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Rural Health
Resources by Topic: Healthcare business and finance

The Path to Coordinated Federal Leadership to Strengthen Primary Health Care
Discusses the potential of a Secretary's Council on Primary Care within the U.S. Department of Health and Human Services. Describes primary care's role in addressing policy challenges related to health equity, payment, workforce training, pandemic recovery and resilience, the opioid crisis, and mental health. Offers recommendations to include and strengthen high-quality primary care as part of a long-term vision of a high-value healthcare system. Includes rural references throughout.
Author(s): Robert L. Phillips Jr., Christopher Koller, Alice Hm Chen
Date: 11/2022
Sponsoring organization: Milbank Memorial Fund
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Rethinking Rurality: Using Hospital Referral Regions to Investigate Rural-Urban Health Outcomes
Examines the relationship between the proportion of rural population served in each of the 306 hospital referral regions (HRRs) and health outcomes, healthcare spending and utilization, and access to and quality of primary care. Explores whether mortality differences in HRRs are associated with differences in price-adjusted Medicare reimbursements, quality of primary care, and access to primary care.
Author(s): Lucy Skinner, Sandra Wong, Carrie Colla
Citation: BMC Health Services Research, 22(1), 1312
Date: 11/2022
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Medicare Program: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems and Quality Reporting Programs; Organ Acquisition; Rural Emergency Hospitals: Payment Policies, Conditions of Participation, Provider Enrollment, Physician Self-Referral; New Service Category for Hospital Outpatient Department Prior Authorization Process; Overall Hospital Quality Star Rating; COVID-19
Establishes the Rural Emergency Hospital (REH) provider type. Outlines REH payment policy, Conditions of Participation (CoPs), quality measures, and enrollment policy. Outlines changes to the Critical Access Hospitals (CAH) CoPs regarding location and distance requirements, patient's rights requirements, and flexibilities for CAHs that are part of a larger health system. Among other things, this rule also revises the Medicare Hospital Outpatient Prospective Payment System (OPPS) and Medicare Ambulatory Surgical Center (ACS) payment system for calendar year 2023 and finalizes provisions included in the COVID-19 interim final rules.
Additional links: Fact Sheet
Date: 11/2022
Sponsoring organization: Centers for Medicare and Medicaid Services
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CY 2023 Medicare Hospital Outpatient Prospective Payment System and Ambulatory Surgical Center Payment System Final Rule (CMS 1772-FC) Rural Emergency Hospitals — New Medicare Provider Type
Provides an overview of Rural Emergency Hospitals, a Medicare provider type established by the Consolidated Appropriations Act, 2021. Details key policies outlined in the Calendar Year 2023 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System Final Rule, including payment policies, conditions of participation, REH provider enrollment, and exceptions to the physician self-referral law.
Date: 11/2022
Sponsoring organization: Centers for Medicare and Medicaid Services
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Financial Characteristics of Critical Access Hospitals (CAHs) Participating in Accountable Care Organizations (ACO)
Examines Critical Access Hospital (CAH) participation in Medicare and non-Medicare Accountable Care Organizations (ACOs) in 2019. Compares the organizational and financial characteristics of CAHs across facilities that participate in ACOs and those that do not participate in an ACO. Includes data on profitability, liquidity, outpatient revenue, and Medicare payer mix.
Author(s): Angelina Budko, George Pink, Susie Gurzenda, Ann Howard, Kristin L. Reiter
Date: 11/2022
Sponsoring organization: Flex Monitoring Team
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Factors Associated with Compliance to the Hospital Price Transparency Final Rule: A National Landscape Study
Examines 3,558 short-term acute-care hospitals' compliance with the Hospital Price Transparency Rule, which requires that hospitals publicly post a machine-readable file containing commercial negotiated prices for 300 services. Compares hospital compliance by state and hospital referral region. Describes factors associated with compliance, including health information technology preparedness, profit status, system affiliation, hospital size, and rural location.
Author(s): John Xuefeng Jiang, Daniel Polsky, Jeff Littlejohn, et al.
Citation: Journal of General Internal Medicine, 37(14), 3577–3584
Date: 11/2022
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Virtual Communication Services in Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs)
Provides information for Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs) regarding billing and payment for virtual communication services as established in the 2019 Physician Fee Schedule Final Rule.
Date: 11/2022
Sponsoring organization: Centers for Medicare and Medicaid Services
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EMS Listening Sessions: Report to the Governor's Healthcare Task Force
A summary of 6 listening sessions on emergency medical services in Wyoming. Discusses issues and potential solutions related to essential service designation, EMS districts, regionalization, education and licensing, reimbursement, the use of 911, and defining critical care. Discusses rural and frontier issues throughout.
Date: 10/2022
Sponsoring organization: Wyoming Department of Health
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Rural Medicare Beneficiaries are Increasingly Likely to Be Admitted to Urban Hospitals
Examines whether the proportion of rural Medicare fee-for-service beneficiaries admitted to urban hospitals increased between 2010 and 2018 using data from the Hospital Service Area File (HSAF) and the American Hospital Association (AHA) survey. Explores whether distance to the nearest hospital and system affiliation of the nearest rural hospital were associated with increases in urban hospital admissions from rural ZIP codes.
Author(s): Hannah R. Friedman, George Mark Holmes
Citation: Health Services Research, 57(5), 1029-1034
Date: 10/2022
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October 2022 MACPAC Meeting Transcript
Transcript from the Medicaid and CHIP Payment and Access Commission's (MACPAC) October 2022 meeting. Covers Medicaid race and ethnicity data collection and reporting, improving access to Medicaid coverage and care for adults leaving incarceration, the unwinding of the Public Health Emergency, streamlining the delivery of home- and community-based services, potential recommendations for structuring Disproportionate Share Hospital allotments during economic crises, and more. Includes rural references and considerations throughout.
Date: 10/2022
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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