Rural Health
Resources by Topic: Medicare
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
view details
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
view details
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
view details
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
view details
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
view details
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
view details
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
view details
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
view details
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
view details
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
view details
Evaluation of Hospital-Setting HCIA Awards: Third Annual Report, Final
Third and final report evaluating 10 Health Care Innovation Awards Round One projects undertaken in a hospital inpatient or emergency department. Presents awardee-specific information on program impact and lessons learned. Includes projects that involved Critical Access Hospitals and other rural hospitals. Includes projects focused on improved care for sepsis and projects using remote electronic intensive care unit (eICU) services.
Additional links: Addendum, March 2017
Date: 11/2016
Type: Document
Sponsoring organizations: Abt Associates, Centers for Medicare and Medicaid Services
view details
Third and final report evaluating 10 Health Care Innovation Awards Round One projects undertaken in a hospital inpatient or emergency department. Presents awardee-specific information on program impact and lessons learned. Includes projects that involved Critical Access Hospitals and other rural hospitals. Includes projects focused on improved care for sepsis and projects using remote electronic intensive care unit (eICU) services.
Additional links: Addendum, March 2017
Date: 11/2016
Type: Document
Sponsoring organizations: Abt Associates, Centers for Medicare and Medicaid Services
view details
MBQIP Quality Measure Trends, 2011-2016
Examines trends in 37 Medicare Beneficiary Quality Improvement Project (MBQIP) quality measures from 2011 to 2016. Groups Critical Access Hospitals (CAHs) within 45 State Flex Programs into five regions, and organizes data into tables and figures which allow in-depth comparisons of the national, regional, and state trends for each MBQIP measure. Presents findings across five quality measure domains: patient engagement, care transitions, outpatient, inpatient, and patient safety.
Author(s): Tami Swenson, Michelle Casey
Date: 11/2016
Type: Document
Sponsoring organization: Flex Monitoring Team
view details
Examines trends in 37 Medicare Beneficiary Quality Improvement Project (MBQIP) quality measures from 2011 to 2016. Groups Critical Access Hospitals (CAHs) within 45 State Flex Programs into five regions, and organizes data into tables and figures which allow in-depth comparisons of the national, regional, and state trends for each MBQIP measure. Presents findings across five quality measure domains: patient engagement, care transitions, outpatient, inpatient, and patient safety.
Author(s): Tami Swenson, Michelle Casey
Date: 11/2016
Type: Document
Sponsoring organization: Flex Monitoring Team
view details
Federal Requirement for Physician Supervision of CRNAs
Discusses the federal requirement affecting participation in the Medicare program by Critical Access Hospitals (CAHs) or Ambulatory Surgical Centers (ASCs) regarding physician supervision of Certified Registered Nurse Anesthetists (CRNAs). Addresses the conditions for states to opt out of the physician supervision Medicare rule if they meet certain conditions and the research comparing the outcomes between states that opt-out and those that do not.
Author(s): Steve Barnett, John H Everett, Pat Schou
Date: 11/2016
Type: Document
Sponsoring organization: National Rural Health Association
view details
Discusses the federal requirement affecting participation in the Medicare program by Critical Access Hospitals (CAHs) or Ambulatory Surgical Centers (ASCs) regarding physician supervision of Certified Registered Nurse Anesthetists (CRNAs). Addresses the conditions for states to opt out of the physician supervision Medicare rule if they meet certain conditions and the research comparing the outcomes between states that opt-out and those that do not.
Author(s): Steve Barnett, John H Everett, Pat Schou
Date: 11/2016
Type: Document
Sponsoring organization: National Rural Health Association
view details
Freestanding Emergency Departments: An Alternative Model for Rural Communities
Describes the freestanding emergency department (FSED) model as an option for rural communities that can no longer support inpatient services. Looks at both hospital-based and independent FSEDs, examines financial viability of the model, and features rural FSEDs in Illinois and Arizona.
Author(s): Jenn Lukens
Citation: Rural Monitor
Date: 11/2016
Type: Document
Sponsoring organization: Rural Health Information Hub
view details
Describes the freestanding emergency department (FSED) model as an option for rural communities that can no longer support inpatient services. Looks at both hospital-based and independent FSEDs, examines financial viability of the model, and features rural FSEDs in Illinois and Arizona.
Author(s): Jenn Lukens
Citation: Rural Monitor
Date: 11/2016
Type: Document
Sponsoring organization: Rural Health Information Hub
view details
The Financial Importance of the Sole Community Hospital Payment Designation
Investigates the economic importance of the Sole Community Hospital (SCH) program by reviewing data between 2006 and 2015 regarding the proportion of SCHs reimbursed at the hospital-specific rate, and their profitability of providing services to Medicare patients. Also, discusses the economic consequences that would occur if the SCH program was not in operation in 2015.
Author(s): Sharita R. Thomas, Randy Randolph, G. Mark Holmes, George H. Pink
Date: 11/2016
Type: Document
Sponsoring organization: North Carolina Rural Health Research Program
view details
Investigates the economic importance of the Sole Community Hospital (SCH) program by reviewing data between 2006 and 2015 regarding the proportion of SCHs reimbursed at the hospital-specific rate, and their profitability of providing services to Medicare patients. Also, discusses the economic consequences that would occur if the SCH program was not in operation in 2015.
Author(s): Sharita R. Thomas, Randy Randolph, G. Mark Holmes, George H. Pink
Date: 11/2016
Type: Document
Sponsoring organization: North Carolina Rural Health Research Program
view details