Rural Health
Resources by Topic: Outpatient care
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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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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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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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 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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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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Higher Electronic Health Record Functionality Is Associated with Lower Operating Costs in Urban—but Not Rural—Hospitals
Explores the relationship between electronic health record (EHR) use and functionality and hospital operating costs. Examines the effects of different categories of EHR functionality on general, inpatient, and outpatient costs. Compares the relationship between EHR functionality and operating costs across urban and rural hospitals.
Author(s): Claudia A. Rhoades, Brian E. Whitacre, Alison F. Davis
Citation: Applied Clinical Informatics, 13(3), 665-676
Date: 05/2022
Type: Document
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Explores the relationship between electronic health record (EHR) use and functionality and hospital operating costs. Examines the effects of different categories of EHR functionality on general, inpatient, and outpatient costs. Compares the relationship between EHR functionality and operating costs across urban and rural hospitals.
Author(s): Claudia A. Rhoades, Brian E. Whitacre, Alison F. Davis
Citation: Applied Clinical Informatics, 13(3), 665-676
Date: 05/2022
Type: Document
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Trends in Revenue Sources among Rural Hospitals
Examines outpatient care as a revenue source for rural hospitals between 2011 and 2019 by analyzing Healthcare Cost Report Information System data from 1,866 rural hospitals. Includes data broken down by rural versus urban, inpatient/outpatient revenue, and hospital payment classification, such as Critical Access Hospital, Medicare-Dependent Hospital, Prospective Payment System, Rural Referral Center, and Sole Community Hospital, among other things.
Author(s): Randall John, Tyler Malone, George Pink
Date: 05/2022
Type: Document
Sponsoring organization: North Carolina Rural Health Research Program
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Examines outpatient care as a revenue source for rural hospitals between 2011 and 2019 by analyzing Healthcare Cost Report Information System data from 1,866 rural hospitals. Includes data broken down by rural versus urban, inpatient/outpatient revenue, and hospital payment classification, such as Critical Access Hospital, Medicare-Dependent Hospital, Prospective Payment System, Rural Referral Center, and Sole Community Hospital, among other things.
Author(s): Randall John, Tyler Malone, George Pink
Date: 05/2022
Type: Document
Sponsoring organization: North Carolina Rural Health Research Program
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MedPAC Report to the Congress: Medicare Payment Policy, 2022
Annual review of Medicare payment policies, with recommendations to Congress. Includes discussion on Medicare payment policies directly affecting rural providers and beneficiaries. Addresses payment adequacy for healthcare facilities and services, improving Medicare payment for post-acute care, Medicare Advantage, Medicare Part D, and the impact of healthcare provider consolidation.
Date: 03/2022
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Annual review of Medicare payment policies, with recommendations to Congress. Includes discussion on Medicare payment policies directly affecting rural providers and beneficiaries. Addresses payment adequacy for healthcare facilities and services, improving Medicare payment for post-acute care, Medicare Advantage, Medicare Part D, and the impact of healthcare provider consolidation.
Date: 03/2022
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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January 2022 MedPAC Meeting Transcript
Transcript from the Medicare Payment Advisory Commission's (MedPAC) January 2022 meeting. Covers payment adequacy and updates for hospital inpatient and outpatient services, physician and other health professional services, outpatient dialysis services and improving the ESRD payment system, skilled nursing facility services, home health agency services, long-term care hospital services, inpatient rehabilitation facility services, hospice services, and ambulatory surgical center services. Includes rural references throughout.
Date: 01/2022
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Transcript from the Medicare Payment Advisory Commission's (MedPAC) January 2022 meeting. Covers payment adequacy and updates for hospital inpatient and outpatient services, physician and other health professional services, outpatient dialysis services and improving the ESRD payment system, skilled nursing facility services, home health agency services, long-term care hospital services, inpatient rehabilitation facility services, hospice services, and ambulatory surgical center services. Includes rural references throughout.
Date: 01/2022
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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The Rural Health Safety Net Under Pressure: Understanding the Potential Impact of COVID-19
Examines the stability of the rural health safety net at the outset of the COVID-19 pandemic. Outlines key factors that will influence the impact of COVID-19 on rural healthcare, including access to intensive care unit beds, outpatient service revenues, and rural provider days cash on hand. Highlights provisions of the CARES Act aimed at mitigating the impact of the pandemic on rural hospitals.
Date: 2022
Type: Document
Sponsoring organization: Chartis Center for Rural Health
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Examines the stability of the rural health safety net at the outset of the COVID-19 pandemic. Outlines key factors that will influence the impact of COVID-19 on rural healthcare, including access to intensive care unit beds, outpatient service revenues, and rural provider days cash on hand. Highlights provisions of the CARES Act aimed at mitigating the impact of the pandemic on rural hospitals.
Date: 2022
Type: Document
Sponsoring organization: Chartis Center for Rural Health
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Medicare and Beneficiaries Pay More for Preadmission Services at Affiliated Hospitals Than at Wholly Owned Settings
Provides an overview of the Medicare diagnosis-related group (DRG) window policy. Examines how much Medicare and Medicare beneficiaries paid affiliated settings, including Critical Access Hospitals, for admission-related outpatient services in 2019 that would have otherwise been covered by the DRG policy at wholly-owned hospitals. Offers recommendations to the Centers for Medicare & Medicaid Services (CMS) for updating the DRG policy.
Date: 12/2021
Type: Document
Sponsoring organization: Office of Inspector General (HHS)
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Provides an overview of the Medicare diagnosis-related group (DRG) window policy. Examines how much Medicare and Medicare beneficiaries paid affiliated settings, including Critical Access Hospitals, for admission-related outpatient services in 2019 that would have otherwise been covered by the DRG policy at wholly-owned hospitals. Offers recommendations to the Centers for Medicare & Medicaid Services (CMS) for updating the DRG policy.
Date: 12/2021
Type: Document
Sponsoring organization: Office of Inspector General (HHS)
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