Rural Health
Resources by Topic: Medicare
Voice of the REH CEO: Perspectives from Those Who Have Led Their Organizations Through REH Conversion
Summarizes interviews with executives from three hospitals that converted to Rural Emergency Hospital (REH) status regarding their perspectives on conversion. Describes the assessment of the financial feasibility of REH status, preparation of the communities for conversion, staffing and service line adjustments, and the impact of conversion. Includes legislative considerations that could make REH status more attractive to rural hospitals.
Author(s): Hope Burch, Tracey Dorff, Anna Anna, Janice Walters
Date: 08/2024
Sponsoring organization: Rural Health Redesign Center
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Summarizes interviews with executives from three hospitals that converted to Rural Emergency Hospital (REH) status regarding their perspectives on conversion. Describes the assessment of the financial feasibility of REH status, preparation of the communities for conversion, staffing and service line adjustments, and the impact of conversion. Includes legislative considerations that could make REH status more attractive to rural hospitals.
Author(s): Hope Burch, Tracey Dorff, Anna Anna, Janice Walters
Date: 08/2024
Sponsoring organization: Rural Health Redesign Center
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Medicare Advantage in 2024: Enrollment Update and Key Trends
Explores trends related to the growth of the Medicare Advantage (MA) program. Provides statistics on MA enrollment, the types of plans in which beneficiaries are enrolled, and geographic variation. Includes interactive maps that display MA penetration rates by state and county.
Author(s): Meredith Freed, Jeannie Fuglesten Biniek, Anthony Damico, Tricia Neuman
Date: 08/2024
Sponsoring organization: KFF
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Explores trends related to the growth of the Medicare Advantage (MA) program. Provides statistics on MA enrollment, the types of plans in which beneficiaries are enrolled, and geographic variation. Includes interactive maps that display MA penetration rates by state and county.
Author(s): Meredith Freed, Jeannie Fuglesten Biniek, Anthony Damico, Tricia Neuman
Date: 08/2024
Sponsoring organization: KFF
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FY 2025 Hospital Inpatient Prospective Payment System (IPPS) and Long-Term Care Hospital Prospective Payment System (LTCH PPS) Final Rule – CMS-1808-F
Fact sheet providing an overview of the Centers for Medicare & Medicaid Services (CMS) fiscal year 2025 hospital inpatient prospective payment system (IPPS) and long-term care hospital prospective payment system (LTCH PPS) final rule. Includes information about the extension of the low-wage index hospital policy, a separate IPPS payment for small and independent hospitals to establish and maintain a buffer stock of essential medicines, the distribution of graduate medical education (GME) residency slots, updates to quality reporting programs, and more.
Date: 08/2024
Sponsoring organization: Centers for Medicare and Medicaid Services
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Fact sheet providing an overview of the Centers for Medicare & Medicaid Services (CMS) fiscal year 2025 hospital inpatient prospective payment system (IPPS) and long-term care hospital prospective payment system (LTCH PPS) final rule. Includes information about the extension of the low-wage index hospital policy, a separate IPPS payment for small and independent hospitals to establish and maintain a buffer stock of essential medicines, the distribution of graduate medical education (GME) residency slots, updates to quality reporting programs, and more.
Date: 08/2024
Sponsoring organization: Centers for Medicare and Medicaid Services
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Merit-based Incentive Payment System (MIPS): 2024 MIPS Promoting Interoperability Performance Category Hardship Exception Application Guide
Provides guidance on how clinicians can apply for a MIPS hardship exception. Highlights guidance for having your MIPS Promoting Interoperability performance category reweighted to 0% in cases of insufficient internet connectivity, decertified electronic health record technology, or other circumstances out of the clinicians control.
Date: 08/2024
Sponsoring organization: Centers for Medicare and Medicaid Services
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Provides guidance on how clinicians can apply for a MIPS hardship exception. Highlights guidance for having your MIPS Promoting Interoperability performance category reweighted to 0% in cases of insufficient internet connectivity, decertified electronic health record technology, or other circumstances out of the clinicians control.
Date: 08/2024
Sponsoring organization: Centers for Medicare and Medicaid Services
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Disability and Independence in Rural America: White Paper
Provides an overview of disability and independence in rural America. Describes disability prevalence in rural areas and U.S. Department of Health and Human Services (HHS) programs for people with disabilities. Outlines key considerations for rural disability services, including access, Medicaid and Medicare coverage, workforce, and telehealth and technology. Highlights themes that emerged during the September 2023 National Advisory Committee on Rural Health and Human Service (NACRHHS) meeting regarding areas for disability and independence policy improvement. Appendix A summarizes NACRHHS subcommittee site visits of two organizations serving rural Colorado residents.
Date: 07/2024
Sponsoring organization: National Advisory Committee on Rural Health and Human Services
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Provides an overview of disability and independence in rural America. Describes disability prevalence in rural areas and U.S. Department of Health and Human Services (HHS) programs for people with disabilities. Outlines key considerations for rural disability services, including access, Medicaid and Medicare coverage, workforce, and telehealth and technology. Highlights themes that emerged during the September 2023 National Advisory Committee on Rural Health and Human Service (NACRHHS) meeting regarding areas for disability and independence policy improvement. Appendix A summarizes NACRHHS subcommittee site visits of two organizations serving rural Colorado residents.
Date: 07/2024
Sponsoring organization: National Advisory Committee on Rural Health and Human Services
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The Low-Volume Hospital Adjustment Before and During COVID-19
Describes characteristics of rural low-volume hospitals (LVHs) between April 2018 and March 2022. Compares the characteristics and profitability of rural LVHs with other rural prospective payment system (PPS) hospitals before and during the COVID-19 pandemic. Presents data on LVH profitability margins with and without the LVH payment adjustment.
Author(s): Emmaline Keesee, Susie Gurzenda, Kristie Thompson, George Pink
Date: 07/2024
Sponsoring organization: North Carolina Rural Health Research Program
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Describes characteristics of rural low-volume hospitals (LVHs) between April 2018 and March 2022. Compares the characteristics and profitability of rural LVHs with other rural prospective payment system (PPS) hospitals before and during the COVID-19 pandemic. Presents data on LVH profitability margins with and without the LVH payment adjustment.
Author(s): Emmaline Keesee, Susie Gurzenda, Kristie Thompson, George Pink
Date: 07/2024
Sponsoring organization: North Carolina Rural Health Research Program
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Medicare Advantage Enrollees Account for a Rising Share of Inpatient Hospital Days
Describes the growth of Medicare Advantage (MA) as a share of hospital inpatient days between 2015 and 2022. Presents data from hospital cost reports submitted to the Centers for Medicare & Medicaid (CMS) regarding the share of inpatient days attributable to MA compared to traditional Medicare, the percentage of hospitals with more inpatient days from Medicare Advantage than traditional Medicare, and the variation across hospitals within counties. Compares trends in the share of inpatient days for MA enrollees across rural, micropolitan, and metropolitan hospitals.
Author(s): Jamie Godwin, Jeannie Fuglesten Biniek, Zachary Levinson, Tricia Neuman
Date: 07/2024
Sponsoring organization: KFF
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Describes the growth of Medicare Advantage (MA) as a share of hospital inpatient days between 2015 and 2022. Presents data from hospital cost reports submitted to the Centers for Medicare & Medicaid (CMS) regarding the share of inpatient days attributable to MA compared to traditional Medicare, the percentage of hospitals with more inpatient days from Medicare Advantage than traditional Medicare, and the variation across hospitals within counties. Compares trends in the share of inpatient days for MA enrollees across rural, micropolitan, and metropolitan hospitals.
Author(s): Jamie Godwin, Jeannie Fuglesten Biniek, Zachary Levinson, Tricia Neuman
Date: 07/2024
Sponsoring organization: KFF
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MedPAC Data Book: Health Care Spending and the Medicare Program, 2024
Provides an overview of Medicare spending and highlights data on Medicare beneficiary demographics, dual-eligible beneficiaries, quality of care provided through the Medicare program, and other payer liability. Examines settings of care, including rural-specific provider sites, as they relate to spending, access to care, and profit margins. Compares rural and urban beneficiaries and providers throughout. Chart 6-2 addresses rural hospital closures.
Date: 07/2024
Sponsoring organization: Medicare Payment Advisory Commission
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Provides an overview of Medicare spending and highlights data on Medicare beneficiary demographics, dual-eligible beneficiaries, quality of care provided through the Medicare program, and other payer liability. Examines settings of care, including rural-specific provider sites, as they relate to spending, access to care, and profit margins. Compares rural and urban beneficiaries and providers throughout. Chart 6-2 addresses rural hospital closures.
Date: 07/2024
Sponsoring organization: Medicare Payment Advisory Commission
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Positioning Telehealth Policy to Ensure High-Quality, Cost-Effective Care
Presents policy recommendations and suggestions to guide policymakers when considering the future of telehealth. Analyzes peer-reviewed research; government reports; and findings from interviews with payers, providers, provider associations, federal agencies, consumer advocates, technology leaders, policy experts, and other stakeholders. Includes rural references and considerations throughout.
Author(s): Maya Sandalow, Julia Harris, Mikayla Curtis, Marilyn Werber Serafini
Date: 07/2024
Sponsoring organization: Bipartisan Policy Center
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Presents policy recommendations and suggestions to guide policymakers when considering the future of telehealth. Analyzes peer-reviewed research; government reports; and findings from interviews with payers, providers, provider associations, federal agencies, consumer advocates, technology leaders, policy experts, and other stakeholders. Includes rural references and considerations throughout.
Author(s): Maya Sandalow, Julia Harris, Mikayla Curtis, Marilyn Werber Serafini
Date: 07/2024
Sponsoring organization: Bipartisan Policy Center
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Standing Technical Expert Panel for the Development, Evaluation, and Maintenance of Post-Acute Care (PAC) and Hospice Quality Reporting Program (QRP) Measurement Sets: Summary Report
Describes a December 15, 2023, Technical Expert Panel (TEP) regarding the development of additional cross-setting measures for the Post-Acute Care (PAC) and Hospice Quality Reporting Programs (QRPs), and filling measurement gaps with the Centers for Medicare & Medicaid Services (CMS) Universal Foundation measures. Summarizes TEP comments on adding measures to PAC and Hospice QRPs in four domains: 1) behavioral and mental health, 2) patient experience of care, 3) pain management, and 4) immunization. Covers panelists' discussions on the appropriateness of the existing measure set and potential new measures, setting-specific considerations, data sources, and other topics related to each domain. Includes rural references throughout.
Date: 07/2024
Sponsoring organizations: Abt Associates, Acumen, Centers for Medicare and Medicaid Services
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Describes a December 15, 2023, Technical Expert Panel (TEP) regarding the development of additional cross-setting measures for the Post-Acute Care (PAC) and Hospice Quality Reporting Programs (QRPs), and filling measurement gaps with the Centers for Medicare & Medicaid Services (CMS) Universal Foundation measures. Summarizes TEP comments on adding measures to PAC and Hospice QRPs in four domains: 1) behavioral and mental health, 2) patient experience of care, 3) pain management, and 4) immunization. Covers panelists' discussions on the appropriateness of the existing measure set and potential new measures, setting-specific considerations, data sources, and other topics related to each domain. Includes rural references throughout.
Date: 07/2024
Sponsoring organizations: Abt Associates, Acumen, Centers for Medicare and Medicaid Services
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