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Rural Health
Resources by Topic: Medicare

Rural Hospitals: Here Today, Gone Tomorrow
Describes the conditions facing rural hospitals and their communities contributing to the high rate of rural hospital closure. Discusses state and federal legislation, policies, and programs developed to support rural hospitals. Provides data for 15 Southern states including their state and rural populations, percentage of population uninsured, Medicaid expansion status, percentage at high financial risk, and number of rural hospital closures.
Author(s): Nick Bowman
Date: 11/2019
Type: Document
Sponsoring organization: Southern Legislative Conference of The Council of State Governments
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Estimate of Federal Payment Reductions to Hospitals Following the ACA: 2010-2029: Estimates and Methodology
Estimates the reduction in Medicare hospital payments due to sequestration from 2010 to 2029, not including reductions enacted under the Affordable Care Act (ACA). Demonstrates how other legislative acts and regulatory changes by the Centers for Medicare and Medicaid Services (CMS) reduced federal payments to hospitals over the same period. Highlights how reductions in Medicare payments for bad debt impacted Critical Access Hospitals (CAHs).
Date: 10/2019
Type: Document
Sponsoring organizations: American Hospital Association, Federation of American Hospitals
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Electronic Prescribing of Controlled Substances among Office-Based Physicians, 2017
Examines rates of electronic prescribing of controlled substances (EPCS), with information by type of physician practice, including rural or urban location, practice size, practice ownership, physician specialty, and technology available. EPCS is mandated for Medicare Part D providers by 2021, through the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act.
Author(s): Sonal Parasrampuria, Martin Blanco, Wesley Barker
Date: 09/2019
Type: Document
Sponsoring organization: Office of the National Coordinator for Health Information Technology
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Financial Alignment Initiative South Carolina Healthy Connections Prime: First Evaluation Report
Evaluation of the first year of the South Carolina Healthy Connections Prime demonstration to integrate care for the state's Medicare-Medicaid beneficiaries. Discusses access and other challenges for rural enrollees and how the program has worked to address rural needs.
Date: 09/2019
Type: Document
Sponsoring organizations: Centers for Medicare and Medicaid Services, RTI International
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Indian Health Service: Facilities Reported Expanding Services Following Increases in Health Insurance Coverage and Collections
Report details rates of health insurance coverage in patients seen at Indian Health Service facilities. Looks at the rates of coverage by third party insurers, such as Medicare, Medicaid, and private plans, from 2013-2018.
Additional links: Full Report
Date: 09/2019
Type: Document
Sponsoring organization: Government Accountability Office
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Evaluation of the Accountable Care Organization Investment Model: AIM Implementation and Impacts over Two Performance Years
Evaluation examining the first two years of the ACO Investment Model (AIM), which tests the use of prepaid shared savings to encourage new ACOs to form in rural and underserved areas (Test 1) and to encourage current Medicare Shared Savings Program ACOs to transition to arrangements with greater financial risk (Test 2). Reports on AIM ACO composition, including rurality. Appendices include detailed information on each AIM ACO.
Additional links: Appendices, Findings at a Glance
Date: 09/2019
Type: Document
Sponsoring organizations: Abt Associates, Centers for Medicare and Medicaid Services
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Rural Hospital Closures Reduce Access to Emergency Care
Recognizes the importance of hospital and emergency care services in providing healthcare in rural communities, and discusses the current hospital closure rate. Uses federal data to compare the financial viability of rural and urban hospitals, and the availability of emergency care in rural communities. Suggests policy recommendations for improving access to healthcare and emergency care for rural populations.
Author(s): Tarun Ramesh, Emily Gee
Date: 09/2019
Type: Document
Sponsoring organization: Center for American Progress
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Small Rural Hospital Transition (SRHT) Project Guide: A Rural Hospital Guide to Improving Care Management: 2019 Update
A guide for rural hospital leadership that identifies best practices in care management. Addresses care management roles and staffing needs and covers utilization review and discharge planning. Helps identify opportunities for process improvement. Also discusses competencies needed to transition to a value-based reimbursement environment focused on population health.
Date: 08/2019
Type: Document
Sponsoring organizations: National Rural Health Resource Center, Stroudwater Associates
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The Evolving Policy Landscape of Telehealth Services Delivered in the Home and Other Nonclinical Settings
Issue brief identifying key findings for state officials considering adopting new policies for home-based telehealth services. Describes Medicaid and Medicare coverage for telehealth services, including those provided in rural and Health Professional Shortage Areas, Critical Access Hospitals, and Rural Health Clinics.
Author(s): Brittany Lazur, Andrea Bennett, Valerie King
Date: 08/2019
Type: Document
Sponsoring organization: Milbank Memorial Fund
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MedPAC Comment on CMS's Proposed Rule on the CY 2020 Home Health PPS Update and Home Infusion Therapy
Comments on a July 18, 2019, Federal Register proposed rule related to Medicare payment policies for home health agencies. Includes comments addressing the proposed rural add-on payments for calendar years 2019 through 2022.
Date: 08/2019
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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