Rural Health
Resources by Topic: Medicare
Medicare Advantage Enrollment, Plan Availability and Premiums in Rural Areas
Research brief analyzing Medicare Advantage enrollment, availability, and premiums in rural areas to identify trends since 2010. Offers rural and urban comparisons.
Author(s): Jeannie Fuglesten Biniek, Gabrielle Clerveau, Anthony Damico, Tricia Neuman
Date: 09/2023
Sponsoring organization: KFF
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Research brief analyzing Medicare Advantage enrollment, availability, and premiums in rural areas to identify trends since 2010. Offers rural and urban comparisons.
Author(s): Jeannie Fuglesten Biniek, Gabrielle Clerveau, Anthony Damico, Tricia Neuman
Date: 09/2023
Sponsoring organization: KFF
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Inflation Reduction Act Research Series: Medicare Enrollees' Use and Out-of-Pocket Expenditures for Drugs Selected for Negotiation under the Medicare Drug Price Negotiation Program
Provides an overview of the Medicare Drug Price Negotiation Program established by the Inflation Reduction Act. Examines prescription drug use and out-of-pocket spending by Medicare Part D enrollees in calendar year 2022 for each of the first 10 drugs selected for price negotiations, which will be applicable in 2026. Includes data on the demographic characteristics of Medicare Part D enrollees taking each drug, including urban-rural status, as well as the number of enrollees and mean out-of-pocket spending on each drug by state.
Date: 09/2023
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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Provides an overview of the Medicare Drug Price Negotiation Program established by the Inflation Reduction Act. Examines prescription drug use and out-of-pocket spending by Medicare Part D enrollees in calendar year 2022 for each of the first 10 drugs selected for price negotiations, which will be applicable in 2026. Includes data on the demographic characteristics of Medicare Part D enrollees taking each drug, including urban-rural status, as well as the number of enrollees and mean out-of-pocket spending on each drug by state.
Date: 09/2023
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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Who's Accountable? Low-Value Care Received By Medicare Beneficiaries Outside Of Their Attributed Health Systems
Examines how much low-volume care and health system spending can be attributed to fee-for-service Medicare beneficiaries aged 65-years-old and older receiving care outside of the health system between 2017-2018. Explores beneficiary and health system factors associated with receiving the thirty most common low-value services, including beneficiaries' rurality and whether the low-value services originated from primary care physicians or specialists.
Author(s): Ishani Ganguli, Maia L. Crawford, Benjamin Usadi, et al.
Citation: Health Affairs, 42(8), 1128-1139
Date: 08/2023
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Examines how much low-volume care and health system spending can be attributed to fee-for-service Medicare beneficiaries aged 65-years-old and older receiving care outside of the health system between 2017-2018. Explores beneficiary and health system factors associated with receiving the thirty most common low-value services, including beneficiaries' rurality and whether the low-value services originated from primary care physicians or specialists.
Author(s): Ishani Ganguli, Maia L. Crawford, Benjamin Usadi, et al.
Citation: Health Affairs, 42(8), 1128-1139
Date: 08/2023
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Evaluation of the Million Hearts® Cardiovascular Disease Risk Reduction Model: Final Evaluation Report
Describes the results of the Centers for Medicare & Medicaid Services (CMS) Million Hearts Cardiovascular Disease Risk Reduction Model, a five-year randomized trial that aimed to reduce the incidence of first-time heart attacks and strokes among Medicare beneficiaries. Covers participant characteristics, including rural or urban status and organization type; changes in cardiovascular disease risk scores; effects of the model on healthcare utilization; intermediate- and long-term impacts on beneficiaries; and the contribution of these findings to the broader literature on cardiovascular disease prevention and value-based care.
Additional links: Findings at a Glance
Date: 08/2023
Sponsoring organizations: Centers for Medicare and Medicaid Services, Mathematica, RAND Corporation
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Describes the results of the Centers for Medicare & Medicaid Services (CMS) Million Hearts Cardiovascular Disease Risk Reduction Model, a five-year randomized trial that aimed to reduce the incidence of first-time heart attacks and strokes among Medicare beneficiaries. Covers participant characteristics, including rural or urban status and organization type; changes in cardiovascular disease risk scores; effects of the model on healthcare utilization; intermediate- and long-term impacts on beneficiaries; and the contribution of these findings to the broader literature on cardiovascular disease prevention and value-based care.
Additional links: Findings at a Glance
Date: 08/2023
Sponsoring organizations: Centers for Medicare and Medicaid Services, Mathematica, RAND Corporation
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MedPAC Comment on CMS's Proposed Rule on the Home Health Prospective Payment System for FY 2024
Comments on a July 10, 2023, Federal Register proposed rule related to Medicare payment policies for home health agencies. Includes comments on expanding the Home Health Value-Based Purchasing Model nationwide, wage index adjustments, the Hospice Special Focus Program (SFP), and more.
Date: 08/2023
Sponsoring organization: Medicare Payment Advisory Commission
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Comments on a July 10, 2023, Federal Register proposed rule related to Medicare payment policies for home health agencies. Includes comments on expanding the Home Health Value-Based Purchasing Model nationwide, wage index adjustments, the Hospice Special Focus Program (SFP), and more.
Date: 08/2023
Sponsoring organization: Medicare Payment Advisory Commission
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MedPAC Comment on CMS's Proposed Rule on the End-Stage Renal Disease Payment System Update for FY 2024
Comments on a June 30, 2023, Federal Register proposed rule related to Medicare payment policies for end-stage renal disease (ESRD). Includes comments addressing the low-volume payment adjustment (LVPA) and recommending the development of a new payment adjustment based on geographic isolation.
Date: 08/2023
Sponsoring organization: Medicare Payment Advisory Commission
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Comments on a June 30, 2023, Federal Register proposed rule related to Medicare payment policies for end-stage renal disease (ESRD). Includes comments addressing the low-volume payment adjustment (LVPA) and recommending the development of a new payment adjustment based on geographic isolation.
Date: 08/2023
Sponsoring organization: Medicare Payment Advisory Commission
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Rates of Nursing Home Closures Were Relatively Stable Over the Past Decade, but Warrant Continuous Monitoring
Evaluates nursing home closures between 2011 and 2021 to identify trends and characteristics associated with closure. Considers location, Medicaid and Medicare, resident race, and more.
Author(s): Kelly Hughes, Zhanlian Feng, Qinghua Li, et al.
Citation: Health Affairs Scholar, 1(2)
Date: 08/2023
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Evaluates nursing home closures between 2011 and 2021 to identify trends and characteristics associated with closure. Considers location, Medicaid and Medicare, resident race, and more.
Author(s): Kelly Hughes, Zhanlian Feng, Qinghua Li, et al.
Citation: Health Affairs Scholar, 1(2)
Date: 08/2023
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Distributional Analysis of Variation in Medicare Advantage Participation Within and Between Metropolitan, Micropolitan, and Noncore Counties
Policy brief identifying penetration rates, number of plans, and enrollment patterns and trends in Medicare Advantage participation in metropolitan and nonmetropolitan counties from 2017-2022. Features statistics with breakdowns by year and metropolitan, micropolitan, and noncore areas.
Author(s): Dan Shane, Ufuoma Ejughemre, Fred Ullrich, Keith Mueller
Date: 08/2023
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Policy brief identifying penetration rates, number of plans, and enrollment patterns and trends in Medicare Advantage participation in metropolitan and nonmetropolitan counties from 2017-2022. Features statistics with breakdowns by year and metropolitan, micropolitan, and noncore areas.
Author(s): Dan Shane, Ufuoma Ejughemre, Fred Ullrich, Keith Mueller
Date: 08/2023
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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RHC Cost Reporting 101 Webinar
Recording of an August 7, 2023, webinar providing an overview of cost reporting for Rural Health Clinics (RHCs). Covers relevant Medicare regulations, differences between provider-based and independent RHC cost reporting, and key cost report drivers. Part of the Rural Health Clinic Technical Assistance Series.
Additional links: Presentation Slides, Transcript
Date: 08/2023
Sponsoring organization: National Association of Rural Health Clinics
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Recording of an August 7, 2023, webinar providing an overview of cost reporting for Rural Health Clinics (RHCs). Covers relevant Medicare regulations, differences between provider-based and independent RHC cost reporting, and key cost report drivers. Part of the Rural Health Clinic Technical Assistance Series.
Additional links: Presentation Slides, Transcript
Date: 08/2023
Sponsoring organization: National Association of Rural Health Clinics
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FY 2024 Hospital Inpatient Prospective Payment System (IPPS) and Long-Term Care Hospital Prospective Payment System (LTCH PPS) Final Rule — CMS-1785-F and CMS-1788-F Fact Sheet
Fact sheet providing an overview of the Centers for Medicare & Medicaid Services (CMS) fiscal year 2024 hospital inpatient prospective payment system (IPPS) and long-term care hospital prospective payment system (LTCH PPS) final rule. Includes information about the low-wage index hospital policy, Rural Emergency Hospitals (REHs) being allowed to receive Medicare Graduate Medical Education (GME) payments, changes to the rural wage index calculation methodology, and more.
Date: 08/2023
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 2024 hospital inpatient prospective payment system (IPPS) and long-term care hospital prospective payment system (LTCH PPS) final rule. Includes information about the low-wage index hospital policy, Rural Emergency Hospitals (REHs) being allowed to receive Medicare Graduate Medical Education (GME) payments, changes to the rural wage index calculation methodology, and more.
Date: 08/2023
Sponsoring organization: Centers for Medicare and Medicaid Services
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