Rural Health
Resources by Topic: Medicare
Medicare Physician Bonus Payment Eligibility Analyzer
Tool to determine if an address is in a Health Professional Shortage Area (HPSA) eligible for a Medicare Physician Bonus.
Type: Tool
Sponsoring organization: Health Resources and Services Administration
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Tool to determine if an address is in a Health Professional Shortage Area (HPSA) eligible for a Medicare Physician Bonus.
Type: Tool
Sponsoring organization: Health Resources and Services Administration
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Mapping Medicare Disparities
Provides access to county-level data and comparisons on chronic disease prevalence, Medicare spending, hospital and emergency department utilization, preventive services, and preventable hospitalizations, readmissions, and mortality rates for Medicare beneficiaries. Also offers 2018 Medicare Advantage encounter data. Includes hospital-level quality of care and cost of care data and comparisons as well as social determinants of health data for both the Medicare and non-Medicare population down to the census tract level.
Type: Map/Mapping System
Sponsoring organization: Centers for Medicare and Medicaid Services
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Provides access to county-level data and comparisons on chronic disease prevalence, Medicare spending, hospital and emergency department utilization, preventive services, and preventable hospitalizations, readmissions, and mortality rates for Medicare beneficiaries. Also offers 2018 Medicare Advantage encounter data. Includes hospital-level quality of care and cost of care data and comparisons as well as social determinants of health data for both the Medicare and non-Medicare population down to the census tract level.
Type: Map/Mapping System
Sponsoring organization: Centers for Medicare and Medicaid Services
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Medicare Part D Opioid Prescribing Mapping Tool
Interactive mapping tool identifies opioid prescription rates at the state, county, and zip code level for de-identified Medicare Part D claims in 2021. Also offers rural/urban opioid prescribing data, changes in prescribing rates in 1 year and 5 year increments, and hot spots and outliers in long-acting opioid prescribing.
Type: Map/Mapping System
Sponsoring organization: Centers for Medicare and Medicaid Services
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Interactive mapping tool identifies opioid prescription rates at the state, county, and zip code level for de-identified Medicare Part D claims in 2021. Also offers rural/urban opioid prescribing data, changes in prescribing rates in 1 year and 5 year increments, and hot spots and outliers in long-acting opioid prescribing.
Type: Map/Mapping System
Sponsoring organization: Centers for Medicare and Medicaid Services
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CMS State Operations Manual (SOM)
Provides guidance to state agencies that survey healthcare facilities and providers to determine if they are in compliance with the Medicare Conditions of Participation (CoP). Includes appendices with regulatory information specific to Critical Access Hospitals (Appendix W), and Federally Qualified Health Centers/Rural Health Clinics (Appendix G). Can be used by healthcare facilities as a tool to self-evaluate their compliance with Medicare CoP.
Type: Website
Sponsoring organization: Centers for Medicare and Medicaid Services
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Provides guidance to state agencies that survey healthcare facilities and providers to determine if they are in compliance with the Medicare Conditions of Participation (CoP). Includes appendices with regulatory information specific to Critical Access Hospitals (Appendix W), and Federally Qualified Health Centers/Rural Health Clinics (Appendix G). Can be used by healthcare facilities as a tool to self-evaluate their compliance with Medicare CoP.
Type: Website
Sponsoring organization: Centers for Medicare and Medicaid Services
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Code of Federal Regulations: Title 42 Public Health, Chapter 4, Subchapter G, Part 491, Subpart A - Rural Health Clinics: Conditions for Certification; and FQHCs Conditions for Coverage
Establishes the conditions Rural Health Clinics and Federally Qualified Health Centers must meet to qualify for reimbursement under Medicare, as well as those that Rural Health Clinics must meet to qualify for reimbursement under Medicaid.
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Establishes the conditions Rural Health Clinics and Federally Qualified Health Centers must meet to qualify for reimbursement under Medicare, as well as those that Rural Health Clinics must meet to qualify for reimbursement under Medicaid.
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Frontier Extended Stay Clinics (FESC) Demonstration
An overview of a completed CMS demonstration that looked at an enhanced clinic model in frontier areas to address the needs of seriously ill or injured patients who cannot be transferred to a hospital, or who need monitoring and observation for a limited period of time.
Type: Website
Sponsoring organization: Centers for Medicare and Medicaid Services
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An overview of a completed CMS demonstration that looked at an enhanced clinic model in frontier areas to address the needs of seriously ill or injured patients who cannot be transferred to a hospital, or who need monitoring and observation for a limited period of time.
Type: Website
Sponsoring organization: Centers for Medicare and Medicaid Services
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Frontier Community Health Integration Project Demonstration (FCHIP)
An overview of a CMS demonstration to develop and test new models of integrated, coordinated health care in the most sparsely-populated rural counties with the goal of improving health outcomes and reducing Medicare expenditures.
Type: Website
Sponsoring organization: Centers for Medicare and Medicaid Services
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An overview of a CMS demonstration to develop and test new models of integrated, coordinated health care in the most sparsely-populated rural counties with the goal of improving health outcomes and reducing Medicare expenditures.
Type: Website
Sponsoring organization: Centers for Medicare and Medicaid Services
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Rural Community Hospital Demonstration
An overview of a CMS demonstration project which provides cost-based reimbursement for small rural hospitals too large to be Critical Access Hospitals. Examines the community benefits and financial impact for participating hospitals.
Type: Website
Sponsoring organization: Centers for Medicare and Medicaid Services
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An overview of a CMS demonstration project which provides cost-based reimbursement for small rural hospitals too large to be Critical Access Hospitals. Examines the community benefits and financial impact for participating hospitals.
Type: Website
Sponsoring organization: Centers for Medicare and Medicaid Services
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Data.CMS.gov
Interactive tool for identifying Centers for Medicare and Medicaid Services (CMS) data and information resources. Sources can be narrowed by the geographic level available, including state, county, hospital referral region, and more. Sources can also be viewed by CMS program, topic, and setting of care.
Type: Website
Sponsoring organization: Centers for Medicare and Medicaid Services
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Interactive tool for identifying Centers for Medicare and Medicaid Services (CMS) data and information resources. Sources can be narrowed by the geographic level available, including state, county, hospital referral region, and more. Sources can also be viewed by CMS program, topic, and setting of care.
Type: Website
Sponsoring organization: Centers for Medicare and Medicaid Services
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Medicare Learning Network: Swing Bed Services
Provides information about the requirements Critical Access Hospitals must meet in order to enter into a swing bed agreement under which they can use beds, as needed, to provide either acute or Skilled Nursing Facility care.
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Provides information about the requirements Critical Access Hospitals must meet in order to enter into a swing bed agreement under which they can use beds, as needed, to provide either acute or Skilled Nursing Facility care.
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
view details