Rural Health
Resources by Topic: Medicare
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. 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. 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 more.
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 more.
Date: 09/2022
Sponsoring organization: Medicare Payment Advisory Commission
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Certain Medicare Beneficiaries, Such as Urban and Hispanic Beneficiaries, Were More Likely Than Others To Use Telehealth During the First Year of the COVID-19 Pandemic
Data brief examining telehealth usage by Medicare beneficiaries during the first year of the COVID-19 pandemic, noting rural and urban differences, state-level trends, and usage by race/ethnicity and age according to Medicare Advantage and fee-for-service claims data. Offers policy recommendations and agency responses.
Date: 09/2022
Sponsoring organization: Office of Inspector General (HHS)
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Data brief examining telehealth usage by Medicare beneficiaries during the first year of the COVID-19 pandemic, noting rural and urban differences, state-level trends, and usage by race/ethnicity and age according to Medicare Advantage and fee-for-service claims data. Offers policy recommendations and agency responses.
Date: 09/2022
Sponsoring organization: Office of Inspector General (HHS)
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MedPAC Comment on CMS's Proposed Rule on the Physician Fee Schedule and Other Revisions to Part B for CY 2023
Comment on a July 29, 2022, 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 coverage of certain telehealth services after the COVID-19 public health emergency, as well as rebasing and revising the Medicare Economic Index (MEI).
Date: 09/2022
Sponsoring organization: Medicare Payment Advisory Commission
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Comment on a July 29, 2022, 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 coverage of certain telehealth services after the COVID-19 public health emergency, as well as rebasing and revising the Medicare Economic Index (MEI).
Date: 09/2022
Sponsoring organization: Medicare Payment Advisory Commission
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Health Panel Comment Letter – Medicare Advantage Program
Offers comments in response to the Centers for Medicare & Medicaid Services (CMS) Request for Information on various aspects of the Medicare Advantage (MA) program. Presents a rural perspective on the MA program and discusses health equity in the MA program, expanding access to care, and value-based contracting. Includes data on the proportion of MA plans offering supplemental benefits in noncore, micropolitan, and metropolitan counties in 2020.
Date: 08/2022
Sponsoring organization: Rural Policy Research Institute Rural Health Panel
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Offers comments in response to the Centers for Medicare & Medicaid Services (CMS) Request for Information on various aspects of the Medicare Advantage (MA) program. Presents a rural perspective on the MA program and discusses health equity in the MA program, expanding access to care, and value-based contracting. Includes data on the proportion of MA plans offering supplemental benefits in noncore, micropolitan, and metropolitan counties in 2020.
Date: 08/2022
Sponsoring organization: Rural Policy Research Institute Rural Health Panel
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