Rural Health
Resources by Topic: Medicare
Medicare Fee-For-Service Beneficiaries with Disabilities, by End Stage Renal Disease Status, 2014
Data highlight describing the characteristics of disabled Medicare beneficiaries by end stage renal disease (ESRD) status. Uses data from the Centers for Medicare and Medicaid Services' (CMS) Chronic Conditions Data Warehouse (CCW) and includes a breakdown of metropolitan, micropolitan, or rural residence of disabled Medicare beneficiaries with ESRD.
Author(s): Elsa Haile, Sonya Bowen, Kenneth Lindenfelser, Chris Haffer
Date: 07/2017
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Data highlight describing the characteristics of disabled Medicare beneficiaries by end stage renal disease (ESRD) status. Uses data from the Centers for Medicare and Medicaid Services' (CMS) Chronic Conditions Data Warehouse (CCW) and includes a breakdown of metropolitan, micropolitan, or rural residence of disabled Medicare beneficiaries with ESRD.
Author(s): Elsa Haile, Sonya Bowen, Kenneth Lindenfelser, Chris Haffer
Date: 07/2017
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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The Financial Importance of Medicare Post-Acute and Hospice Care to Rural Hospitals
Findings brief describing variation in the number of hospitals in rural areas providing Medicare post-acute care (PAC) and hospice care, average amount of revenue generated for these services, and financial importance to rural hospitals. Includes statistics on 2015 Medicare PAC and hospice care revenue as percentage of patient revenue in 1,205 Critical Access Hospitals and 964 Prospective Payment System hospitals.
Author(s): Alex Schulte, H. Ann Howard, George H. Pink
Date: 07/2017
Type: Document
Sponsoring organization: North Carolina Rural Health Research Program
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Findings brief describing variation in the number of hospitals in rural areas providing Medicare post-acute care (PAC) and hospice care, average amount of revenue generated for these services, and financial importance to rural hospitals. Includes statistics on 2015 Medicare PAC and hospice care revenue as percentage of patient revenue in 1,205 Critical Access Hospitals and 964 Prospective Payment System hospitals.
Author(s): Alex Schulte, H. Ann Howard, George H. Pink
Date: 07/2017
Type: Document
Sponsoring organization: North Carolina Rural Health Research Program
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Telehealth: Use in Medicare and Medicaid
Discusses the extent to which telehealth is used by Medicare and Medicaid, the factors affecting the use of telehealth in Medicare, and how emerging payment and delivery models could affect future telehealth use. Includes rural-specific information throughout with particular attention paid to the role of rural healthcare facilities as originating sites.
Additional links: Full Report
Date: 07/2017
Type: Document
Sponsoring organization: Government Accountability Office
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Discusses the extent to which telehealth is used by Medicare and Medicaid, the factors affecting the use of telehealth in Medicare, and how emerging payment and delivery models could affect future telehealth use. Includes rural-specific information throughout with particular attention paid to the role of rural healthcare facilities as originating sites.
Additional links: Full Report
Date: 07/2017
Type: Document
Sponsoring organization: Government Accountability Office
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Changes in Hospital Quality Associated with Hospital Value-Based Purchasing
Examines whether quality improved more in acute care hospitals exposed to Medicare's Hospital Value-Based Purchasing (HVBP) program. Uses Critical Access Hospitals as a comparison for clinical process, patient experience, and mortality measures.
Author(s): Andrew M. Ryan, Sam Krinsky, Kristen A. Maurer, Justin B. Dimick
Citation: New England Journal of Medicine, 376(24), 2358-2366
Date: 06/2017
Type: Document
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Examines whether quality improved more in acute care hospitals exposed to Medicare's Hospital Value-Based Purchasing (HVBP) program. Uses Critical Access Hospitals as a comparison for clinical process, patient experience, and mortality measures.
Author(s): Andrew M. Ryan, Sam Krinsky, Kristen A. Maurer, Justin B. Dimick
Citation: New England Journal of Medicine, 376(24), 2358-2366
Date: 06/2017
Type: Document
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Hospital Value-Based Purchasing: CMS Should Take Steps to Ensure Lower Quality Hospitals Do Not Qualify for Bonuses
Examines the scoring methodology used by the Hospital Value-Based Purchasing (HVBP) program, which measures quality and efficiency within multiple hospital types including small, rural, and safety-net hospitals. Addresses differences in how safety net, small rural, and small urban hospitals performed, how payment adjustments changed for them over time, and the impact of an efficiency score on payment adjustments. Supports revising the methodology to apply the standards more evenly.
Additional links: Full Report
Date: 06/2017
Type: Document
Sponsoring organization: Government Accountability Office
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Examines the scoring methodology used by the Hospital Value-Based Purchasing (HVBP) program, which measures quality and efficiency within multiple hospital types including small, rural, and safety-net hospitals. Addresses differences in how safety net, small rural, and small urban hospitals performed, how payment adjustments changed for them over time, and the impact of an efficiency score on payment adjustments. Supports revising the methodology to apply the standards more evenly.
Additional links: Full Report
Date: 06/2017
Type: Document
Sponsoring organization: Government Accountability Office
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MedPAC Report to the Congress: Medicare and the Health Care Delivery System, June 2017
Includes chapters on implementing a unified payment system for post-acute care, Part B drug payment policies, the redesign of the Merit-Based Incentive Payment System (MIPS) and other alternative payment models, drug and device manufacturer payments to physicians and teaching hospitals, stand-alone emergency departments, and skilled nursing facility use. Rural hospitals and rural patient populations are discussed throughout the report.
Date: 06/2017
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Includes chapters on implementing a unified payment system for post-acute care, Part B drug payment policies, the redesign of the Merit-Based Incentive Payment System (MIPS) and other alternative payment models, drug and device manufacturer payments to physicians and teaching hospitals, stand-alone emergency departments, and skilled nursing facility use. Rural hospitals and rural patient populations are discussed throughout the report.
Date: 06/2017
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Compendium of Unimplemented Recommendations: May 2017
Annual report identifying the top 25 unimplemented recommendations from the Office of Inspector General (OIG) that, in OIG's view, would have the most substantial positive impact on Health and Human Services (HHS) programs. Positive impact may refer to cost savings, program efficacy and efficiency, and/or quality improvement. Primary areas of interest in the May 2017 edition include: Critical Access Hospital (CAH) swing bed reimbursement rates, Medicare payment policies, combating prescription opioid abuse, and quality compliance in Indian Health Service (IHS) hospitals.
Date: 05/2017
Type: Document
Sponsoring organization: Office of Inspector General (HHS)
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Annual report identifying the top 25 unimplemented recommendations from the Office of Inspector General (OIG) that, in OIG's view, would have the most substantial positive impact on Health and Human Services (HHS) programs. Positive impact may refer to cost savings, program efficacy and efficiency, and/or quality improvement. Primary areas of interest in the May 2017 edition include: Critical Access Hospital (CAH) swing bed reimbursement rates, Medicare payment policies, combating prescription opioid abuse, and quality compliance in Indian Health Service (IHS) hospitals.
Date: 05/2017
Type: Document
Sponsoring organization: Office of Inspector General (HHS)
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Federal Health Centers: An Overview
Explains the Federal Health Center program, with information relating to the statutory authority, program requirements, funding, location, patient populations, health outcomes, and more. Also discusses the Federally Qualified Health Center (FQHC) designation, and how this designation affects Medicare and Medicaid payment levels.
Date: 05/2017
Type: Document
Sponsoring organization: Congressional Research Service
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Explains the Federal Health Center program, with information relating to the statutory authority, program requirements, funding, location, patient populations, health outcomes, and more. Also discusses the Federally Qualified Health Center (FQHC) designation, and how this designation affects Medicare and Medicaid payment levels.
Date: 05/2017
Type: Document
Sponsoring organization: Congressional Research Service
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Health Care: Telehealth and Remote Patient Monitoring Use in Medicare and Selected Federal Programs
Examines factors affecting the provision of telehealth and remote patient monitoring (RPM) in Medicare and emerging payment and delivery models that could affect its future use. Analyzes data collected through review of agency documents and regulations, and interviews with officials representing 9 general and medical specialty associations familiar with telehealth. Includes state Medicaid reimbursement examples. Rural-specific implications are discussed throughout.
Additional links: Full Report
Date: 04/2017
Type: Document
Sponsoring organization: Government Accountability Office
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Examines factors affecting the provision of telehealth and remote patient monitoring (RPM) in Medicare and emerging payment and delivery models that could affect its future use. Analyzes data collected through review of agency documents and regulations, and interviews with officials representing 9 general and medical specialty associations familiar with telehealth. Includes state Medicaid reimbursement examples. Rural-specific implications are discussed throughout.
Additional links: Full Report
Date: 04/2017
Type: Document
Sponsoring organization: Government Accountability Office
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Issues Confronting Rural Pharmacies after a Decade of Medicare Part D
Discusses the major challenges facing rural independent pharmacies, focusing on delayed maximum allowable cost (MAC) adjustments, and direct and indirect remuneration (DIR) fees. Other challenges include competition from mail order pharmacies, being a non-preferred pharmacy, and orderly succession planning. Also examines the implications for rural communities when independent pharmacies close.
Author(s): Abiodun Salako, Fred Ullrich, Keith Mueller
Date: 04/2017
Type: Document
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Discusses the major challenges facing rural independent pharmacies, focusing on delayed maximum allowable cost (MAC) adjustments, and direct and indirect remuneration (DIR) fees. Other challenges include competition from mail order pharmacies, being a non-preferred pharmacy, and orderly succession planning. Also examines the implications for rural communities when independent pharmacies close.
Author(s): Abiodun Salako, Fred Ullrich, Keith Mueller
Date: 04/2017
Type: Document
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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