Rural Health
Resources by Topic: Medicare
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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The Swing Bed Program: Impacting Patients, Providers, and Community
Brief video overview of the swing bed program, which helps rural hospitals provide patient- and community-centric post-acute healthcare. Describes the history, related policy issues, early implementation, and evolution of the program.
Date: 08/2021
Sponsoring organization: Rural Health Information Hub
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Brief video overview of the swing bed program, which helps rural hospitals provide patient- and community-centric post-acute healthcare. Describes the history, related policy issues, early implementation, and evolution of the program.
Date: 08/2021
Sponsoring organization: Rural Health Information Hub
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History of the Swing Bed: A Look Through the Rural Rearview Mirror
Reviews the history of the swing bed program, which helps rural hospitals serve patients and the community through provision of post-acute care. Shares insights from experts who describe early implementation and key program elements that have contributed to the program's success.
Author(s): Kay Miller Temple
Citation: Rural Monitor
Date: 08/2021
Sponsoring organization: Rural Health Information Hub
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Reviews the history of the swing bed program, which helps rural hospitals serve patients and the community through provision of post-acute care. Shares insights from experts who describe early implementation and key program elements that have contributed to the program's success.
Author(s): Kay Miller Temple
Citation: Rural Monitor
Date: 08/2021
Sponsoring organization: Rural Health Information Hub
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Understanding the Rural Swing Bed: More than Just a Reimbursement Policy
Provides an overview of the swing bed program and its role as a patient-centric post-acute care solution that helps rural hospitals serve their communities. Discusses the impact of the program, reimbursement, quality measures, and more.
Author(s): Kay Miller Temple
Citation: Rural Monitor
Date: 08/2021
Sponsoring organization: Rural Health Information Hub
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Provides an overview of the swing bed program and its role as a patient-centric post-acute care solution that helps rural hospitals serve their communities. Discusses the impact of the program, reimbursement, quality measures, and more.
Author(s): Kay Miller Temple
Citation: Rural Monitor
Date: 08/2021
Sponsoring organization: Rural Health Information Hub
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The Rural Emergency Hospital and Value-Based Care
Summarizes the new Rural Emergency Hospital (REH) legislation, outlines local considerations before REH conversion, and prepares stakeholders to comment when the Centers for Medicare & Medicaid Services releases REH proposed rules for public input. Addresses questions regarding anticipated proposed rules and describes opportunities to inform REH rulemaking.
Date: 08/2021
Sponsoring organization: Rural Health Value
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Summarizes the new Rural Emergency Hospital (REH) legislation, outlines local considerations before REH conversion, and prepares stakeholders to comment when the Centers for Medicare & Medicaid Services releases REH proposed rules for public input. Addresses questions regarding anticipated proposed rules and describes opportunities to inform REH rulemaking.
Date: 08/2021
Sponsoring organization: Rural Health Value
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A Cross-Sectional Analysis of High Acuity Professional Services Performed by Urban and Rural Emergency Care Physicians Across the United States
Evaluates high acuity service practices between 34,256 metropolitan and nonmetropolitan physicians offering emergency care to Medicare fee-for-service beneficiaries. Discusses rural-specific factors that may contribute to disparities.
Author(s): Cameron J. Gettel, Maureen E. Canavan, Margaret B. Greenwood-Ericksen, et al.
Citation: Annals of Emergency Medicine: An International Journal 78(1), 140-149
Date: 07/2021
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Evaluates high acuity service practices between 34,256 metropolitan and nonmetropolitan physicians offering emergency care to Medicare fee-for-service beneficiaries. Discusses rural-specific factors that may contribute to disparities.
Author(s): Cameron J. Gettel, Maureen E. Canavan, Margaret B. Greenwood-Ericksen, et al.
Citation: Annals of Emergency Medicine: An International Journal 78(1), 140-149
Date: 07/2021
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How Many Hospitals Might Convert to a Rural Emergency Hospital (REH)?
Results of a study to predict the number of rural hospitals with 50 beds or fewer that are likely to consider conversion to Rural Emergency Hospital designation under the Medicare program. Features statistics on number and percent of complete closures and converted closures between 2011-2020 among hospitals with 50 beds or fewer, and open hospitals as of 2019-2020, with breakdowns by financial measures, operational measures, Medicare payment type, and census division.
Author(s): George H. Pink, Kristie W. Thompson, H. Ann Howard, G. Mark Holmes
Date: 07/2021
Sponsoring organization: North Carolina Rural Health Research Program
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Results of a study to predict the number of rural hospitals with 50 beds or fewer that are likely to consider conversion to Rural Emergency Hospital designation under the Medicare program. Features statistics on number and percent of complete closures and converted closures between 2011-2020 among hospitals with 50 beds or fewer, and open hospitals as of 2019-2020, with breakdowns by financial measures, operational measures, Medicare payment type, and census division.
Author(s): George H. Pink, Kristie W. Thompson, H. Ann Howard, G. Mark Holmes
Date: 07/2021
Sponsoring organization: North Carolina Rural Health Research Program
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Evaluation of the State Innovation Models (SIM) Initiative Round 2: Model Test Final Report
Final report on the Round 2 State Innovation Models (SIM) program across eleven participating states - Colorado, Connecticut, Delaware, Idaho, Iowa, Michigan, New York, Ohio, Rhode Island, Tennessee, and Washington. Discusses the adoption of delivery models and payment reforms related to value-based payment (VBP) and alternative payment models (APMs). Examines whether the implementation efforts and healthcare delivery system reforms impacted the quality of care, health outcomes, population health, and spending.
Additional links: Appendix, Findings at a Glance
Date: 06/2021
Sponsoring organizations: Centers for Medicare and Medicaid Services, RTI International
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Final report on the Round 2 State Innovation Models (SIM) program across eleven participating states - Colorado, Connecticut, Delaware, Idaho, Iowa, Michigan, New York, Ohio, Rhode Island, Tennessee, and Washington. Discusses the adoption of delivery models and payment reforms related to value-based payment (VBP) and alternative payment models (APMs). Examines whether the implementation efforts and healthcare delivery system reforms impacted the quality of care, health outcomes, population health, and spending.
Additional links: Appendix, Findings at a Glance
Date: 06/2021
Sponsoring organizations: Centers for Medicare and Medicaid Services, RTI International
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