Rural Health
Resources by Topic: Medicare
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
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
Sponsoring organization: Government Accountability Office
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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
Sponsoring organizations: Abt Associates, Centers for Medicare and Medicaid Services
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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
Sponsoring organizations: Abt Associates, Centers for Medicare and Medicaid Services
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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
Sponsoring organization: Flex Monitoring Team
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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
Sponsoring organization: Flex Monitoring Team
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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
Sponsoring organization: National Rural Health Association
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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
Sponsoring organization: National Rural Health Association
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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
Sponsoring organization: Rural Health Information Hub
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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
Sponsoring organization: Rural Health Information Hub
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Impact of Race/Ethnicity and Socioeconomic Status on Risk-Adjusted Readmission Rates: Implications for the Hospital Readmissions Reduction Program
Examines what would happen to hospitals' excess readmission ratios and potential penalties if socioeconomic status and race/ethnicity were added to the Centers for Medicare & Medicaid Services risk-adjustment algorithm. Includes information on potential change in penalties for metropolitan, micropolitan, and nonmetro hospitals.
Author(s): Grant R. Martsolf, Marguerite L. Barrett, Audrey J. Weiss, et al.
Citation: Inquiry, 53
Date: 10/2016
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Examines what would happen to hospitals' excess readmission ratios and potential penalties if socioeconomic status and race/ethnicity were added to the Centers for Medicare & Medicaid Services risk-adjustment algorithm. Includes information on potential change in penalties for metropolitan, micropolitan, and nonmetro hospitals.
Author(s): Grant R. Martsolf, Marguerite L. Barrett, Audrey J. Weiss, et al.
Citation: Inquiry, 53
Date: 10/2016
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The Impact of the Low Volume Hospital (LVH) Program on the Viability of Small, Rural Hospitals
Compares rural low volume hospitals (LVH) with non-LVH (Inpatient Prospective Payment System) hospitals. Discusses the financial impact of removing the LVH program and returning to the 2005 LVH classification and payment adjustment, and the effect this will have on Medicare beneficiaries.
Author(s): Rebecca G. Whitaker, G. Mark Holmes, George H. Pink
Date: 10/2016
Sponsoring organization: North Carolina Rural Health Research Program
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Compares rural low volume hospitals (LVH) with non-LVH (Inpatient Prospective Payment System) hospitals. Discusses the financial impact of removing the LVH program and returning to the 2005 LVH classification and payment adjustment, and the effect this will have on Medicare beneficiaries.
Author(s): Rebecca G. Whitaker, G. Mark Holmes, George H. Pink
Date: 10/2016
Sponsoring organization: North Carolina Rural Health Research Program
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Aging in Rural and Frontier Oregon: Challenges Facing Rural and Frontier Home Health Agencies
Provides an overview of the services and challenges affecting home health agencies offering assistance to the aging population in rural Oregon by county. Includes discussion on healthcare access, home health agency regulation and reimbursement, recruitment and retention of healthcare providers, and physician compliance.
Author(s): Callie Walsh-Bailey, Jamie Horst
Date: 09/2016
Sponsoring organization: Oregon Office of Rural Health
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Provides an overview of the services and challenges affecting home health agencies offering assistance to the aging population in rural Oregon by county. Includes discussion on healthcare access, home health agency regulation and reimbursement, recruitment and retention of healthcare providers, and physician compliance.
Author(s): Callie Walsh-Bailey, Jamie Horst
Date: 09/2016
Sponsoring organization: Oregon Office of Rural Health
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State Innovation Models (SIM) Initiative Evaluation: Model Test Year Two Annual Report
Second 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, Vermont, and Oregon - to accelerate health system transformation in the areas of delivery systems, payment models, information technology, workforce development, and more. Presents results from the second of three planned site visits to the states, including interviews, focus groups, and surveys. Connections made throughout to issues specifically affecting rural healthcare.
Date: 08/2016
Sponsoring organizations: Centers for Medicare and Medicaid Services, RTI International
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Second 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, Vermont, and Oregon - to accelerate health system transformation in the areas of delivery systems, payment models, information technology, workforce development, and more. Presents results from the second of three planned site visits to the states, including interviews, focus groups, and surveys. Connections made throughout to issues specifically affecting rural healthcare.
Date: 08/2016
Sponsoring organizations: Centers for Medicare and Medicaid Services, RTI International
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Evaluation of the Round Two Health Care Innovation Awards (HCIA R2): First Annual Report
Summarizes the first year evaluation results of the 39 Health Care Innovation Awards Round Two projects. Includes findings for the individual grantees, which include 14 projects that serve rural areas.
Date: 08/2016
Sponsoring organizations: Centers for Medicare and Medicaid Services, Mathematica Policy Research
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Summarizes the first year evaluation results of the 39 Health Care Innovation Awards Round Two projects. Includes findings for the individual grantees, which include 14 projects that serve rural areas.
Date: 08/2016
Sponsoring organizations: Centers for Medicare and Medicaid Services, Mathematica Policy Research
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