Rural Health
Resources by Topic: Healthcare business and finance
Health Care Transparency: CMS Needs More Information on Hospital Pricing Data Completeness and Accuracy
Provides an overview of the Centers for Medicare & Medicaid Services (CMS) hospital price transparency requirements before and after 2024 updates to the requirements. Describes users' experiences with hospital pricing data before the 2024 updates. Examines CMS's enforcement of hospital price transparency requirements and offers recommendations to CMS regarding the sufficiency and accuracy of the data reported. Table 3 compares CMS enforcement actions by hospitals' rural or urban designation between 2021 and 2023.
Additional links: Full Report
Date: 10/2024
Sponsoring organization: Government Accountability Office
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Provides an overview of the Centers for Medicare & Medicaid Services (CMS) hospital price transparency requirements before and after 2024 updates to the requirements. Describes users' experiences with hospital pricing data before the 2024 updates. Examines CMS's enforcement of hospital price transparency requirements and offers recommendations to CMS regarding the sufficiency and accuracy of the data reported. Table 3 compares CMS enforcement actions by hospitals' rural or urban designation between 2021 and 2023.
Additional links: Full Report
Date: 10/2024
Sponsoring organization: Government Accountability Office
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One or Two Health Systems Controlled the Entire Market for Inpatient Hospital Care in Nearly Half of Metropolitan Areas in 2022
Examines the competitiveness of hospital markets in 2022 by analyzing RAND Hospital Data and American Hospital Association (AHA) survey data. Presents data on the share of metropolitan statistical areas (MSAs) controlled by a small number of health systems, the level of market concentration in MSAs, and the share of hospitals affiliated with health systems over time. Compares the share of hospitals affiliated with health systems in rural and non-rural areas.
Author(s): Jamie Godwin, Zachary Levinson, Tricia Neuman
Date: 10/2024
Sponsoring organization: KFF
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Examines the competitiveness of hospital markets in 2022 by analyzing RAND Hospital Data and American Hospital Association (AHA) survey data. Presents data on the share of metropolitan statistical areas (MSAs) controlled by a small number of health systems, the level of market concentration in MSAs, and the share of hospitals affiliated with health systems over time. Compares the share of hospitals affiliated with health systems in rural and non-rural areas.
Author(s): Jamie Godwin, Zachary Levinson, Tricia Neuman
Date: 10/2024
Sponsoring organization: KFF
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Merit-Based Incentive Payment System (MIPS): 2025 MIPS Payment Year (2023 Performance Year) - Payment Adjustment User Guide
Provides information on Merit-Based Incentive Payment System (MIPS) payment adjustments for calendar year 2025. Describes how 2023 MIPS scores relate to 2025 payment adjustments and how payment adjustments are applied. Offers answers to frequently asked questions.
Date: 10/2024
Sponsoring organization: Centers for Medicare and Medicaid Services
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Provides information on Merit-Based Incentive Payment System (MIPS) payment adjustments for calendar year 2025. Describes how 2023 MIPS scores relate to 2025 payment adjustments and how payment adjustments are applied. Offers answers to frequently asked questions.
Date: 10/2024
Sponsoring organization: Centers for Medicare and Medicaid Services
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Nebraska - Breaking the Pattern: Driving Initiatives to Safely Transition Patients Across the Care Continuum
Discusses challenges of discharging hospitalized patients in Nebraska to post-acute care. Provides data on patients awaiting discharge, reasons for delay, impact of Medicare advantage, and possible solutions. Includes county-level information on availability of long-term care or assisted living facilities and discusses impact on rural areas.
Date: 09/2024
Sponsoring organization: Nebraska Hospital Association
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Discusses challenges of discharging hospitalized patients in Nebraska to post-acute care. Provides data on patients awaiting discharge, reasons for delay, impact of Medicare advantage, and possible solutions. Includes county-level information on availability of long-term care or assisted living facilities and discusses impact on rural areas.
Date: 09/2024
Sponsoring organization: Nebraska Hospital Association
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Costs of Treat-and-Release Emergency Department Visits in the United States, 2021
Explores the cost of treat-and-release emergency department (ED) visits in the United States in 2021. Describes findings from an analysis of the 2021 Healthcare Cost and Utilization Project (HCUP) Nationwide Emergency Department Sample. Presents data on the aggregate costs, average cost, and number of ED visits by patient and hospital characteristics, including patient age; sex; primary expected payer; community-level income; and metropolitan, micropolitan, or rural status.
Author(s): Marc Roemer
Date: 09/2024
Sponsoring organization: Agency for Healthcare Research and Quality
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Explores the cost of treat-and-release emergency department (ED) visits in the United States in 2021. Describes findings from an analysis of the 2021 Healthcare Cost and Utilization Project (HCUP) Nationwide Emergency Department Sample. Presents data on the aggregate costs, average cost, and number of ED visits by patient and hospital characteristics, including patient age; sex; primary expected payer; community-level income; and metropolitan, micropolitan, or rural status.
Author(s): Marc Roemer
Date: 09/2024
Sponsoring organization: Agency for Healthcare Research and Quality
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States Could Better Leverage Coverage and Access Requirements To Promote Maternal Health Care Access in Medicaid Managed Care
Describes challenges to maternal healthcare access. Explores the provider coverage rules and network adequacy standards state Medicaid agencies have set for maternal healthcare in Medicaid managed care. Examines state oversight of quantitative network adequacy standards. Offers recommendations to the Centers for Medicare & Medicaid Services (CMS) to ensure access to pregnancy and postpartum care in Medicaid managed care. Includes rural references throughout.
Additional links: Report in Brief
Date: 09/2024
Sponsoring organization: Office of Inspector General (HHS)
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Describes challenges to maternal healthcare access. Explores the provider coverage rules and network adequacy standards state Medicaid agencies have set for maternal healthcare in Medicaid managed care. Examines state oversight of quantitative network adequacy standards. Offers recommendations to the Centers for Medicare & Medicaid Services (CMS) to ensure access to pregnancy and postpartum care in Medicaid managed care. Includes rural references throughout.
Additional links: Report in Brief
Date: 09/2024
Sponsoring organization: Office of Inspector General (HHS)
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Who Owns Rural Hospitals? A Comparison of Findings across Four National Datasets
Explores rural hospital ownership characteristics as reported across four national datasets: the Centers for Medicare & Medicaid Services (CMS) Healthcare Cost Reporting Information System (HCRIS); the CMS Provider Enrollment, Chain, and Ownership System (PECOS); the Private Equity Stakeholder Project (PESP); and the Agency for Healthcare Research and Quality (AHRQ). Compares rural hospitals with consistent ownership characteristics across datasets with those with inconsistent reports of ownership by Census division, Medicare payment classification, long-term care service provision, Rural Health Clinic (RHC) service provision, and more.
Author(s): Anastasia Dai, Tyler Malone
Date: 09/2024
Sponsoring organization: North Carolina Rural Health Research Program
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Explores rural hospital ownership characteristics as reported across four national datasets: the Centers for Medicare & Medicaid Services (CMS) Healthcare Cost Reporting Information System (HCRIS); the CMS Provider Enrollment, Chain, and Ownership System (PECOS); the Private Equity Stakeholder Project (PESP); and the Agency for Healthcare Research and Quality (AHRQ). Compares rural hospitals with consistent ownership characteristics across datasets with those with inconsistent reports of ownership by Census division, Medicare payment classification, long-term care service provision, Rural Health Clinic (RHC) service provision, and more.
Author(s): Anastasia Dai, Tyler Malone
Date: 09/2024
Sponsoring organization: North Carolina Rural Health Research Program
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Health Care Affordability and Medical Debt: Differences by Rurality, Region, and Socio-Demographic Characteristics
Policy brief examining rural/urban differences in health care affordability and medical debt concerns. Features statistics including rates of affordability issues with breakdowns by rural and urban location, and among rural residents with breakdowns by sociodemographic characteristics.
Author(s): Ingrid Jacobson, Katie Rydberg, Mariana Tuttle, et al.
Date: 09/2024
Sponsoring organization: University of Minnesota Rural Health Research Center
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Policy brief examining rural/urban differences in health care affordability and medical debt concerns. Features statistics including rates of affordability issues with breakdowns by rural and urban location, and among rural residents with breakdowns by sociodemographic characteristics.
Author(s): Ingrid Jacobson, Katie Rydberg, Mariana Tuttle, et al.
Date: 09/2024
Sponsoring organization: University of Minnesota Rural Health Research Center
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Leveraging Medicaid to Support Housing and Nutrition in Ohio
Describes the Ohio Medicaid program and the federal Medicaid health-related social needs (HRSN) framework. Discusses how Medicaid coverage in Ohio can cover aspects of housing and nutrition needs as of 2023. Includes county-level map depicting percent of income spent on housing in Ohio as well as examples of programs addressing HRSNs in rural areas.
Author(s): Hailey Akah, Robin Blair-Ackison, Edith Nkenganyi, et al.
Date: 09/2024
Sponsoring organization: Health Policy Institute of Ohio
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Describes the Ohio Medicaid program and the federal Medicaid health-related social needs (HRSN) framework. Discusses how Medicaid coverage in Ohio can cover aspects of housing and nutrition needs as of 2023. Includes county-level map depicting percent of income spent on housing in Ohio as well as examples of programs addressing HRSNs in rural areas.
Author(s): Hailey Akah, Robin Blair-Ackison, Edith Nkenganyi, et al.
Date: 09/2024
Sponsoring organization: Health Policy Institute of Ohio
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Final Report of the Rural Texas Obstetrics Study
Uses data analysis, interviews, and surveys to report on rural obstetrics access issues in Texas. Discusses facility closures, distance to care, provider shortages, reimbursements, and healthcare quality. Offers an analysis of 15 facilities that closed OB departments to understand potential drivers of closures. Email address required to access report.
Date: 09/2024
Sponsoring organization: Stroudwater Associates
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Uses data analysis, interviews, and surveys to report on rural obstetrics access issues in Texas. Discusses facility closures, distance to care, provider shortages, reimbursements, and healthcare quality. Offers an analysis of 15 facilities that closed OB departments to understand potential drivers of closures. Email address required to access report.
Date: 09/2024
Sponsoring organization: Stroudwater Associates
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