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Rural Health Information Hub

Rural Health
Resources by Topic: Outpatient care

Impact of the Medicare Improvements for Patients And Providers Act on Mental Health Service Utilization And Spending among Older Adults
Examines the impact of the Medicare Improvements for Patients and Providers Act (MIPPA) on outpatient mental healthcare utilization. Utilizes 2008-2017 Medicare claims and administrative data to analyze MIPPA in a pre-implementation phase as well as 4 post-implementation phases. Includes data on mental healthcare outpatient visits by age group, race, dual eligibility status, substance use disorder, comorbidities, and urban, large rural, small rural, or isolated rural location.
Author(s): Matt Toth, Brent Gibbons, Abbie Levinson, et al.
Date: 01/2025
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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Understanding Barriers and Facilitators to Implementation of a Patient Safety Bundle for Pregnancy-Related Severe Hypertension in 3 North Carolina Outpatient Clinics: A Qualitative Study
Examines the Alliance for Innovation on Maternal Health's Patient Safety Bundle (Bundle) implementation in North Carolina, which aims to address complications of pregnancy related hypertension. Utilizes feedback from 11 key informant interviews working at a rural outpatient Federally Qualified Health Center (FQHC) in central North Carolina. Discusses facilitators and barriers of the Bundle implementation, with a focus on access issues in rural and underserved communities.
Author(s): Aparna G. Kachoria, Hiba Fatima, Alexandra F. Lightfoot, et al.
Citation: Implementation Science Communications, 6, 7
Date: 01/2025
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Effects of Rural Hospital Closures on Nurse Staffing Levels and Health Care Utilization at Nearby Hospitals
Analyzes healthcare utilization and nurse staffing levels when nearby rural hospitals close. Utilizes 2014-2019 American Hospital Association Survey data to examine vocational nurse/licensed practical nurse (LPN), registered nurse (RN), and advanced practice nurse (APN) staffing levels as well as inpatient and outpatient surgical operations and emergency department (ED) visits within 4 years of a hospital closure.
Author(s): Jing Dong, Siying Liu, Asefeh Faraz Covelli, Guido Cataife
Citation: Health Economics, 33(12), 2687-2707
Date: 12/2024
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National Hospital Ambulatory Medical Care Survey: 2022 Emergency Department Summary Tables
Provides data on ambulatory care emergency department (ED) hospital visits in 2022. Table 1 provides metropolitan/nonmetropolitan ED visit data based on hospital location.
Date: 11/2024
Sponsoring organization: National Center for Health Statistics
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CY 2025 Medicare Hospital Outpatient Prospective Payment System and Ambulatory Surgical Center Payment System Final Rule (CMS 1809-FC)
Fact sheet providing an overview of the Centers for Medicare & Medicaid Services (CMS) final rule regarding updates and changes to the Medicare payments for hospital outpatient and Ambulatory Surgical Center (ASC) services for calendar year 2025. Summarizes provisions regarding changes to Intensive Outpatient Program (IOP) and partial hospital program rate setting; incorporating an add-on payment to the Medicare outpatient hospital all-inclusive rate (AIR) for certain high-cost drugs for people with Medicare who receive care at Indian Health Service (IHS) or tribal hospitals; updates to the Hospital Outpatient Quality Reporting (OQR), Ambulatory Surgical Center Quality Reporting (ASCQR), and Rural Emergency Hospital Quality Reporting (REHQR) Programs; a new Conditions of Participation (CoPs) for hospitals and Critical Access Hospitals (CAHs) for obstetrical services; Medicaid and CHIP continuous eligibility; Medicaid clinic services "four walls" exceptions; and more.
Date: 11/2024
Sponsoring organization: Centers for Medicare and Medicaid Services
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An REH Conversion Story: Harper County Hospital
Profiles Oklahoma's Harper County Hospital and its transition from a Critical Access Hospital (CAH) to a Rural Emergency Hospital (REH). Summarizes an interview with Kevin O'Brien, Chief Executive Officer (CEO) of Harper County Hospital, regarding the experience of converting to REH status. Covers the hospital's financial position before conversion, including limitations to being a county-owned hospital; the exploration of the REH designation; and the financial and operational impacts of the REH designation, including services added by the hospital after the conversion.
Date: 07/2024
Sponsoring organization: Rural Health Redesign Center
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An REH Conversion Story: Mercy Hospital
Profiles Mercy Hospital, in Moundridge, Kansas, and its transition from a prospective payment system (PPS) hospital to a Rural Emergency Hospital (REH). Summarizes an interview with Aaron Herbel, Chief Executive Officer (CEO) of Mercy Hospital, regarding the experience of converting to REH status. Covers the conversion timeline, the involvement of hospital and community stakeholders, and the opening of a walk-in clinic that coincided with the REH conversion.
Author(s): Hope Burch, Tracey Dorff, Anna Anna, Janice Walters
Date: 07/2024
Sponsoring organization: Rural Health Redesign Center
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Rural Community Health Worker Programs: Proving Value and Finding Sustainability
Features four rural healthcare organizations describing the impact of their community health worker (CHW) programs and strategies for sustaining them. Discusses CHW roles, activities, reimbursement options, and more.
Author(s): Kay Miller Temple
Citation: Rural Monitor
Date: 07/2024
Sponsoring organization: Rural Health Information Hub
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Healthcare Spending among Diverse Populations with Alzheimer's Disease and Related Dementias: A Claims-Based Analysis
Examines healthcare spending and utilization among commercially insured Alzheimer's disease and related dementia (ADRD) patients. Explores the impact of sociodemographic factors and urban/rural status on annual spending among ADRD patients by analyzing data from the FAIR Health National Private Insurance Claims between January 2016 and December 2023, along with demographic and socioeconomic data from the U.S. Census American Community Survey. Includes data on the probability of ADRD patients using different care venues and the average and expected amounts allowed within each venue based on patient characteristics.
Date: 06/2024
Sponsoring organization: FAIR Health
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Five Things to Know About Medicare Site-Neutral Payment Reforms
Discusses site-neutral payment reforms that seek to align Medicare payments with outpatient services in different settings. Examines benefits and drawbacks of the policy and discusses how the policy would impact rural hospitals.
Author(s): Zachary Levinson, Tricia Neuman, Scott Hulver
Date: 06/2024
Sponsoring organization: KFF
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