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Rural Health
Resources by Topic: Health reform

Evaluation of the Vermont All-Payer Accountable Care Organization Model: First Evaluation Report
Evaluates the first two performance years of the Vermont All-Payer Accountable Care Organization Model (VTAPM), which aims to assess whether scaling an Accountable Care Organization (ACO) across all payers in the state can reduce program expenditures while preserving or improving care quality. Discusses the implementation of the model, provider engagement, efforts to address population health goals; characteristics of participating hospitals, practitioners, and beneficiaries; and the model's impacts on Medicare spending, utilization, and quality of care. Includes information on hospital and provider participation in rural counties and unique challenges for rural Critical Access Hospitals.
Additional links: Findings at a Glance, Technical Appendices
Date: 08/2021
Type: Document
Sponsoring organizations: Centers for Medicare and Medicaid Services, NORC at the University of Chicago
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The Pennsylvania Rural Health Model (PARHM): First Annual Report
Evaluates the first year of the Pennsylvania Rural Health Model (PARHM), an initiative designed to test if global budgets can help rural hospitals improve their financial viability, provide flexibility to meet locally defined community health needs, and reduce overall health care spending. Provides an overview of the model and describes the implementation experience of the first cohort of participating hospitals. Presents preliminary, descriptive data on the financial performance and utilization outcomes of Cohort 1 participants.
Additional links: Appendix, Findings at a Glance
Date: 08/2021
Type: Document
Sponsoring organizations: Centers for Medicare and Medicaid Services, NORC at the University of Chicago
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The Rural Emergency Hospital and Value-Based Care
Summarizes the new Rural Emergency Hospital (REH) legislation, outlines local considerations before REH conversion, and prepares stakeholders to comment when the Centers for Medicare & Medicaid Services releases REH proposed rules for public input. Addresses questions regarding anticipated proposed rules and describes opportunities to inform REH rulemaking.
Date: 08/2021
Type: Document
Sponsoring organization: Rural Health Value
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CMS Bundled Payments for Care Improvement Initiative Models 2­-4: Year 7 Evaluation & Monitoring Annual Report
Seventh and final report describing findings from an evaluation of Models 2, 3, and 4 of the Bundled Payments for Care Improvement (BPCI) initiative, linking provider payments for an episode of care with the goal of decreasing cost of care while improving quality. Includes information specific to rural BPCI-participating hospitals, skilled nursing facilities, and home health agencies.
Additional links: Appendices, Findings at a Glance
Author(s): The Lewin Group, Abt Associates, GDIT, Telligen
Date: 03/2021
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Which Hospitals Could Be Financially Affected by a Public Option?
Describes the potential impacts of a public option health insurance plan on hospital finances, including rural hospitals. Analyzes hospital discharge data to identify hospitals that had a greater share of total charges paid by private insurance across 25 states. Presents data by hospital and patient characteristics.
Author(s): Anuj Gangopadhyaya, Claire O'Brien
Date: 03/2021
Type: Document
Sponsoring organization: Urban Institute
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Independent Evaluation of Comprehensive Primary Care Plus (CPC+): Third Annual Report
Reports on the first three program years of the Comprehensive Primary Care Plus (CPC+) model, a CMS primary care payment and delivery reform effort. Discusses CPC+ participating practices, payer partners, and health information technology (HIT) vendors supporting the program. Describes practice changes and outcomes for Medicare fee-for-service beneficiaries.
Additional links: Appendices, CMS Perspective Report, Findings at a Glance
Date: 01/2021
Type: Document
Sponsoring organizations: Centers for Medicare and Medicaid Services, Mathematica
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Rural Variation of Medicaid Expansion on Access to Naloxone
Poster examining the rate of naloxone prescriptions dispensed by retail pharmacies between 2011 and 2017. Compares the rate of naloxone prescriptions before and after Medicaid expansion and as the rural population increased.
Author(s): Yue Cheng, Minji Sohn, Patricia R. Freeman,Eugene Shin, Chris Delcher
Date: 09/2020
Type: Document
Sponsoring organization: Rural and Underserved Health Research Center
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Evaluation of the Health Care Innovation Awards, Round 2: Final Report
Summarizes the final evaluation results of 38 Health Care Innovation Awards Round Two projects. Discusses program impacts on healthcare service use and costs, factors associated with positive impacts, and awardees' experiences sustaining programs and implementing payment models after the end of the awards. Offers overall findings and awardee-specific evaluation reports. Includes some information on results for projects serving rural areas.
Additional links: Findings at a Glance
Date: 09/2020
Type: Document
Sponsoring organizations: Centers for Medicare and Medicaid Services, Mathematica Policy Research
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State Innovation Model (SIM) Summative Evaluation Report: Activities and Goal Evaluation Award Year 2-4 (AY2-4)
Summarizes the process and implementation activities of the State Innovation Model (SIM) test grant program in Iowa during award years 2 through 4, which spanned November 2016 through April 2019. SIM test awards are administered by the Centers of Medicare and Medicaid Services (CMS) Innovation Center and allow states to implement and test strategies for health system transformation that meet the specific needs of residents of each state. Describes the process evaluation of SIM implementation activities and results of the 2016 and 2018 statewide evaluation surveys. Presents data on outcome measures regarding access and cost of care, diabetes, obesity, and tobacco use.
Author(s): Tessa Heeren, Rochelle Schultz Spinarski, Elizabeth Momany, et al.
Date: 08/2020
Type: Document
Sponsoring organization: University of Iowa Public Policy Center
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Independent Evaluation of Comprehensive Primary Care Plus (CPC+): Second Annual Report
Reports on the first two program years of the CPC+, a CMS primary care payment and delivery reform effort. Discusses CPC+ participating practices, payer partners, and health information technology (HIT) vendors supporting the program. Describes practices changes and outcomes for Medicare fee-for-service beneficiaries. Includes statistics with breakdowns by rural, suburban, or urban practice location.
Additional links: Appendices to the Supplemental Volume, CMS Perspective Report, Findings at a Glance, Supplemental Volume
Date: 07/2020
Type: Document
Sponsoring organizations: Centers for Medicare and Medicaid Services, Mathematica
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