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Rural Health
Resources by Topic: Medicare

Second Evaluation Report: Next Generation Accountable Care Organization Model Evaluation
Reports on the impact of the Next Generation Accountable Care Organization model in 2016 and 2017, with information on the full sample of 46 participating NGACOs. Provides information on the models' impact on gross and net Medicare spending. The appendices include data on community characteristics, including rurality.
Additional links: Findings at a Glance, Technical Appendices
Date: 01/2020
Type: Document
Sponsoring organizations: Centers for Medicare and Medicaid Services, NORC at the University of Chicago
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Access to Specialty Care for Medicare Beneficiaries in Rural Communities
Findings from a voluntary online survey conducted in 2019 of 111 Rural Health Clinic (RHC) staff, from 27 states, to identify the most difficult specialty healthcare service to access, and why it is the most difficult to access. Conducts an analysis of RHC distance to the nearest hospital or clinic to determine variation in difficulty accessing specialty services.
Author(s): Megan Lahr, Hannah Neprash, Carrie Henning-Smith, Mariana S. Tuttle, Ashley M. Hernandez
Date: 12/2019
Type: Document
Sponsoring organization: University of Minnesota Rural Health Research Center
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Access and Capacity to Care for Medicare Beneficiaries in Rural Health Clinics
Findings from a voluntary online survey conducted in 2019 of 111 Rural Health Clinic (RHC) staff from 27 states, to better understand how they address issues on accessibility, capacity, flexibility of services, and other clinic characteristics for Medicare beneficiaries, and to identify any gaps in healthcare.
Author(s): Megan Lahr, Carrie Henning-Smith, Ashley M. Hernandez, Hannah Neprash
Date: 12/2019
Type: Document
Sponsoring organization: University of Minnesota Rural Health Research Center
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Impact of the Medicare Disproportionate Share Hospital Payment Cap on Rural and Urban Hospitals
Describes the number and location of hospitals that qualify for Medicare Disproportionate Share Hospital (DSH) payments and meet the criteria for a 12% payment cap. Examines how the payment cap and lost revenue impacts urban and rural hospitals. Presents options to modify DSH payments to ease the financial strain on rural hospitals.
Author(s): Paula Weigel, Fred Ullrich, Keith J. Mueller
Date: 12/2019
Type: Document
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Evaluation of the Home Health Value-Based Purchasing (HHVBP) Model: Second Annual Report
Evaluates the Home Health Value-Based Purchasing (HHVBP) Model, designed by the Center for Medicare & Medicaid Innovation (CMMI), implemented in nine states: Arizona, Florida, Iowa, Massachusetts, Maryland, Nebraska, North Carolina, Tennessee, and Washington. The HHVBP Model was created to establish the impact of providing financial incentives to home health agencies (HHAs) for improvements in quality of care. The analysis, based on data from the implementation stages (2013-2015) and performance years (2016-2017), reports on the effects of financial incentives on quality of care, Medicare expenditures, patient outcomes, and identifies regional differences in beneficiary demographics, and rural and urban status.
Author(s): Alyssa Pozniak, Marc Turenne, Purna Mukhopadhyay, et al.
Date: 12/2019
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Evaluation of the Initiative to Reduce Avoidable Hospitalizations among Nursing Facility Residents-Payment Reform
Third annual report evaluating a Centers for Medicare and Medicaid (CMS) Innovation payment model intended to reduce avoidable hospitalizations for long-term care nursing facility residents by offering incentives for the provision of in-house care to eligible residents, rather than a transfer to a hospital for treatment. Presents details on the effect of the payment model on Medicare expenditures in the participating states: Alabama, Missouri, Indiana, Nevada, New York, and Pennsylvania. Discusses the implication of the payment model in rural facilities.
Date: 12/2019
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Rural-Urban Differences in Access to and Attitudes Toward Care for Medicare Beneficiaries
Results of a study using data from the 2016 Medicare Current Beneficiary Survey to analyze differences between rural and urban Medicare beneficiaries in terms of travel time to usual provider, access barriers, and attitudes toward seeking care.
Author(s): Carrie Henning-Smith, Ashley M. Hernandez, Megan Lahr
Date: 12/2019
Type: Document
Sponsoring organization: University of Minnesota Rural Health Research Center
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Evaluation of the Maryland All-Payer Model: Volume I - Final Report
Evaluation of the All-Payer Model operating under an agreement with the Centers for Medicare & Medicaid Services (CMS) for hospitals in rural and urban settings implemented in Maryland in 2014. This model shifted the state's hospital payment structure to an annual, global hospital budget that includes both inpatient and outpatient hospital services. Report covers 4.5 years of implementation, and compares outcomes by rural and urban residency.
Author(s): Susan Haber, Heather Beil, Marisa Morrison, et al.
Date: 11/2019
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Rural-Urban Disparities in Health Care in Medicare
Examines rural/urban differences in the quality of healthcare received by Medicare beneficiaries in 2018, with breakdowns by race and ethnicity. Focuses on patient experience and clinical care measures, including screening for and management of health conditions and medication-related issues.
Date: 11/2019
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Rural Health Clinic Costs and Medicare Reimbursement
Policy brief exploring whether updates to the Medicare per-visit reimbursement cap have allowed Rural Health Clinics (RHCs) of various types and sizes to keep pace with increases in staffing and other costs. Features statistics including RHC mean Medicare adjusted cost per visit and RHC mean Medicare healthcare staff costs as of 2014, with breakdowns by 4 sizes of RHCs and private or publicly-owned status.
Author(s): John Gale, Zachariah T. Croll, Andrew F. Coburn
Date: 11/2019
Type: Document
Sponsoring organization: Maine Rural Health Research Center
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