Rural Health
Resources by Topic: Healthcare business and finance
Mobile Health Clinics in a Rural Setting: A Cost Analysis and Time Motion Study of La Clínica in Oregon, United States
Evaluates provider time allocation and retrospective economic cost of nurse practitioner (NP) and community health worker (CHW) services through La Clínica, a Mobile Health Clinic (MHC) intervention in rural Oregon. Discusses populations served by La Clínica, including people experiencing homelessness, Native Americans, and migrant and seasonal farmworkers. Provides data on program costs and NP and CHW time use by task type and population subgroup.
Author(s): Abigail Higgins, Middy Tilghman, Tracy Kuo Lin
Citation: BMC Health Services Research, 25, 97
Date: 01/2025
Type: Document
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Evaluates provider time allocation and retrospective economic cost of nurse practitioner (NP) and community health worker (CHW) services through La Clínica, a Mobile Health Clinic (MHC) intervention in rural Oregon. Discusses populations served by La Clínica, including people experiencing homelessness, Native Americans, and migrant and seasonal farmworkers. Provides data on program costs and NP and CHW time use by task type and population subgroup.
Author(s): Abigail Higgins, Middy Tilghman, Tracy Kuo Lin
Citation: BMC Health Services Research, 25, 97
Date: 01/2025
Type: Document
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Impact of the Medicare Improvements for Patients And Providers Act on Mental Health Service Utilization And Spending among Older Adults
Examines the impact of the Medicare Improvements for Patients and Providers Act (MIPPA) on outpatient mental healthcare utilization. Utilizes 2008-2017 Medicare claims and administrative data to analyze MIPPA in a pre-implementation phase as well as 4 post-implementation phases. Includes data on mental healthcare outpatient visits by age group, race, dual eligibility status, substance use disorder, comorbidities, and urban, large rural, small rural, or isolated rural location.
Author(s): Matt Toth, Brent Gibbons, Abbie Levinson, et al.
Date: 01/2025
Type: Document
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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Examines the impact of the Medicare Improvements for Patients and Providers Act (MIPPA) on outpatient mental healthcare utilization. Utilizes 2008-2017 Medicare claims and administrative data to analyze MIPPA in a pre-implementation phase as well as 4 post-implementation phases. Includes data on mental healthcare outpatient visits by age group, race, dual eligibility status, substance use disorder, comorbidities, and urban, large rural, small rural, or isolated rural location.
Author(s): Matt Toth, Brent Gibbons, Abbie Levinson, et al.
Date: 01/2025
Type: Document
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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Postpartum Health Care Use in Medicaid During the COVID-19 Public Health Emergency: Implications for Extending Postpartum Coverage
Examines the impact of Medicaid continuous enrollment during the COVID-19 public health emergency (PHE) on postpartum healthcare utilization. Utilizes 2018-2023 claims data from the Centers for Medicare and Medicaid Services (CMS) Transformed Medicaid Statistical Information System (T-MSIS) to analyze a pre-PHE versus PHE cohort of women. Includes healthcare utilization data with breakdowns according to age, race/ethnicity, eligibility group (Medicaid or other form), rural versus urban location, maternity care desert status, severe maternal morbidity and/or chronic health condition, postpartum month, and state.
Author(s): Amelia Whitman, Anupama Warrier, Sarah Gordon, et al.
Date: 01/2025
Type: Document
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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Examines the impact of Medicaid continuous enrollment during the COVID-19 public health emergency (PHE) on postpartum healthcare utilization. Utilizes 2018-2023 claims data from the Centers for Medicare and Medicaid Services (CMS) Transformed Medicaid Statistical Information System (T-MSIS) to analyze a pre-PHE versus PHE cohort of women. Includes healthcare utilization data with breakdowns according to age, race/ethnicity, eligibility group (Medicaid or other form), rural versus urban location, maternity care desert status, severe maternal morbidity and/or chronic health condition, postpartum month, and state.
Author(s): Amelia Whitman, Anupama Warrier, Sarah Gordon, et al.
Date: 01/2025
Type: Document
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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A Rural-Urban Analysis of Buprenorphine Therapy During and After Pregnancy Among the Commercially Insured
Explores the use of evidence-based buprenorphine treatment and adherence during the peri-pregnancy period among commercially insured individuals by rurality. Analyzes data on 1,331,040 people between 15 and 44 years-old with diagnosis codes for pregnancy and labor/delivery from January 1, 2015, to December 31, 2019.
Author(s): KariLynn Dowling-McClay, Bill Brooks, Daniel Krauss, et al.
Date: 01/2025
Type: Document
Sponsoring organization: ETSU/NORC Rural Health Research Center
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Explores the use of evidence-based buprenorphine treatment and adherence during the peri-pregnancy period among commercially insured individuals by rurality. Analyzes data on 1,331,040 people between 15 and 44 years-old with diagnosis codes for pregnancy and labor/delivery from January 1, 2015, to December 31, 2019.
Author(s): KariLynn Dowling-McClay, Bill Brooks, Daniel Krauss, et al.
Date: 01/2025
Type: Document
Sponsoring organization: ETSU/NORC Rural Health Research Center
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Projecting the Impact of the $2,000 Part D Out-Of-Pocket Cap for Medicare Part D Enrollees with High Prescription Drug Spending
Examines the impact of the Medicare Part D $2,000 cap on out-of-pocket prescription drugs. Provides projected savings according to low-income subsidy (LIS) status, state, and demographic characteristics, including urban, rural-micropolitan, rural-other, or unclassified geographic location.
Date: 01/2025
Type: Document
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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Examines the impact of the Medicare Part D $2,000 cap on out-of-pocket prescription drugs. Provides projected savings according to low-income subsidy (LIS) status, state, and demographic characteristics, including urban, rural-micropolitan, rural-other, or unclassified geographic location.
Date: 01/2025
Type: Document
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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Behavioral Health Crisis Services Billed to Commercial Insurance, Medicaid, and Medicare
Examines the extent to which three specific crisis service billing codes are used by commercial payors, Medicaid, and Medicare in 2020 in the 11 states and District of Columbia that cover these services in their Medicaid fee-for-service plans. Compares the rate of crisis service claims by state, rurality, and provider type.
Author(s): Crystal Blyler, Amy Edmonds, Allison Wishon, et al.
Date: 01/2025
Type: Document
Sponsoring organizations: HHS Office of the Assistant Secretary for Planning and Evaluation, Mathematica
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Examines the extent to which three specific crisis service billing codes are used by commercial payors, Medicaid, and Medicare in 2020 in the 11 states and District of Columbia that cover these services in their Medicaid fee-for-service plans. Compares the rate of crisis service claims by state, rurality, and provider type.
Author(s): Crystal Blyler, Amy Edmonds, Allison Wishon, et al.
Date: 01/2025
Type: Document
Sponsoring organizations: HHS Office of the Assistant Secretary for Planning and Evaluation, Mathematica
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Emergency Triage, Treat, and Transport (ET3) Model: Final Evaluation Report
Presents quantitative and qualitative results from the evaluation of the Emergency Triage, Treat, and Transport (ET3) Model, a voluntary model that allowed ambulance care teams to use alternate models of emergency healthcare to improve quality and lower care costs. Describes the characteristics of ET3 participants, the extent to which ET3 interventions successfully prevented emergency department (ED) visits, and how average Medicare Parts A and B spending for patients that received ET3 interventions compared to patients who had low acuity ED visits. Discusses challenges and barriers to delivering ET3 interventions. Includes rural references throughout.
Additional links: Findings at a Glance, Technical Appendix
Date: 01/2025
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Presents quantitative and qualitative results from the evaluation of the Emergency Triage, Treat, and Transport (ET3) Model, a voluntary model that allowed ambulance care teams to use alternate models of emergency healthcare to improve quality and lower care costs. Describes the characteristics of ET3 participants, the extent to which ET3 interventions successfully prevented emergency department (ED) visits, and how average Medicare Parts A and B spending for patients that received ET3 interventions compared to patients who had low acuity ED visits. Discusses challenges and barriers to delivering ET3 interventions. Includes rural references throughout.
Additional links: Findings at a Glance, Technical Appendix
Date: 01/2025
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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A Summary of State Innovation Models (SIM) Evaluation Results Across 17 States (2013-2020)
Summarizes evaluation results of the State Innovation Models (SIM), which examined the ability of 17 state governments to implement and test innovative value-based payment (VBP) healthcare models across multiple payers between 2013 and 2020. Presents findings regarding the implementation and impact of 29 delivery and payment models, including patient-centered medical homes, accountable care organizations, behavioral health integration, and more. Covers state contracting and consensus building, practice transformation, pediatric care, behavioral healthcare, beneficiary and provider perspectives, and more. Includes a section on payment model designs tailored to unique state needs, including rural populations, as well as rural references throughout.
Additional links: A Summary of State Innovation Models (SIM): Focus on State-Led Transformation - Findings at a Glance, Executive Summary, Findings at a Glance
Date: 01/2025
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Summarizes evaluation results of the State Innovation Models (SIM), which examined the ability of 17 state governments to implement and test innovative value-based payment (VBP) healthcare models across multiple payers between 2013 and 2020. Presents findings regarding the implementation and impact of 29 delivery and payment models, including patient-centered medical homes, accountable care organizations, behavioral health integration, and more. Covers state contracting and consensus building, practice transformation, pediatric care, behavioral healthcare, beneficiary and provider perspectives, and more. Includes a section on payment model designs tailored to unique state needs, including rural populations, as well as rural references throughout.
Additional links: A Summary of State Innovation Models (SIM): Focus on State-Led Transformation - Findings at a Glance, Executive Summary, Findings at a Glance
Date: 01/2025
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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The Latest HIPAA Requirements - A Check-In on Your RHC's Compliance
Recording of a January 14, 2025, webinar on HIPAA compliance for Rural Health Clinics (RHCs). Covers HIPAA related legislation, HIPAA-related complaints and investigations by the U.S. Department of Health and Human Services (HHS) Office for Civil Rights (OCR), and new regulations and proposed rules related to patient privacy. Part of the Rural Health Clinic Technical Assistance Series.
Additional links: Presentation Slides
Date: 01/2025
Type: Video/Multimedia
Sponsoring organization: National Association of Rural Health Clinics
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Recording of a January 14, 2025, webinar on HIPAA compliance for Rural Health Clinics (RHCs). Covers HIPAA related legislation, HIPAA-related complaints and investigations by the U.S. Department of Health and Human Services (HHS) Office for Civil Rights (OCR), and new regulations and proposed rules related to patient privacy. Part of the Rural Health Clinic Technical Assistance Series.
Additional links: Presentation Slides
Date: 01/2025
Type: Video/Multimedia
Sponsoring organization: National Association of Rural Health Clinics
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Shared Savings Program Fast Facts
Provides summary statistics on the Medicare Shared Savings Program as of January 1, 2025. Offers data on the number of Accountable Care Organizations (ACOs), assigned beneficiaries, total earned shared savings, and quality scores each year since 2012; the number and percent of ACOs in each track; and more. Includes information on ACO participants, including the number of Rural Health Clinics (RHCs) and Critical Access Hospitals (CAHs) participating in the program.
Date: 01/2025
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Provides summary statistics on the Medicare Shared Savings Program as of January 1, 2025. Offers data on the number of Accountable Care Organizations (ACOs), assigned beneficiaries, total earned shared savings, and quality scores each year since 2012; the number and percent of ACOs in each track; and more. Includes information on ACO participants, including the number of Rural Health Clinics (RHCs) and Critical Access Hospitals (CAHs) participating in the program.
Date: 01/2025
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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