Rural Health
Resources by Topic: Medicaid
The Center for Medicare and Medicaid Innovation 2018 Report to Congress
Reports to Congress on payment and service delivery models and initiatives tested or announced by the Center for Medicare and Medicaid Innovation between October 2016 and 2018. Addresses Accountable Care Organization (ACO) models, population-based payment models, bundled payment models, and models that integrated Medicaid and Medicare beneficiary care. Identifies model adaptations for rural health organizations, such as the ACO Investment model, and includes a section on the Pennsylvania Rural Health Model.
Date: 04/2019
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Reports to Congress on payment and service delivery models and initiatives tested or announced by the Center for Medicare and Medicaid Innovation between October 2016 and 2018. Addresses Accountable Care Organization (ACO) models, population-based payment models, bundled payment models, and models that integrated Medicaid and Medicare beneficiary care. Identifies model adaptations for rural health organizations, such as the ACO Investment model, and includes a section on the Pennsylvania Rural Health Model.
Date: 04/2019
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Integrating Care through Dual Eligible Special Needs Plans (D-SNPs): Opportunities and Challenges
Examines state and federal policy options for increasing alignment and integration of people eligible for Medicare and Medicaid through Dual Eligible Special Needs Plans (D-SNPs). Reviews the literature on the topic, provides case studies from 5 states, reports on a meeting with officials from states working on D-SNPs, and addresses challenges for offering D-SNPs in rural areas.
Author(s): Nancy Archibald, Michelle Soper, Leah Smith, Alexandra Kruse, Joshua Wiener
Date: 04/2019
Type: Document
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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Examines state and federal policy options for increasing alignment and integration of people eligible for Medicare and Medicaid through Dual Eligible Special Needs Plans (D-SNPs). Reviews the literature on the topic, provides case studies from 5 states, reports on a meeting with officials from states working on D-SNPs, and addresses challenges for offering D-SNPs in rural areas.
Author(s): Nancy Archibald, Michelle Soper, Leah Smith, Alexandra Kruse, Joshua Wiener
Date: 04/2019
Type: Document
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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Addressing Low Case-Volume in Healthcare Performance Measurement of Rural Providers: Recommendations from the MAP Rural Health Technical Expert Panel
Final report recommending how to measure healthcare performance in low case-volume situations, such as rural providers. Reviews existing and proposed low-volume healthcare quality measures, how measures are calculated, data use, and data analysis techniques. Focuses on Centers for Medicare and Medicaid Services (CMS) quality programs reporting requirements.
Date: 03/2019
Type: Document
Sponsoring organization: National Quality Forum MAP Rural Health Advisory Workgroup
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Final report recommending how to measure healthcare performance in low case-volume situations, such as rural providers. Reviews existing and proposed low-volume healthcare quality measures, how measures are calculated, data use, and data analysis techniques. Focuses on Centers for Medicare and Medicaid Services (CMS) quality programs reporting requirements.
Date: 03/2019
Type: Document
Sponsoring organization: National Quality Forum MAP Rural Health Advisory Workgroup
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Community Health Center Financing: The Role of Medicaid and Section 330 Grant Funding Explained
Describes the two main sources of funds, Medicaid and Section 330 grant funding, that enable community health centers (CHCs) to provide healthcare services for underserved rural and urban populations in the U.S. Discusses Medicaid's special payment rules for CHCs, the role of Section 330 funding, and the expansion of CHCs due to funding increases.
Author(s): Sara Rosenbaum, Jessica Sharac, Peter Shin, Jennifer Tolbert
Date: 03/2019
Type: Document
Sponsoring organization: KFF
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Describes the two main sources of funds, Medicaid and Section 330 grant funding, that enable community health centers (CHCs) to provide healthcare services for underserved rural and urban populations in the U.S. Discusses Medicaid's special payment rules for CHCs, the role of Section 330 funding, and the expansion of CHCs due to funding increases.
Author(s): Sara Rosenbaum, Jessica Sharac, Peter Shin, Jennifer Tolbert
Date: 03/2019
Type: Document
Sponsoring organization: KFF
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Strengthening Medicaid Long-term Services and Supports in an Evolving Policy Environment: A Toolkit for States
Shares strategies states can use to reform their long-term services and supports (LTSS) framework, focusing on improving LTSS in two key areas: rebalancing LTSS to increase the proportion of LTSS provided in community-based settings and integrating LTSS with physical and behavioral health services through managed care. Uses case studies to provide examples of each strategy, and discusses rural considerations throughout.
Additional links: Brief for Legislators, Summary of Reforms
Author(s): Stephanie Anthony, Arielle Traub, Sarah Lewis, et al.
Date: 03/2019
Type: Document
Sponsoring organization: Center for Health Care Strategies
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Shares strategies states can use to reform their long-term services and supports (LTSS) framework, focusing on improving LTSS in two key areas: rebalancing LTSS to increase the proportion of LTSS provided in community-based settings and integrating LTSS with physical and behavioral health services through managed care. Uses case studies to provide examples of each strategy, and discusses rural considerations throughout.
Additional links: Brief for Legislators, Summary of Reforms
Author(s): Stephanie Anthony, Arielle Traub, Sarah Lewis, et al.
Date: 03/2019
Type: Document
Sponsoring organization: Center for Health Care Strategies
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Examining the Cost Effectiveness of Teaching Health Centers
Examines areas where the Teaching Health Center Graduate Medical Education (THCGME) program can produce savings, focusing on physician spending for patient encounters during and after residency training and patient Medicaid and Medicare insurance coverage. Identifies the location of THCGME programs and highlights program outcomes, including the percent of graduates who work in rural and underserved areas and practice primary care.
Author(s): Candice Chen, Leighton Ku, Marsha Regenstein, Fitzhugh Mullan
Date: 03/2019
Type: Document
Sponsoring organizations: Geiger Gibson Program in Community Health, George Washington University Milken Institute School of Public Health Department of Health Policy and Management, RCHN Community Health Foundation
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Examines areas where the Teaching Health Center Graduate Medical Education (THCGME) program can produce savings, focusing on physician spending for patient encounters during and after residency training and patient Medicaid and Medicare insurance coverage. Identifies the location of THCGME programs and highlights program outcomes, including the percent of graduates who work in rural and underserved areas and practice primary care.
Author(s): Candice Chen, Leighton Ku, Marsha Regenstein, Fitzhugh Mullan
Date: 03/2019
Type: Document
Sponsoring organizations: Geiger Gibson Program in Community Health, George Washington University Milken Institute School of Public Health Department of Health Policy and Management, RCHN Community Health Foundation
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Report to Congress on Medicaid and CHIP, March 2019
Reports on three aspects of Medicaid: improving the structure of Disproportionate Share Hospital (DSH) payment reductions, oversight of upper payment limits for supplemental payments to hospitals, and Disproportionate Share Hospital (DSH) payments to states. Chapter 3 includes the annual report on DSH payments, which provide support to safety-net hospitals to help offset uncompensated care costs for Medicaid and uninsured patients. Table 3-1 identifies DSH spending for urban and rural hospitals and for Critical Access Hospitals.
Date: 03/2019
Type: Document
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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Reports on three aspects of Medicaid: improving the structure of Disproportionate Share Hospital (DSH) payment reductions, oversight of upper payment limits for supplemental payments to hospitals, and Disproportionate Share Hospital (DSH) payments to states. Chapter 3 includes the annual report on DSH payments, which provide support to safety-net hospitals to help offset uncompensated care costs for Medicaid and uninsured patients. Table 3-1 identifies DSH spending for urban and rural hospitals and for Critical Access Hospitals.
Date: 03/2019
Type: Document
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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Best Practices and Barriers to Engaging People with Substance Use Disorders in Treatment
Reports on a study of how health plans are successfully engaging people in substance use disorder treatment for alcohol, opioids, and other substances. Discusses how initiation and engagement can be improved for commercial and Medicaid health insurance plans. Addresses rural factors throughout.
Author(s): Peggy O'Brien, Erika Crable, Catherine Fullerton, Lauren Hughey
Date: 03/2019
Type: Document
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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Reports on a study of how health plans are successfully engaging people in substance use disorder treatment for alcohol, opioids, and other substances. Discusses how initiation and engagement can be improved for commercial and Medicaid health insurance plans. Addresses rural factors throughout.
Author(s): Peggy O'Brien, Erika Crable, Catherine Fullerton, Lauren Hughey
Date: 03/2019
Type: Document
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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2019 Telehealth Reimbursement
Provides an overview of Medicare reimbursement for telehealth services and discusses factors, policies, and legislation affecting reimbursement including: geographic and originating site restrictions; provider restrictions; service restrictions; payment for remote communication technology; chronic care management and remote monitoring; Medicare Advantage; Accountable Care Organizations, bundled care, and telehealth. Covers Medicaid and private payer telehealth reimbursement policies.
Date: 02/2019
Type: Document
Sponsoring organization: Center for Connected Health Policy: The National Telehealth Policy Resource Center
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Provides an overview of Medicare reimbursement for telehealth services and discusses factors, policies, and legislation affecting reimbursement including: geographic and originating site restrictions; provider restrictions; service restrictions; payment for remote communication technology; chronic care management and remote monitoring; Medicare Advantage; Accountable Care Organizations, bundled care, and telehealth. Covers Medicaid and private payer telehealth reimbursement policies.
Date: 02/2019
Type: Document
Sponsoring organization: Center for Connected Health Policy: The National Telehealth Policy Resource Center
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Fact Sheet: Rural Nebraska's Shifting Long-term Care System
Highlights the state of Nebraska's rural long-term care system. Addresses access, capacity, provider shortages, and reimbursements.
Date: 02/2019
Type: Document
Sponsoring organization: Center for Rural Affairs
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Highlights the state of Nebraska's rural long-term care system. Addresses access, capacity, provider shortages, and reimbursements.
Date: 02/2019
Type: Document
Sponsoring organization: Center for Rural Affairs
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