Rural Health
Resources by Topic: Healthcare business and finance
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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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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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 & Medicaid Services
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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 & 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 & Medicaid Services
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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 & Medicaid Services
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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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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 & Medicaid Services
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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 & Medicaid Services
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MOBILE Health Care Act (P.L. 117-204)
Text of the Maximizing Outcomes through Better Investments in Lifesaving Equipment for (MOBILE) Health Care Act (P.L. 117-204). Amends Section 330 of the Public Health Service Act to allow HRSA-supported health centers to apply for New Access Points (NAP) funding to establish a new delivery site that is a mobile unit with or without a permanent site.
Date: 10/2022
Sponsoring organization: U.S. Congress
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Text of the Maximizing Outcomes through Better Investments in Lifesaving Equipment for (MOBILE) Health Care Act (P.L. 117-204). Amends Section 330 of the Public Health Service Act to allow HRSA-supported health centers to apply for New Access Points (NAP) funding to establish a new delivery site that is a mobile unit with or without a permanent site.
Date: 10/2022
Sponsoring organization: U.S. Congress
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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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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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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 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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Transcript from the Medicaid and CHIP Payment and Access Commission's (MACPAC) October 2022 meeting. Covers 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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Technical Report of The Maryland Telehealth Study
Presents the results of a study examining the quality and cost of telehealth following its expansion during the COVID-19 pandemic, as well as impact on access to healthcare, alignment with other models of care, and provider and patient satisfaction with a focus on policy impacts in Maryland. Includes findings of a literature review, consumer interviews, behavioral healthcare organization focus groups, and a provider survey.
Date: 10/2022
Sponsoring organizations: NORC at the University of Chicago, The Maryland Health Care Commission
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Presents the results of a study examining the quality and cost of telehealth following its expansion during the COVID-19 pandemic, as well as impact on access to healthcare, alignment with other models of care, and provider and patient satisfaction with a focus on policy impacts in Maryland. Includes findings of a literature review, consumer interviews, behavioral healthcare organization focus groups, and a provider survey.
Date: 10/2022
Sponsoring organizations: NORC at the University of Chicago, The Maryland Health Care Commission
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