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Rural Health
Resources by Topic: Medicare

Trends in Primary Care Provision to Medicare Beneficiaries by Physicians, Nurse Practitioners, or Physician Assistants: 2008-2014
Examines trends in elderly patients receiving primary care from physicians alone, physicians with nurse practitioners (NPs) and/or physician assistants (PAs), and NPs/PAs without physicians. Considered these models for delivering primary care to Medicare patients with multiple chronic conditions and Medicare patients in rural and health professional shortage areas (HPSAs).
Author(s): Ying Xue, James S. Goodwin, Deepak Adhikari, Mukaila A. Raji, Yong-Fang Kuo
Citation: Journal of Primary Care and Community Health, 8(4), 256-263
Date: 10/2017
Type: Document
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Mountain-Pacific Quality Health Pilot: Closing the Gaps in Rural Complex Care
Profiles Mountain-Pacific Quality Health, a nonprofit corporation that established a pilot program to improve the health of rural patients through the use of technology and interdisciplinary care teams working together in Montana's Flathead Valley. Describes a $1 million innovation award from the Center for Medicare and Medicaid Innovation to support their use of ReSource Teams and help care for high-cost, high-need Medicare patients in the region.
Additional links: Case Study: Shared Military Background Helps Community Health Workers Connect with Patients in Rural Montana
Date: 10/2017
Type: Document
Sponsoring organization: Center for Health Care Strategies
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Ambulance Services for Medicare Beneficiaries: State Differences in Usage, 2012-2014
Policy brief analyzing how ambulance use varies among U.S. communities. Features state-level statistics including number of Medicare patients transported by ambulance, miles transported, and number of days ambulance transport was used per patient. Compares mean characteristics of states by census division, including percentage of population living in rural areas.
Author(s): SuZanne Troske, Alison Davis
Date: 10/2017
Type: Document
Sponsoring organization: Rural & Underserved Health Research Center
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Medicare Inappropriately Paid Acute-Care Hospitals for Outpatient Services They Provided to Beneficiaries Who Were Inpatients of Other Facilities
Results of an audit to determine whether Medicare made payments appropriately to acute-care hospitals for outpatient services provided to other facilities' inpatients, from January 2013 through August 2016. Includes recommendations from the Office of Inspector General, and CMS's responses.
Author(s): Daniel R. Levinson
Date: 09/2017
Type: Document
Sponsoring organization: U.S. Department of Health and Human Services
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What is the Quality Payment Program?
Provides an overview of the Quality Payment Program (QPP) and its two associated payment tracks: the Merit-Based Incentive Payment System (MIPS) and Advanced Alternative Payment Models (Advanced APMs). Describes how the QPP may affect rural practices and includes links to additional resources.
Date: 09/2017
Type: Document
Sponsoring organization: National Organization of State Offices of Rural Health
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Medicare Performance-Based Payment Adjustment Programs
Describes three Medicare Performance-Based Payment Adjustment programs for hospitals: the Hospital Acquired Condition Reduction Program (HACRP), the Hospital Readmission Reduction Program (HRRP), and the Hospital Value-Based Purchasing Program (HVBPP). Explains how these programs may affect rural hospitals.
Date: 09/2017
Type: Document
Sponsoring organization: National Organization of State Offices of Rural Health
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MedPAC Report to the Congress: Regional Variation in Medicare Part A, Part B, and Part D Spending and Service Use
Compares Medicare spending and service use based on geographic location, including across metropolitan and nonmetropolitan areas. Seeks to identify factors that influence regional variation and determine if higher service use and/or spending results in higher quality care and outcomes. Utilizes updated data to build on findings that were published in the January 2011 Report to the Congress: Regional Variation in Medicare Service Use. Data is adjusted to account for differences in payment rates to certain providers, such as Critical Access Hospitals.
Date: 09/2017
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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State Innovation Models (SIM) Initiative Evaluation: Model Test Year Three Annual Report
Third annual report detailing the findings of CMS's State Innovation Models (SIM) Initiative, which tests the ability of the governments in six states - Arkansas, Maine, Massachusetts, Minnesota, Oregon, and Vermont - to accelerate health system transformation in the areas of delivery systems, payment models, information technology, workforce development, and more. Focuses on sharing cross-state progress and findings, state-specific findings and lessons learned, and lessons for policymakers. Additional emphasis is placed on monitoring healthcare experience, utilization, and expenditures in participating SIM states.
Date: 09/2017
Type: Document
Sponsoring organizations: Centers for Medicare and Medicaid Services, RTI International
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Rural-Urban Variations in Medicare Live Discharge Patterns from Hospice, 2012-2013
Details a study on the instances of live discharges from the Medicare hospice program from 2012-2013. Compares rural and urban discharge rates, as well as for-profit and nonprofit business models.
Author(s): Rachel Dolin, Denise Kirk, Mark Holmes
Date: 09/2017
Type: Document
Sponsoring organization: North Carolina Rural Health Research Program
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Promoting Integrated and Coordinated Care that Addresses Social Risk for the Dual Eligible Beneficiary Population, 2017
Describes the Measure Applications Partnership's (MAP) recent recommendations and guidance on the use of performance measures to assess and improve healthcare for dually eligible individuals/beneficiaries. Examines current measure gaps, updates to address these gaps, and measures that can help address social risk factors and health disparities. Includes a discussion on categorizing rural location as a social risk factor.
Date: 08/2017
Type: Document
Sponsoring organization: National Quality Forum
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