Rural Health
Resources by Topic: Medicare
Significant Vulnerabilities Exist in the Hospital Wage Index System for Medicare Payments
Reports on 41 examinations of wage data of individual acute care hospitals from 2004 to 2017 to describe significant vulnerabilities observed in the wage index system for Medicare payments. Includes discussion on the rural floor wage index and the effects it has on wage index accuracy. Offers recommendations to reform the hospital wage index system.
Date: 11/2018
Type: Document
Sponsoring organization: Office of Inspector General (HHS)
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Reports on 41 examinations of wage data of individual acute care hospitals from 2004 to 2017 to describe significant vulnerabilities observed in the wage index system for Medicare payments. Includes discussion on the rural floor wage index and the effects it has on wage index accuracy. Offers recommendations to reform the hospital wage index system.
Date: 11/2018
Type: Document
Sponsoring organization: Office of Inspector General (HHS)
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Update: Rural/Urban Disparities in Pneumococcal Vaccine Service Delivery Among the Fee-for-Service Medicare Population, 2012-2015
Updated report on a study to identify disparities in vaccine provision to people ages 65 and over, and to assess the impact of pharmacies as alternate site providers in rural areas. Revised version specifically assesses the uptake of the 13-valent pneumococcal conjugate vaccine, in response to the revised vaccination recommendations issued in 2014. Includes statistics on pneumococcal vaccine services provided by fee-for-service pharmacies and primary care providers, with breakdowns by rural and urban frequency, and state-level maps with rate of service delivery per eligible population, using 2014 and 2015 data.
Author(s): Joseph C. Vanghelof, Aric Schadler, Patricia R. Freeman, Jeffery C. Talbert
Date: 11/2018
Type: Document
Sponsoring organization: Rural and Underserved Health Research Center
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Updated report on a study to identify disparities in vaccine provision to people ages 65 and over, and to assess the impact of pharmacies as alternate site providers in rural areas. Revised version specifically assesses the uptake of the 13-valent pneumococcal conjugate vaccine, in response to the revised vaccination recommendations issued in 2014. Includes statistics on pneumococcal vaccine services provided by fee-for-service pharmacies and primary care providers, with breakdowns by rural and urban frequency, and state-level maps with rate of service delivery per eligible population, using 2014 and 2015 data.
Author(s): Joseph C. Vanghelof, Aric Schadler, Patricia R. Freeman, Jeffery C. Talbert
Date: 11/2018
Type: Document
Sponsoring organization: Rural and Underserved Health Research Center
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Changes to the Merit-based Incentive Payment System Pertinent to Small and Rural Practices, 2018
Describes the importance of legislative changes to the Merit-Based Incentive Payment System that occurred as part of the Bipartisan Budget Act of 2018. Includes an appendix comparing the original framework for the system with changes for 2018/2019.
Author(s): Abiodun Salako, A. Clinton MacKinney, Fred Ullrich, Keith Mueller
Date: 11/2018
Type: Document
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Describes the importance of legislative changes to the Merit-Based Incentive Payment System that occurred as part of the Bipartisan Budget Act of 2018. Includes an appendix comparing the original framework for the system with changes for 2018/2019.
Author(s): Abiodun Salako, A. Clinton MacKinney, Fred Ullrich, Keith Mueller
Date: 11/2018
Type: Document
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Information on Medicare Telehealth
Report to Congress, as mandated by the 21st Century Cures Act, examining how Medicare patients are using telehealth, particularly in rural areas, with breakdowns by race/ethnicity, age group, and primary diagnoses including mental health issues. Includes an analysis of Medicare claims data regarding high volume services that could be delivered through telehealth, an overview of telehealth models funded by the Center for Medicare and Medicaid Innovation, and state-level breakdowns of Medicare telehealth data. Discusses who may benefit from telehealth expansion and barriers to expansion.
Date: 11/2018
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Report to Congress, as mandated by the 21st Century Cures Act, examining how Medicare patients are using telehealth, particularly in rural areas, with breakdowns by race/ethnicity, age group, and primary diagnoses including mental health issues. Includes an analysis of Medicare claims data regarding high volume services that could be delivered through telehealth, an overview of telehealth models funded by the Center for Medicare and Medicaid Innovation, and state-level breakdowns of Medicare telehealth data. Discusses who may benefit from telehealth expansion and barriers to expansion.
Date: 11/2018
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Report to Congress: Rural Community Hospital Demonstration
Summarizes findings from the Rural Community Hospital Demonstration (RCHD) over the twelve years authorized by the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) and the Patient Protection and Affordable Care Act (ACA). Reports on the characteristics of the participating hospitals and the effect of the demonstration on hospital finances and other outcomes. Also discusses steps the hospitals expected to take at the end of the demonstration, if it had not been extended for an additional five years by the 21st Century Cures Act of 2016.
Date: 10/2018
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Summarizes findings from the Rural Community Hospital Demonstration (RCHD) over the twelve years authorized by the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) and the Patient Protection and Affordable Care Act (ACA). Reports on the characteristics of the participating hospitals and the effect of the demonstration on hospital finances and other outcomes. Also discusses steps the hospitals expected to take at the end of the demonstration, if it had not been extended for an additional five years by the 21st Century Cures Act of 2016.
Date: 10/2018
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Addressing Social Determinants of Health Needs of Dually Enrolled Beneficiaries in Medicare Advantage Plans: Findings from Interviews and Case Studies
Examines structures and approaches used by Medicare Advantage (MA) plans for dually enrolled and other high-cost beneficiaries. Includes case studies showcasing care models and how organizations are addressing social determinants of health for these beneficiaries. Discusses some challenges for rural areas and small community partnerships.
Author(s): Melony E. Sorbero, Ashley M. Kranz, Kathryn E. Bouskill, et al.
Date: 10/2018
Type: Document
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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Examines structures and approaches used by Medicare Advantage (MA) plans for dually enrolled and other high-cost beneficiaries. Includes case studies showcasing care models and how organizations are addressing social determinants of health for these beneficiaries. Discusses some challenges for rural areas and small community partnerships.
Author(s): Melony E. Sorbero, Ashley M. Kranz, Kathryn E. Bouskill, et al.
Date: 10/2018
Type: Document
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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MedPAC Comment on CMS's Proposed Rule on Medicare Shared Savings Program ACOs
Comments on an August 17, 2018, Federal Register proposed rule changing the Medicare Shared Savings Program (MSSP). Focuses on the proposed changes for Accountable Care Organizations (ACOs), including a move to two-sided risk models, using regional spending benchmarks, and more. Addresses potential impacts for small ACOs, which include rural ACOs.
Date: 10/2018
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Comments on an August 17, 2018, Federal Register proposed rule changing the Medicare Shared Savings Program (MSSP). Focuses on the proposed changes for Accountable Care Organizations (ACOs), including a move to two-sided risk models, using regional spending benchmarks, and more. Addresses potential impacts for small ACOs, which include rural ACOs.
Date: 10/2018
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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CMS Bundled Payments for Care Improvement Initiative Models 2-4: Year 5 Evaluation & Monitoring Annual Report
Shares findings from an evaluation of Models 2, 3, and 4 of the Bundled Payments for Care Improvement (BPCI) initiative, linking provider payments for an episode of care with the goal of decreasing cost of care while improving quality. Includes information specific to rural BPCI-participating hospitals.
Author(s): The Lewin Group, Abt Associates, GDIT, Telligen
Date: 10/2018
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Shares findings from an evaluation of Models 2, 3, and 4 of the Bundled Payments for Care Improvement (BPCI) initiative, linking provider payments for an episode of care with the goal of decreasing cost of care while improving quality. Includes information specific to rural BPCI-participating hospitals.
Author(s): The Lewin Group, Abt Associates, GDIT, Telligen
Date: 10/2018
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Examining Barriers to Expanding Innovative, Value-Based Care in Medicare
Presents the September 2018 U.S. House of Representatives Energy and Commerce Committee hearing on Medicare efforts to transition from a fee-for-service model to a value-based payment model. Features testimony from physicians and healthcare associations, healthcare systems, first responders, and an information technology association. Testimony briefly addresses rural areas, particularly how broadband access and telehealth can benefit rural Americans.
Additional links: Morgan Reed Testimony
Date: 09/2018
Type: Video/Multimedia
Sponsoring organization: House Energy and Commerce Committee, Subcommittee on Health
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Presents the September 2018 U.S. House of Representatives Energy and Commerce Committee hearing on Medicare efforts to transition from a fee-for-service model to a value-based payment model. Features testimony from physicians and healthcare associations, healthcare systems, first responders, and an information technology association. Testimony briefly addresses rural areas, particularly how broadband access and telehealth can benefit rural Americans.
Additional links: Morgan Reed Testimony
Date: 09/2018
Type: Video/Multimedia
Sponsoring organization: House Energy and Commerce Committee, Subcommittee on Health
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Report to Congress: Demonstration Project on Community Health Integration Models in Certain Rural Counties, Interim Report 2018
Provides an overview of and first year findings from the Frontier Community Health Integration Project Demonstration (FCHIP), which includes 10 Critical Access Hospitals (CAHs) in three states: North Dakota, Montana, and Nevada. The demonstration intends to increase the quality and coordination of care, with focuses on access to and payments for telehealth, ambulance services, and skilled nursing facility/nursing facility beds, as well as related regulatory challenges.
Date: 09/2018
Type: Document
Sponsoring organization: U.S. Department of Health and Human Services
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Provides an overview of and first year findings from the Frontier Community Health Integration Project Demonstration (FCHIP), which includes 10 Critical Access Hospitals (CAHs) in three states: North Dakota, Montana, and Nevada. The demonstration intends to increase the quality and coordination of care, with focuses on access to and payments for telehealth, ambulance services, and skilled nursing facility/nursing facility beds, as well as related regulatory challenges.
Date: 09/2018
Type: Document
Sponsoring organization: U.S. Department of Health and Human Services
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