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Rural Health
Resources by Topic: Healthcare business and finance

Coronavirus Aid, Recovery, and Economic Security (CARES) Act & Related Legislation and Administrative Action Impacting Rural Health
Provides an overview of legislation passed by Congress regarding COVID-19. Identifies provisions relevant to rural healthcare providers, including the Paycheck Protection Program, funding for public health and rural workforce programs, telehealth flexibilities, and more.
Date: 04/2021
Type: Document
Sponsoring organization: National Rural Health Association
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Changes in Provision of Selected Services by Rural and Urban Hospitals between 2009 and 2017
Examines the increase in number of rural hospitals that have closed or converted to a model eliminating inpatient care, as well as rural hospitals that have reduced or terminated historically essential services including obstetrics, surgery, long-term care, home health, and oncology. Features statistics on numbers of various types of healthcare services offered in hospitals in 2009 and in 2017, with breakdowns by urban and rural location.
Author(s): Kathleen Knocke, George H. Pink, Kristie W. Thompson, Randy K. Randolph, Mark Holmes
Date: 04/2021
Type: Document
Sponsoring organization: North Carolina Rural Health Research Program
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Promising Flex Program Initiatives to Support Critical Access Hospitals during the COVID-19 Pandemic
Reports on promising State Flex Program (SFP) strategies to support Critical Access Hospitals (CAHs) and address priority needs during the COVID-19 pandemic. Highlights initiatives implemented by SFPs in seven states: Alaska, Arizona, Idaho, Kentucky, Montana, Pennsylvania, and Wyoming. Discusses strategies regarding support for frontline staff, staff communication, communication to rural communities, clinical and service improvement, and CAH and Rural Health Clinic financial performance. Discusses ongoing considerations and concerns.
Author(s): Celia Jewell, Sara Kahn-Troster, John Gale
Date: 04/2021
Type: Document
Sponsoring organization: Flex Monitoring Team
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Rural Emergency Hospital (REH) Model Summary
Provides an overview of the Rural Emergency Hospital (REH) model, a Medicare provider type established by the Consolidated Appropriations Act, 2021. Describes key features of the REH model and the REH payment methodology. Identifies considerations that must be addressed by the Centers for Medicare and Medicaid Services (CMS) and state Medicaid programs, as well as areas that will require technical assistance.
Date: 04/2021
Type: Document
Sponsoring organization: National Rural Health Association
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Merit-Based Incentive Payment System (MIPS): Participating in the Improvement Activities Performance Category in the 2021 Performance Year - Traditional MIPS
Provides details on how to participate in the performance improvement part of the Merit-based Incentive Payment System (MIPS), one of two payment options under the Medicare Quality Payment Program. Identifies differences for small practices and clinicians located in a rural or Health Professional Shortage Area.
Date: 04/2021
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Graduate Medical Education: Programs and Residents Increased During Transition to Single Accreditor; Distribution Largely Unchanged
Examines the number of graduate medical education (GME) programs and the number of residents in GME programs between the 2014-2015 and 2019-2020 academic years. Describes changes in the number, specialty or subspecialty, and geographic distribution of GME programs and their residents.
Additional links: Full Report
Date: 04/2021
Type: Document
Sponsoring organization: Government Accountability Office
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Geographic Access to Health Care for Rural Medicare Beneficiaries in Five States: An Update
Describes the provider mix caring for rural and urban Medicare beneficiaries in Alaska, Idaho, North Carolina, South Carolina, and Washington, using 2014 data. Examines the quality of care, number of annual visits, and the distances traveled for treatment of several conditions. Compares 2014 data with estimates from 1998, to assess the changes in geographical access to care. Features statistics with breakdowns by urban, large rural, small rural, and isolated rural locations.
Date: 04/2021
Type: Document
Sponsoring organization: WWAMI Rural Health Research Center
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Rural and Urban Hospital Characteristics by Obstetric Service Provision Status, 2010-2018
Illustrates the differences between urban and rural hospitals providing obstetric (OB) services. Compares them by size, capacity, location, and community characteristics, and compares these factors between rural hospitals with OB units and those that had discontinued services during the study period. Features statistics with breakdowns by urban and rural location.
Additional links: Characteristics of Rural and Urban U.S. Hospitals Based on Obstetric Services
Author(s): Julia D. Interrante, Lindsay K. Admon, Mariana S. Tuttle, Bridget Basile Ibrahim, Katy B. Kozhimannil
Date: 04/2021
Type: Document
Sponsoring organization: University of Minnesota Rural Health Research Center
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States Work to Support Rural Hospitals Despite Pandemic Challenges
Blog post highlighting state-level policies to address and prevent rural hospital closures. Discusses proposals in state legislatures regarding alternative payment methodologies and funding, service delivery models, and the recruitment and retention of a rural healthcare workforce.
Author(s): Beth Giambrone
Date: 04/2021
Type: Document
Sponsoring organization: Association of State and Territorial Health Officials
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Strengthening Primary Care and Improving Population Health: Nebraska's Approach
Explores efforts to strengthen primary care in Nebraska through Patient-Centered Medical Homes, Accountable Care Organizations (ACOs), and the Comprehensive Primary Care Plus program. Discusses the development of pilot programs and a partnership with a local nonprofit and the University of Nebraska College of Public Health.
Author(s): Martha Hostetter, Sarah Klein
Date: 04/2021
Type: Document
Sponsoring organization: Milbank Memorial Fund
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