Rural Health
Resources by Topic: Medicare
Environmental Scan on Identifying a Pathway Toward Maximizing Participation in Population-Based Total Cost of Care (PB-TCOC) Models
Presents results of an environmental scan on the identification of a pathway toward maximizing participation in population-based total cost of care (PB-TCOC) models. Describes the Center for Medicare & Medicaid Services's (CMS's) goal of having all Medicare beneficiaries with Parts A and B in accountable care relationships by 2030. Discusses challenges and technical issues related to maximizing participation in PB-TCOC models, including organizational structure, payment, and risk adjustment. Summarizes relevant features of CMS Innovation Center (CMMI) models identified in previous Physician-Focused Payment Model Technical Advisory Committee (PTAC) proposals. Includes rural references and considerations throughout.
Date: 09/2024
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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Presents results of an environmental scan on the identification of a pathway toward maximizing participation in population-based total cost of care (PB-TCOC) models. Describes the Center for Medicare & Medicaid Services's (CMS's) goal of having all Medicare beneficiaries with Parts A and B in accountable care relationships by 2030. Discusses challenges and technical issues related to maximizing participation in PB-TCOC models, including organizational structure, payment, and risk adjustment. Summarizes relevant features of CMS Innovation Center (CMMI) models identified in previous Physician-Focused Payment Model Technical Advisory Committee (PTAC) proposals. Includes rural references and considerations throughout.
Date: 09/2024
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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Rural Emergency Hospitals Fact Sheet
Provides a brief overview of the Rural Emergency Hospital (REH) provider designation. Outlines REH payment, services, eligibility requirements, and how to apply for REH designation.
Date: 09/2024
Sponsoring organization: Centers for Medicare & Medicaid Services
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Provides a brief overview of the Rural Emergency Hospital (REH) provider designation. Outlines REH payment, services, eligibility requirements, and how to apply for REH designation.
Date: 09/2024
Sponsoring organization: Centers for Medicare & Medicaid Services
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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 & 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 & 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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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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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 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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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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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 rural and urban data by multiple factors including dually eligible status.
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 rural and urban data by multiple factors including dually eligible status.
Date: 08/2024
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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