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Rural Health
Resources by Topic: Medicare

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
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
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
Sponsoring organization: North Carolina Rural Health Research Program
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State Innovation Models (SIM) Round 2: Model Design Final Report
Shares results from a federal evaluation of the Round 2 State Innovation Models (SIM) Initiative awards, which focused on reforming payment and delivery systems, health information exchanges, workforce development, and sustainability. Provides a summary and review of each awardees' final State Health System Innovations Plan (SHSIP). Includes several suggestions and recommendations for improving rural healthcare delivery, payment, and access.
Author(s): Donald Nichols, Kathleen Farrell, Marisa Morrison, et al.
Date: 08/2017
Sponsoring organization: Centers for Medicare and Medicaid Services
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Home is Where the Heart Is: Insights on the Coordination and Delivery of Home Health Services in Rural America
Identifies facilitators and barriers to providing home health services in rural areas, discusses how rural home health services are currently provided, and offers thoughts about the provision of home health services in the future. Addresses electronic health records, reimbursement issues, workforce challenges, value-based payment, and more.
Author(s): Alana Knudson, Britta Anderson, Kellie Schueler, Emily Arsen
Date: 08/2017
Sponsoring organization: Rural Health Reform Policy Research Center
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Evaluation of the Round Two Health Care Innovation Awards (HCIA R2): Second Annual Report
Summarizes the second year evaluation results of the 39 Health Care Innovation Awards Round Two projects. Describes implementation experiences during the second program year and examines pre-enrollment characteristics of participants. Focuses on program enrollment, implementation of service delivery models, development and implementation of payment models, and sustainability plans. Provides findings for the individual grantees, which include projects that serve rural areas.
Date: 08/2017
Sponsoring organizations: Centers for Medicare and Medicaid Services, Mathematica Policy Research
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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
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
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
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
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