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Rural Health
Resources by Topic: Healthcare business and finance

MedPAC Report to the Congress: Medicare Payment Policy, 2021
Annual review of Medicare payment policies, with recommendations to Congress. Includes discussion on Medicare payment policies directly affecting rural providers and beneficiaries. Addresses payment adequacy for healthcare facilities and services, improving Medicare payment for post-acute care, Medicare Advantage, Medicare Part D, and the impact of healthcare provider consolidation. Contains information on the effects of the COVID-19 pandemic on Medicare beneficiary healthcare access, mortality, and service use. Presents an option for Medicare's coverage of telehealth beyond the public health emergency.
Date: 03/2021
Sponsoring organization: Medicare Payment Advisory Commission
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Report to Congress on Medicaid and CHIP, March 2021
Reports on five aspects of Medicaid: 1) improving Medicaid's responsiveness during economic downturns; 2) addressing concerns about high rates of maternal morbidity and mortality; 3) reexamining Medicaid's estate recovery policies; 4) integrating care for people who are dually eligible for Medicaid and Medicare; and 5) improving hospital payment policy for the nation's safety-net hospitals. Chapter 5 examines the relationship between disproportionate share hospital (DSH) allotments to states and the number of uninsured individuals, the amounts and sources of hospitals' uncompensated care costs, and the number of hospitals with high levels of uncompensated care that also provide essential community services. Table 5-1 details DSH spending for urban and rural hospitals and for Critical Access Hospitals.
Date: 03/2021
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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Innovations and Workforce Challenges for CAHs during COVID-19
Presents results from a survey of Critical Access Hospitals (CAHs) on hospital operation and workforce adaptations in response to the COVID-19 pandemic. Discusses innovative practices adopted by CAHs related to hospital processes and clinical care. Describes how CAHs overcame workforce challenges during COVID-19.
Author(s): Madeleine Pick, Megan Lahr, Keelia Silvis, Ira Moscovice
Date: 03/2021
Sponsoring organization: Flex Monitoring Team
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2021 RHC Billing and Coding Update
Recording of a March 9, 2021, webinar providing an overview of coding and billing changes relevant to Rural Health Clinics (RHCs). Discusses guidelines for reporting COVID-19 immunizations and monoclonal antibody infusions, telehealth coding and billing during the COVID-19 public health emergency, ICD-10-CM diagnosis coding for COVID-19, and RHC lab billing and COVID test reporting. Part of the Rural Health Clinic Technical Assistance Series.
Additional links: AMA Code & Guideline Changes, COVID Vaccine Log, Presentation Slides, Transcript
Date: 03/2021
Sponsoring organization: National Association of Rural Health Clinics
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Medicare Hospital Payments: Adjusting for Variation in Geographic Area Wages
Provides an overview of the use of the hospital wage index applied to the Medicare inpatient prospective payment system (IPPS) to account for geographic differences in hospitals' labor costs. Discusses the effect of the wage index on Medicare payments for inpatient hospital services, exceptions to wage index adjustments, and proposals for wage index reforms.
Date: 03/2021
Sponsoring organization: Congressional Research Service
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Sources of Insurance Coverage in Nonmetropolitan Areas: The Role of Public and Private Insurance Since 2009
Describes regional variation in insurance coverage rates, using the American Community Survey 5-year estimates from 2009-2013 and 2013-2017 to compare types of health insurance coverage for people less than 65 years of age. Features statistics including share of nonmetropolitan nonelderly population per region, health insurance rates for nonelderly with breakdowns by metropolitan and nonmetropolitan areas, and source of health insurance for nonelderly by region.
Author(s): Linda Li, Matthew Najarian, Abigail R. Barker, Timothy D. McBride, Keith J. Mueller
Date: 03/2021
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Geographic Expansion of Medicaid Managed Care Organizations: Assessing Access to Primary Care in Nonmetropolitan Counties
Presents a study on primary care access for Medicaid beneficiaries in nonmetropolitan counties who were enrolled through managed care organizations (MCOs) from 2012 to 2018. Details the level of access to primary care in the nonmetropolitan counties of 15 states and compares the rates of access for beneficiaries enrolled through MCOs established before 2012 and after 2012. Discusses findings and makes recommendations for policy makers.
Author(s): Linda Li, Matthew Najarian, Abigail R. Barker, et al.
Date: 03/2021
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Monitoring State Flex Program Financial and Operational Improvement Activities
Presents the results of a qualitative evaluation of State Flex Program interventions implemented under Program Area 2: Financial and Operational Improvement (FOI). Describes the type of projects proposed by a subset of 14 State Flex Programs, key themes, and challenges faced to monitoring and documenting these interventions on financial and operational performance. Includes an inventory of all 45 State Flex Program FOI initiatives.
Author(s): John Gale, Sara Kahn-Troster, Zachariah Croll, Nathan First
Date: 03/2021
Sponsoring organization: Flex Monitoring Team
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Rural Initiatives Addressing Community Social Needs
Describes the role of Critical Access Hospitals (CAHs) in improving population health and addressing social needs in their communities. Profiles two Critical Access Hospital social needs programs: Lakewood Health System's food access initiatives in Minnesota, and Northeastern Vermont Regional Hospital's NEK Prosper. Provides an overview of both programs and highlights best practices of each.
Author(s): Madeleine Pick, Megan Lahr, Ira Moscovice
Date: 03/2021
Sponsoring organization: Flex Monitoring Team
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Sustainability Strategies for Community-based Palliative Care
Summarizes themes from two roundtable discussions conducted in late 2018 with 9 rural palliative care programs in Minnesota and surrounding states. Offers examples and resources for sustainability strategies to support community-based palliative care programs.
Date: 03/2021
Sponsoring organization: Stratis Health
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