Rural Health
Resources by Topic: Medicare
MedPAC Report to the Congress: Medicare Payment Policy, 2024
Annual review of Medicare payment policies, with recommendations to Congress. Includes discussion on Medicare payment policies directly affecting rural providers and beneficiaries. Addresses payment adequacy for Medicare fee-for-service payment systems, Medicare Advantage (MA), and Medicare Part D. Includes two mandated reports on special needs plans for beneficiaries dually eligible for Medicare and Medicaid and the Rural Emergency Hospital (REH) designation.
Date: 03/2024
Sponsoring organization: Medicare Payment Advisory Commission
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Annual review of Medicare payment policies, with recommendations to Congress. Includes discussion on Medicare payment policies directly affecting rural providers and beneficiaries. Addresses payment adequacy for Medicare fee-for-service payment systems, Medicare Advantage (MA), and Medicare Part D. Includes two mandated reports on special needs plans for beneficiaries dually eligible for Medicare and Medicaid and the Rural Emergency Hospital (REH) designation.
Date: 03/2024
Sponsoring organization: Medicare Payment Advisory Commission
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Generic Drug Utilization and Spending Among Medicare Part D Enrollees in 2022
Issue brief on prescriptions for generic drugs filled by Medicare Part D enrollees using 2022 Part D prescription drug event (PDE) data. Covers commonly used prescription drugs, costs, and conditions treated, and includes data breakdowns by plan type, race and ethnicity, and level of rurality throughout. Discusses formulary design to improve access by promoting affordability and reducing confusion among enrollees.
Author(s): Yevgeniy Feyman, Bisma Sayed, Kenneth Finegold, et al.
Date: 03/2024
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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Issue brief on prescriptions for generic drugs filled by Medicare Part D enrollees using 2022 Part D prescription drug event (PDE) data. Covers commonly used prescription drugs, costs, and conditions treated, and includes data breakdowns by plan type, race and ethnicity, and level of rurality throughout. Discusses formulary design to improve access by promoting affordability and reducing confusion among enrollees.
Author(s): Yevgeniy Feyman, Bisma Sayed, Kenneth Finegold, et al.
Date: 03/2024
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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2024 National Impact Assessment of the Centers for Medicare & Medicaid Services (CMS) Quality Measures Report
Evaluates the quality measures used across 26 Centers for Medicare & Medicaid Services (CMS) quality reporting programs. Explores whether quality measure scores during the COVID-19 public health emergency (2020-2021) differed from expected trends. Analyzes how urban and rural residents performed at a national level in order to inform future quality measure development. Provides statistics concerning participation and performance within Medicare quality reporting programs, including statistics specific to rural populations and facilities.
Additional links: Appendices ZIP File
Date: 03/2024
Sponsoring organization: Centers for Medicare and Medicaid Services
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Evaluates the quality measures used across 26 Centers for Medicare & Medicaid Services (CMS) quality reporting programs. Explores whether quality measure scores during the COVID-19 public health emergency (2020-2021) differed from expected trends. Analyzes how urban and rural residents performed at a national level in order to inform future quality measure development. Provides statistics concerning participation and performance within Medicare quality reporting programs, including statistics specific to rural populations and facilities.
Additional links: Appendices ZIP File
Date: 03/2024
Sponsoring organization: Centers for Medicare and Medicaid Services
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Breast Cancer Screening among Medicare Advantage Enrollees with Dementia
Compares rates of mammogram screening among screening-eligible women with Alzheimer's disease and related dementias (ADRD) using 2012-2019 Medicare Current Beneficiary Survey data. Compares screening rates of Medicare Advantage and fee-for-service Medicare enrollees, with data breakdowns by race and ethnicity, rural versus urban status, and more. Identifies potential risks related to over-screening.
Author(s): Eli Raver, Wendy Y. Xu, Jean Jung, Sunmin Lee
Citation: BMC Health Services Research, 24, 283
Date: 03/2024
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Compares rates of mammogram screening among screening-eligible women with Alzheimer's disease and related dementias (ADRD) using 2012-2019 Medicare Current Beneficiary Survey data. Compares screening rates of Medicare Advantage and fee-for-service Medicare enrollees, with data breakdowns by race and ethnicity, rural versus urban status, and more. Identifies potential risks related to over-screening.
Author(s): Eli Raver, Wendy Y. Xu, Jean Jung, Sunmin Lee
Citation: BMC Health Services Research, 24, 283
Date: 03/2024
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Inflation Reduction Act Research Series: Projected Impacts for Rural Medicare Enrollees
Provides an overview of how the Inflation Reduction Act (IRA) is intended to improve prescription drug affordability for Medicare enrollees. Describes Medicare enrollment in rural areas and rural residents' health status and access to care. Outlines the projected impact of drug-related IRA provisions for rural Medicare beneficiaries, including the expansion of financial assistance through the low-income subsidy program, out-of-pocket spending caps for insulin, changes in Part D benefit design, and more.
Date: 03/2024
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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Provides an overview of how the Inflation Reduction Act (IRA) is intended to improve prescription drug affordability for Medicare enrollees. Describes Medicare enrollment in rural areas and rural residents' health status and access to care. Outlines the projected impact of drug-related IRA provisions for rural Medicare beneficiaries, including the expansion of financial assistance through the low-income subsidy program, out-of-pocket spending caps for insulin, changes in Part D benefit design, and more.
Date: 03/2024
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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Rural Health Research Recap: Post-Acute Care in Rural Areas: The Role of Swing Beds and Nursing Homes
Offers statistics on availability of post-acute care in rural areas through skilled nursing facilities, home health agencies, hospice, inpatient rehabilitation facilities, and swing beds. Includes sections on prospective payment system and cost-based reimbursement, and provides statistics on the proportion of nursing home closures in metropolitan and nonmetropolitan areas from 2008-2018.
Author(s): Per Ostmo
Date: 03/2024
Sponsoring organization: Rural Health Research Gateway
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Offers statistics on availability of post-acute care in rural areas through skilled nursing facilities, home health agencies, hospice, inpatient rehabilitation facilities, and swing beds. Includes sections on prospective payment system and cost-based reimbursement, and provides statistics on the proportion of nursing home closures in metropolitan and nonmetropolitan areas from 2008-2018.
Author(s): Per Ostmo
Date: 03/2024
Sponsoring organization: Rural Health Research Gateway
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Consensus-Based Entity 2023 Annual Report to Congress and the Secretary of Health and Human Services: Final Report
Summarizes the 2023 work of Battelle's Partnership for Quality Measurement (PQM) to measure healthcare quality. Includes a discussion on engaging rural perspectives to consider the unique challenges experienced in rural communities.
Date: 02/2024
Sponsoring organization: Partnership for Quality Measurement
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Summarizes the 2023 work of Battelle's Partnership for Quality Measurement (PQM) to measure healthcare quality. Includes a discussion on engaging rural perspectives to consider the unique challenges experienced in rural communities.
Date: 02/2024
Sponsoring organization: Partnership for Quality Measurement
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What Does It Mean to Be a Rural Emergency Hospital? Hear This Kansas CEO's Journey to An REH
Recording of a February 8, 2024, webinar discussing the Rural Emergency Hospital (REH) program. Provides an overview of the REH designation, policy and regulatory requirements, REH Technical Assistance Center (TAC) services, and REH conversion timeline. Features a discussion with Jeff Bowman, Chief Executive Officer of South Central Kansas Medical Center, regarding the facility's conversion to REH status.
Date: 02/2024
Sponsoring organization: Rural Health Redesign Center
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Recording of a February 8, 2024, webinar discussing the Rural Emergency Hospital (REH) program. Provides an overview of the REH designation, policy and regulatory requirements, REH Technical Assistance Center (TAC) services, and REH conversion timeline. Features a discussion with Jeff Bowman, Chief Executive Officer of South Central Kansas Medical Center, regarding the facility's conversion to REH status.
Date: 02/2024
Sponsoring organization: Rural Health Redesign Center
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Beneficiary and Clinician Perspectives on Medicare and Other Issues: Findings from 2023 Focus Groups in Select States
Summarizes findings from 24 focus groups of Medicare beneficiaries, Medicare and Medicaid (dual eligible) beneficiaries, and clinicians conducted between May and July 2023, including three virtual focus groups of rural Medicare beneficiaries. Highlights themes that emerged across the focus groups covering Medicare coverage options, access to care, telehealth, organization of care, and prescription drugs.
Date: 02/2024
Sponsoring organizations: Medicare Payment Advisory Commission, NORC at the University of Chicago
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Summarizes findings from 24 focus groups of Medicare beneficiaries, Medicare and Medicaid (dual eligible) beneficiaries, and clinicians conducted between May and July 2023, including three virtual focus groups of rural Medicare beneficiaries. Highlights themes that emerged across the focus groups covering Medicare coverage options, access to care, telehealth, organization of care, and prescription drugs.
Date: 02/2024
Sponsoring organizations: Medicare Payment Advisory Commission, NORC at the University of Chicago
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Evaluation of the Primary Care First Model: Second Annual Report
Provides an overview of the Primary Care First (PCF) model, which aims to enhance primary care and move primary care practitioners toward value-based payment. Describes the PCF model implementation experiences for Cohort 1 and Cohort 2 practices. Explores the preliminary impact of the PCF Model on acute hospitalizations and Medicare Part A and B expenditures relative to a comparison group. Estimates the impacts of the model on a set of seven leading indicators to provide an early assessment of whether care delivery changes are resulting in meaningful early outcome changes. Highlights implications from this report for the Primary Care First model and future models.
Additional links: Findings at a Glance
Date: 02/2024
Sponsoring organizations: Centers for Medicare and Medicaid Services, Mathematica
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Provides an overview of the Primary Care First (PCF) model, which aims to enhance primary care and move primary care practitioners toward value-based payment. Describes the PCF model implementation experiences for Cohort 1 and Cohort 2 practices. Explores the preliminary impact of the PCF Model on acute hospitalizations and Medicare Part A and B expenditures relative to a comparison group. Estimates the impacts of the model on a set of seven leading indicators to provide an early assessment of whether care delivery changes are resulting in meaningful early outcome changes. Highlights implications from this report for the Primary Care First model and future models.
Additional links: Findings at a Glance
Date: 02/2024
Sponsoring organizations: Centers for Medicare and Medicaid Services, Mathematica
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