Rural Health
Resources by Topic: Medicare
Making the Most of Evolving Payment Policies to Enhance Hospital-based Care in Rural Communities
Presentation slides from the 2017 Rural Health Care Leadership Conference that discuss the transition from volume to value for rural hospital payment and how to make the most of resources available to facilities. Includes examples of services and documents for reference as well as data and statistics surrounding Medicare Advantage and Accountable Care Organizations in rural communities.
Author(s): Keith J. Mueller
Date: 02/2017
Type: Document
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Presentation slides from the 2017 Rural Health Care Leadership Conference that discuss the transition from volume to value for rural hospital payment and how to make the most of resources available to facilities. Includes examples of services and documents for reference as well as data and statistics surrounding Medicare Advantage and Accountable Care Organizations in rural communities.
Author(s): Keith J. Mueller
Date: 02/2017
Type: Document
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Telemedicine and Primary Care Obesity Management in Rural Areas – Innovative Approach for Older Adults?
Explores telemedicine as a potential delivery tool for the Medicare Obesity Benefit in primary care settings. Describes challenges in implementing the benefit in rural areas, including increasing older adult populations, shortages in primary care and specialized healthcare providers, reimbursement issues, and transportation barriers. Presents the potential utility of telemedicine in rural obesity care and non-physician staff delivery options, which require regulatory changes.
Author(s): John Batsis, Sarah Pletcher, James Stahl
Citation: BMC Geriatrics, 17, 6
Date: 01/2017
Type: Document
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Explores telemedicine as a potential delivery tool for the Medicare Obesity Benefit in primary care settings. Describes challenges in implementing the benefit in rural areas, including increasing older adult populations, shortages in primary care and specialized healthcare providers, reimbursement issues, and transportation barriers. Presents the potential utility of telemedicine in rural obesity care and non-physician staff delivery options, which require regulatory changes.
Author(s): John Batsis, Sarah Pletcher, James Stahl
Citation: BMC Geriatrics, 17, 6
Date: 01/2017
Type: Document
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Evaluating the HCIA - Behavioral Health/Substance Abuse Awards: Third Annual Report
Third annual evaluations of 10 Health Care Innovation Awards Round One projects focused on mental health and substance abuse services. Awardee-specific chapters focus on program objectives, implementation experiences, and participant outcomes. Programs include HealthLinkNow, which uses telehealth to provide behavioral care services in rural areas, and the Prevention and Recovery in Early Psychosis Program, which was expanded to serve to rural counties in California.
Additional links: Addendum, July 2017
Date: 01/2017
Type: Document
Sponsoring organizations: Centers for Medicare and Medicaid Services, Mathematica Policy Research
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Third annual evaluations of 10 Health Care Innovation Awards Round One projects focused on mental health and substance abuse services. Awardee-specific chapters focus on program objectives, implementation experiences, and participant outcomes. Programs include HealthLinkNow, which uses telehealth to provide behavioral care services in rural areas, and the Prevention and Recovery in Early Psychosis Program, which was expanded to serve to rural counties in California.
Additional links: Addendum, July 2017
Date: 01/2017
Type: Document
Sponsoring organizations: Centers for Medicare and Medicaid Services, Mathematica Policy Research
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Accounting for Social Risk Factors in Medicare Payment
Fifth and final report in a series designed to identify social risk factors that affect the health outcomes of Medicare beneficiaries and methods to account for these factors in Medicare payment programs. Offers thoughts about selecting the best methods to account for social risk factors and achieve policy goals. Chapter 2 includes a discussion about urbanicity and rurality, and suggests that a beneficiary's place of residence is a stronger indicator of social risk than their provider's location. Report was assembled by an ad hoc committee under the direction of the U.S. Department of Health and Human Services, Office of the Assistant Secretary of Planning and Evaluation.
Additional links: Read Online
Author(s): Committee on Accounting for Socioeconomic Status in Medicare Payment Programs
Date: 01/2017
Type: Document
Sponsoring organization: Health and Medicine Division (HMD), National Academies of Sciences, Engineering, and Medicine
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Fifth and final report in a series designed to identify social risk factors that affect the health outcomes of Medicare beneficiaries and methods to account for these factors in Medicare payment programs. Offers thoughts about selecting the best methods to account for social risk factors and achieve policy goals. Chapter 2 includes a discussion about urbanicity and rurality, and suggests that a beneficiary's place of residence is a stronger indicator of social risk than their provider's location. Report was assembled by an ad hoc committee under the direction of the U.S. Department of Health and Human Services, Office of the Assistant Secretary of Planning and Evaluation.
Additional links: Read Online
Author(s): Committee on Accounting for Socioeconomic Status in Medicare Payment Programs
Date: 01/2017
Type: Document
Sponsoring organization: Health and Medicine Division (HMD), National Academies of Sciences, Engineering, and Medicine
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Critical Access Hospital Financial Model
Excel-based modeling tool designed to help Critical Access Hospitals (CAHs) anticipate and analyze the financial impacts of joining a Medicare Shared Savings Program (MSSP) Accountable Care Organization (ACO).
Date: 2017
Type: Tool
Sponsoring organization: Rural Health Value
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Excel-based modeling tool designed to help Critical Access Hospitals (CAHs) anticipate and analyze the financial impacts of joining a Medicare Shared Savings Program (MSSP) Accountable Care Organization (ACO).
Date: 2017
Type: Tool
Sponsoring organization: Rural Health Value
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Rural Training Track Programs: A Guide to the Medicare Requirements
Provides guidance to urban hospitals, rural hospitals, and rural nonhospital clinical training sites on how to take part in a Rural Training Track (RTT) to train residents to practice in rural areas. Explains how hospitals can receive additional payments from Medicare to train residents in an RTT program, beyond the graduate medical education (GME) caps in place since 1996.
Date: 2017
Type: Document
Sponsoring organization: Association of American Medical Colleges
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Provides guidance to urban hospitals, rural hospitals, and rural nonhospital clinical training sites on how to take part in a Rural Training Track (RTT) to train residents to practice in rural areas. Explains how hospitals can receive additional payments from Medicare to train residents in an RTT program, beyond the graduate medical education (GME) caps in place since 1996.
Date: 2017
Type: Document
Sponsoring organization: Association of American Medical Colleges
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Iowa State Innovation Model (SIM): Baseline Process/Implementation Report
Reports on the progress, challenges, and future concerns during the pre-implementation (2015) and the first-year implementation (2016) of the Iowa State Innovation Model (SIM) test grant to improve population health, transform healthcare, and promote sustainability in rural and urban counties of Iowa. Discusses 5 main SIM activities: Plan for Population Health (PPH), Community Care Coalitions (C3) including rural counties, Statewide Alert Network (SWAN), Community-Based Performance Improvement (CBPI), and Value-Based Purchasing (VBP).
Author(s): Suzanne Bentler, Tessa Heeren, Rochelle Schultz Spinarski, Elizabeth Momany, Peter Damiano
Date: 12/2016
Type: Document
Sponsoring organization: University of Iowa Public Policy Center
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Reports on the progress, challenges, and future concerns during the pre-implementation (2015) and the first-year implementation (2016) of the Iowa State Innovation Model (SIM) test grant to improve population health, transform healthcare, and promote sustainability in rural and urban counties of Iowa. Discusses 5 main SIM activities: Plan for Population Health (PPH), Community Care Coalitions (C3) including rural counties, Statewide Alert Network (SWAN), Community-Based Performance Improvement (CBPI), and Value-Based Purchasing (VBP).
Author(s): Suzanne Bentler, Tessa Heeren, Rochelle Schultz Spinarski, Elizabeth Momany, Peter Damiano
Date: 12/2016
Type: Document
Sponsoring organization: University of Iowa Public Policy Center
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Center for Medicare and Medicaid Innovation: Report to Congress
Details the activities and progress of the CMS Innovation Center, focusing on the time period between October 1, 2014, and September 30, 2016. Includes updates on multiple rural-relevant models and initiatives such as the Accountable Care Organization Investment Model, Health Care Innovation Awards, and the Strong Start for Mothers and Newborns initiative.
Date: 12/2016
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Details the activities and progress of the CMS Innovation Center, focusing on the time period between October 1, 2014, and September 30, 2016. Includes updates on multiple rural-relevant models and initiatives such as the Accountable Care Organization Investment Model, Health Care Innovation Awards, and the Strong Start for Mothers and Newborns initiative.
Date: 12/2016
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Report to Congress: Social Risk Factors and Performance Under Medicare's Value-Based Purchasing Program
Uses Medicare data to examine the relationship between social risk factors and the performance of value-based purchasing programs. Discusses policy considerations that could help ensure value-based purchasing programs achieve their intended results, especially among high social risk populations. Categorizes rurality as a community risk factor and discusses whether beneficiaries with social risk factors such as rurality have worse outcomes due to their social risk profile, or because of the providers they see. Also provides rural-specific statistics and recommendations for using value-based purchasing to improve health outcomes among high social risk populations. Appendices summarize and provide additional details for each of the 9 programs evaluated. See the second report.
Additional links: Appendices
Date: 12/2016
Type: Document
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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Uses Medicare data to examine the relationship between social risk factors and the performance of value-based purchasing programs. Discusses policy considerations that could help ensure value-based purchasing programs achieve their intended results, especially among high social risk populations. Categorizes rurality as a community risk factor and discusses whether beneficiaries with social risk factors such as rurality have worse outcomes due to their social risk profile, or because of the providers they see. Also provides rural-specific statistics and recommendations for using value-based purchasing to improve health outcomes among high social risk populations. Appendices summarize and provide additional details for each of the 9 programs evaluated. See the second report.
Additional links: Appendices
Date: 12/2016
Type: Document
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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Medicare Value-Based Payment Models: Participation Challenges and Available Assistance for Small and Rural Practices
Identifies challenges faced by small and rural physician practices when participating in Medicare's new value-based payment models, and groups them into five key areas: financial resources and risk management, health IT and data, population health management care delivery, quality and efficiency performance measurement and reporting, and effects of model participation and managing compliance with requirements. Also identifies two types of organizations, partner and non-partner, along with the services they provide, that can help small and rural practices overcome these challenges.
Additional links: Full Report
Date: 12/2016
Type: Document
Sponsoring organization: Government Accountability Office
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Identifies challenges faced by small and rural physician practices when participating in Medicare's new value-based payment models, and groups them into five key areas: financial resources and risk management, health IT and data, population health management care delivery, quality and efficiency performance measurement and reporting, and effects of model participation and managing compliance with requirements. Also identifies two types of organizations, partner and non-partner, along with the services they provide, that can help small and rural practices overcome these challenges.
Additional links: Full Report
Date: 12/2016
Type: Document
Sponsoring organization: Government Accountability Office
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