Rural Health
Resources by Topic: Medicare
Configuration and Delivery of Primary Care in Rural and Urban Settings
Compares structure, capabilities, and payment reform participation of isolated, small town, micropolitan, and metropolitan physician practices. Features statistics on characteristics of physician practices, Medicare beneficiaries, and beneficiary utilization in 2017, with breakdowns by rurality.
Author(s): Taressa K. Fraze, Valerie A. Lewis, Andrew Wood, Helen Newton, Carrie H. Colla
Citation: Journal of General Internal Medicine, 37(12), 3045-3053
Date: 09/2022
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Compares structure, capabilities, and payment reform participation of isolated, small town, micropolitan, and metropolitan physician practices. Features statistics on characteristics of physician practices, Medicare beneficiaries, and beneficiary utilization in 2017, with breakdowns by rurality.
Author(s): Taressa K. Fraze, Valerie A. Lewis, Andrew Wood, Helen Newton, Carrie H. Colla
Citation: Journal of General Internal Medicine, 37(12), 3045-3053
Date: 09/2022
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September 2022 MedPAC Meeting Transcript
Transcript from the Medicare Payment Advisory Commission's (MedPAC) September 2022 meeting. Covers Medicare payments to safety-net clinicians, the development of a prototype post-acute care prospective payment system, nursing facility staffing requirements and data, the expansion of telehealth during the COVID-19 public health emergency (PHE) and payment for telehealth services after the PHE, inpatient psychiatric facility care, and Part D data on drug rebates and discounts. Includes rural references and considerations throughout.
Date: 09/2022
Sponsoring organization: Medicare Payment Advisory Commission
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Transcript from the Medicare Payment Advisory Commission's (MedPAC) September 2022 meeting. Covers Medicare payments to safety-net clinicians, the development of a prototype post-acute care prospective payment system, nursing facility staffing requirements and data, the expansion of telehealth during the COVID-19 public health emergency (PHE) and payment for telehealth services after the PHE, inpatient psychiatric facility care, and Part D data on drug rebates and discounts. Includes rural references and considerations throughout.
Date: 09/2022
Sponsoring organization: Medicare Payment Advisory Commission
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Health Panel Comment Letter – Medicare Shared Savings Program Requirements
Comments offered in response to a July 29, 2022, proposed rule regarding changes to the Medicare Shared Savings Program (SSP) to facilitate more widespread participation in Accountable Care Organizations (ACOs). Discusses how changes will impact rural Medicare beneficiaries, as well as challenges to extending ACOs to all rural counties. Covers advanced interest payments, extended time in one-sided risk, changes to calculating benchmarks, proposals to allow low revenue ACOs to realize shared savings at a lower minimum, a health equity adjustment, and social determinants of health measures.
Date: 09/2022
Sponsoring organization: Rural Policy Research Institute Rural Health Panel
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Comments offered in response to a July 29, 2022, proposed rule regarding changes to the Medicare Shared Savings Program (SSP) to facilitate more widespread participation in Accountable Care Organizations (ACOs). Discusses how changes will impact rural Medicare beneficiaries, as well as challenges to extending ACOs to all rural counties. Covers advanced interest payments, extended time in one-sided risk, changes to calculating benchmarks, proposals to allow low revenue ACOs to realize shared savings at a lower minimum, a health equity adjustment, and social determinants of health measures.
Date: 09/2022
Sponsoring organization: Rural Policy Research Institute Rural Health Panel
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Medicare Telehealth: Actions Needed to Strengthen Oversight and Help Providers Educate Patients on Privacy and Security Risks
Analyzes 2019 and 2020 Medicare claims data to explore the utilization of telehealth services before and after the implementation of regulatory flexibilities and waivers in March 2020 in response to the COVID-19 pandemic. Describes efforts taken by the Centers for Medicare & Medicaid Services (CMS) to identify and monitor risks posed by Medicare telehealth waivers, as well as a change made to the enforcement of regulations governing patients' protected health information during the COVID-19 public health emergency. Offers three recommendations to CMS to strengthen oversight and assess the quality of telehealth services and one recommendation regarding assistance to providers to explain the privacy and security risks of telehealth to patients.
Additional links: Full Report
Date: 09/2022
Sponsoring organization: Government Accountability Office
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Analyzes 2019 and 2020 Medicare claims data to explore the utilization of telehealth services before and after the implementation of regulatory flexibilities and waivers in March 2020 in response to the COVID-19 pandemic. Describes efforts taken by the Centers for Medicare & Medicaid Services (CMS) to identify and monitor risks posed by Medicare telehealth waivers, as well as a change made to the enforcement of regulations governing patients' protected health information during the COVID-19 public health emergency. Offers three recommendations to CMS to strengthen oversight and assess the quality of telehealth services and one recommendation regarding assistance to providers to explain the privacy and security risks of telehealth to patients.
Additional links: Full Report
Date: 09/2022
Sponsoring organization: Government Accountability Office
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Measure Applications Partnership 2022 Considerations for Measure Set Review in Federal Programs: Clinician, Hospital, and Post-Acute Care/Long-Term Care
Reviews the 32 healthcare quality and efficiency measures used by the National Quality Forum's Measure Applications Partnership (MAP) during 2022. Discusses measures for clinician programs, hospital programs, and post-acute care/long-term care programs. Includes the MAP Rural Health Advisory Group's support or determination of the suitability of each measure for rural providers.
Date: 09/2022
Sponsoring organization: National Quality Forum
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Reviews the 32 healthcare quality and efficiency measures used by the National Quality Forum's Measure Applications Partnership (MAP) during 2022. Discusses measures for clinician programs, hospital programs, and post-acute care/long-term care programs. Includes the MAP Rural Health Advisory Group's support or determination of the suitability of each measure for rural providers.
Date: 09/2022
Sponsoring organization: National Quality Forum
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Next Steps for the Rural Emergency Hospital Model
Blog post discussing rural hospital closures and how the Rural Emergency Hospital (REH) model can help financially vulnerable hospitals align their services to the needs of the community. Highlights recommendations to the U.S. Department of Health and Human Services regarding REH Conditions of Participation and payment.
Date: 09/2022
Sponsoring organization: Bipartisan Policy Center
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Blog post discussing rural hospital closures and how the Rural Emergency Hospital (REH) model can help financially vulnerable hospitals align their services to the needs of the community. Highlights recommendations to the U.S. Department of Health and Human Services regarding REH Conditions of Participation and payment.
Date: 09/2022
Sponsoring organization: Bipartisan Policy Center
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Receipt of Out-of-State Telemedicine Visits Among Medicare Beneficiaries During the COVID-19 Pandemic
Study examining out-of-state telemedicine utilization during the COVID-19 pandemic by Medicare beneficiaries from January to June 2021 based on Medicare fee-for-service claims. Presents patient characteristics, variation in out-of-state telemedicine by geography, and benefits of out-of-state telemedicine access for rural beneficiaries.
Author(s): Ateev Mehrotra, Haiden A. Huskamp, Alok Nimgaonkar, et al.
Citation: JAMA Health Forum, 3(9), e223013
Date: 09/2022
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Study examining out-of-state telemedicine utilization during the COVID-19 pandemic by Medicare beneficiaries from January to June 2021 based on Medicare fee-for-service claims. Presents patient characteristics, variation in out-of-state telemedicine by geography, and benefits of out-of-state telemedicine access for rural beneficiaries.
Author(s): Ateev Mehrotra, Haiden A. Huskamp, Alok Nimgaonkar, et al.
Citation: JAMA Health Forum, 3(9), e223013
Date: 09/2022
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Health Panel Comment Letter – Hospital Outpatient Prospective Payment System and Rural Emergency Hospitals
Comments offered in response to a July 26, 2022, Federal Register proposed rule revising the Medicare Hospital Outpatient Prospective Payment System (OPPS) and Medicare Ambulatory Surgical Center (ACS) payment system for calendar year 2023 and establishing Rural Emergency Hospital (REH) payment policy, quality measures, and enrollment policy. Discusses telehealth services for mental healthcare; REH quality measures, telehealth, and Conditions of Participation; and the use of Centers for Medicare & Medicaid Services (CMS) data on hospital and skilled nursing facilities changes in ownership.
Date: 09/2022
Sponsoring organization: Rural Policy Research Institute Rural Health Panel
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Comments offered in response to a July 26, 2022, Federal Register proposed rule revising the Medicare Hospital Outpatient Prospective Payment System (OPPS) and Medicare Ambulatory Surgical Center (ACS) payment system for calendar year 2023 and establishing Rural Emergency Hospital (REH) payment policy, quality measures, and enrollment policy. Discusses telehealth services for mental healthcare; REH quality measures, telehealth, and Conditions of Participation; and the use of Centers for Medicare & Medicaid Services (CMS) data on hospital and skilled nursing facilities changes in ownership.
Date: 09/2022
Sponsoring organization: Rural Policy Research Institute Rural Health Panel
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Beneficiary Experience, Affordability, Utilization, and Quality in Medicare Advantage and Traditional Medicare: A Review of the Literature
Summarizes the results of a review of 62 studies published between January 1, 2016, and May 1, 2022, that compare Medicare Advantage and traditional Medicare across beneficiary experience, affordability, service utilization, and quality. Includes information on Medicare enrollment patterns in rural areas and identifies gaps in research on rural Medicare beneficiaries and other subgroups. Builds on a literature review that examined studies published between 2000 and early 2014.
Author(s): Nancy Ochieng, Jeannie Fuglesten Biniek
Date: 09/2022
Sponsoring organization: KFF
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Summarizes the results of a review of 62 studies published between January 1, 2016, and May 1, 2022, that compare Medicare Advantage and traditional Medicare across beneficiary experience, affordability, service utilization, and quality. Includes information on Medicare enrollment patterns in rural areas and identifies gaps in research on rural Medicare beneficiaries and other subgroups. Builds on a literature review that examined studies published between 2000 and early 2014.
Author(s): Nancy Ochieng, Jeannie Fuglesten Biniek
Date: 09/2022
Sponsoring organization: KFF
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MedPAC Comment on CMS's Proposed Rule on the Payment Systems for Hospital Outpatient Departments and Ambulatory Surgical Centers for 2023
Comments on a July 26, 2022, Federal Register proposed rule revising the Medicare Hospital Outpatient Prospective Payment System (OPPS) and Medicare Ambulatory Surgical Center (ACS) payment system for calendar year 2023. Includes considerations for payment for 340B drugs, additional facility payments for Rural Emergency Hospitals, telehealth rehabilitation services beyond the COVID-19 public health emergency, and efforts for measuring equity and healthcare quality disparities.
Date: 09/2022
Sponsoring organization: Medicare Payment Advisory Commission
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Comments on a July 26, 2022, Federal Register proposed rule revising the Medicare Hospital Outpatient Prospective Payment System (OPPS) and Medicare Ambulatory Surgical Center (ACS) payment system for calendar year 2023. Includes considerations for payment for 340B drugs, additional facility payments for Rural Emergency Hospitals, telehealth rehabilitation services beyond the COVID-19 public health emergency, and efforts for measuring equity and healthcare quality disparities.
Date: 09/2022
Sponsoring organization: Medicare Payment Advisory Commission
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