Rural Health
Resources by Topic: Medicare
State Innovation Model Testing Awards from the Centers for Medicare & Medicaid Services Innovation Center: Highlighting Rural Focus
Summarizes the activities and accomplishments of rural-specific State Innovation Models (SIM) in 11 states: Arkansas, Colorado, Idaho, Iowa, Maine, Michigan, Minnesota, New York, Ohio, Oregon, and Vermont. Describes the SIM initiative, which began in 2012 to support states committed to designing and testing strategies for payment model and delivery system reform.
Date: 06/2022
Sponsoring organization: Rural Health Value
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Summarizes the activities and accomplishments of rural-specific State Innovation Models (SIM) in 11 states: Arkansas, Colorado, Idaho, Iowa, Maine, Michigan, Minnesota, New York, Ohio, Oregon, and Vermont. Describes the SIM initiative, which began in 2012 to support states committed to designing and testing strategies for payment model and delivery system reform.
Date: 06/2022
Sponsoring organization: Rural Health Value
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MedPAC Comment on CMS's Proposed Rule on the Inpatient Rehabilitation Facility PPS for FY 2023
Comments on an April 6, 2022, Federal Register proposed rule addressing updates to the prospective payment system for inpatient rehabilitation facilities (IRFs) for fiscal year 2023. Includes comments on the IRF teaching and rural payment adjustments.
Date: 05/2022
Sponsoring organization: Medicare Payment Advisory Commission
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Comments on an April 6, 2022, Federal Register proposed rule addressing updates to the prospective payment system for inpatient rehabilitation facilities (IRFs) for fiscal year 2023. Includes comments on the IRF teaching and rural payment adjustments.
Date: 05/2022
Sponsoring organization: Medicare Payment Advisory Commission
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MedPAC Comment on CMS's Proposed Rule on the Inpatient Psychiatric Facility PPS for FY 2023
Comment on an April 4, 2022, Federal Register proposed rule revising the Inpatient Psychiatric Facility Prospective Payment System (IPF PPS) for fiscal year 2023. Includes a discussion of rural and Disproportionate Share Hospital (DSH) IPF PPS payment adjustments.
Date: 05/2022
Sponsoring organization: Medicare Payment Advisory Commission
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Comment on an April 4, 2022, Federal Register proposed rule revising the Inpatient Psychiatric Facility Prospective Payment System (IPF PPS) for fiscal year 2023. Includes a discussion of rural and Disproportionate Share Hospital (DSH) IPF PPS payment adjustments.
Date: 05/2022
Sponsoring organization: Medicare Payment Advisory Commission
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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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