Rural Health
Resources by Topic: Medicare
Revised: Guidance for Rural Emergency Hospital Provisions, Conversion Process and Conditions of Participation
Provides guidance regarding the enrollment and conversion processes for facilities interested in participating in the Medicare and Medicaid programs as a Rural Emergency Hospital (REH). Covers eligibility, enrollment, conversion action plans, action plans, and attestation. Includes answers to frequently asked questions about the REH program.
Date: 09/2024
Sponsoring organization: Centers for Medicare and Medicaid Services
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Provides guidance regarding the enrollment and conversion processes for facilities interested in participating in the Medicare and Medicaid programs as a Rural Emergency Hospital (REH). Covers eligibility, enrollment, conversion action plans, action plans, and attestation. Includes answers to frequently asked questions about the REH program.
Date: 09/2024
Sponsoring organization: Centers for Medicare and Medicaid Services
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Financial Performance of Rural and Urban Hospitals in the Medicare Shared Savings Program
Presents financial performance trends of hospitals that participated in Medicare's Shared Savings Program (SSP) from 2011-2018. Compares trends in 6 financial outcomes between SSP and non-SSP hospitals, and differences in these trends among rural and urban hospitals.
Author(s): Huang Huang, Xi Zhu, Fred Ullrich, A. Clinton MacKinney, Keith Mueller
Date: 09/2024
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Presents financial performance trends of hospitals that participated in Medicare's Shared Savings Program (SSP) from 2011-2018. Compares trends in 6 financial outcomes between SSP and non-SSP hospitals, and differences in these trends among rural and urban hospitals.
Author(s): Huang Huang, Xi Zhu, Fred Ullrich, A. Clinton MacKinney, Keith Mueller
Date: 09/2024
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Prescription Medication Use, Coverage, and Nonadherence Among Adults Age 65 and Older: United States, 2021–2022
Reports on medication use, prescription drug insurance coverage, and nonadherence due to cost for older adults between 2021 and 2022. Includes data breakdown of various demographic and health status characteristics including 4 levels of urbanization.
Author(s): Robin A. Cohen, Laryssa Mykyta
Date: 09/2024
Sponsoring organization: National Center for Health Statistics
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Reports on medication use, prescription drug insurance coverage, and nonadherence due to cost for older adults between 2021 and 2022. Includes data breakdown of various demographic and health status characteristics including 4 levels of urbanization.
Author(s): Robin A. Cohen, Laryssa Mykyta
Date: 09/2024
Sponsoring organization: National Center for Health Statistics
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Merit-based Incentive Payment System (MIPS): 2024 What's New for Small Practices
Summarizes new elements of the Merit-based Incentive Payment System (MIPS) for small practices - a group of 15 or fewer clinicians billing under a practice's Taxpayer Identification Number (TIN) - during the 2024 performance year. Discusses changes to performance category requirements and flexibilities, new MIPS Value Pathways (MVPs), and performance threshold and payment adjustments. Includes information on performance category redistribution policies for small practices.
Date: 09/2024
Sponsoring organization: Centers for Medicare and Medicaid Services
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Summarizes new elements of the Merit-based Incentive Payment System (MIPS) for small practices - a group of 15 or fewer clinicians billing under a practice's Taxpayer Identification Number (TIN) - during the 2024 performance year. Discusses changes to performance category requirements and flexibilities, new MIPS Value Pathways (MVPs), and performance threshold and payment adjustments. Includes information on performance category redistribution policies for small practices.
Date: 09/2024
Sponsoring organization: Centers for Medicare and Medicaid Services
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Medicare Billing for Telehealth Encounters: An Introductory Guide on Fee-for-Service
Presents an overview of how to bill fee-for-service Medicare and Medicaid for telehealth encounters. Includes information on originating and distant sites, virtual healthcare, and coding telehealth services. Lists types of practice sites, including Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs), and implications for billing telehealth services. Provides contact information for Regional Telehealth Research Centers (RTRC).
Date: 09/2024
Sponsoring organization: Center for Connected Health Policy: The National Telehealth Policy Resource Center
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Presents an overview of how to bill fee-for-service Medicare and Medicaid for telehealth encounters. Includes information on originating and distant sites, virtual healthcare, and coding telehealth services. Lists types of practice sites, including Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs), and implications for billing telehealth services. Provides contact information for Regional Telehealth Research Centers (RTRC).
Date: 09/2024
Sponsoring organization: Center for Connected Health Policy: The National Telehealth Policy Resource Center
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Medicare Benefit Policy Manual: Chapter 13 - Rural Health Clinic (RHC) and Federally Qualified Health Center (FQHC) Services
Current regulations, as of January 2023, regarding Medicare payment policies for Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs).
Date: 09/2024
Sponsoring organization: Centers for Medicare and Medicaid Services
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Current regulations, as of January 2023, regarding Medicare payment policies for Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs).
Date: 09/2024
Sponsoring organization: Centers for Medicare and Medicaid Services
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Predictors of Telehealth Use after the Minnesota Telehealth Act: Analysis Using the Minnesota All Payer Claims Database
Examines factors contributing to telehealth use among commercially insured and Medicare Advantage patients in Minnesota. Factors evaluated include age, sex, various chronic health conditions, rurality, broadband access, and more.
Author(s): Arkadipta Ghosh, Ethan Jacobs, Elizabeth Greener, et al.
Citation: Health Affairs Scholar, 2(8)
Date: 08/2024
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Examines factors contributing to telehealth use among commercially insured and Medicare Advantage patients in Minnesota. Factors evaluated include age, sex, various chronic health conditions, rurality, broadband access, and more.
Author(s): Arkadipta Ghosh, Ethan Jacobs, Elizabeth Greener, et al.
Citation: Health Affairs Scholar, 2(8)
Date: 08/2024
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MedPAC Comment on CMS's Proposed Rule on the Payment System for End-Stage Renal Disease for CY 2025
Comments on a July 5, 2024, Federal Register proposed rule related to Medicare payment policies for end-stage renal disease (ESRD). Includes comments addressing modifications to the outlier policy, updates to the low-volume payment adjustment (LVPA), and updates to the wage index methodology.
Date: 08/2024
Sponsoring organization: Medicare Payment Advisory Commission
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Comments on a July 5, 2024, Federal Register proposed rule related to Medicare payment policies for end-stage renal disease (ESRD). Includes comments addressing modifications to the outlier policy, updates to the low-volume payment adjustment (LVPA), and updates to the wage index methodology.
Date: 08/2024
Sponsoring organization: Medicare Payment Advisory Commission
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MedPAC Comment on CMS's Proposed Rule on the Home Health Prospective Payment System for CY 2025
Comments on a July 3, 2024, Federal Register proposed rule related to Medicare payment policies for home health agencies. Includes comments regarding permanent and temporary budget-neutrality adjustments, the plan of care development and scope of services home health patients receive, and the proposed adoption of the core-based statistical area (CBSA) delineations for the home health wage index.
Date: 08/2024
Sponsoring organization: Medicare Payment Advisory Commission
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Comments on a July 3, 2024, Federal Register proposed rule related to Medicare payment policies for home health agencies. Includes comments regarding permanent and temporary budget-neutrality adjustments, the plan of care development and scope of services home health patients receive, and the proposed adoption of the core-based statistical area (CBSA) delineations for the home health wage index.
Date: 08/2024
Sponsoring organization: Medicare Payment Advisory Commission
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Access in Brief: Seniors and Adults with Physical Disabilities
Explores access to Medicaid-funded long-term services and supports (LTSS) among Medicaid beneficiaries age 65 and older and Medicaid beneficiaries aged 18-64 with physical disabilities. Describes the demographics, health status, service use, and experiences with Medicaid home and community-based services (HCBS) of these Medicaid beneficiaries using data from the 2017-2018 National Core Indicators Aging and Disabilities (NCI-AD) Adult Consumer Survey. Presents data by race and ethnicity, dually eligible status, and age.
Date: 08/2024
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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Explores access to Medicaid-funded long-term services and supports (LTSS) among Medicaid beneficiaries age 65 and older and Medicaid beneficiaries aged 18-64 with physical disabilities. Describes the demographics, health status, service use, and experiences with Medicaid home and community-based services (HCBS) of these Medicaid beneficiaries using data from the 2017-2018 National Core Indicators Aging and Disabilities (NCI-AD) Adult Consumer Survey. Presents data by race and ethnicity, dually eligible status, and age.
Date: 08/2024
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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