Rural Health
Resources by Topic: Medicare
Patterns of Care and Home Health Utilization for Community-Admitted Medicare Patients
Focuses on differences between community-admitted and post-acute care Medicare home health patients over time in order to identify reasons for the increase in community-admitted patients. Addresses differences in rural/urban residency in Tables B.1. and E.1., as well as whether the county of residence is a primary care shortage area.
Author(s): Andrea Wysocki, Valerie Cheh
Date: 04/2019
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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Focuses on differences between community-admitted and post-acute care Medicare home health patients over time in order to identify reasons for the increase in community-admitted patients. Addresses differences in rural/urban residency in Tables B.1. and E.1., as well as whether the county of residence is a primary care shortage area.
Author(s): Andrea Wysocki, Valerie Cheh
Date: 04/2019
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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Is Duration of Hospital Participation in Meaningful Use Associated with Value in Medicare?
Analyzes hospital participation in Medicare's meaningful use (MU) of electronic health records (EHRs) to determine the extent of their use of value-based initiatives in order to evaluate whether the duration of participation was linked with lower Medicare inpatient spending and lower readmission rates. Data was extracted from CMS sources including the Hospital Compare Website. Hospital-level data for analysis included inpatient spending, accreditation status, hospital location (urban/rural), ownership status, and hospital size.
Author(s): Yanick N. Brice, Karen E. Joynt Maddox
Citation: Journal of the American Medical Informatics Association (JAMIA) Open, 2(2), 238-245
Date: 03/2019
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Analyzes hospital participation in Medicare's meaningful use (MU) of electronic health records (EHRs) to determine the extent of their use of value-based initiatives in order to evaluate whether the duration of participation was linked with lower Medicare inpatient spending and lower readmission rates. Data was extracted from CMS sources including the Hospital Compare Website. Hospital-level data for analysis included inpatient spending, accreditation status, hospital location (urban/rural), ownership status, and hospital size.
Author(s): Yanick N. Brice, Karen E. Joynt Maddox
Citation: Journal of the American Medical Informatics Association (JAMIA) Open, 2(2), 238-245
Date: 03/2019
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Addressing Low Case-Volume in Healthcare Performance Measurement of Rural Providers: Recommendations from the MAP Rural Health Technical Expert Panel
Final report recommending how to measure healthcare performance in low case-volume situations, such as rural providers. Reviews existing and proposed low-volume healthcare quality measures, how measures are calculated, data use, and data analysis techniques. Focuses on Centers for Medicare and Medicaid Services (CMS) quality programs reporting requirements.
Date: 03/2019
Sponsoring organizations: MAP Rural Health Workgroup, National Quality Forum
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Final report recommending how to measure healthcare performance in low case-volume situations, such as rural providers. Reviews existing and proposed low-volume healthcare quality measures, how measures are calculated, data use, and data analysis techniques. Focuses on Centers for Medicare and Medicaid Services (CMS) quality programs reporting requirements.
Date: 03/2019
Sponsoring organizations: MAP Rural Health Workgroup, National Quality Forum
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Evaluation of the Initiative to Reduce Avoidable Hospitalizations among Nursing Facility Residents - Payment Reform
Second annual report evaluating a Centers for Medicare and Medicaid (CMS) Innovation payment model intended to reduce avoidable hospitalizations for long-term care nursing facility residents. Appendices include findings from participating programs in Alabama, Missouri, Indiana, Nevada, Colorado, New York, and Pennsylvania. Addresses challenges for rural participants throughout.
Additional links: Findings at a Glance
Date: 03/2019
Sponsoring organizations: Centers for Medicare and Medicaid Services, RTI International
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Second annual report evaluating a Centers for Medicare and Medicaid (CMS) Innovation payment model intended to reduce avoidable hospitalizations for long-term care nursing facility residents. Appendices include findings from participating programs in Alabama, Missouri, Indiana, Nevada, Colorado, New York, and Pennsylvania. Addresses challenges for rural participants throughout.
Additional links: Findings at a Glance
Date: 03/2019
Sponsoring organizations: Centers for Medicare and Medicaid Services, RTI International
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Examining the Cost Effectiveness of Teaching Health Centers
Examines areas where the Teaching Health Center Graduate Medical Education (THCGME) program can produce savings, focusing on physician spending for patient encounters during and after residency training and patient Medicaid and Medicare insurance coverage. Identifies the location of THCGME programs and highlights program outcomes, including the percent of graduates who work in rural and underserved areas and practice primary care.
Author(s): Candice Chen, Leighton Ku, Marsha Regenstein, Fitzhugh Mullan
Date: 03/2019
Sponsoring organizations: Geiger Gibson Program in Community Health, George Washington University Milken Institute School of Public Health Department of Health Policy and Management, RCHN Community Health Foundation
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Examines areas where the Teaching Health Center Graduate Medical Education (THCGME) program can produce savings, focusing on physician spending for patient encounters during and after residency training and patient Medicaid and Medicare insurance coverage. Identifies the location of THCGME programs and highlights program outcomes, including the percent of graduates who work in rural and underserved areas and practice primary care.
Author(s): Candice Chen, Leighton Ku, Marsha Regenstein, Fitzhugh Mullan
Date: 03/2019
Sponsoring organizations: Geiger Gibson Program in Community Health, George Washington University Milken Institute School of Public Health Department of Health Policy and Management, RCHN Community Health Foundation
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MedPAC Report to the Congress: Medicare Payment Policy: Hospital Inpatient and Outpatient Services: Chapter 3
Examines the adequacy of Medicare payments to hospitals in 2017 and offers recommendations for changes. Includes a discussion of rural hospital closures and provides rural/urban breakdowns for hospital occupancy rates, Medicare inpatient discharges, and Medicare margins.
Date: 03/2019
Sponsoring organization: Medicare Payment Advisory Commission
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Examines the adequacy of Medicare payments to hospitals in 2017 and offers recommendations for changes. Includes a discussion of rural hospital closures and provides rural/urban breakdowns for hospital occupancy rates, Medicare inpatient discharges, and Medicare margins.
Date: 03/2019
Sponsoring organization: Medicare Payment Advisory Commission
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MedPAC Report to the Congress: Medicare Payment Policy, 2019
Annual review of Medicare payment policies, with recommendations to Congress. Includes discussion on Medicare payment policies directly affecting rural providers and beneficiaries. Addresses opioids, Medicare Part D, Medicare Advantage, Medicare's quality incentive program for hospitals, and payment adequacy for healthcare facilities and services.
Date: 03/2019
Sponsoring organization: Medicare Payment Advisory Commission
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Annual review of Medicare payment policies, with recommendations to Congress. Includes discussion on Medicare payment policies directly affecting rural providers and beneficiaries. Addresses opioids, Medicare Part D, Medicare Advantage, Medicare's quality incentive program for hospitals, and payment adequacy for healthcare facilities and services.
Date: 03/2019
Sponsoring organization: Medicare Payment Advisory Commission
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Drilling Down on Dental Coverage and Costs for Medicare Beneficiaries
Examines the oral health of Medicare beneficiaries. Addresses the costs of not obtaining dental care, use of dental services, current sources of dental coverage, and out-of-pocket spending. Includes rural/urban breakdowns.
Date: 03/2019
Sponsoring organization: KFF
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Examines the oral health of Medicare beneficiaries. Addresses the costs of not obtaining dental care, use of dental services, current sources of dental coverage, and out-of-pocket spending. Includes rural/urban breakdowns.
Date: 03/2019
Sponsoring organization: KFF
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Implementation and Early Results of the Flex Program's Innovative Models Program Area: Final Evaluation Report
Reports on the implementation of the Flex Program and the integration of the Innovative Health Care Models (Innovative Projects) program area in 7 states focused on telehealth, care coordination, and quality improvement. Highlights lessons learned, program discussion, and the evaluation methods for each of the projects. Builds on a 2018 briefing paper, An Interim Evaluation Report of the Innovative Projects Portfolio of the Medicare Flex Grant Program.
Author(s): John A. Gale, Sara Kahn-Troster, Andrew Coburn
Date: 03/2019
Sponsoring organization: Flex Monitoring Team
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Reports on the implementation of the Flex Program and the integration of the Innovative Health Care Models (Innovative Projects) program area in 7 states focused on telehealth, care coordination, and quality improvement. Highlights lessons learned, program discussion, and the evaluation methods for each of the projects. Builds on a 2018 briefing paper, An Interim Evaluation Report of the Innovative Projects Portfolio of the Medicare Flex Grant Program.
Author(s): John A. Gale, Sara Kahn-Troster, Andrew Coburn
Date: 03/2019
Sponsoring organization: Flex Monitoring Team
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2019 Telehealth Reimbursement
Provides an overview of Medicare reimbursement for telehealth services and discusses factors, policies, and legislation affecting reimbursement including: geographic and originating site restrictions; provider restrictions; service restrictions; payment for remote communication technology; chronic care management and remote monitoring; Medicare Advantage; Accountable Care Organizations, bundled care, and telehealth. Covers Medicaid and private payer telehealth reimbursement policies.
Date: 02/2019
Sponsoring organization: Center for Connected Health Policy: The National Telehealth Policy Resource Center
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Provides an overview of Medicare reimbursement for telehealth services and discusses factors, policies, and legislation affecting reimbursement including: geographic and originating site restrictions; provider restrictions; service restrictions; payment for remote communication technology; chronic care management and remote monitoring; Medicare Advantage; Accountable Care Organizations, bundled care, and telehealth. Covers Medicaid and private payer telehealth reimbursement policies.
Date: 02/2019
Sponsoring organization: Center for Connected Health Policy: The National Telehealth Policy Resource Center
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