Rural Health
Resources by Topic: Medicare
Alternative Payment Models in the Quality Payment Program as of December 2023
A set of three tables that list brief information about Alternative Payment Models (APMs) that the Centers for Medicare and Medicaid Services (CMS) operates or has announced, as of December 2023. Identifies Advanced APMs, Merit Based Incentive Program (MIPs) APMs, and Other Payer Advanced APMs, which include Medicaid Other Payer Advanced APMs, Medicare Health Plan Payment Arrangements, and commercial payment arrangements.
Date: 12/2023
Sponsoring organization: Centers for Medicare and Medicaid Services
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A set of three tables that list brief information about Alternative Payment Models (APMs) that the Centers for Medicare and Medicaid Services (CMS) operates or has announced, as of December 2023. Identifies Advanced APMs, Merit Based Incentive Program (MIPs) APMs, and Other Payer Advanced APMs, which include Medicaid Other Payer Advanced APMs, Medicare Health Plan Payment Arrangements, and commercial payment arrangements.
Date: 12/2023
Sponsoring organization: Centers for Medicare and Medicaid Services
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Independent Evaluation of Comprehensive Primary Care Plus (CPC+): Final Annual Report
Reports on the Comprehensive Primary Care Plus (CPC+) model, a CMS primary care payment and delivery reform effort that ran from 2017-2021. Outlines key findings from the model, including CPC+ supports to practices, care delivery changes made by practices, impacts on outcomes for Medicare fee-for-service beneficiaries, and implications for primary care models. Describes the experiences of payers, practices, health IT vendors, and patients. Includes rural references throughout.
Additional links: Appendices to the Final Report, Volume 1, Appendices to the Final Report, Volume 2, Findings at a Glance
Date: 12/2023
Sponsoring organizations: Centers for Medicare and Medicaid Services, Mathematica
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Reports on the Comprehensive Primary Care Plus (CPC+) model, a CMS primary care payment and delivery reform effort that ran from 2017-2021. Outlines key findings from the model, including CPC+ supports to practices, care delivery changes made by practices, impacts on outcomes for Medicare fee-for-service beneficiaries, and implications for primary care models. Describes the experiences of payers, practices, health IT vendors, and patients. Includes rural references throughout.
Additional links: Appendices to the Final Report, Volume 1, Appendices to the Final Report, Volume 2, Findings at a Glance
Date: 12/2023
Sponsoring organizations: Centers for Medicare and Medicaid Services, Mathematica
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Disparities in Health Measures By Race and Ethnicity Among Beneficiaries in Medicare Advantage: A Review of the Literature
Summarizes the results of a review of 20 studies published between January 2018 and April 2023 to examine racial and ethnic disparities in quality of care and beneficiary experience among Medicare Advantage (MA) plan enrollees. Discusses gaps in data and in the literature that contribute to challenges in understanding racial and ethnic disparities in MA quality and beneficiary experience. Includes information on nine studies that explored 25 measures of quality of care received by American Indian and Alaska Native enrollees and two studies that examined disparities among MA enrollees in rural areas by race and ethnicity.
Author(s): Nancy Ochieng, Jeannie Fuglesten Biniek, Juliette Cubanski, Tricia Neuman
Date: 12/2023
Sponsoring organization: KFF
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Summarizes the results of a review of 20 studies published between January 2018 and April 2023 to examine racial and ethnic disparities in quality of care and beneficiary experience among Medicare Advantage (MA) plan enrollees. Discusses gaps in data and in the literature that contribute to challenges in understanding racial and ethnic disparities in MA quality and beneficiary experience. Includes information on nine studies that explored 25 measures of quality of care received by American Indian and Alaska Native enrollees and two studies that examined disparities among MA enrollees in rural areas by race and ethnicity.
Author(s): Nancy Ochieng, Jeannie Fuglesten Biniek, Juliette Cubanski, Tricia Neuman
Date: 12/2023
Sponsoring organization: KFF
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Medicare Cognitive Assessments: Utilization Tripled between 2018 and 2022, but Challenges Remain
Describes the utilization of traditional Medicare's cognitive assessment service from 2018 through 2022. Presents stakeholder views on challenges providers and beneficiaries face in providing and accessing the service, respectively. Discusses steps the Centers for Medicare & Medicaid Services (CMS) has taken to increase awareness of the service. Includes information on the number of cognitive assessment services by urban and rural beneficiaries by race and ethnicity.
Additional links: Full Report
Date: 12/2023
Sponsoring organization: Government Accountability Office
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Describes the utilization of traditional Medicare's cognitive assessment service from 2018 through 2022. Presents stakeholder views on challenges providers and beneficiaries face in providing and accessing the service, respectively. Discusses steps the Centers for Medicare & Medicaid Services (CMS) has taken to increase awareness of the service. Includes information on the number of cognitive assessment services by urban and rural beneficiaries by race and ethnicity.
Additional links: Full Report
Date: 12/2023
Sponsoring organization: Government Accountability Office
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CMS Final Rules Overview - Impact for RHCs Beginning January 1, 2024
Recording of a December 11, 2023, webinar providing an overview of telehealth payment rates for Rural Health Clinics (RHCs) and other regulatory updates and potential changes for 2024. Covers new billable providers for RHCs, changes to care management services and billing, telehealth regulations, intensive outpatient program (IOP) services, and more. Part of the Rural Health Clinic Technical Assistance Series.
Additional links: Presentation Slides
Date: 12/2023
Sponsoring organization: National Association of Rural Health Clinics
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Recording of a December 11, 2023, webinar providing an overview of telehealth payment rates for Rural Health Clinics (RHCs) and other regulatory updates and potential changes for 2024. Covers new billable providers for RHCs, changes to care management services and billing, telehealth regulations, intensive outpatient program (IOP) services, and more. Part of the Rural Health Clinic Technical Assistance Series.
Additional links: Presentation Slides
Date: 12/2023
Sponsoring organization: National Association of Rural Health Clinics
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Section 1915(c) Waiver Program Participants in 2020
Presents data on the percentage and number of Medicaid enrollees who participated in a Section 1915(c) waiver program in 2020. Includes data on the share of enrollees who participated in a Section 1915(c) waiver program overall and by age, race and ethnicity, urban or rural residence, Medicaid eligibility category, and dual eligibility status.
Date: 12/2023
Sponsoring organization: Centers for Medicare and Medicaid Services
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Presents data on the percentage and number of Medicaid enrollees who participated in a Section 1915(c) waiver program in 2020. Includes data on the share of enrollees who participated in a Section 1915(c) waiver program overall and by age, race and ethnicity, urban or rural residence, Medicaid eligibility category, and dual eligibility status.
Date: 12/2023
Sponsoring organization: Centers for Medicare and Medicaid Services
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Participation in a Medicare Advanced Primary Care Model and the Delivery of High-Value Services
Examines if participation in the Comprehensive Primary Care Plus Initiative (CPC+) impacted the high-value services delivered by primary care providers. Utilizes multiple national data sets to estimate the association of CPC+ and services such as annual wellness visits (AWVs), advance care planning (ACP), flu shots, tobacco prevention counseling, and depression screening. Provides data on intervention groups and comparison groups by patient demographics as well as provider demographics, specialty, and location, including urban, large rural, small rural, and isolated rural.
Author(s): Fang He, Angela Gasdaska, Lindsay White, Yan Tang, Chris Beadles
Citation: Health Services Research, 58(6), 1266-1291
Date: 12/2023
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Examines if participation in the Comprehensive Primary Care Plus Initiative (CPC+) impacted the high-value services delivered by primary care providers. Utilizes multiple national data sets to estimate the association of CPC+ and services such as annual wellness visits (AWVs), advance care planning (ACP), flu shots, tobacco prevention counseling, and depression screening. Provides data on intervention groups and comparison groups by patient demographics as well as provider demographics, specialty, and location, including urban, large rural, small rural, and isolated rural.
Author(s): Fang He, Angela Gasdaska, Lindsay White, Yan Tang, Chris Beadles
Citation: Health Services Research, 58(6), 1266-1291
Date: 12/2023
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Medicare Advantage in Rural Areas: Implications for Hospital Sustainability
Explores the relationship between Medicare Advantage (MA) penetration levels in rural areas and acute care hospital financial distress and closure between 2008 and 2019. Analyzes data from Healthcare Cost and Utilization Project (HCUP) State Inpatient Databases from 14 states to describe rural acute care hospitals with low and high MA penetration.
Author(s): Rachel Mosher Henke, Kathryn R. Fingar, Lan Liang, H. Joanna Jiang
Citation: American Journal of Managed Care, 29(11), 594–600
Date: 11/2023
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Explores the relationship between Medicare Advantage (MA) penetration levels in rural areas and acute care hospital financial distress and closure between 2008 and 2019. Analyzes data from Healthcare Cost and Utilization Project (HCUP) State Inpatient Databases from 14 states to describe rural acute care hospitals with low and high MA penetration.
Author(s): Rachel Mosher Henke, Kathryn R. Fingar, Lan Liang, H. Joanna Jiang
Citation: American Journal of Managed Care, 29(11), 594–600
Date: 11/2023
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2023 Rural-Urban Disparities in Health Care in Medicare
Examines rural/urban differences in the quality of healthcare received by Medicare beneficiaries in 2022, with breakdowns by race and ethnicity. Focuses on patient experience and clinical care measures, including screening for and management of health conditions, medication-related issues, and access to and availability of care.
Date: 11/2023
Sponsoring organizations: Centers for Medicare and Medicaid Services, RAND Corporation
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Examines rural/urban differences in the quality of healthcare received by Medicare beneficiaries in 2022, with breakdowns by race and ethnicity. Focuses on patient experience and clinical care measures, including screening for and management of health conditions, medication-related issues, and access to and availability of care.
Date: 11/2023
Sponsoring organizations: Centers for Medicare and Medicaid Services, RAND Corporation
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Final Rule for CY 2024 Physician Fee Schedule: Fact Sheet
Fact sheet covering Centers for Medicare & Medicaid Services (CMS) telehealth policy changes for 2024 as outlined in the final calendar year (CY) 2024 Physician Fee Schedule. Covers eligible services that can be delivered by telehealth, remote monitoring services, physician supervision, diabetes self-management training (DSMT), and more.
Date: 11/2023
Sponsoring organization: Center for Connected Health Policy: The National Telehealth Policy Resource Center
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Fact sheet covering Centers for Medicare & Medicaid Services (CMS) telehealth policy changes for 2024 as outlined in the final calendar year (CY) 2024 Physician Fee Schedule. Covers eligible services that can be delivered by telehealth, remote monitoring services, physician supervision, diabetes self-management training (DSMT), and more.
Date: 11/2023
Sponsoring organization: Center for Connected Health Policy: The National Telehealth Policy Resource Center
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