Rural Health
Resources by Topic: Policy
Exploring the Rural Context for Adverse Childhood Experiences (ACEs)
Discusses adverse childhood experiences (ACEs) and how they may impact rural health. Provides policy recommendations focused on the rural dimensions of ACEs. Addresses categories of ACEs, prevalence in rural areas and for Native populations, federal efforts to address ACEs, and the opioid epidemic. Covers the role of school-based healthcare programs to increase access to pediatric specialty services or linking children to needed non-medical services. Profiles a committee site visit focused on a model ACEs program in New York in Appendix A.
Date: 08/2018
Sponsoring organization: National Advisory Committee on Rural Health and Human Services
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Discusses adverse childhood experiences (ACEs) and how they may impact rural health. Provides policy recommendations focused on the rural dimensions of ACEs. Addresses categories of ACEs, prevalence in rural areas and for Native populations, federal efforts to address ACEs, and the opioid epidemic. Covers the role of school-based healthcare programs to increase access to pediatric specialty services or linking children to needed non-medical services. Profiles a committee site visit focused on a model ACEs program in New York in Appendix A.
Date: 08/2018
Sponsoring organization: National Advisory Committee on Rural Health and Human Services
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Advanced Primary Care: A Key Contributor to Successful ACOs
Reviews the literature on accountable care organizations (ACOs) regarding characteristics of successful ACOs and outcomes for cost, quality, and utilization, including literature on rural ACOs. Analyzes Medicare and National Committee for Quality Assurance (NCQA) data on ACO cost and quality outcomes to assess the role of advanced primary care models such as patient-centered medical homes on ACO success.
Additional links: Executive Summary, White Paper
Author(s): Yalda Jabbarpour, Megan Coffman, Andy Habib, et al.
Date: 08/2018
Sponsoring organizations: Primary Care Collaborative, Robert Graham Center
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Reviews the literature on accountable care organizations (ACOs) regarding characteristics of successful ACOs and outcomes for cost, quality, and utilization, including literature on rural ACOs. Analyzes Medicare and National Committee for Quality Assurance (NCQA) data on ACO cost and quality outcomes to assess the role of advanced primary care models such as patient-centered medical homes on ACO success.
Additional links: Executive Summary, White Paper
Author(s): Yalda Jabbarpour, Megan Coffman, Andy Habib, et al.
Date: 08/2018
Sponsoring organizations: Primary Care Collaborative, Robert Graham Center
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Rural Health Insurance Market Challenges
Policy brief examining challenges affecting rural health insurance markets with a focus on Medicare Advantage, Medicare Part D, Medicaid Managed Care, and the Health Insurance Marketplace. Provides recommendations related to health insurance availability, network development and adequacy, and consumer and provider engagement.
Date: 08/2018
Sponsoring organization: National Advisory Committee on Rural Health and Human Services
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Policy brief examining challenges affecting rural health insurance markets with a focus on Medicare Advantage, Medicare Part D, Medicaid Managed Care, and the Health Insurance Marketplace. Provides recommendations related to health insurance availability, network development and adequacy, and consumer and provider engagement.
Date: 08/2018
Sponsoring organization: National Advisory Committee on Rural Health and Human Services
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Field Oversight Hearing on "Overcrowded Housing and the Impacts on American Indian and Alaska Natives."
Presents the Senate Committee on Indian Affairs field hearing in Savoonga, AK on the effect the lack of housing is having on the Native Village of Savoonga. Features testimony from representatives from Savoonga, AK, the U.S. Department of Housing and Urban Development, the Bering Straits Regional Housing Authority, and the Norton Sound Health Corporation.
Date: 08/2018
Sponsoring organization: Senate Committee on Indian Affairs
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Presents the Senate Committee on Indian Affairs field hearing in Savoonga, AK on the effect the lack of housing is having on the Native Village of Savoonga. Features testimony from representatives from Savoonga, AK, the U.S. Department of Housing and Urban Development, the Bering Straits Regional Housing Authority, and the Norton Sound Health Corporation.
Date: 08/2018
Sponsoring organization: Senate Committee on Indian Affairs
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Evaluation of the Accountable Care Organization Investment Model: AIM Impacts in the First Performance Year
Evaluation examining the first year performance of the 47 Accountable Care Organizations (ACOs) participating in the ACO Investment Model (AIM), which tests the use of prepaid shared savings to encourage new ACOs to form in rural and underserved areas (Test 1) and to encourage current Medicare Shared Savings Program ACOs to transition to arrangements with greater financial risk (Test 2). Describes provider characteristics, beneficiary characteristics, and impacts of the 41 Test 1 AIM ACOs. Includes data on rurality for both Test 1 and Test 2 AIM ACOs.
Additional links: Appendices, Findings At-A-Glance
Date: 08/2018
Sponsoring organizations: Abt Associates, Centers for Medicare and Medicaid Services
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Evaluation examining the first year performance of the 47 Accountable Care Organizations (ACOs) participating in the ACO Investment Model (AIM), which tests the use of prepaid shared savings to encourage new ACOs to form in rural and underserved areas (Test 1) and to encourage current Medicare Shared Savings Program ACOs to transition to arrangements with greater financial risk (Test 2). Describes provider characteristics, beneficiary characteristics, and impacts of the 41 Test 1 AIM ACOs. Includes data on rurality for both Test 1 and Test 2 AIM ACOs.
Additional links: Appendices, Findings At-A-Glance
Date: 08/2018
Sponsoring organizations: Abt Associates, Centers for Medicare and Medicaid Services
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MedPAC Comment on CMS's Proposed Rule on the CY 2019 Home Health PPS Update and 2020 Case Mix Refinements
Comment on a July 12, 2018, Federal Register proposed rule revising payments for home health services. Includes a section addressing a proposed rural add-on payment policy.
Date: 08/2018
Sponsoring organization: Medicare Payment Advisory Commission
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Comment on a July 12, 2018, Federal Register proposed rule revising payments for home health services. Includes a section addressing a proposed rural add-on payment policy.
Date: 08/2018
Sponsoring organization: Medicare Payment Advisory Commission
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First Annual Report: Next Generation Accountable Care Organization (NGACO) Model Evaluation
Reports initial descriptive and analytic findings for the 18 Next Generation ACOs (NGACOs) that launched in 2016. Includes information on NGACO organizational characteristics, market characteristics, model implementation, and performance. Offers some data and discussion related to the inclusion of rural areas. Also provides information on institutional providers by type of facility, including Critical Access Hospitals, Rural Health Clinics, and Federally Qualified Health Centers.
Additional links: Findings at a Glance, Volume II: Technical Appendices, January 2018
Date: 08/2018
Sponsoring organizations: Centers for Medicare and Medicaid Services, NORC at the University of Chicago
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Reports initial descriptive and analytic findings for the 18 Next Generation ACOs (NGACOs) that launched in 2016. Includes information on NGACO organizational characteristics, market characteristics, model implementation, and performance. Offers some data and discussion related to the inclusion of rural areas. Also provides information on institutional providers by type of facility, including Critical Access Hospitals, Rural Health Clinics, and Federally Qualified Health Centers.
Additional links: Findings at a Glance, Volume II: Technical Appendices, January 2018
Date: 08/2018
Sponsoring organizations: Centers for Medicare and Medicaid Services, NORC at the University of Chicago
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Perspectives on Rural Caregiving Challenges and Interventions
Policy brief describing challenges and opportunities to support unpaid caregivers in rural areas, based on 34 interviews with 41 key informants, from October 2017 through February 2018. Highlights work that informal caregivers are doing and identifies policy levers that have been used to support them.
Author(s): Carrie Henning-Smith, Megan Lahr
Date: 08/2018
Sponsoring organization: University of Minnesota Rural Health Research Center
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Policy brief describing challenges and opportunities to support unpaid caregivers in rural areas, based on 34 interviews with 41 key informants, from October 2017 through February 2018. Highlights work that informal caregivers are doing and identifies policy levers that have been used to support them.
Author(s): Carrie Henning-Smith, Megan Lahr
Date: 08/2018
Sponsoring organization: University of Minnesota Rural Health Research Center
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Association of State Medicaid Expansion With Rate of Uninsured Hospitalizations for Major Cardiovascular Events, 2009-2014
Results of a study to investigate whether rates of uninsured hospitalizations for cardiovascular events and in-hospital mortality varied by Affordable Care Act Medicaid expansion at the state level. Features statistics including demographics with breakdowns by rural or urban/suburban location.
Author(s): Ehimare Akhabue, Lindsay R. Pool, Clyde W. Yancy, Philip Greenland, Donald Lloyd-Jones
Citation: JAMA Network Open 1(4)
Date: 08/2018
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Results of a study to investigate whether rates of uninsured hospitalizations for cardiovascular events and in-hospital mortality varied by Affordable Care Act Medicaid expansion at the state level. Features statistics including demographics with breakdowns by rural or urban/suburban location.
Author(s): Ehimare Akhabue, Lindsay R. Pool, Clyde W. Yancy, Philip Greenland, Donald Lloyd-Jones
Citation: JAMA Network Open 1(4)
Date: 08/2018
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Medicare Fee-for-Service: Information on the First Year of Nationwide Reduced Payment Rates for Durable Medical Equipment
Examines the effects of reduced payment rates for certain durable medical equipment (DME) in non-bid areas. Reports on changes in the number of suppliers, utilization of rate-adjusted items, and beneficiaries' access to rate-adjusted items. Includes information on changes in rural and non-rural non-bid areas.
Additional links: Full Report
Date: 08/2018
Sponsoring organization: Government Accountability Office
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Examines the effects of reduced payment rates for certain durable medical equipment (DME) in non-bid areas. Reports on changes in the number of suppliers, utilization of rate-adjusted items, and beneficiaries' access to rate-adjusted items. Includes information on changes in rural and non-rural non-bid areas.
Additional links: Full Report
Date: 08/2018
Sponsoring organization: Government Accountability Office
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