Rural Health
Resources by Topic: Medicare
Medicare Advantage Enrollment Update 2021
Reports on the percentage of rural Medicare beneficiaries enrolled in Medicare Advantage (MA) and other prepaid enrollment plans by metropolitan and nonmetropolitan location, from 2009-2021.
Author(s): Mina Shrestha, Fred Ullrich, Keith Mueller
Date: 09/2021
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Reports on the percentage of rural Medicare beneficiaries enrolled in Medicare Advantage (MA) and other prepaid enrollment plans by metropolitan and nonmetropolitan location, from 2009-2021.
Author(s): Mina Shrestha, Fred Ullrich, Keith Mueller
Date: 09/2021
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Disparities in Health Care in Medicare Advantage Associated with Dual Eligibility or Eligibility for a Low-Income Subsidy
Shares Medicare Advantage (MA) plan performance data for specific healthcare quality measures reported in 2019, which represents care received in 2018. Analyzes and compares the quality of clinical care for dual-eligible (DE) beneficiaries, those who qualify for both Medicare and Medicaid, and Medicare beneficiaries who are eligible for a Part D low-income subsidy (LIS) with the quality of care for beneficiaries who do not qualify as DE nor LIS by racial/ethnic groups and rural status.
Date: 09/2021
Sponsoring organization: Centers for Medicare and Medicaid Services
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Shares Medicare Advantage (MA) plan performance data for specific healthcare quality measures reported in 2019, which represents care received in 2018. Analyzes and compares the quality of clinical care for dual-eligible (DE) beneficiaries, those who qualify for both Medicare and Medicaid, and Medicare beneficiaries who are eligible for a Part D low-income subsidy (LIS) with the quality of care for beneficiaries who do not qualify as DE nor LIS by racial/ethnic groups and rural status.
Date: 09/2021
Sponsoring organization: Centers for Medicare and Medicaid Services
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Evaluation of the Rural Community Hospital Demonstration: Report Covering 2005-2017 (Interim Report 1)
Provides an overview of the Rural Community Hospital Demonstration (RCHD). Describes the characteristics of RCHD participants that entered the demonstration between 2005-2012, the Medicare payments received under program, and the impact of the RCHD on hospital finances between 2005-2017.
Additional links: Findings at a Glance
Date: 09/2021
Sponsoring organization: Centers for Medicare and Medicaid Services
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Provides an overview of the Rural Community Hospital Demonstration (RCHD). Describes the characteristics of RCHD participants that entered the demonstration between 2005-2012, the Medicare payments received under program, and the impact of the RCHD on hospital finances between 2005-2017.
Additional links: Findings at a Glance
Date: 09/2021
Sponsoring organization: Centers for Medicare and Medicaid Services
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MedPAC Comment on CMS's Proposed Rule on Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems and Quality Reporting Programs for CY 2022
Comments on an August 4, 2021, Federal Register proposed rule revising the Medicare Hospital Outpatient Prospective Payment System (OPPS) and Medicare Ambulatory Surgical Center (ACS) payment system for calendar year 2022. Includes considerations for Rural Emergency Hospital payments and emergency department staffing requirements.
Date: 09/2021
Sponsoring organization: Medicare Payment Advisory Commission
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Comments on an August 4, 2021, Federal Register proposed rule revising the Medicare Hospital Outpatient Prospective Payment System (OPPS) and Medicare Ambulatory Surgical Center (ACS) payment system for calendar year 2022. Includes considerations for Rural Emergency Hospital payments and emergency department staffing requirements.
Date: 09/2021
Sponsoring organization: Medicare Payment Advisory Commission
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Air Ambulance Use and Surprise Billing
Provides an overview of air ambulance services, including the types and number of air ambulance providers and suppliers, utilization rates by patients, average costs, and the potential for balance billing for air ambulance transport. Summarizes key policies and legislation related to air ambulances, including the No Surprises Act. Presents data on air ambulance utilization by rurality between 2014-2018.
Author(s): Gina Turrini, Joel Ruhter, Andre R. Chappel, Nancy De Lew
Date: 09/2021
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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Provides an overview of air ambulance services, including the types and number of air ambulance providers and suppliers, utilization rates by patients, average costs, and the potential for balance billing for air ambulance transport. Summarizes key policies and legislation related to air ambulances, including the No Surprises Act. Presents data on air ambulance utilization by rurality between 2014-2018.
Author(s): Gina Turrini, Joel Ruhter, Andre R. Chappel, Nancy De Lew
Date: 09/2021
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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MedPAC Comment on CMS's Proposed Rule on the Physician Fee Schedule and Other Revisions to Part B for CY 2022
Comment on a July 23, 2021, Federal Register proposed rule revising the physician fee schedule to improve payment systems for physicians and other Medicare Part B revisions. Includes a discussion of the expansion of telehealth service coverage after the COVID-19 public health emergency, as well as reimbursement rates to Rural Health Clinics and Federally Qualified Health Centers for telehealth mental health services.
Date: 09/2021
Sponsoring organization: Medicare Payment Advisory Commission
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Comment on a July 23, 2021, Federal Register proposed rule revising the physician fee schedule to improve payment systems for physicians and other Medicare Part B revisions. Includes a discussion of the expansion of telehealth service coverage after the COVID-19 public health emergency, as well as reimbursement rates to Rural Health Clinics and Federally Qualified Health Centers for telehealth mental health services.
Date: 09/2021
Sponsoring organization: Medicare Payment Advisory Commission
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Geographic Access to Health Care for Rural Medicare Beneficiaries: A National Study
Policy brief exploring rural and urban healthcare, geographic access to providers, and types of providers seen by Medicare beneficiaries based on Medicare administrative data from 2014. Charts offer rural and urban comparisons of characteristics of beneficiaries, number of visits by region, number of visits by race/ethnicity, visits by provider type, and travel distance and time.
Author(s): Eric H. Larson, C. Holly A. Andrilla, Lisa A. Garberson, David V. Evans
Date: 09/2021
Sponsoring organization: WWAMI Rural Health Research Center
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Policy brief exploring rural and urban healthcare, geographic access to providers, and types of providers seen by Medicare beneficiaries based on Medicare administrative data from 2014. Charts offer rural and urban comparisons of characteristics of beneficiaries, number of visits by region, number of visits by race/ethnicity, visits by provider type, and travel distance and time.
Author(s): Eric H. Larson, C. Holly A. Andrilla, Lisa A. Garberson, David V. Evans
Date: 09/2021
Sponsoring organization: WWAMI Rural Health Research Center
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Medicare Covers a Lower Percentage of Outpatient Costs in Hospitals Located in Rural Areas
Policy brief describing differences in Medicare Outpatient Prospective Payment System (OPPS) payments between urban and rural hospitals. Features statistics on OPPS payments as a percent of total net patient revenue, as a percent of Medicare outpatient cost by hospital payment classification, and as a percent of Medicare outpatient cost by number of acute beds, with breakdowns by urban and rural location.
Author(s): Pranathi Sana, George H. Pink
Date: 09/2021
Sponsoring organization: North Carolina Rural Health Research Program
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Policy brief describing differences in Medicare Outpatient Prospective Payment System (OPPS) payments between urban and rural hospitals. Features statistics on OPPS payments as a percent of total net patient revenue, as a percent of Medicare outpatient cost by hospital payment classification, and as a percent of Medicare outpatient cost by number of acute beds, with breakdowns by urban and rural location.
Author(s): Pranathi Sana, George H. Pink
Date: 09/2021
Sponsoring organization: North Carolina Rural Health Research Program
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Evaluation of the Vermont All-Payer Accountable Care Organization Model: First Evaluation Report
Evaluates the first two performance years of the Vermont All-Payer Accountable Care Organization Model (VTAPM), which aims to assess whether scaling an Accountable Care Organization (ACO) across all payers in the state can reduce program expenditures while preserving or improving care quality. Discusses the implementation of the model, provider engagement, efforts to address population health goals; characteristics of participating hospitals, practitioners, and beneficiaries; and the model's impacts on Medicare spending, utilization, and quality of care. Includes information on hospital and provider participation in rural counties and unique challenges for rural Critical Access Hospitals.
Additional links: Findings at a Glance, Technical Appendices
Date: 08/2021
Sponsoring organizations: Centers for Medicare and Medicaid Services, NORC at the University of Chicago
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Evaluates the first two performance years of the Vermont All-Payer Accountable Care Organization Model (VTAPM), which aims to assess whether scaling an Accountable Care Organization (ACO) across all payers in the state can reduce program expenditures while preserving or improving care quality. Discusses the implementation of the model, provider engagement, efforts to address population health goals; characteristics of participating hospitals, practitioners, and beneficiaries; and the model's impacts on Medicare spending, utilization, and quality of care. Includes information on hospital and provider participation in rural counties and unique challenges for rural Critical Access Hospitals.
Additional links: Findings at a Glance, Technical Appendices
Date: 08/2021
Sponsoring organizations: Centers for Medicare and Medicaid Services, NORC at the University of Chicago
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MedPAC Comment on CMS's Proposed Rule on the ESRD PPS for CY 2022
Comments on a July 9, 2021, Federal Register proposed rule related to Medicare payment policies for end-stage renal disease (ESRD). Includes comments addressing the low-volume payment adjustment (LVPA) and the rural adjustment.
Date: 08/2021
Sponsoring organization: Medicare Payment Advisory Commission
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Comments on a July 9, 2021, Federal Register proposed rule related to Medicare payment policies for end-stage renal disease (ESRD). Includes comments addressing the low-volume payment adjustment (LVPA) and the rural adjustment.
Date: 08/2021
Sponsoring organization: Medicare Payment Advisory Commission
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