Rural Health
Resources by Topic: Healthcare business and finance
Report to Congress: Social Risk Factors and Performance Under Medicare's Value-Based Purchasing Program
Uses Medicare data to examine the relationship between social risk factors and the performance of value-based purchasing programs. Discusses policy considerations that could help ensure value-based purchasing programs achieve their intended results, especially among high social risk populations. Categorizes rurality as a community risk factor and discusses whether beneficiaries with social risk factors such as rurality have worse outcomes due to their social risk profile, or because of the providers they see. Also provides rural-specific statistics and recommendations for using value-based purchasing to improve health outcomes among high social risk populations. Appendices summarize and provide additional details for each of the 9 programs evaluated. See the second report.
Additional links: Appendices
Date: 12/2016
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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Uses Medicare data to examine the relationship between social risk factors and the performance of value-based purchasing programs. Discusses policy considerations that could help ensure value-based purchasing programs achieve their intended results, especially among high social risk populations. Categorizes rurality as a community risk factor and discusses whether beneficiaries with social risk factors such as rurality have worse outcomes due to their social risk profile, or because of the providers they see. Also provides rural-specific statistics and recommendations for using value-based purchasing to improve health outcomes among high social risk populations. Appendices summarize and provide additional details for each of the 9 programs evaluated. See the second report.
Additional links: Appendices
Date: 12/2016
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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Medicare Value-Based Payment Models: Participation Challenges and Available Assistance for Small and Rural Practices
Identifies challenges faced by small and rural physician practices when participating in Medicare's new value-based payment models, and groups them into five key areas: financial resources and risk management, health IT and data, population health management care delivery, quality and efficiency performance measurement and reporting, and effects of model participation and managing compliance with requirements. Also identifies two types of organizations, partner and non-partner, along with the services they provide, that can help small and rural practices overcome these challenges.
Additional links: Full Report
Date: 12/2016
Sponsoring organization: Government Accountability Office
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Identifies challenges faced by small and rural physician practices when participating in Medicare's new value-based payment models, and groups them into five key areas: financial resources and risk management, health IT and data, population health management care delivery, quality and efficiency performance measurement and reporting, and effects of model participation and managing compliance with requirements. Also identifies two types of organizations, partner and non-partner, along with the services they provide, that can help small and rural practices overcome these challenges.
Additional links: Full Report
Date: 12/2016
Sponsoring organization: Government Accountability Office
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The Impact of State Medicaid Expansion Under the Affordable Care Act on Health Insurance Coverage at the County Level
Compares health insurance coverage in 2013, prior to the Affordable Care Act, and in 2015. Includes data on health insurance coverage for metropolitan and nonmetro counties. Discusses the impact of Medicaid expansion on health insurance coverage.
Author(s): Danielle C. Rhubart
Date: 12/2016
Sponsoring organization: Carsey School of Public Policy
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Compares health insurance coverage in 2013, prior to the Affordable Care Act, and in 2015. Includes data on health insurance coverage for metropolitan and nonmetro counties. Discusses the impact of Medicaid expansion on health insurance coverage.
Author(s): Danielle C. Rhubart
Date: 12/2016
Sponsoring organization: Carsey School of Public Policy
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Evaluation of Hospital-Setting HCIA Awards: Third Annual Report, Final
Third and final report evaluating 10 Health Care Innovation Awards Round One projects undertaken in a hospital inpatient or emergency department. Presents awardee-specific information on program impact and lessons learned. Includes projects that involved Critical Access Hospitals and other rural hospitals. Includes projects focused on improved care for sepsis and projects using remote electronic intensive care unit (eICU) services.
Additional links: Addendum, March 2017
Date: 11/2016
Sponsoring organizations: Abt Associates, Centers for Medicare and Medicaid Services
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Third and final report evaluating 10 Health Care Innovation Awards Round One projects undertaken in a hospital inpatient or emergency department. Presents awardee-specific information on program impact and lessons learned. Includes projects that involved Critical Access Hospitals and other rural hospitals. Includes projects focused on improved care for sepsis and projects using remote electronic intensive care unit (eICU) services.
Additional links: Addendum, March 2017
Date: 11/2016
Sponsoring organizations: Abt Associates, Centers for Medicare and Medicaid Services
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MBQIP Quality Measure Trends, 2011-2016
Examines trends in 37 Medicare Beneficiary Quality Improvement Project (MBQIP) quality measures from 2011 to 2016. Groups Critical Access Hospitals (CAHs) within 45 State Flex Programs into five regions, and organizes data into tables and figures which allow in-depth comparisons of the national, regional, and state trends for each MBQIP measure. Presents findings across five quality measure domains: patient engagement, care transitions, outpatient, inpatient, and patient safety.
Author(s): Tami Swenson, Michelle Casey
Date: 11/2016
Sponsoring organization: Flex Monitoring Team
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Examines trends in 37 Medicare Beneficiary Quality Improvement Project (MBQIP) quality measures from 2011 to 2016. Groups Critical Access Hospitals (CAHs) within 45 State Flex Programs into five regions, and organizes data into tables and figures which allow in-depth comparisons of the national, regional, and state trends for each MBQIP measure. Presents findings across five quality measure domains: patient engagement, care transitions, outpatient, inpatient, and patient safety.
Author(s): Tami Swenson, Michelle Casey
Date: 11/2016
Sponsoring organization: Flex Monitoring Team
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Federal Requirement for Physician Supervision of CRNAs
Discusses the federal requirement affecting participation in the Medicare program by Critical Access Hospitals (CAHs) or Ambulatory Surgical Centers (ASCs) regarding physician supervision of Certified Registered Nurse Anesthetists (CRNAs). Addresses the conditions for states to opt out of the physician supervision Medicare rule if they meet certain conditions and the research comparing the outcomes between states that opt-out and those that do not.
Author(s): Steve Barnett, John H Everett, Pat Schou
Date: 11/2016
Sponsoring organization: National Rural Health Association
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Discusses the federal requirement affecting participation in the Medicare program by Critical Access Hospitals (CAHs) or Ambulatory Surgical Centers (ASCs) regarding physician supervision of Certified Registered Nurse Anesthetists (CRNAs). Addresses the conditions for states to opt out of the physician supervision Medicare rule if they meet certain conditions and the research comparing the outcomes between states that opt-out and those that do not.
Author(s): Steve Barnett, John H Everett, Pat Schou
Date: 11/2016
Sponsoring organization: National Rural Health Association
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Comparing the Community Benefit Spending of Critical Access, Other Rural, and Urban Hospitals
Examines the levels and types of community benefit spending by Critical Access, rural, and urban hospitals. Compares the spending by percentage of total expenses, as well as by category, direct patient care versus community-building activities.
Author(s): John Gale, Zach Croll, Andrew Coburn, Jamar Croom
Date: 11/2016
Sponsoring organization: Flex Monitoring Team
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Examines the levels and types of community benefit spending by Critical Access, rural, and urban hospitals. Compares the spending by percentage of total expenses, as well as by category, direct patient care versus community-building activities.
Author(s): John Gale, Zach Croll, Andrew Coburn, Jamar Croom
Date: 11/2016
Sponsoring organization: Flex Monitoring Team
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Freestanding Emergency Departments: An Alternative Model for Rural Communities
Describes the freestanding emergency department (FSED) model as an option for rural communities that can no longer support inpatient services. Looks at both hospital-based and independent FSEDs, examines financial viability of the model, and features rural FSEDs in Illinois and Arizona.
Author(s): Jenn Lukens
Citation: Rural Monitor
Date: 11/2016
Sponsoring organization: Rural Health Information Hub
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Describes the freestanding emergency department (FSED) model as an option for rural communities that can no longer support inpatient services. Looks at both hospital-based and independent FSEDs, examines financial viability of the model, and features rural FSEDs in Illinois and Arizona.
Author(s): Jenn Lukens
Citation: Rural Monitor
Date: 11/2016
Sponsoring organization: Rural Health Information Hub
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Reassessing Financial Peer Groups for Critical Access Hospitals
Policy brief analyzing the influence of hospital, geographic, and community characteristics on the financial performance and conditions of Critical Access Hospitals (CAHs). Discusses the current factors of net patient revenue, government ownership, provision of long-term care, and operation of a Rural Health Clinic (RHC), which are used to determine peer groups for the Critical Access Hospital Financial Indicators Report (CAHFIR).
Author(s): Walter L. Hawkins, Kristin L. Reiter, George H. Pink
Date: 11/2016
Sponsoring organization: Flex Monitoring Team
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Policy brief analyzing the influence of hospital, geographic, and community characteristics on the financial performance and conditions of Critical Access Hospitals (CAHs). Discusses the current factors of net patient revenue, government ownership, provision of long-term care, and operation of a Rural Health Clinic (RHC), which are used to determine peer groups for the Critical Access Hospital Financial Indicators Report (CAHFIR).
Author(s): Walter L. Hawkins, Kristin L. Reiter, George H. Pink
Date: 11/2016
Sponsoring organization: Flex Monitoring Team
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"How Can We Talk about Patient-centered Care without Patients at the Table?" Lessons Learned from Patient Advisory Councils
Reports on a survey of patient advisory council (PAC) members associated with 8 primary care clinics and Federally Qualified Health Clinics (FQHCs), both rural and urban, in Northern California. Focuses on how PACs are developed, challenges faced, and the benefits of effective PACs.
Author(s): Anjana E. Sharma, Rachel Willard-Grace, Andrew Willis, et al.
Citation: Journal of the American Board of Family Medicine, 29(6), 775-784
Date: 11/2016
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Reports on a survey of patient advisory council (PAC) members associated with 8 primary care clinics and Federally Qualified Health Clinics (FQHCs), both rural and urban, in Northern California. Focuses on how PACs are developed, challenges faced, and the benefits of effective PACs.
Author(s): Anjana E. Sharma, Rachel Willard-Grace, Andrew Willis, et al.
Citation: Journal of the American Board of Family Medicine, 29(6), 775-784
Date: 11/2016
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