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Rural Health
Resources by Topic: Medicare

Data Book: Beneficiaries Dually Eligible for Medicare and Medicaid
Provides an overview of dual-eligible beneficiaries who receive benefits from both Medicare and Medicaid. Analyzes data from calendar year 2021 to examine beneficiary demographics, eligibility pathways, utilization and spending patterns, and more. Exhibit 6 on page 35 includes a breakdown of beneficiaries based on urban or rural residence.
Date: 01/2024
Type: Document
Sponsoring organizations: Medicaid and CHIP Payment and Access Commission, Medicare Payment Advisory Commission
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January 2024 MedPAC Meeting Transcript
Transcript from the Medicare Payment Advisory Commission's (MedPAC) January 2024 meeting. Covers payment adequacy and updates for physician and other health professional services, hospital inpatient and outpatient services, outpatient dialysis services, hospice services, skilled nursing facility services, home health agency services, and inpatient rehabilitation facility services. Discusses status reports on ambulatory surgical centers, Medicare Part D, and the Medicare Advantage program, as well as policy options for standardized benefits in Medicare Advantage plans. Includes rural references and considerations throughout.
Date: 01/2024
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Medicare Advantage Demographics Report, 2021
Summarizes demographics data on Medicare Advantage enrollment in 2021. Compares rural/urban residence of Medicare Advantage, Original Medicare, and dually eligible enrollees in Appendix B.
Date: 01/2024
Type: Document
Sponsoring organization: AHIP
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Evaluation of the Next Generation Accountable Care Organization (NGACO) Model: Final Report
Sixth and final evaluation report on the Next Generation Accountable Care Organization (NGACO) Model. Summarizes findings from across all six performance years (2016-2021) and explores how participating entities responded to the model and how they did or did not achieve model goals. Presents information on cumulative model-wide impacts on Medicare spending, utilization, and quality of care; variations in model outcomes by organization characteristics; spending patterns of beneficiaries served by NGACOs; population health strategies and pathways to reduced spending; lessons learned; and more. The appendices include data on community and beneficiary characteristics, including rurality.
Additional links: Findings at a Glance, Technical Appendices
Date: 01/2024
Type: Document
Sponsoring organizations: Centers for Medicare and Medicaid Services, NORC at the University of Chicago
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End-Stage Renal Disease Treatment Choices (ETC) Model: Second Annual Evaluation Report
Evaluation of the End-Stage Renal Disease Treatment Choices (ETC) Model, incorporating analyses of home dialysis use, transplantation, acute care hospitalizations, outpatient ED visits, and hospital readmissions. Features results from interviews and surveys involving model participants and beneficiaries, and examines impacts of the ETC Model during calendar years 2021 and 2022. Includes facility-level statistics with breakdowns by urban and rural areas.
Additional links: Findings at a Glance
Author(s): Brighita Negrusa, Jennifer Wiens, Darin Ullman, et al.
Date: 01/2024
Type: Document
Sponsoring organizations: Centers for Medicare and Medicaid Services, The Lewin Group
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Graduate Medical Education Funding
Explores graduate medical education (GME), focusing on types of locations where it is offered and sources of funding available, including Medicare and Medicaid. Describes ways in which states are rethinking GME to better meet the needs of states and communities most impacted by physician workforce shortages, including rural areas. Includes a map with shadings showing levels of Medicare GME-funded residents by state.
Date: 01/2024
Type: Document
Sponsoring organization: National Conference of State Legislatures
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Merit-based Incentive Payment System (MIPS): 2024 Eligibility and Participation Quick Start Guide
Provides an overview of the Merit-Based Incentive Payment System (MIPS) eligibility criteria. Addresses calculation of the low-volume threshold exclusion at the individual and group levels, opt-in and voluntary reporting options, and the impact of special status designations such as rural and small practices.
Date: 01/2024
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Medicare Claims Processing Manual Chapter 4 - Part B Hospital (Including Inpatient Hospital Part B and OPPS)
Outlines rules and regulations for processing Medicare Part B hospital claims. Covers special rules for Critical Access Hospital outpatient billing, hospital-based Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs) billing for non-RHC/FQHC services, and payment adjustments for Rural Emergency Hospitals (REHs).
Date: 01/2024
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Merit-Based Incentive Payment System (MIPS): 2023 Merit-Based Incentive Payment (MIPS) Value Pathways (MVPs) Implementation Guide
Provides an overview of the Merit-based Incentive Payment System (MIPS) Value Pathways (MVPs), a new voluntary reporting option that can be used to meet MIPS reporting requirements beginning with the 2023 performance year. Describes subgroup reporting, reporting requirements, scoring, performance feedback and public reporting, and how to register to report an MVP. Includes information on considerations and exceptions for small practices and clinicians in a rural or Health Professional Shortage Area.
Date: 01/2024
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Medicare COVID-19 Hospitalization Trends Report
Reports cases and hospitalization data for Medicare beneficiaries diagnosed with COVID-19 between January 1, 2020, and June 30, 2023. Includes data on beneficiary demographics, case and hospitalization trends, and discharge status among beneficiaries hospitalized for COVID-19. Compares COVID-19 case and hospitalization rates by rural and urban status.
Date: 01/2024
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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