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Rural Health
Resources by Topic: Outpatient care

Patterns of Health Care Use among Rural-Urban Medicare Beneficiaries Age 85 and Older, 2010-2017
Policy brief examining how rural and urban Medicare beneficiaries age 85+ differ in terms of their socioeconomic and health characteristics that may inform healthcare use. Features statistics on trends in healthcare use, including inpatient and emergency department care, outpatient and prescription services, specialists and dentists, and home health and durable medical equipment, with breakdowns by urban and rural location.
Author(s): Yvonne Jonk, Heidi O'Connor, Amanda Burgess, Carly Milkowski
Date: 11/2022
Type: Document
Sponsoring organization: Maine Rural Health Research Center
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Medicare Program: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems and Quality Reporting Programs; Organ Acquisition; Rural Emergency Hospitals: Payment Policies, Conditions of Participation, Provider Enrollment, Physician Self-Referral; New Service Category for Hospital Outpatient Department Prior Authorization Process; Overall Hospital Quality Star Rating; COVID-19
Establishes the Rural Emergency Hospital (REH) provider type. Outlines REH payment policy, Conditions of Participation (CoPs), quality measures, and enrollment policy. Outlines changes to the Critical Access Hospitals (CAH) CoPs regarding location and distance requirements, patient's rights requirements, and flexibilities for CAHs that are part of a larger health system. Among other things, this rule also revises the Medicare Hospital Outpatient Prospective Payment System (OPPS) and Medicare Ambulatory Surgical Center (ACS) payment system for calendar year 2023 and finalizes provisions included in the COVID-19 interim final rules.
Additional links: Fact Sheet
Date: 11/2022
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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MedPAC Payment Basics
Series of briefs providing an of Medicare payment systems. Covers payments systems including Accountable Care Organizations (ACO), Critical Access Hospitals (CAH), Federally Qualified Health Centers and Rural Health Clinics, hospital acute inpatient services, and more.
Date: 10/2022
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Medicare Payment Basics: Outpatient Hospital Services Payment System
Outlines Medicare's payments for outpatient hospital services, including considerations for rural sole community hospitals.
Date: 10/2022
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Medicare Payment Basics: Outpatient Dialysis Services Payment System
Overview of Medicare payment methods for outpatient dialysis services of beneficiaries with end-stage renal disease (ESRD). Describes the base payment rate for freestanding and hospital-based facilities and identifies facility-level adjustments, including facilities located in rural areas.
Date: 10/2022
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Health Panel Comment Letter – Hospital Outpatient Prospective Payment System and Rural Emergency Hospitals
Comments offered in response to a July 26, 2022, Federal Register proposed rule revising the Medicare Hospital Outpatient Prospective Payment System (OPPS) and Medicare Ambulatory Surgical Center (ACS) payment system for calendar year 2023 and establishing Rural Emergency Hospital (REH) payment policy, quality measures, and enrollment policy. Discusses telehealth services for mental healthcare; REH quality measures, telehealth, and Conditions of Participation; and the use of Centers for Medicare & Medicaid Services (CMS) data on hospital and skilled nursing facilities changes in ownership.
Date: 09/2022
Type: Document
Sponsoring organization: Rural Policy Research Institute Rural Health Panel
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MedPAC Comment on CMS's Proposed Rule on the Payment Systems for Hospital Outpatient Departments and Ambulatory Surgical Centers for 2023
Comments on a July 26, 2022, Federal Register proposed rule revising the Medicare Hospital Outpatient Prospective Payment System (OPPS) and Medicare Ambulatory Surgical Center (ACS) payment system for calendar year 2023. Includes considerations for payment for 340B drugs, additional facility payments for Rural Emergency Hospitals, telehealth rehabilitation services beyond the COVID-19 public health emergency, and efforts for measuring equity and healthcare quality disparities.
Date: 09/2022
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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National Hospital Ambulatory Medical Care Survey: 2019 Emergency Department Summary Tables
Provides data on ambulatory care emergency department (ED) hospital visits. Table 1 provides metropolitan/nonmetropolitan ED visit data based on hospital location. Table 2 includes metro/nonmetro ED visit data by location of patient residence. Table 14 has metro/nonmetro injury visit data based on hospital location.
Date: 08/2022
Type: Document
Sponsoring organization: National Center for Health Statistics
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MedPAC Data Book: Health Care Spending and the Medicare Program, 2022
Provides an overview of Medicare spending and highlights data on Medicare beneficiary demographics, dual-eligible beneficiaries, quality of care provided through the Medicare program, and other payer liability. Examines settings of care, including rural specific provider sites, as they relate to spending, access to care, and profit margins. Compares rural and urban beneficiaries and providers throughout. Chart 6-2 addresses rural hospital closures.
Date: 07/2022
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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MedPAC Report to the Congress: Medicare and the Health Care Delivery System, June 2022
Evaluates Medicare payment issues and provides recommendations to the U.S. Congress. Chapter 2 presents a report on access to care for beneficiaries in Medically Underserved Areas (MUAs), who are dually eligible for Medicare and Medicaid, or have multiple chronic conditions. Also includes chapters on alternative payment models, safety net providers, the cost of drugs covered under Medicare Part B, the accuracy of Medicare Advantage payments, the alignment of fee-for-service payment rates across ambulatory settings, and segmentation in the stand-alone Part D plan market.
Date: 06/2022
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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