Rural Health
Resources by Topic: Medicare
Observation Care Services for Medicare Beneficiaries in Rural Hospitals: Policy Issues and Stakeholder Perspectives
Seeks to provide a greater understanding of rural-specific issues surrounding hospital outpatient observation status and the related implications for rural hospitals, skilled nursing facilities (SNFs), and Medicare beneficiaries. Results are based on a multi-state, qualitative analysis of input from three respondent groups: state hospital associations, long-term care ombudsman offices, and Quality Improvement Organizations (QIOs). Analysis focuses on the use of observation status by Medicare beneficiaries from 2010-2013.
Author(s): Walter Gregg, Samantha Mills, Yvonne Jonk
Date: 10/2014
Sponsoring organization: University of Minnesota Rural Health Research Center
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Seeks to provide a greater understanding of rural-specific issues surrounding hospital outpatient observation status and the related implications for rural hospitals, skilled nursing facilities (SNFs), and Medicare beneficiaries. Results are based on a multi-state, qualitative analysis of input from three respondent groups: state hospital associations, long-term care ombudsman offices, and Quality Improvement Organizations (QIOs). Analysis focuses on the use of observation status by Medicare beneficiaries from 2010-2013.
Author(s): Walter Gregg, Samantha Mills, Yvonne Jonk
Date: 10/2014
Sponsoring organization: University of Minnesota Rural Health Research Center
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Medicare Beneficiaries Paid Nearly Half of the Costs for Outpatient Services at Critical Access Hospitals
Compares the system Medicare used to calculate outpatient coinsurance amounts for patients who receive services at Critical Access Hospitals (CAHs) with the system used for acute-care hospital patients. Recommends that the Centers for Medicare and Medicaid Services seek legislative authority to modify the coinsurance calculation.
Date: 10/2014
Sponsoring organization: Office of Inspector General (HHS)
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Compares the system Medicare used to calculate outpatient coinsurance amounts for patients who receive services at Critical Access Hospitals (CAHs) with the system used for acute-care hospital patients. Recommends that the Centers for Medicare and Medicaid Services seek legislative authority to modify the coinsurance calculation.
Date: 10/2014
Sponsoring organization: Office of Inspector General (HHS)
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State Innovation Models (SIM) Initiative Evaluation: Model Design and Model Pre-Test Evaluation Report
Reports on the experiences of 19 states that received federal support to work on state health care innovation plans focused on developing innovative healthcare delivery and payment models. Discusses rural concerns in these states, as well as strategies to address rural healthcare needs. Some topics addressed include patient-centered medical homes, accountable care organizations, workforce, broadband access, electronic health record adoption, and telehealth.
Date: 07/2014
Sponsoring organizations: Centers for Medicare and Medicaid Services, RTI International
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Reports on the experiences of 19 states that received federal support to work on state health care innovation plans focused on developing innovative healthcare delivery and payment models. Discusses rural concerns in these states, as well as strategies to address rural healthcare needs. Some topics addressed include patient-centered medical homes, accountable care organizations, workforce, broadband access, electronic health record adoption, and telehealth.
Date: 07/2014
Sponsoring organizations: Centers for Medicare and Medicaid Services, RTI International
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MedPAC Report to the Congress: Medicare and the Health Care Delivery System, June 2014
Includes chapters on synchronizing Medicare policy across payment models; improving risk adjustment; measuring quality of care; financial assistance for low-income beneficiaries; per beneficiary payment for primary care; site-neutral payments for select conditions treated in inpatient rehabilitation facilities and skilled nursing facilities; and measuring the effects of medication adherence for the Medicare population. Mentions rural throughout.
Date: 06/2014
Sponsoring organization: Medicare Payment Advisory Commission
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Includes chapters on synchronizing Medicare policy across payment models; improving risk adjustment; measuring quality of care; financial assistance for low-income beneficiaries; per beneficiary payment for primary care; site-neutral payments for select conditions treated in inpatient rehabilitation facilities and skilled nursing facilities; and measuring the effects of medication adherence for the Medicare population. Mentions rural throughout.
Date: 06/2014
Sponsoring organization: Medicare Payment Advisory Commission
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Medicare Program; Prospective Payment System for FQHCs; Changes to Contracting Policies for RHCs; and Changes to Clinical Laboratory Improvement Amendments of 1988 Enforcement Actions for Proficiency Testing Referral
The final rule with comment period that implements the methodology and payment rates for a prospective payment system (PPS) for Federally Qualified Health Centers (FQHCs) services beginning October 1, 2014, under Medicare Part B, in compliance with the Affordable Care Act (ACA). Identifies the policy allowing Rural Health Clinics (RHCs) to contract with nonphysician practitioners when statutory requirements for employment of nurse practitioners and physician assistants are met, and incorporated other technical changes to FQHC and RHC regulations. Changes to the Clinical Laboratory Improvement Amendments of 1988 enforcement actions for proficiency testing referral are included.
Date: 05/2014
Sponsoring organization: Centers for Medicare and Medicaid Services
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The final rule with comment period that implements the methodology and payment rates for a prospective payment system (PPS) for Federally Qualified Health Centers (FQHCs) services beginning October 1, 2014, under Medicare Part B, in compliance with the Affordable Care Act (ACA). Identifies the policy allowing Rural Health Clinics (RHCs) to contract with nonphysician practitioners when statutory requirements for employment of nurse practitioners and physician assistants are met, and incorporated other technical changes to FQHC and RHC regulations. Changes to the Clinical Laboratory Improvement Amendments of 1988 enforcement actions for proficiency testing referral are included.
Date: 05/2014
Sponsoring organization: Centers for Medicare and Medicaid Services
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The Patient Protection and Affordable Care Act of 2010: Impacts on Rural People, Places, and Providers: A Second Look
Addresses the impact of the Patient Protection and Affordable Care Act on rural communities with a focus on health insurance coverage, Medicare and Medicaid payment, quality and delivery system reform, public health, healthcare workforce, and long-term care.
Author(s): Andrew F. Coburn, Jennifer P. Lundblad, A. Clinton MacKinney, et al.
Date: 04/2014
Sponsoring organization: Rural Policy Research Institute Rural Health Panel
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Addresses the impact of the Patient Protection and Affordable Care Act on rural communities with a focus on health insurance coverage, Medicare and Medicaid payment, quality and delivery system reform, public health, healthcare workforce, and long-term care.
Author(s): Andrew F. Coburn, Jennifer P. Lundblad, A. Clinton MacKinney, et al.
Date: 04/2014
Sponsoring organization: Rural Policy Research Institute Rural Health Panel
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MedPAC Report to the Congress: Medicare Payment Policy, 2014
Annual review of Medicare payment policies, with recommendations to Congress. Discussions of rural aspects of Medicare payment policies are included throughout the report.
Date: 03/2014
Sponsoring organization: Medicare Payment Advisory Commission
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Annual review of Medicare payment policies, with recommendations to Congress. Discussions of rural aspects of Medicare payment policies are included throughout the report.
Date: 03/2014
Sponsoring organization: Medicare Payment Advisory Commission
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The Future of the Frontier Extended Stay Clinic
Describes the Centers for Medicaid and Medicare Services (CMS) Frontier Extended Stay Clinic (FESC) demonstration project. Identifies the successes and challenges, and discusses the financial sustainability of the FESC model. Includes policy recommendations and lessons learned.
Author(s): Susan Wilger, Saskia Van Hecke
Date: 02/2014
Sponsoring organization: National Rural Health Association
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Describes the Centers for Medicaid and Medicare Services (CMS) Frontier Extended Stay Clinic (FESC) demonstration project. Identifies the successes and challenges, and discusses the financial sustainability of the FESC model. Includes policy recommendations and lessons learned.
Author(s): Susan Wilger, Saskia Van Hecke
Date: 02/2014
Sponsoring organization: National Rural Health Association
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The Extender Policies: What Are They and How Should They Continue Under a Permanent SGR Repeal Landscape
Provides resources from the U.S. House of Representatives Energy and Commerce Committee hearing on Medicare extender policies to determine whether they should be made permanent. Addresses payment adjustments for low-volume hospitals, rural areas, and more. Includes statements from the Rural Hospital Coalition, American Hospital Association, and National Rural Health Association on the impact of these payment policies on rural hospitals and rural beneficiaries.
Additional links: Statement of the American Hospital Association, Statement of the National Rural Health Association, Statement of the Rural Hospital Coalition, Transcript
Date: 01/2014
Sponsoring organization: House Energy and Commerce Committee, Subcommittee on Health
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Provides resources from the U.S. House of Representatives Energy and Commerce Committee hearing on Medicare extender policies to determine whether they should be made permanent. Addresses payment adjustments for low-volume hospitals, rural areas, and more. Includes statements from the Rural Hospital Coalition, American Hospital Association, and National Rural Health Association on the impact of these payment policies on rural hospitals and rural beneficiaries.
Additional links: Statement of the American Hospital Association, Statement of the National Rural Health Association, Statement of the Rural Hospital Coalition, Transcript
Date: 01/2014
Sponsoring organization: House Energy and Commerce Committee, Subcommittee on Health
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Indian Health Care: Impact of the Affordable Care Act (ACA)
Summarizes key changes made in the re-authorization of the Indian Health Care Improvement Act (IHCIA), including the Affordable Care Act (ACA) provisions related to American Indians and Alaska Natives enrolled in and receiving services from Medicare, Medicaid, and the Children's Health Insurance Program (CHIP).
Date: 01/2014
Sponsoring organization: Congressional Research Service
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Summarizes key changes made in the re-authorization of the Indian Health Care Improvement Act (IHCIA), including the Affordable Care Act (ACA) provisions related to American Indians and Alaska Natives enrolled in and receiving services from Medicare, Medicaid, and the Children's Health Insurance Program (CHIP).
Date: 01/2014
Sponsoring organization: Congressional Research Service
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