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Rural Health Information Hub

Rural Health
Resources by Topic: Healthcare business and finance

High-Functioning Rural Medicare ACOs – A Qualitative Review
Describes the success factors common to high-performing Accountable Care Organizations (ACOs) based in rural areas of New York, Maine, Missouri and Arkansas, and New Hampshire. Examines these organizations' governance, ACO history, operations, finances, population health, and lessons learned.
Author(s): Thomas Vaughn, Keith Mueller, Clinton MacKinney
Date: 02/2021
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Trends in Nursing Home Closures in Nonmetropolitan and Metropolitan Counties in the United States, 2008-2018
Policy brief documenting closures of facilities dually certified by Medicare and Medicaid or facilities certified by Medicaid only. Identifies areas lacking nursing homes and summarizes characteristics of open and closed nursing homes. Features statistics with breakdowns by metropolitan and nonmetropolitan areas, and county-level maps showing areas with one or more nursing home closures from 2008-2018 and counties considered nursing home deserts.
Author(s): Hari Sharma, Redwan Bin Abdul Baten, Fred Ullrich, A. Clinton MacKinney, Keith J. Mueller
Date: 02/2021
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Crises Collide: The COVID-19 Pandemic and the Stability of the Rural Health Safety Net
Examines the vulnerability of rural hospitals based on financial and operational metrics, and the impact of COVID-19 on these hospitals. Discusses declining access to obstetrics and chemotherapy services at rural hospitals. Includes a chart highlighting financial indicators and information on the availability of intensive care beds at rural hospitals by state.
Date: 02/2021
Sponsoring organization: Chartis Center for Rural Health
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CMS Needs to Implement Risk-Based Oversight of Puerto Rico's Procurement Process
Report details the lack of oversight by Centers for Medicare and Medicaid Services (CMS) of contractors hired to facilitate Puerto Rico's Medicaid program. Discusses Puerto Rico's Medicaid procurement process and outlines the risk of fraud, waste, and abuse of funds due to lack oversight.
Additional links: Full Report
Date: 02/2021
Sponsoring organization: Government Accountability Office
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Medicaid's Role in Health Care for American Indians and Alaska Natives
Provides an overview of the federal government's role in providing healthcare to American Indians and Alaska Natives (AI/AN). Discusses AI/AN demographics, economic and health disparities, and access to healthcare and insurance coverage. Describes the structure of the Indian Health Service (IHS), services provided, and IHS financing and spending. Highlights special rules and protections that apply to AI/AN Medicaid beneficiaries. Presents a series of policy issues that have been raised regarding the Medicaid and IHS relationship, as well as opportunities for improving Medicaid's role in providing healthcare to AI/AN populations.
Date: 02/2021
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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MBQIP Quality Measures National Annual Report - 2019
Summarizes quality measure reporting rates and performance among Critical Access Hospitals (CAHs) in 2019. Presents data on the four Medicare Beneficiary Quality Improvement Project (MBQIP) domains: patient safety/inpatient, outpatient, patient engagement, and care transitions.
Author(s): Megan Lahr, Madeleine Pick, Tongtan Chantarat, Nathan Bean, Ira Moscovice
Date: 02/2021
Sponsoring organization: Flex Monitoring Team
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Alternatives to Hospital Closure: Findings from a National Survey of CAH Executives
Discusses factors leading to rural hospital closures and alternatives to closure to maintain access to healthcare in rural areas and/or Critical Access Hospital (CAH) viability. Presents data from a survey of 227 CAH CEOs and other management staff, discussing their responses to a list of alternatives to hospital closure, including Rural Health Clinic (RHC) certification, conversion to emergency or urgent care services, Federally Qualified Health Center (FQHC) certification, and other alternatives.
Author(s): Sharita Thomas, Kristie Thompson, Kathleen Knocke, George Pink
Date: 02/2021
Sponsoring organization: North Carolina Rural Health Research Program
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Health System Challenges for Critical Access Hospitals: Findings from a National Survey of CAH Executives
Results of a 2019 survey of 174 respondents, examining challenges including uncompensated care, affordability of health insurance, patients seeking care beyond their local hospital, and prescription drug prices. Intended to help rural health policymakers in development of strategies to maintain Critical Access Hospital viability and access to healthcare in rural communities.
Author(s): Sharita Thomas, Kristie Thompson, Kathleen Knocke, George Pink
Date: 02/2021
Sponsoring organization: North Carolina Rural Health Research Program
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Quality Time: Sharing PIE - Involving Board and Leadership to Drive Quality Outcomes
Podcast recording exploring how a Critical Access Hospital (CAH) board and leadership are engaged with and support quality improvement work. Features quality, clinical, and board representatives from Paris Community Hospital, a CAH in Paris, Illinois.
Date: 02/2021
Sponsoring organization: Stratis Health
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Medicaid and CHIP in the U.S. Virgin Islands
Summarizes key requirements and design features of Medicaid and the State Children's Health Insurance Program (CHIP) in the U.S. Virgin Islands. Features statistics on program costs from fiscal years 2011-2019, with breakdowns by federal spending and U.S. Virgin Islands spending.
Date: 02/2021
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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