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Rural Health
Resources by Topic: Health reform

HCIA Complex/High-Risk Patient Targeting: Third Annual Report
Third annual evaluations of Health Care Innovation Awards Round One projects focused on patients with medically complex conditions at high risk for hospitalization, re-hospitalization, emergency department visits, or nursing home stays. Presents program effectiveness findings based on Medicare and Medicaid claims data, surveys, site visits, and interviews. Several projects serve rural areas, offering caregiver education and support, telehealth services, and various care coordination approaches.
Additional links: Addendum, April 2017
Date: 02/2017
Sponsoring organizations: Centers for Medicare and Medicaid Services, NORC at the University of Chicago
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Evaluating the HCIA - Behavioral Health/Substance Abuse Awards: Third Annual Report
Third annual evaluations of 10 Health Care Innovation Awards Round One projects focused on mental health and substance abuse services. Awardee-specific chapters focus on program objectives, implementation experiences, and participant outcomes. Programs include HealthLinkNow, which uses telehealth to provide behavioral care services in rural areas, and the Prevention and Recovery in Early Psychosis Program, which was expanded to serve to rural counties in California.
Additional links: Addendum, July 2017
Date: 01/2017
Sponsoring organizations: Centers for Medicare and Medicaid Services, Mathematica Policy Research
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Accounting for Social Risk Factors in Medicare Payment
Fifth and final report in a series designed to identify social risk factors that affect the health outcomes of Medicare beneficiaries and methods to account for these factors in Medicare payment programs. Offers thoughts about selecting the best methods to account for social risk factors and achieve policy goals. Chapter 2 includes a discussion about urbanicity and rurality, and suggests that a beneficiary's place of residence is a stronger indicator of social risk than their provider's location. Report was assembled by an ad hoc committee under the direction of the U.S. Department of Health and Human Services, Office of the Assistant Secretary of Planning and Evaluation.
Additional links: Read Online
Author(s): Committee on Accounting for Socioeconomic Status in Medicare Payment Programs
Date: 01/2017
Sponsoring organization: Health and Medicine Division (HMD), National Academies of Sciences, Engineering, and Medicine
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Center for Medicare and Medicaid Innovation: Report to Congress
Details the activities and progress of the CMS Innovation Center, focusing on the time period between October 1, 2014, and September 30, 2016. Includes updates on multiple rural-relevant models and initiatives such as the Accountable Care Organization Investment Model, Health Care Innovation Awards, and the Strong Start for Mothers and Newborns initiative.
Date: 12/2016
Sponsoring organization: Centers for Medicare and Medicaid Services
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Report to Congress: Social Risk Factors and Performance Under Medicare's Value-Based Purchasing Program
Uses Medicare data to examine the relationship between social risk factors and the performance of value-based purchasing programs. Discusses policy considerations that could help ensure value-based purchasing programs achieve their intended results, especially among high social risk populations. Categorizes rurality as a community risk factor and discusses whether beneficiaries with social risk factors such as rurality have worse outcomes due to their social risk profile, or because of the providers they see. Also provides rural-specific statistics and recommendations for using value-based purchasing to improve health outcomes among high social risk populations. Appendices summarize and provide additional details for each of the 9 programs evaluated. See the second report.
Additional links: Appendices
Date: 12/2016
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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Medicare Value-Based Payment Models: Participation Challenges and Available Assistance for Small and Rural Practices
Identifies challenges faced by small and rural physician practices when participating in Medicare's new value-based payment models, and groups them into five key areas: financial resources and risk management, health IT and data, population health management care delivery, quality and efficiency performance measurement and reporting, and effects of model participation and managing compliance with requirements. Also identifies two types of organizations, partner and non-partner, along with the services they provide, that can help small and rural practices overcome these challenges.
Additional links: Full Report
Date: 12/2016
Sponsoring organization: Government Accountability Office
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Improving Community Health through Hospital Community Benefit Spending: Charting a Path to Reform
Provides background on the origin and importance of nonprofit hospital community benefit spending, and explains the difference between community building and community benefit activities. Examines policy options that the IRS could use to enhance community benefit spending focused on improving social determinants of health community-wide. Includes rural-specific statistics and multiple comparisons of items identified in community health needs assessments (CHNAs).
Author(s): Sara Rosenbaum, Maureen Byrnes, Sara Rothenberg, Rachel Gunsalus
Date: 12/2016
Sponsoring organizations: George Washington University Milken Institute School of Public Health Department of Health Policy and Management, Milken Institute School of Public Health
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Healthcare Eligibility and Availability and Healthcare Reform: Are We Addressing Rural Women's Barriers to Accessing Care?
Reports the results from a focus group of women living in 7 rural Illinois counties to identify barriers in accessing healthcare prior to the Patient Protection and Affordable Care Act (ACA). Covers potential gaps in the legislation and how they can add to the existing barriers rural populations experience when accessing healthcare.
Author(s): Kristine Zimmermann, Leslie Carnahan, Ellen Paulsey, Yamile Molina
Citation: Journal of Health Care for the Poor and Underserved, 27(4A), 204-219
Date: 11/2016
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Evaluation of Hospital-Setting HCIA Awards: Third Annual Report, Final
Third and final report evaluating 10 Health Care Innovation Awards Round One projects undertaken in a hospital inpatient or emergency department. Presents awardee-specific information on program impact and lessons learned. Includes projects that involved Critical Access Hospitals and other rural hospitals. Includes projects focused on improved care for sepsis and projects using remote electronic intensive care unit (eICU) services.
Additional links: Addendum, March 2017
Date: 11/2016
Sponsoring organizations: Abt Associates, Centers for Medicare and Medicaid Services
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Health Insurance CO-OPs: Product Availability and Premiums in Rural Counties
Describes the role of CO-OPs, their regional distribution, and national prevalence in rural and urban counties. Compares the number of products available in counties with and without CO-OP plans in 2014 and 2015.
Author(s): Erika C. Ziller, Zachariah Croll, Andrew F. Coburn
Date: 10/2016
Sponsoring organization: Maine Rural Health Research Center
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