Rural Health
Resources by Topic: Medicare
Medicare: Performance-Based and Geographic Adjustments to Physician Payments
Statement to the U.S. House of Representatives Committee on Energy and Commerce, Subcommittee on Health, summarizing the Government Accountability Organization's (GAO) 2021 reports on the Quality Payment Program and the two tracks it established to incentivize Medicare providers and its 2022 report on geographic adjustments to physician payments. Includes information on the participation of providers in rural and underserved areas in Advanced Alternative Payment Models (APMs) and the challenges these providers face in transitioning to APMs.
Additional links: Full Report
Date: 10/2023
Sponsoring organization: Government Accountability Office
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Statement to the U.S. House of Representatives Committee on Energy and Commerce, Subcommittee on Health, summarizing the Government Accountability Organization's (GAO) 2021 reports on the Quality Payment Program and the two tracks it established to incentivize Medicare providers and its 2022 report on geographic adjustments to physician payments. Includes information on the participation of providers in rural and underserved areas in Advanced Alternative Payment Models (APMs) and the challenges these providers face in transitioning to APMs.
Additional links: Full Report
Date: 10/2023
Sponsoring organization: Government Accountability Office
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October 2023 MedPAC Meeting Transcript
Transcript from the Medicare Payment Advisory Commission's (MedPAC) October 2023 meeting. Covers updates to Medicare payment rates for clinician services, staffing ratios and turnover rates in nursing facilities, an alternative method to establish Medicare payments for select conditions treated in inpatient rehabilitation facilities, and a work plan relating to generic drug prices under Medicare Part D. Includes rural references and considerations throughout.
Date: 10/2023
Sponsoring organization: Medicare Payment Advisory Commission
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Transcript from the Medicare Payment Advisory Commission's (MedPAC) October 2023 meeting. Covers updates to Medicare payment rates for clinician services, staffing ratios and turnover rates in nursing facilities, an alternative method to establish Medicare payments for select conditions treated in inpatient rehabilitation facilities, and a work plan relating to generic drug prices under Medicare Part D. Includes rural references and considerations throughout.
Date: 10/2023
Sponsoring organization: Medicare Payment Advisory Commission
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CMS Native American Contacts
Features Centers for Medicare and Medicaid Services contacts for personnel in the Division of Tribal Affairs and the contacts responsible for the different Indian Health Services areas.
Date: 10/2023
Sponsoring organization: Centers for Medicare and Medicaid Services
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Features Centers for Medicare and Medicaid Services contacts for personnel in the Division of Tribal Affairs and the contacts responsible for the different Indian Health Services areas.
Date: 10/2023
Sponsoring organization: Centers for Medicare and Medicaid Services
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Environmental Scan on Encouraging Rural Participation in Population-Based TCOC Models
Presents results of an environmental scan regarding population-based total cost of care (PB-TCOC) payment models and encouraging rural participation in these models. Describes challenges affecting rural patients and providers; opportunities for alternative payment models (APMs) and PB-TCOC models to address challenges in rural areas; trends in rural providers' participation in APMs; driving care delivery transformation in rural providers, including models that include or target rural participants in their model designs; leveraging financial incentives to improve rural health care; adoption and use of health information technology, including telehealth and data analytics among rural providers; and the measurement of rural providers' performance in APMs.
Date: 09/2023
Sponsoring organizations: HHS Office of the Assistant Secretary for Planning and Evaluation, NORC at the University of Chicago
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Presents results of an environmental scan regarding population-based total cost of care (PB-TCOC) payment models and encouraging rural participation in these models. Describes challenges affecting rural patients and providers; opportunities for alternative payment models (APMs) and PB-TCOC models to address challenges in rural areas; trends in rural providers' participation in APMs; driving care delivery transformation in rural providers, including models that include or target rural participants in their model designs; leveraging financial incentives to improve rural health care; adoption and use of health information technology, including telehealth and data analytics among rural providers; and the measurement of rural providers' performance in APMs.
Date: 09/2023
Sponsoring organizations: HHS Office of the Assistant Secretary for Planning and Evaluation, NORC at the University of Chicago
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Medicare Advantage Value-Based Insurance Design Model Phase II: Second Annual Evaluation Report
Presents findings from an evaluation of Phase II of the Medicare Advantage (MA) Value-Based Insurance Design (VBID) Model, which allows participating MA parent organizations to offer supplemental benefits and incentives to beneficiaries, hospice benefits, and wellness and healthcare planning through their MA plans. Summarizes findings from interviews with representatives of participating MA organizations, in-network and out-of-network hospices, and beneficiaries. Covers MA organization and beneficiary implementation experiences, plan enrollment, quality of care, health outcomes, and more, for the VBID Model generally and for the VBID Hospice Benefit Component.
Additional links: Appendices, Findings at a Glance, Hospice Benefit Component Findings at a Glance
Date: 09/2023
Sponsoring organizations: Centers for Medicare and Medicaid Services, RAND Corporation
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Presents findings from an evaluation of Phase II of the Medicare Advantage (MA) Value-Based Insurance Design (VBID) Model, which allows participating MA parent organizations to offer supplemental benefits and incentives to beneficiaries, hospice benefits, and wellness and healthcare planning through their MA plans. Summarizes findings from interviews with representatives of participating MA organizations, in-network and out-of-network hospices, and beneficiaries. Covers MA organization and beneficiary implementation experiences, plan enrollment, quality of care, health outcomes, and more, for the VBID Model generally and for the VBID Hospice Benefit Component.
Additional links: Appendices, Findings at a Glance, Hospice Benefit Component Findings at a Glance
Date: 09/2023
Sponsoring organizations: Centers for Medicare and Medicaid Services, RAND Corporation
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MedPAC Response to a Congressional Request for Information on Improving Access to Health Care in Rural and Underserved Areas
Letter to the House Committee on Ways and Means responding to a request for information on improving access to healthcare in rural and underserved areas. Covers MedPAC recommendations for policies to target payments to better support rural beneficiaries' access to care, including the Rural Emergency Hospital program and a proposed Medicare Safety-Net Index; changes to the hospital wage index to address geographic inequities; and the alignment of payment rates across ambulatory settings for certain services.
Date: 09/2023
Sponsoring organization: Medicare Payment Advisory Commission
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Letter to the House Committee on Ways and Means responding to a request for information on improving access to healthcare in rural and underserved areas. Covers MedPAC recommendations for policies to target payments to better support rural beneficiaries' access to care, including the Rural Emergency Hospital program and a proposed Medicare Safety-Net Index; changes to the hospital wage index to address geographic inequities; and the alignment of payment rates across ambulatory settings for certain services.
Date: 09/2023
Sponsoring organization: Medicare Payment Advisory Commission
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Oral Health Among Medicare Beneficiaries in Nursing Homes
Evaluated oral health among 2,355,366 Medicare beneficiaries living in nursing homes. Highlights characteristics associated with specific types of dental issues including age, sex, rurality, and more.
Author(s): Steffany Chamut, Carla Shoff, Kristiana Yao, Lee A. Fleisher, Natalia I. Chalmers
Citation: JAMA Network Open, 6(9)
Date: 09/2023
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Evaluated oral health among 2,355,366 Medicare beneficiaries living in nursing homes. Highlights characteristics associated with specific types of dental issues including age, sex, rurality, and more.
Author(s): Steffany Chamut, Carla Shoff, Kristiana Yao, Lee A. Fleisher, Natalia I. Chalmers
Citation: JAMA Network Open, 6(9)
Date: 09/2023
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September 2023 MedPAC Meeting Transcript
Transcript from the Medicare Payment Advisory Commission's (MedPAC) September 2022 meeting. Covers Medicare Advantage benefits and coding, the Acute Care Hospital at Home program, and the shift of some surgical procedures from hospital outpatient departments to ambulatory surgical centers (ASCs). Includes rural references and considerations throughout.
Date: 09/2023
Sponsoring organization: Medicare Payment Advisory Commission
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Transcript from the Medicare Payment Advisory Commission's (MedPAC) September 2022 meeting. Covers Medicare Advantage benefits and coding, the Acute Care Hospital at Home program, and the shift of some surgical procedures from hospital outpatient departments to ambulatory surgical centers (ASCs). Includes rural references and considerations throughout.
Date: 09/2023
Sponsoring organization: Medicare Payment Advisory Commission
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Medicare Switching: Patterns Of Enrollment Growth In Medicare Advantage, 2006–22
Analyzes enrollment in Medicare Advantage (MA) and traditional Medicare between 2006 and 2022 to identify trends in switching services. Discusses demographic and geographic characteristics of those who switched including rurality.
Author(s): Lanlan Xu, W. Pete Welch, Steven Sheingold, Nancy De Lew, Benjamin D. Sommers
Citation: Health Affairs, 42(9)
Date: 09/2023
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Analyzes enrollment in Medicare Advantage (MA) and traditional Medicare between 2006 and 2022 to identify trends in switching services. Discusses demographic and geographic characteristics of those who switched including rurality.
Author(s): Lanlan Xu, W. Pete Welch, Steven Sheingold, Nancy De Lew, Benjamin D. Sommers
Citation: Health Affairs, 42(9)
Date: 09/2023
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Aging in Place: The Vital Role of Home Health in Access to Care
Recording of a September 19, 2023, U.S. Senate Committee on Finance Subcommittee on Health Care hearing on access to home health services and the role of home health in supporting aging in place. Features testimony from Carrie Edwards, Director of Home Care Services at Mary Lanning Healthcare in rural Nebraska, and Tracy Mroz, Associate Professor at the University of Washington and Investigator at the WWAMI Rural Health Research Center.
Additional links: Carrie Edwards, Mary Lanning Healthcare - Testimony, Tracy M. Mroz, University of Washington - Testimony
Date: 09/2023
Sponsoring organization: Senate Committee on Finance, Subcommittee on Health Care
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Recording of a September 19, 2023, U.S. Senate Committee on Finance Subcommittee on Health Care hearing on access to home health services and the role of home health in supporting aging in place. Features testimony from Carrie Edwards, Director of Home Care Services at Mary Lanning Healthcare in rural Nebraska, and Tracy Mroz, Associate Professor at the University of Washington and Investigator at the WWAMI Rural Health Research Center.
Additional links: Carrie Edwards, Mary Lanning Healthcare - Testimony, Tracy M. Mroz, University of Washington - Testimony
Date: 09/2023
Sponsoring organization: Senate Committee on Finance, Subcommittee on Health Care
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