Rural Health
Resources by Topic: Medicare
Independent Evaluation of Comprehensive Primary Care Plus (CPC+): Fourth Annual Report
Reports on the first four program years of the Comprehensive Primary Care Plus (CPC+) model, a CMS primary care payment and delivery reform effort. Discusses CPC+ participating practices, payer partners, and health information technology (HIT) vendors supporting the program. Describes practice changes regarding care delivery and outcomes for Medicare fee-for-service beneficiaries.
Additional links: Appendices, Findings at a Glance
Date: 05/2022
Sponsoring organizations: Centers for Medicare and Medicaid Services, Mathematica
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Reports on the first four program years of the Comprehensive Primary Care Plus (CPC+) model, a CMS primary care payment and delivery reform effort. Discusses CPC+ participating practices, payer partners, and health information technology (HIT) vendors supporting the program. Describes practice changes regarding care delivery and outcomes for Medicare fee-for-service beneficiaries.
Additional links: Appendices, Findings at a Glance
Date: 05/2022
Sponsoring organizations: Centers for Medicare and Medicaid Services, Mathematica
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The Impact of COVID-19 on the Rural Health Care Landscape: Challenges and Opportunities
Presents an overview of key findings from interviews with stakeholders in eight states - Iowa, Minnesota, Montana, Nebraska, Nevada, North Dakota, South Dakota, and Wyoming - regarding the rural healthcare landscape. Discusses rural hospital financial health, rural hospital transformation models, challenges facing the rural healthcare workforce, and the role of telehealth in increasing access to care. Provides recommendations aimed at further advancing the use of virtual care in all communities, including rural and frontier areas, beyond the temporary federal COVID-19 public health emergency flexibilities.
Author(s): Sabah Bhatnagar, Julia Harris, Tara Hartnett, et al.
Date: 05/2022
Sponsoring organization: Bipartisan Policy Center
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Presents an overview of key findings from interviews with stakeholders in eight states - Iowa, Minnesota, Montana, Nebraska, Nevada, North Dakota, South Dakota, and Wyoming - regarding the rural healthcare landscape. Discusses rural hospital financial health, rural hospital transformation models, challenges facing the rural healthcare workforce, and the role of telehealth in increasing access to care. Provides recommendations aimed at further advancing the use of virtual care in all communities, including rural and frontier areas, beyond the temporary federal COVID-19 public health emergency flexibilities.
Author(s): Sabah Bhatnagar, Julia Harris, Tara Hartnett, et al.
Date: 05/2022
Sponsoring organization: Bipartisan Policy Center
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April 2022 MedPAC Meeting Transcript
Transcript from the Medicare Payment Advisory Commission's (MedPAC) April 2022 meeting. Covers high prices of drugs covered under Medicare Part B, initial findings from MedPAC's analysis of Part D data on drug rebates and discounts, segmentation in the stand-alone Part D prescription drug plan market, leveraging Medicare policies to address social determinants of health, an approach to streamline and harmonize Medicare's portfolio of alternative payment models, and aligning fee-for-service payment rates across ambulatory settings. Includes rural references throughout.
Date: 04/2022
Sponsoring organization: Medicare Payment Advisory Commission
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Transcript from the Medicare Payment Advisory Commission's (MedPAC) April 2022 meeting. Covers high prices of drugs covered under Medicare Part B, initial findings from MedPAC's analysis of Part D data on drug rebates and discounts, segmentation in the stand-alone Part D prescription drug plan market, leveraging Medicare policies to address social determinants of health, an approach to streamline and harmonize Medicare's portfolio of alternative payment models, and aligning fee-for-service payment rates across ambulatory settings. Includes rural references throughout.
Date: 04/2022
Sponsoring organization: Medicare Payment Advisory Commission
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Medicare's Prospective Payment System for Inpatient Psychiatric Facilities at 15 Years
Examine how Medicare enrollees' use of inpatient psychiatric facility (IPF) services and the characteristics of IPFs have changed since the introduction of the IPF-PPS in 2005. Explores whether there have been changes in events that occur before or after IPF stays that may indicate potential changes in the quality of services. Includes information on per diem costs for rural IPFs compared to urban facilities.
Date: 04/2022
Sponsoring organizations: Medicare Payment Advisory Commission, Urban Institute
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Examine how Medicare enrollees' use of inpatient psychiatric facility (IPF) services and the characteristics of IPFs have changed since the introduction of the IPF-PPS in 2005. Explores whether there have been changes in events that occur before or after IPF stays that may indicate potential changes in the quality of services. Includes information on per diem costs for rural IPFs compared to urban facilities.
Date: 04/2022
Sponsoring organizations: Medicare Payment Advisory Commission, Urban Institute
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Evaluation of the Medicare Care Choices Model: Annual Report 4
Evaluates the Medicare Care Choice Model (MCCM), which tests whether offering eligible Medicare beneficiaries the option to receive supportive services without forgoing payment for treatment of their terminal conditions improved their quality of life and care, increased patient and family satisfaction, and reduced Medicare expenditures. Reports on MCCM beneficiary outcomes through March 2021. Includes information on rural beneficiary participation in the model and compares rural and urban beneficiary outcomes.
Additional links: Findings at a Glance
Date: 04/2022
Sponsoring organizations: Centers for Medicare and Medicaid Services, Mathematica
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Evaluates the Medicare Care Choice Model (MCCM), which tests whether offering eligible Medicare beneficiaries the option to receive supportive services without forgoing payment for treatment of their terminal conditions improved their quality of life and care, increased patient and family satisfaction, and reduced Medicare expenditures. Reports on MCCM beneficiary outcomes through March 2021. Includes information on rural beneficiary participation in the model and compares rural and urban beneficiary outcomes.
Additional links: Findings at a Glance
Date: 04/2022
Sponsoring organizations: Centers for Medicare and Medicaid Services, Mathematica
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Evaluation of the Home Health Value-Based Purchasing (HHVBP) Model: Fifth Annual Report
Evaluates the Home Health Value-Based Purchasing (HHVBP) Model, which tests the impact of providing financial incentives to home health agencies in nine states: Arizona, Florida, Iowa, Massachusetts, Maryland, Nebraska, North Carolina, Tennessee, and Washington. Reports on the experiences of home health agencies and patients through 2020, the fifth performance year of the HHVBP Model, and the third year that agencies in the HHVBP states received a payment adjustment. Examines the impacts of the HHVBP Model on Medicare expenditures, healthcare utilization, quality of care and patient experience, and agency operations. Discusses rural access to high-quality home health agencies and the impact of HHVBP on rural home health patients.
Additional links: Findings at a Glance, Technical Appendices
Author(s): Alyssa Pozniak, Marc Turenne, Eric Lammers, et al.
Date: 04/2022
Sponsoring organization: Centers for Medicare and Medicaid Services
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Evaluates the Home Health Value-Based Purchasing (HHVBP) Model, which tests the impact of providing financial incentives to home health agencies in nine states: Arizona, Florida, Iowa, Massachusetts, Maryland, Nebraska, North Carolina, Tennessee, and Washington. Reports on the experiences of home health agencies and patients through 2020, the fifth performance year of the HHVBP Model, and the third year that agencies in the HHVBP states received a payment adjustment. Examines the impacts of the HHVBP Model on Medicare expenditures, healthcare utilization, quality of care and patient experience, and agency operations. Discusses rural access to high-quality home health agencies and the impact of HHVBP on rural home health patients.
Additional links: Findings at a Glance, Technical Appendices
Author(s): Alyssa Pozniak, Marc Turenne, Eric Lammers, et al.
Date: 04/2022
Sponsoring organization: Centers for Medicare and Medicaid Services
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Utilization of Z Codes for Social Determinants of Health among a Sample of Medicare Advantage Enrollees, 2017 and 2019
Examines the use of Z codes for social determinants of health in a sample of Medicare Advantage (MA) enrollees from 2016 through 2019. Identifies the five most-used Z codes among MA enrollees, including the percent of enrollees and claims with these Z codes in 2017 and 2019. Presents data on the proportion of MA enrollees with Z code claims in 2017 and 2019 across demographic characteristics, including rurality, place of service, and provider type.
Date: 04/2022
Sponsoring organization: Centers for Medicare and Medicaid Services
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Examines the use of Z codes for social determinants of health in a sample of Medicare Advantage (MA) enrollees from 2016 through 2019. Identifies the five most-used Z codes among MA enrollees, including the percent of enrollees and claims with these Z codes in 2017 and 2019. Presents data on the proportion of MA enrollees with Z code claims in 2017 and 2019 across demographic characteristics, including rurality, place of service, and provider type.
Date: 04/2022
Sponsoring organization: Centers for Medicare and Medicaid Services
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Learning From COVID-19-Related Flexibilities: Moving Toward More Person-Centered Medicare and Medicaid Programs
Presents a person-centered framework to facilitate policymakers' decisions regarding the future of COVID-19-related temporary regulatory flexibilities. Identifies priority flexibilities that should be considered for permanence, modification, or further evaluation. Covers regulatory flexibilities regarding telehealth, scope of practice, Medicare Advantage requirements, and more. Includes rural references throughout.
Date: 03/2022
Sponsoring organizations: Health Management Associates, Manatt Health, The Scan Foundation
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Presents a person-centered framework to facilitate policymakers' decisions regarding the future of COVID-19-related temporary regulatory flexibilities. Identifies priority flexibilities that should be considered for permanence, modification, or further evaluation. Covers regulatory flexibilities regarding telehealth, scope of practice, Medicare Advantage requirements, and more. Includes rural references throughout.
Date: 03/2022
Sponsoring organizations: Health Management Associates, Manatt Health, The Scan Foundation
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March 2022 MedPAC Meeting Transcript
Transcript from the Medicare Payment Advisory Commission's (MedPAC) March 2022 meeting. Covers findings from MedPAC's annual beneficiary and clinician focus groups, Medicare payment policies to support safety-net providers, opportunities to strengthen the geriatric workforce, integrating episode-based payment with population-based payment, and improving Medicare Advantage risk adjustment. Includes rural references throughout.
Date: 03/2022
Sponsoring organization: Medicare Payment Advisory Commission
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Transcript from the Medicare Payment Advisory Commission's (MedPAC) March 2022 meeting. Covers findings from MedPAC's annual beneficiary and clinician focus groups, Medicare payment policies to support safety-net providers, opportunities to strengthen the geriatric workforce, integrating episode-based payment with population-based payment, and improving Medicare Advantage risk adjustment. Includes rural references throughout.
Date: 03/2022
Sponsoring organization: Medicare Payment Advisory Commission
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Environmental Scan on Issues Related to the Development of Population-Based Total Cost of Care (TCOC) Models in the Broader Context of Alternative Payment Models (APMs) and Physician-Focused Payment Models (PFPMs)
Presents results of an environmental scan regarding population-based total cost of care (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 TCOC payment models, relevant performance and outcome measures used in reporting and evaluation, findings from research related to population-based models and programs that seek to reduce TCOC, barriers and challenges related to implementing population-based TCOC models, and opportunities for improving and optimizing efforts to develop and implement these models. Highlights rural considerations and examples throughout.
Date: 03/2022
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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Presents results of an environmental scan regarding population-based total cost of care (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 TCOC payment models, relevant performance and outcome measures used in reporting and evaluation, findings from research related to population-based models and programs that seek to reduce TCOC, barriers and challenges related to implementing population-based TCOC models, and opportunities for improving and optimizing efforts to develop and implement these models. Highlights rural considerations and examples throughout.
Date: 03/2022
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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