, including data report release timelines, MBQIP acronyms, and MBQIP measure change summaries.
Date: 02/2021
Sponsoring organization: Stratis Health
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Paving the Way to Equity: A Progress Report (2015-2021)
Provides an overview of the 2015 Centers for Medicare & Medicaid Services (CMS) Equity Plan for Improving Quality in Medicare and its Path to Equity, an organizing framework to achieve health equity. Discusses ways CMS has demonstrated progress in increasing understanding and awareness of disparities, developing and disseminating solutions to health equity, and implementing sustainable actions to achieve health equity. Considers emerging opportunities to build on this progress toward health equity. Includes information on rural disparities throughout.
Date: 01/2021
Sponsoring organization: Centers for Medicare and Medicaid Services
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January 2021 MACPAC Meeting Transcript
Transcript from the Medicaid and CHIP Payment and Access Commission's (MACPAC) January 2021 meeting. Covers the review of draft chapters and recommendations regarding postpartum coverage, estate recovery, automatic countercyclical financing adjustment, design considerations for creating a new unified program for dually eligible beneficiaries, and housing supports for individuals with substance use disorder, among other things. Also details a MACPAC study on non-emergency medical transportation (NEMT), which includes a discussion of NEMT in rural areas.
Date: 01/2021
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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