Rural Health
Resources by Topic: Legislation and regulations
California Assembly Bill 2024: Report to the Legislature July 2023
Report analyzing hospital annual reports, surveys, and key informant interviews to determine the impact of California's Assembly Bill 2024 on physician recruitment and retention, discussing the benefits of employment versus contracting. Outlines how the bill addressed rural hospital-specific challenges and what challenges still remain.
Date: 07/2023
Sponsoring organization: California Department of Health Care Access and Information
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Report analyzing hospital annual reports, surveys, and key informant interviews to determine the impact of California's Assembly Bill 2024 on physician recruitment and retention, discussing the benefits of employment versus contracting. Outlines how the bill addressed rural hospital-specific challenges and what challenges still remain.
Date: 07/2023
Sponsoring organization: California Department of Health Care Access and Information
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Improving the Social Determinants of Health in Rural America Through Medicaid Section 1115 Waivers
Policy brief discussing how Medicaid Section 1115 waivers can allow states to modify the social determinants of health in rural areas through pilot programs, delivery system reform, or enhanced benefit packages. Highlights existing Section 1115 waiver programs and recently approved and renewed waivers, as well as challenges related to improving health-related social needs and access to services in rural areas. Offers policy recommendations to improve health equity in rural areas through Medicaid programs.
Author(s): Alexandra Zimmerman
Date: 07/2023
Sponsoring organization: National Rural Health Association
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Policy brief discussing how Medicaid Section 1115 waivers can allow states to modify the social determinants of health in rural areas through pilot programs, delivery system reform, or enhanced benefit packages. Highlights existing Section 1115 waiver programs and recently approved and renewed waivers, as well as challenges related to improving health-related social needs and access to services in rural areas. Offers policy recommendations to improve health equity in rural areas through Medicaid programs.
Author(s): Alexandra Zimmerman
Date: 07/2023
Sponsoring organization: National Rural Health Association
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COVID-19 Impact on Dental Service Delivery, Financing, Regulation, and Education Systems: An Environmental Scan
Describes the immediate and longer-term impacts of the COVID-19 pandemic on dental care delivery, regulation, education, and finance. Mentions rural throughout.
Author(s): Margaret Langelier, Aubri Kottek, Theekshana Fernando, et al.
Date: 07/2023
Sponsoring organization: Oral Health Workforce Research Center
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Describes the immediate and longer-term impacts of the COVID-19 pandemic on dental care delivery, regulation, education, and finance. Mentions rural throughout.
Author(s): Margaret Langelier, Aubri Kottek, Theekshana Fernando, et al.
Date: 07/2023
Sponsoring organization: Oral Health Workforce Research Center
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Changes in Telehealth Experienced by Advanced Practice RNs During COVID-19
Summarizes 7,467 advanced practice RNs' national survey responses from June-September 2020 about the use of telehealth before and during the pandemic, and analyzes free-text comments about how the use of telehealth changed during the pandemic. Discusses challenges in rural areas, including provider shortages and lack of broadband access.
Author(s): Mavis N. Schorn, Carole R. Myers, Julie Barroso, et al.
Citation: Computers, Informatics, Nursing, 41(7), 507–513
Date: 07/2023
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Summarizes 7,467 advanced practice RNs' national survey responses from June-September 2020 about the use of telehealth before and during the pandemic, and analyzes free-text comments about how the use of telehealth changed during the pandemic. Discusses challenges in rural areas, including provider shortages and lack of broadband access.
Author(s): Mavis N. Schorn, Carole R. Myers, Julie Barroso, et al.
Citation: Computers, Informatics, Nursing, 41(7), 507–513
Date: 07/2023
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Addressing the Opioid Crisis: A Look at the Evolving Landscape of Federal OUD Treatment Policies
Provides an overview of five federal policies that impacted the provision of opioid use disorder (OUD) treatments during the COVID-19 pandemic. Covers regulations related to buprenorphine medication, methadone dispensing programs, overdose prevention and reversal methods, and leveraging Medicaid for pre- and post-release from prison OUD treatment services. Discusses how state laws may limit federal efforts.
Author(s): Heather Saunders, Nirmita Panchal
Date: 07/2023
Sponsoring organization: KFF
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Provides an overview of five federal policies that impacted the provision of opioid use disorder (OUD) treatments during the COVID-19 pandemic. Covers regulations related to buprenorphine medication, methadone dispensing programs, overdose prevention and reversal methods, and leveraging Medicaid for pre- and post-release from prison OUD treatment services. Discusses how state laws may limit federal efforts.
Author(s): Heather Saunders, Nirmita Panchal
Date: 07/2023
Sponsoring organization: KFF
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Evaluation of the Impact of the No Surprises Act on Health Care Market Outcomes: Baseline Trends and Framework for Analysis - First Annual Report
Provides an overview of the No Surprises Act, which aims to protect participants, beneficiaries, and enrollees in group health plans and group and individual health insurance coverage from surprise medical bills. Details key trends in factors that will be important to evaluate the effects of the No Surprises Act, including the implementation and impacts of state surprise billing laws already in effect; trends in market consolidation and concentration; the impact of market consolidation and concentration on prices, quality, and spending; and trends in out-of-network billing. Describes a conceptual framework for considering the healthcare market effects of the No Surprises Act. Figure 4-3 shows rates of out-of-network billing prevalence by urban and rural patient residence.
Additional links: Cover Memo
Date: 07/2023
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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Provides an overview of the No Surprises Act, which aims to protect participants, beneficiaries, and enrollees in group health plans and group and individual health insurance coverage from surprise medical bills. Details key trends in factors that will be important to evaluate the effects of the No Surprises Act, including the implementation and impacts of state surprise billing laws already in effect; trends in market consolidation and concentration; the impact of market consolidation and concentration on prices, quality, and spending; and trends in out-of-network billing. Describes a conceptual framework for considering the healthcare market effects of the No Surprises Act. Figure 4-3 shows rates of out-of-network billing prevalence by urban and rural patient residence.
Additional links: Cover Memo
Date: 07/2023
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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Interim CMS Rural Health Clinic (RHC) Rural Location Determinations Due to Census Bureau (CB) Regulatory Changes
Describes how 2022 Census Bureau changes to urban and rural definitions impact the Rural Health Clinic (RHC) eligibility determinations. Details the interim process the Centers for Medicare & Medicaid Services will use for making RHC rural location determinations.
Date: 07/2023
Sponsoring organization: Centers for Medicare and Medicaid Services
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Describes how 2022 Census Bureau changes to urban and rural definitions impact the Rural Health Clinic (RHC) eligibility determinations. Details the interim process the Centers for Medicare & Medicaid Services will use for making RHC rural location determinations.
Date: 07/2023
Sponsoring organization: Centers for Medicare and Medicaid Services
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Arkansas State Plan on Aging: Fiscal Years 2024-2027
Provides direction for long-term care efforts in the state of Arkansas. Focuses on implementation of the Older American Act (OAA), COVID-19 recovery, equity, access to home and community-based services, and caregiving infrastructure. Highlights population data on rural Arkansas citizens and rural-specific priorities.
Date: 06/2023
Sponsoring organization: Arkansas Department of Human Services
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Provides direction for long-term care efforts in the state of Arkansas. Focuses on implementation of the Older American Act (OAA), COVID-19 recovery, equity, access to home and community-based services, and caregiving infrastructure. Highlights population data on rural Arkansas citizens and rural-specific priorities.
Date: 06/2023
Sponsoring organization: Arkansas Department of Human Services
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Impact of Higher Payments for Rural Home Health Episodes on Rehospitalizations
Examines the impact of home health rural add-on payments on beneficiary outcomes, specifically on rehospitalizations. Uses Medicare data from 2007 to 2014 to compare rehospitalizations between rural and urban post-acute home health episodes before and after the implementation of the add-on payments in 2010. Discusses the implications of the findings on home health payment policy.
Author(s): Lacey Loomer, Momotazur Rahman, Tracy M. Mroz, Pedro L. Gozalo, Vincent Mor
Citation: Journal of Rural Health, 39(3), 604-610
Date: 06/2023
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Examines the impact of home health rural add-on payments on beneficiary outcomes, specifically on rehospitalizations. Uses Medicare data from 2007 to 2014 to compare rehospitalizations between rural and urban post-acute home health episodes before and after the implementation of the add-on payments in 2010. Discusses the implications of the findings on home health payment policy.
Author(s): Lacey Loomer, Momotazur Rahman, Tracy M. Mroz, Pedro L. Gozalo, Vincent Mor
Citation: Journal of Rural Health, 39(3), 604-610
Date: 06/2023
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Expanded Report to Congress: Non-Emergency Medical Transportation in Medicaid, 2018–2021
Examines the Medicaid analysis of non-emergency medical transportation (NEMT) using Transformed Medicaid Statistical Information System (T-MSIS) data from 2018-2021. Explores the number and percentage of Medicaid beneficiaries using NEMT, the average number of NEMT "ride days" per NEMT user per month enrolled in Medicaid, the types of medical services accessed when using NEMT, monthly trends in the use of NEMT versus telehealth services before and during the COVID-19 public health emergency (PHE), and the volume of NEMT services used by type of NEMT delivery model. Offers recommendations for states and local stakeholders regarding Medicaid coverage of NEMT. Presents data by state and by beneficiary characteristics, including Medicaid eligibility category, health conditions, and urban-rural location.
Date: 06/2023
Sponsoring organizations: Centers for Medicare and Medicaid Services, U.S. Department of Health and Human Services
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Examines the Medicaid analysis of non-emergency medical transportation (NEMT) using Transformed Medicaid Statistical Information System (T-MSIS) data from 2018-2021. Explores the number and percentage of Medicaid beneficiaries using NEMT, the average number of NEMT "ride days" per NEMT user per month enrolled in Medicaid, the types of medical services accessed when using NEMT, monthly trends in the use of NEMT versus telehealth services before and during the COVID-19 public health emergency (PHE), and the volume of NEMT services used by type of NEMT delivery model. Offers recommendations for states and local stakeholders regarding Medicaid coverage of NEMT. Presents data by state and by beneficiary characteristics, including Medicaid eligibility category, health conditions, and urban-rural location.
Date: 06/2023
Sponsoring organizations: Centers for Medicare and Medicaid Services, U.S. Department of Health and Human Services
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