Rural Health
Resources by Topic: Medicare
Optimizing Population-Based Total Cost of Care (PB-TCOC) Models in the Context of Alternative Payment Models (APMs) and Physician-Focused Payment Models (PFPMs)
Report from the Physician-Focused Payment Model Technical Advisory Committee (PTAC) summarizing findings on population-based total cost of care (PB-TCOC) payment models and the role these models can play in optimizing health care delivery and value-based transformation in the context of alternative payment models (APMs) and physician-focused payment models (PFPMs). Provides an overview of key issues relating to PB-TCOC models and value-based care transformation. Identifies areas where additional research is needed and some potential next steps. Includes rural references throughout.
Date: 03/2023
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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Report from the Physician-Focused Payment Model Technical Advisory Committee (PTAC) summarizing findings on population-based total cost of care (PB-TCOC) payment models and the role these models can play in optimizing health care delivery and value-based transformation in the context of alternative payment models (APMs) and physician-focused payment models (PFPMs). Provides an overview of key issues relating to PB-TCOC models and value-based care transformation. Identifies areas where additional research is needed and some potential next steps. Includes rural references throughout.
Date: 03/2023
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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Financial Risk Acceptance among Rural Health Care Providers Participating in the Quality Payment Program
Summarizes nonmetropolitan and metropolitan providers' participation in different Quality Payment Program tracks and subdivisions, and evaluates provider and patient-panel characteristics associated with financial risk acceptance. Features statistics on risk acceptance with breakdowns by specialty type and metropolitan status, and patient panel characteristics by risk type.
Author(s): Xi Zhu, Mina Shrestha, Fred Ullrich, Keith Mueller
Date: 03/2023
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Summarizes nonmetropolitan and metropolitan providers' participation in different Quality Payment Program tracks and subdivisions, and evaluates provider and patient-panel characteristics associated with financial risk acceptance. Features statistics on risk acceptance with breakdowns by specialty type and metropolitan status, and patient panel characteristics by risk type.
Author(s): Xi Zhu, Mina Shrestha, Fred Ullrich, Keith Mueller
Date: 03/2023
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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MedPAC Report to the Congress: Medicare Payment Policy, 2023
Annual review of Medicare payment policies, with recommendations to Congress. Includes discussion on Medicare payment policies directly affecting rural providers and beneficiaries. Addresses payment adequacy for healthcare facilities and services; Medicare Advantage (MA), including a mandated report comparing per enrollee spending in the MA program with that of traditional fee-for-service (FFS) Medicare; and Medicare Part D.
Date: 03/2023
Sponsoring organization: Medicare Payment Advisory Commission
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Annual review of Medicare payment policies, with recommendations to Congress. Includes discussion on Medicare payment policies directly affecting rural providers and beneficiaries. Addresses payment adequacy for healthcare facilities and services; Medicare Advantage (MA), including a mandated report comparing per enrollee spending in the MA program with that of traditional fee-for-service (FFS) Medicare; and Medicare Part D.
Date: 03/2023
Sponsoring organization: Medicare Payment Advisory Commission
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RHCs & the Medicare Shared Savings Program - What You Need to Know
Recording of a March 7, 2023, webinar providing an overview of the transition to value-based care, Accountable Care Organizations, and the Medicare Shared Savings Program. Discusses considerations for Rural Health Clinic participation in the Shared Savings Program. Part of the Rural Health Clinic Technical Assistance Series.
Additional links: Presentation Slides, Transcript
Date: 03/2023
Sponsoring organization: National Association of Rural Health Clinics
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Recording of a March 7, 2023, webinar providing an overview of the transition to value-based care, Accountable Care Organizations, and the Medicare Shared Savings Program. Discusses considerations for Rural Health Clinic participation in the Shared Savings Program. Part of the Rural Health Clinic Technical Assistance Series.
Additional links: Presentation Slides, Transcript
Date: 03/2023
Sponsoring organization: National Association of Rural Health Clinics
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Rural Track Program Funding: An Erosion in Definitions of Rural Places Requires New Action
Policy position paper discussing graduate medical education (GME) in rural areas. Discusses policy changes to rural hospital classification and the impact of these changes on rural GME and rural training track programs.
Date: 03/2023
Sponsoring organization: National Rural Health Association
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Policy position paper discussing graduate medical education (GME) in rural areas. Discusses policy changes to rural hospital classification and the impact of these changes on rural GME and rural training track programs.
Date: 03/2023
Sponsoring organization: National Rural Health Association
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CMS Bundled Payments for Care Improvement Advanced Model: Fourth Evaluation Report
Fourth annual report of the Bundled Payments for Care Improvement Advanced (BPCI Advanced) Model, which tests whether linking payments for a clinical episode of care can reduce Medicare expenditures while maintaining or improving the quality of care. Explores the impact of BPCI Advanced on episode payments, utilization, and quality of care, as well as estimates of Medicare program savings in Model Year 3. Analyzes BPCI Advanced outcomes for beneficiaries from underserved communities, including beneficiaries in rural areas and areas with a high Area Deprivation Index (ADI).
Additional links: Appendices, Findings at a Glance
Author(s): The Lewin Group, Abt Associates, GDIT, Telligen
Date: 03/2023
Sponsoring organization: Centers for Medicare and Medicaid Services
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Fourth annual report of the Bundled Payments for Care Improvement Advanced (BPCI Advanced) Model, which tests whether linking payments for a clinical episode of care can reduce Medicare expenditures while maintaining or improving the quality of care. Explores the impact of BPCI Advanced on episode payments, utilization, and quality of care, as well as estimates of Medicare program savings in Model Year 3. Analyzes BPCI Advanced outcomes for beneficiaries from underserved communities, including beneficiaries in rural areas and areas with a high Area Deprivation Index (ADI).
Additional links: Appendices, Findings at a Glance
Author(s): The Lewin Group, Abt Associates, GDIT, Telligen
Date: 03/2023
Sponsoring organization: Centers for Medicare and Medicaid Services
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Quality Improvement in Rural Health Care
Policy position paper regarding challenges rural providers face in participating in quality improvement initiatives. Offers policy recommendations on the establishment and support of rural-relevant quality measures.
Author(s): Michelle Mills, Roger Wells
Date: 02/2023
Sponsoring organization: National Rural Health Association
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Policy position paper regarding challenges rural providers face in participating in quality improvement initiatives. Offers policy recommendations on the establishment and support of rural-relevant quality measures.
Author(s): Michelle Mills, Roger Wells
Date: 02/2023
Sponsoring organization: National Rural Health Association
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Obesity Prevention and Treatment in Rural America Through Changes in Diet and Food Availability
Policy position paper regarding obesity prevention and treatment through rural-specific programming and equitable coverage. Offers policy recommendations to address obesity among rural populations.
Date: 02/2023
Sponsoring organization: National Rural Health Association
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Policy position paper regarding obesity prevention and treatment through rural-specific programming and equitable coverage. Offers policy recommendations to address obesity among rural populations.
Date: 02/2023
Sponsoring organization: National Rural Health Association
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Center for Medicare & Medicaid Innovation Initiatives to Address Rural Health and Health Disparities
Policy brief describing three national Center for Medicare & Medicaid Innovation (CMMI) value-based initiatives that allow providers to work toward health equity. Provides policy recommendations to design and refine programs to engage rural providers.
Author(s): Andrea Mitchell, Alyssa Meller, Hunter Nostrant
Date: 02/2023
Sponsoring organization: National Rural Health Association
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Policy brief describing three national Center for Medicare & Medicaid Innovation (CMMI) value-based initiatives that allow providers to work toward health equity. Provides policy recommendations to design and refine programs to engage rural providers.
Author(s): Andrea Mitchell, Alyssa Meller, Hunter Nostrant
Date: 02/2023
Sponsoring organization: National Rural Health Association
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FQHC & RHC CMS Policy Manual Updates
Highlights policy changes in the 2022 and 2023 Final Physician Fee Schedules, but not included in the FQHC/RHC CMS Policy Manual, regarding mental health face-to-face and telehealth encounters, and care management services. Details when permanent policies take effect. Discusses the current CMS modified definition of a mental health visit. Provides clarification on the Medicare allowance for general care management services including chronic care, chronic pain, and behavioral health integration.
Date: 02/2023
Sponsoring organization: Center for Connected Health Policy: The National Telehealth Policy Resource Center
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Highlights policy changes in the 2022 and 2023 Final Physician Fee Schedules, but not included in the FQHC/RHC CMS Policy Manual, regarding mental health face-to-face and telehealth encounters, and care management services. Details when permanent policies take effect. Discusses the current CMS modified definition of a mental health visit. Provides clarification on the Medicare allowance for general care management services including chronic care, chronic pain, and behavioral health integration.
Date: 02/2023
Sponsoring organization: Center for Connected Health Policy: The National Telehealth Policy Resource Center
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