Rural Health
Resources by Topic: Medicare
Rural Health Leaders Overcoming Challenges with Alan Morgan, Kathy Kuepers and Steve Tenhouse
Podcast episode featuring two Critical Access Hospital (CAH) executives discussing factors that influence a rural health organization's growth and vitality, replacement facility projects, and building trust and stakeholder engagement. Also highlights a national partnership addressing rural hospital cybersecurity involving the White House, Google, Microsoft, the American Hospital Association, and the National Rural Health Association.
Date: 06/2024
Sponsoring organization: Impact! Communications, Inc.
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Podcast episode featuring two Critical Access Hospital (CAH) executives discussing factors that influence a rural health organization's growth and vitality, replacement facility projects, and building trust and stakeholder engagement. Also highlights a national partnership addressing rural hospital cybersecurity involving the White House, Google, Microsoft, the American Hospital Association, and the National Rural Health Association.
Date: 06/2024
Sponsoring organization: Impact! Communications, Inc.
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Five Things to Know About Medicare Site-Neutral Payment Reforms
Discusses site-neutral payment reforms that seek to align Medicare payments with outpatient services in different settings. Examines benefits and drawbacks of the policy and discusses how the policy would impact rural hospitals.
Author(s): Zachary Levinson, Tricia Neuman, Scott Hulver
Date: 06/2024
Sponsoring organization: KFF
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Discusses site-neutral payment reforms that seek to align Medicare payments with outpatient services in different settings. Examines benefits and drawbacks of the policy and discusses how the policy would impact rural hospitals.
Author(s): Zachary Levinson, Tricia Neuman, Scott Hulver
Date: 06/2024
Sponsoring organization: KFF
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Updated Analysis: Using Population-Based Outcome Measures to Assess the Impact of Telehealth Expansion on Medicare Beneficiaries' Access to Care and Quality of Care
Explores the association between telehealth use, quality of care, and access to care when both telehealth and in-person visits are available to fee-for-service (FFS) Medicare beneficiaries. Compares data from the second half of 2018 and 2019 to the second half of 2022 by the level of telehealth utilization in Hospital Service Areas (HSAs). Describes the effects of telehealth for urban and rural beneficiaries and differentiates between telehealth utilization for behavioral and non-behavioral health services. Updates a June 2023 report that analyzed data from 2021.
Author(s): Tanvi Rao, Angshuman Gooptu, Karin Johnson, Guido Cataife, Steven Susana-Castillo
Date: 06/2024
Sponsoring organizations: American Institutes for Research, Medicare Payment Advisory Commission
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Explores the association between telehealth use, quality of care, and access to care when both telehealth and in-person visits are available to fee-for-service (FFS) Medicare beneficiaries. Compares data from the second half of 2018 and 2019 to the second half of 2022 by the level of telehealth utilization in Hospital Service Areas (HSAs). Describes the effects of telehealth for urban and rural beneficiaries and differentiates between telehealth utilization for behavioral and non-behavioral health services. Updates a June 2023 report that analyzed data from 2021.
Author(s): Tanvi Rao, Angshuman Gooptu, Karin Johnson, Guido Cataife, Steven Susana-Castillo
Date: 06/2024
Sponsoring organizations: American Institutes for Research, Medicare Payment Advisory Commission
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MedPAC Report to the Congress: Medicare and the Health Care Delivery System, June 2024
Evaluates Medicare payment issues and provides recommendations to the U.S. Congress. Covers approaches for updating fee-for-service (FFS) Medicare's physician fee schedule (PFS) payments and incentivizing participation in alternative payment models; provider networks and prior authorization in Medicare Advantage (MA) plans; an assessment of the relative completeness of MA encounter data and other data sources; Medicare coverage and payments for medical software; alternate approaches to lower Medicare payment rates for select conditions in inpatient rehabilitation facilities; and Medicare's Acute Hospital Care at Home program. Includes rural references throughout.
Additional links: Executive Summary
Date: 06/2024
Sponsoring organization: Medicare Payment Advisory Commission
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Evaluates Medicare payment issues and provides recommendations to the U.S. Congress. Covers approaches for updating fee-for-service (FFS) Medicare's physician fee schedule (PFS) payments and incentivizing participation in alternative payment models; provider networks and prior authorization in Medicare Advantage (MA) plans; an assessment of the relative completeness of MA encounter data and other data sources; Medicare coverage and payments for medical software; alternate approaches to lower Medicare payment rates for select conditions in inpatient rehabilitation facilities; and Medicare's Acute Hospital Care at Home program. Includes rural references throughout.
Additional links: Executive Summary
Date: 06/2024
Sponsoring organization: Medicare Payment Advisory Commission
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Effort Required and Lessons Learned from Recruiting Health Plans and Rural Primary Care Practices for a Cancer Screening Outreach Study
Explores factors influencing recruitment and enrollment of primary care practices for SMARTER CRC, a rural colorectal cancer (CRC) screening trial in Oregon. Discusses outreach strategies, relationship-building, messaging, reasons for participation among clinical practices and Medicare health plans, and more. Highlights rural-specific factors throughout.
Author(s): Brittany Badicke, Jennifer Coury, Emily Myers, et al.
Citation: Journal of Primary Care & Community Health, 15
Date: 06/2024
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Explores factors influencing recruitment and enrollment of primary care practices for SMARTER CRC, a rural colorectal cancer (CRC) screening trial in Oregon. Discusses outreach strategies, relationship-building, messaging, reasons for participation among clinical practices and Medicare health plans, and more. Highlights rural-specific factors throughout.
Author(s): Brittany Badicke, Jennifer Coury, Emily Myers, et al.
Citation: Journal of Primary Care & Community Health, 15
Date: 06/2024
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Report to Congress on Medicaid and CHIP, June 2024
Semi-annual report to Congress from the Medicaid and CHIP Payment and Access Commission (MACPAC). Covers recommendations for increased transparency in Medicaid and CHIP financing, tools for optimizing state Medicaid agency contracts (SMACs), enrollment trends in Medicare Savings Programs (MSPs), and demographic data collection in Medicaid. Includes rural references throughout.
Date: 06/2024
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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Semi-annual report to Congress from the Medicaid and CHIP Payment and Access Commission (MACPAC). Covers recommendations for increased transparency in Medicaid and CHIP financing, tools for optimizing state Medicaid agency contracts (SMACs), enrollment trends in Medicare Savings Programs (MSPs), and demographic data collection in Medicaid. Includes rural references throughout.
Date: 06/2024
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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MedPAC Comment on CMS's Proposed Rule on the Hospital Inpatient PPS and the Long-term Care Hospital PPS for FY 2025
Comments on a May 2, 2024, Federal Register proposed rule revising the hospital inpatient and long-term care hospital (LTCH) prospective payment systems (PPS). Discusses proposals on rate-setting in both the inpatient prospective payment systems (IPPS) and LTCH PPS; the Transforming Episode Accountability Model (TEAM), including the definition of rural hospitals eligible to participate in a lower-risk track; new payments to small, independent hospitals that establish and maintain a 6-month buffer supply of essential medicines; updates to wage index values and policies; and updates to outlier reconciliation thresholds.
Date: 06/2024
Sponsoring organization: Medicare Payment Advisory Commission
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Comments on a May 2, 2024, Federal Register proposed rule revising the hospital inpatient and long-term care hospital (LTCH) prospective payment systems (PPS). Discusses proposals on rate-setting in both the inpatient prospective payment systems (IPPS) and LTCH PPS; the Transforming Episode Accountability Model (TEAM), including the definition of rural hospitals eligible to participate in a lower-risk track; new payments to small, independent hospitals that establish and maintain a 6-month buffer supply of essential medicines; updates to wage index values and policies; and updates to outlier reconciliation thresholds.
Date: 06/2024
Sponsoring organization: Medicare Payment Advisory Commission
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Sources of Federal Funding for Health Care Facilities: Frequently Asked Questions
Provides an overview of how the federal government supports healthcare facilities, with a focus on hospitals. Discusses how Medicare and Medicaid pay acute care hospitals and for services rendered to beneficiaries and enrollees, as well as other payments these programs make. Identifies federal grants, loans, and technical assistance programs that can support health facilities. Describes how federal agencies, including the Health Resources and Services Administration (HRSA) and the U.S. Department of Agriculture (USDA), have supported healthcare facilities during emergencies.
Date: 06/2024
Sponsoring organization: Congressional Research Service
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Provides an overview of how the federal government supports healthcare facilities, with a focus on hospitals. Discusses how Medicare and Medicaid pay acute care hospitals and for services rendered to beneficiaries and enrollees, as well as other payments these programs make. Identifies federal grants, loans, and technical assistance programs that can support health facilities. Describes how federal agencies, including the Health Resources and Services Administration (HRSA) and the U.S. Department of Agriculture (USDA), have supported healthcare facilities during emergencies.
Date: 06/2024
Sponsoring organization: Congressional Research Service
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Medicare Claims Processing Manual Chapter 4 - Part B Hospital (Including Inpatient Hospital Part B and OPPS)
Outlines rules and regulations for processing Medicare Part B hospital claims. Covers special rules for Critical Access Hospital outpatient billing, hospital-based Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs) billing for non-RHC/FQHC services, and payment adjustments for Rural Emergency Hospitals (REHs).
Date: 06/2024
Sponsoring organization: Centers for Medicare and Medicaid Services
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Outlines rules and regulations for processing Medicare Part B hospital claims. Covers special rules for Critical Access Hospital outpatient billing, hospital-based Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs) billing for non-RHC/FQHC services, and payment adjustments for Rural Emergency Hospitals (REHs).
Date: 06/2024
Sponsoring organization: Centers for Medicare and Medicaid Services
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CMS Bundled Payments for Care Improvement Advanced Model: Fifth Annual Evaluation Report
Fifth annual report of the Bundled Payments for Care Improvement Advanced (BPCI Advanced) Model, which tests whether linking payments for a clinical episode of care can reduce Medicare expenditures while maintaining or improving the quality of care. Explores the impact of BPCI Advanced on episode payments, utilization, and quality of care, as well as estimates of Medicare program savings in Model Year 4. Describes changes to the model that were implemented in Model Year 4 and how BPCI Advanced relates to Medicare Accountable Care Organizations (ACOs). Includes rural references throughout.
Additional links: Appendices, Executive Summary, Findings at a Glance
Author(s): The Lewin Group, Abt Associates, GDIT, Telligen
Date: 05/2024
Sponsoring organization: Centers for Medicare and Medicaid Services
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Fifth annual report of the Bundled Payments for Care Improvement Advanced (BPCI Advanced) Model, which tests whether linking payments for a clinical episode of care can reduce Medicare expenditures while maintaining or improving the quality of care. Explores the impact of BPCI Advanced on episode payments, utilization, and quality of care, as well as estimates of Medicare program savings in Model Year 4. Describes changes to the model that were implemented in Model Year 4 and how BPCI Advanced relates to Medicare Accountable Care Organizations (ACOs). Includes rural references throughout.
Additional links: Appendices, Executive Summary, Findings at a Glance
Author(s): The Lewin Group, Abt Associates, GDIT, Telligen
Date: 05/2024
Sponsoring organization: Centers for Medicare and Medicaid Services
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