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Resources by Topic: Healthcare business and finance

CMS Bundled Payments for Care Improvement Advanced Model: Fifth Annual Evaluation Report
Fifth annual report of the Bundled Payments for Care Improvement Advanced (BPCI Advanced) Model, which tests whether linking payments for a clinical episode of care can reduce Medicare expenditures while maintaining or improving the quality of care. Explores the impact of BPCI Advanced on episode payments, utilization, and quality of care, as well as estimates of Medicare program savings in Model Year 4. Describes changes to the model that were implemented in Model Year 4 and how BPCI Advanced relates to Medicare Accountable Care Organizations (ACOs). Includes rural references throughout.
Additional links: Appendices, Executive Summary, Findings at a Glance
Author(s): The Lewin Group, Abt Associates, GDIT, Telligen
Date: 05/2024
Sponsoring organization: Centers for Medicare & Medicaid Services
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Senate Finance Committee Bipartisan Medicare GME Working Group Draft Proposal Outline and Questions for Consideration
Outlines draft policy proposals regarding the Medicare Graduate Medical Education (GME) program aimed at addressing healthcare workforce shortages. Proposals cover the distribution of Medicare GME slots to rural areas and key specialties, encouraging hospitals to train physicians in rural areas, the establishment of a Medicare GME Policy Council, GME data collection and transparency, and more. Includes questions for consideration on policies under consideration.
Date: 05/2024
Sponsoring organization: Senate Committee on Finance
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MedPAC Comment on CMS's Proposed Rule on the Payment System for Inpatient Psychiatric Facilities for FY 2025
Comment on an April 3, 2024, Federal Register proposed rule revising the Inpatient Psychiatric Facility Prospective Payment System (IPF PPS) for fiscal year 2025. Includes a discussion of rural IPF PPS payment adjustments.
Date: 05/2024
Sponsoring organization: Medicare Payment Advisory Commission
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A Closer Look at the Final Nursing Facility Rule and Which Facilities Might Meet New Staffing Requirements
Summarizes new Centers for Medicare & Medicaid Services's (CMS) nurse staffing requirements for nursing facilities outlined in the April 22, 2024, final rule. Analyzes Nursing Home Compare data from April 2024, which reflects nursing home staffing levels from December 2023, to explore the percentage of facilities that meet each of the new nurse staffing requirements. Presents data by nursing ownership status, rural and urban location, special focus facility status, and state.
Author(s): Priya Chidambaram, Alice Burns, Tricia Neuman, Robin Rudowitz
Date: 05/2024
Sponsoring organization: KFF
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Calculation of Overall Hospital Quality Star Ratings With and Without Inclusion of the Peer Grouping Step
Examines potential implications of including a peer grouping step in the calculation of Centers for Medicare & Medicaid Services (CMS) Overall Star Ratings. Uses January 2023 Medicare Care Compare data on 3,076 hospitals that received a star rating to calculate the peer groups based on the number of quality measure groups for which hospitals had 3 or more reported measures. Presents data on the characteristics of each peer group, the distribution of star ratings whether the peer grouping step was used or not used, and the number of hospitals with a higher, lower, or identical star rating when the peer grouping step was applied. Compares data by hospital characteristics, including safety-net status, Critical Access Hospital status, rural or urban location, and more.
Author(s): Cameron J. Gettel, Kyle Bagshaw, Li Qin, et al.
Citation: JAMA Network Open, 7(5), e2411933
Date: 05/2024
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Examining the Dental Care Crisis in America: How Can We Make Dental Care More Affordable and More Available?
Recording of a May 16, 2024, U.S. Senate Committee on Health, Education, Labor & Pensions hearing on the accessibility and affordability of dental care, including in rural areas. Features testimony from the CareQuest Institute for Oral Health.
Additional links: Myechia Minter-Jordan, CareQuest Institute for Oral Health - Testimony
Date: 05/2024
Sponsoring organization: Senate Committee on Health, Education, Labor & Pensions
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State Innovations to Advance Respite Care: Policy Strategies Shared at the State-Federal Respite Summit
Presents strategies utilized by states to improve access to and quality of respite care services for family caregivers. Strategies cover awareness and outreach, respite workforce education, and serving diverse populations. Highlights strategies from Colorado, North Dakota, and Oklahoma focused on rural areas.
Author(s): Kimberly Hodges, Ella Taggart, Salom Teshale
Date: 05/2024
Sponsoring organization: National Academy for State Health Policy
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Converting to Rural Emergency Hospitals
Podcast episode featuring a discussion with Rural Emergency Hospital (REH) Chief Executive Officers in New Mexico and Oklahoma regarding the conversion to REH status. Discusses the conversion process of each REH; how they built trust and buy-in from patients and communities, including state and federal policymakers; and financial considerations of conversion.
Date: 05/2024
Sponsoring organization: American Hospital Association
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Rural Health Care: Supporting Lives and Improving Communities
Presents the U.S. Senate Committee on Finance May 16, 2024, hearing on rural healthcare. Discusses the financial vulnerability of rural hospitals, the rural healthcare workforce and graduate medical education (GME), access to maternal healthcare, health information technology and telehealth, and more. Features testimony from the Chartis Center for Rural Health; Grande Ronde Hospital, a Critical Access Hospital in Oregon; the Wisconsin Collaborative for Rural Graduate Medical Education; and the Rural Policy Research Institute.
Additional links: Jeremy P. Davis, Grande Ronde Hospital - Testimony, Keith J. Mueller, Rural Policy Research Institute - Testimony, Lori Rodefeld, Wisconsin Collaborative for Rural Graduate Medical Education - Testimony, Michael Topchik, Chartis Center for Rural Health - Testimony
Date: 05/2024
Sponsoring organization: Senate Committee on Finance
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Differences in Measurement of Operating Margin: An Update
Describes how differences in measurement of operating margin for hospitals can affect the reported values. Compares the operating margins of urban and rural prospective payment system hospitals and Critical Access Hospitals (CAHs) across three definitions of operating margin using Medicare Cost Report data from April 2021 through March 2022. Describes situations in which each operating margin would be the most appropriate to calculate. Updates a 2008 study from the Flex Monitoring Team.
Author(s): Jessie Ma, Susie Gurzenda, Kristin Reiter, George Pink
Date: 05/2024
Sponsoring organization: North Carolina Rural Health Research Program
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