Rural Health
Resources by Topic: Medicare
State Innovation Models (SIM) Round 2: Model Test Annual Report One
First annual report describing the design and progress of the Round 2 State Innovation Models (SIM) program across eleven participating states - Colorado, Connecticut, Delaware, Idaho, Iowa, Michigan, New York, Ohio, Rhode Island, Tennessee, and Washington. Includes information about the program's organization, data and methods, and implementation activities. Addresses challenges for rural areas throughout and shares highlights from each state's site visits.
Date: 12/2017
Sponsoring organizations: Centers for Medicare and Medicaid Services, RTI International
view details
First annual report describing the design and progress of the Round 2 State Innovation Models (SIM) program across eleven participating states - Colorado, Connecticut, Delaware, Idaho, Iowa, Michigan, New York, Ohio, Rhode Island, Tennessee, and Washington. Includes information about the program's organization, data and methods, and implementation activities. Addresses challenges for rural areas throughout and shares highlights from each state's site visits.
Date: 12/2017
Sponsoring organizations: Centers for Medicare and Medicaid Services, RTI International
view details
Modernizing Rural Health Clinic Provisions
Reviews Rural Health Clinics (RHCs) statutory authorization and current regulations to identify areas for improvement to meet the current and future healthcare needs. Includes recommendations regarding payment options, program support, services offered, workforce issues, and law requirements.
Date: 12/2017
Sponsoring organization: National Advisory Committee on Rural Health and Human Services
view details
Reviews Rural Health Clinics (RHCs) statutory authorization and current regulations to identify areas for improvement to meet the current and future healthcare needs. Includes recommendations regarding payment options, program support, services offered, workforce issues, and law requirements.
Date: 12/2017
Sponsoring organization: National Advisory Committee on Rural Health and Human Services
view details
The Evolution of Private Plans in Medicare
Examines major policy changes affecting Medicare Advantage plans, and the impact of these policies on plan participation, enrollment, average premiums and cost-sharing, total costs to Medicare, and quality of care. Briefly discusses the challenges associate with providing risk-based plans in rural areas.
Author(s): Yash M. Patel, Stuart Guterman
Date: 12/2017
Sponsoring organization: Commonwealth Fund
view details
Examines major policy changes affecting Medicare Advantage plans, and the impact of these policies on plan participation, enrollment, average premiums and cost-sharing, total costs to Medicare, and quality of care. Briefly discusses the challenges associate with providing risk-based plans in rural areas.
Author(s): Yash M. Patel, Stuart Guterman
Date: 12/2017
Sponsoring organization: Commonwealth Fund
view details
MedPAC Report to the Congress: Physician Supervision Requirements in Critical Access Hospitals and Small Rural Hospitals
Provides background information on Medicare physician supervision requirements, and examines how enforcement of these requirements impacts access to care, quality of care, and staffing needs in Critical Access Hospitals (CAHs) and small rural hospitals. Findings are based on interviews with CMS officials, hospital association representatives, and CAH administrators in several states.
Date: 12/2017
Sponsoring organization: Medicare Payment Advisory Commission
view details
Provides background information on Medicare physician supervision requirements, and examines how enforcement of these requirements impacts access to care, quality of care, and staffing needs in Critical Access Hospitals (CAHs) and small rural hospitals. Findings are based on interviews with CMS officials, hospital association representatives, and CAH administrators in several states.
Date: 12/2017
Sponsoring organization: Medicare Payment Advisory Commission
view details
Emerging Strategies to Ensure Access to Health Care Services: Emergency Medical Center
Provides an overview of the emergency medical center (EMC) model, which would allow struggling hospitals to convert to EMC status and provide emergency and outpatient services, without having to provide inpatient acute care services. Also outlines rural-specific federal policy proposals that seek to create similar hospital designations, with the goal of improving access to and the delivery of care in underserved communities.
Date: 11/2017
Sponsoring organization: American Hospital Association
view details
Provides an overview of the emergency medical center (EMC) model, which would allow struggling hospitals to convert to EMC status and provide emergency and outpatient services, without having to provide inpatient acute care services. Also outlines rural-specific federal policy proposals that seek to create similar hospital designations, with the goal of improving access to and the delivery of care in underserved communities.
Date: 11/2017
Sponsoring organization: American Hospital Association
view details
Differences in Community Characteristics of Sole Community Hospitals
Findings brief presenting a snapshot of Sole Community Hospitals (SCHs) and their communities in 2015, and identifying trends in characteristics of selected SCHs and their communities from 2006 through 2015. Features statistics including breakdowns by large rural, small rural, and isolated rural location.
Author(s): Sharita R. Thomas, Mark Holmes, George H. Pink
Date: 11/2017
Sponsoring organization: North Carolina Rural Health Research Program
view details
Findings brief presenting a snapshot of Sole Community Hospitals (SCHs) and their communities in 2015, and identifying trends in characteristics of selected SCHs and their communities from 2006 through 2015. Features statistics including breakdowns by large rural, small rural, and isolated rural location.
Author(s): Sharita R. Thomas, Mark Holmes, George H. Pink
Date: 11/2017
Sponsoring organization: North Carolina Rural Health Research Program
view details
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
view details
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
view details
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
Sponsoring organization: Center for Health Care Strategies
view details
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
Sponsoring organization: Center for Health Care Strategies
view details
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
Sponsoring organization: Rural and Underserved Health Research Center
view details
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
Sponsoring organization: Rural and Underserved Health Research Center
view details
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.
Additional links: Report in Brief
Author(s): Daniel R. Levinson
Date: 09/2017
Sponsoring organization: U.S. Department of Health and Human Services
view details
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.
Additional links: Report in Brief
Author(s): Daniel R. Levinson
Date: 09/2017
Sponsoring organization: U.S. Department of Health and Human Services
view details