Rural Health
Resources by Topic: Medicare
Person-Centered Innovation – An Update on the Implementation of the CMS Innovation Center's Strategy
Provides an update on the Centers for Medicare and Medicaid Services' (CMS) Innovation Center's progress in the implementation of the strategy refresh announced in 2021. Describes accomplishments from the first year of implementing the strategy refresh and outlines areas of focus for the upcoming year across the five strategic objectives: driving accountable care, advancing health equity, supporting innovation, addressing affordability, and partnering to achieve healthcare system transformation. Includes information on the Accountable Care Organization Realizing Equity, Access, and Community Health (ACO REACH) Model and the Community Health Access and Rural Transformation (CHART) Model.
Additional links: Supplemental Document
Date: 11/2022
Sponsoring organization: Centers for Medicare and Medicaid Services
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Provides an update on the Centers for Medicare and Medicaid Services' (CMS) Innovation Center's progress in the implementation of the strategy refresh announced in 2021. Describes accomplishments from the first year of implementing the strategy refresh and outlines areas of focus for the upcoming year across the five strategic objectives: driving accountable care, advancing health equity, supporting innovation, addressing affordability, and partnering to achieve healthcare system transformation. Includes information on the Accountable Care Organization Realizing Equity, Access, and Community Health (ACO REACH) Model and the Community Health Access and Rural Transformation (CHART) Model.
Additional links: Supplemental Document
Date: 11/2022
Sponsoring organization: Centers for Medicare and Medicaid Services
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Medicare Program: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems and Quality Reporting Programs; Organ Acquisition; Rural Emergency Hospitals: Payment Policies, Conditions of Participation, Provider Enrollment, Physician Self-Referral; New Service Category for Hospital Outpatient Department Prior Authorization Process; Overall Hospital Quality Star Rating; COVID-19
Establishes the Rural Emergency Hospital (REH) provider type. Outlines REH payment policy, Conditions of Participation (CoPs), quality measures, and enrollment policy. Outlines changes to the Critical Access Hospitals (CAH) CoPs regarding location and distance requirements, patient's rights requirements, and flexibilities for CAHs that are part of a larger health system. Among other things, this rule also revises the Medicare Hospital Outpatient Prospective Payment System (OPPS) and Medicare Ambulatory Surgical Center (ACS) payment system for calendar year 2023 and finalizes provisions included in the COVID-19 interim final rules.
Additional links: Fact Sheet
Date: 11/2022
Sponsoring organization: Centers for Medicare and Medicaid Services
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Establishes the Rural Emergency Hospital (REH) provider type. Outlines REH payment policy, Conditions of Participation (CoPs), quality measures, and enrollment policy. Outlines changes to the Critical Access Hospitals (CAH) CoPs regarding location and distance requirements, patient's rights requirements, and flexibilities for CAHs that are part of a larger health system. Among other things, this rule also revises the Medicare Hospital Outpatient Prospective Payment System (OPPS) and Medicare Ambulatory Surgical Center (ACS) payment system for calendar year 2023 and finalizes provisions included in the COVID-19 interim final rules.
Additional links: Fact Sheet
Date: 11/2022
Sponsoring organization: Centers for Medicare and Medicaid Services
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CY 2023 Medicare Hospital Outpatient Prospective Payment System and Ambulatory Surgical Center Payment System Final Rule (CMS 1772-FC) Rural Emergency Hospitals — New Medicare Provider Type
Provides an overview of Rural Emergency Hospitals, a Medicare provider type established by the Consolidated Appropriations Act, 2021. Details key policies outlined in the Calendar Year 2023 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System Final Rule, including payment policies, conditions of participation, REH provider enrollment, and exceptions to the physician self-referral law.
Date: 11/2022
Sponsoring organization: Centers for Medicare and Medicaid Services
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Provides an overview of Rural Emergency Hospitals, a Medicare provider type established by the Consolidated Appropriations Act, 2021. Details key policies outlined in the Calendar Year 2023 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System Final Rule, including payment policies, conditions of participation, REH provider enrollment, and exceptions to the physician self-referral law.
Date: 11/2022
Sponsoring organization: Centers for Medicare and Medicaid Services
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Financial Characteristics of Critical Access Hospitals (CAHs) Participating in Accountable Care Organizations (ACO)
Examines Critical Access Hospital (CAH) participation in Medicare and non-Medicare Accountable Care Organizations (ACOs) in 2019. Compares the organizational and financial characteristics of CAHs across facilities that participate in ACOs and those that do not participate in an ACO. Includes data on profitability, liquidity, outpatient revenue, and Medicare payer mix.
Author(s): Angelina Budko, George Pink, Susie Gurzenda, Ann Howard, Kristin L. Reiter
Date: 11/2022
Sponsoring organization: Flex Monitoring Team
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Examines Critical Access Hospital (CAH) participation in Medicare and non-Medicare Accountable Care Organizations (ACOs) in 2019. Compares the organizational and financial characteristics of CAHs across facilities that participate in ACOs and those that do not participate in an ACO. Includes data on profitability, liquidity, outpatient revenue, and Medicare payer mix.
Author(s): Angelina Budko, George Pink, Susie Gurzenda, Ann Howard, Kristin L. Reiter
Date: 11/2022
Sponsoring organization: Flex Monitoring Team
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Virtual Communication Services in Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs)
Provides information for Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs) regarding billing and payment for virtual communication services as established in the 2019 Physician Fee Schedule Final Rule.
Date: 11/2022
Sponsoring organization: Centers for Medicare and Medicaid Services
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Provides information for Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs) regarding billing and payment for virtual communication services as established in the 2019 Physician Fee Schedule Final Rule.
Date: 11/2022
Sponsoring organization: Centers for Medicare and Medicaid Services
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The Impact of Medicare Shared Savings Program Participation on Hospital Financial Performance: An Event-Study Analysis
Examines the effects of hospitals' participation in the Medicare Shared Savings Program (MSSP) on their financial performance. Compares within-hospital changes over time between MSSP and non-MSSP hospitals. Includes a comparison of the effects of MSSP participation between Critical Access Hospitals (CAHs) and non-CAHs.
Author(s): Huang Huang, Fred Ullrich, A. Clinton MacKinney, Keith Mueller
Citation: Health Services Research, 2022
Date: 10/2022
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Examines the effects of hospitals' participation in the Medicare Shared Savings Program (MSSP) on their financial performance. Compares within-hospital changes over time between MSSP and non-MSSP hospitals. Includes a comparison of the effects of MSSP participation between Critical Access Hospitals (CAHs) and non-CAHs.
Author(s): Huang Huang, Fred Ullrich, A. Clinton MacKinney, Keith Mueller
Citation: Health Services Research, 2022
Date: 10/2022
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Federal Policy & Telehealth: What to be Aware of Going Forward
Webinar describing the telehealth policy landscape following the COVID-19 pandemic and the associated public health emergency, highlighting federal policy issues as of October 2022. Describes policy flexibilities, Medicare telehealth during the pandemic, and research initiatives examining telehealth.
Additional links: Presentation Slide Deck
Date: 10/2022
Sponsoring organization: Center for Connected Health Policy: The National Telehealth Policy Resource Center
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Webinar describing the telehealth policy landscape following the COVID-19 pandemic and the associated public health emergency, highlighting federal policy issues as of October 2022. Describes policy flexibilities, Medicare telehealth during the pandemic, and research initiatives examining telehealth.
Additional links: Presentation Slide Deck
Date: 10/2022
Sponsoring organization: Center for Connected Health Policy: The National Telehealth Policy Resource Center
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The Future of Telehealth After COVID-19: New Opportunities and Challenges
Provides an overview of the current evidence regarding telehealth's impact on equitable access to care and on quality of care, patient outcomes, and cost. Describes the COVID-19 pandemic-related regulatory flexibilities for mental health and substance use disorder services. Discusses the importance of telehealth on primary and specialty care during the public health emergency (PHE). Offers recommendations for Medicare telehealth policies to promote better outcomes for Medicare beneficiaries and value for the Medicare program.
Additional links: Medicare Telehealth Utilization and Spending Impacts 2019-2021, Webinar Recording
Author(s): Julia Harris, Sabah Bhatnagar, Brady Newell, et al.
Date: 10/2022
Sponsoring organization: Bipartisan Policy Center
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Provides an overview of the current evidence regarding telehealth's impact on equitable access to care and on quality of care, patient outcomes, and cost. Describes the COVID-19 pandemic-related regulatory flexibilities for mental health and substance use disorder services. Discusses the importance of telehealth on primary and specialty care during the public health emergency (PHE). Offers recommendations for Medicare telehealth policies to promote better outcomes for Medicare beneficiaries and value for the Medicare program.
Additional links: Medicare Telehealth Utilization and Spending Impacts 2019-2021, Webinar Recording
Author(s): Julia Harris, Sabah Bhatnagar, Brady Newell, et al.
Date: 10/2022
Sponsoring organization: Bipartisan Policy Center
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A Career of Influencing Rural Healthcare Delivery: Bill Finerfrock and the NARHC Origin Story
Reviews the founding of the National Association of Rural Health Clinics (NARHC), with insights from long-time NARHC executive director Bill Finerfrock about collaborative work with other rural health organizations to support the Rural Health Clinic program.
Author(s): Kay Miller Temple
Citation: Rural Monitor
Date: 10/2022
Sponsoring organization: Rural Health Information Hub
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Reviews the founding of the National Association of Rural Health Clinics (NARHC), with insights from long-time NARHC executive director Bill Finerfrock about collaborative work with other rural health organizations to support the Rural Health Clinic program.
Author(s): Kay Miller Temple
Citation: Rural Monitor
Date: 10/2022
Sponsoring organization: Rural Health Information Hub
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Rural Health Clinic Program at 45 Years: Created for Access and Still Delivering Care
Features rural health policy experts, researchers, and clinicians discussing the impact of the Rural Health Clinic (RHC) program on outpatient healthcare delivery.
Author(s): Kay Miller Temple
Citation: Rural Monitor
Date: 10/2022
Sponsoring organization: Rural Health Information Hub
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Features rural health policy experts, researchers, and clinicians discussing the impact of the Rural Health Clinic (RHC) program on outpatient healthcare delivery.
Author(s): Kay Miller Temple
Citation: Rural Monitor
Date: 10/2022
Sponsoring organization: Rural Health Information Hub
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