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Rural Health
Resources by Topic: Policy

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: 10/2023
Sponsoring organization: Medicare Payment Advisory Commission
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Exploring Patient Care Navigation in the Medicare Program
Presents an overview of patient navigation programs through an environmental scan of literature published between 2013 and 2023 and discussions with key informants at four healthcare organizations. Describes the variety of patient navigation services, types of patients targeted, settings that offer navigation services, staffing, funding, clinical outcomes, and more. Includes a brief discussion of programs targeting patients in rural areas. Identifies implementation and policy considerations and potential barriers to supporting patient navigation services.
Additional links: Annex, Executive Summary
Author(s): Zachary Predmore, Joachim Hero, Stephanie Dellva, et al.
Date: 09/2023
Sponsoring organizations: HHS Office of the Assistant Secretary for Planning and Evaluation, RAND Health Care
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Environmental Scan on Encouraging Rural Participation in Population-Based TCOC Models
Presents results of an environmental scan regarding population-based total cost of care (PB-TCOC) payment models and encouraging rural participation in these models. Describes challenges affecting rural patients and providers; opportunities for alternative payment models (APMs) and PB-TCOC models to address challenges in rural areas; trends in rural providers' participation in APMs; driving care delivery transformation in rural providers, including models that include or target rural participants in their model designs; leveraging financial incentives to improve rural health care; adoption and use of health information technology, including telehealth and data analytics among rural providers; and the measurement of rural providers' performance in APMs.
Date: 09/2023
Sponsoring organizations: HHS Office of the Assistant Secretary for Planning and Evaluation, NORC at the University of Chicago
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Medicare Advantage Value-Based Insurance Design Model Phase II: Second Annual Evaluation Report
Presents findings from an evaluation of Phase II of the Medicare Advantage (MA) Value-Based Insurance Design (VBID) Model, which allows participating MA parent organizations to offer supplemental benefits and incentives to beneficiaries, hospice benefits, and wellness and healthcare planning through their MA plans. Summarizes findings from interviews with representatives of participating MA organizations, in-network and out-of-network hospices, and beneficiaries. Covers MA organization and beneficiary implementation experiences, plan enrollment, quality of care, health outcomes, and more, for the VBID Model generally and for the VBID Hospice Benefit Component.
Additional links: Appendices, Findings at a Glance, Hospice Benefit Component Findings at a Glance
Date: 09/2023
Sponsoring organizations: Centers for Medicare and Medicaid Services, RAND Corporation
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National Advisory Committee on Rural Health and Human Services Meeting Summary, Colorado Springs, Colorado, September 6-8, 2023
Summarizes the 93nd meeting of the National Advisory Committee on Rural Health and Human Services (NACRHHS), which was held in Colorado Springs, Colorado. Presents an overview of national and state perspectives on disability and independence in rural communities.
Additional links: Lincoln County Human Services Site Visit Summary
Date: 09/2023
Sponsoring organization: National Advisory Committee on Rural Health and Human Services
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Implementation of Acute Care Services and Long-Term Services and Supports System Redesign for Individuals with an Intellectual or Developmental Disability
Report on 2022 initiatives related to acute care and long-term services and supports (LTSS) systems for people with intellectual or developmental disabilities (IDD) in Texas. Includes both assessment of implementation and recommendations to the state legislature for improvements. Includes rural considerations throughout.
Date: 09/2023
Sponsoring organization: Texas Health and Human Services
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September 2023 MACPAC Meeting Transcript
Transcript from the Medicaid and CHIP Payment and Access Commission's (MACPAC) September 2023 meeting. Covers managed care denials and appeals, Medicaid demographic data collection, the unwinding of the Medicaid continuous coverage requirement, the MACPAC hospital supplemental payment work plan, a review of the proposed rule on nursing facility staffing and payment transparency, and school-based behavioral health services for students enrolled in Medicaid, among other things. Includes rural references throughout.
Date: 09/2023
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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MedPAC Response to a Congressional Request for Information on Improving Access to Health Care in Rural and Underserved Areas
Letter to the House Committee on Ways and Means request for information on improving access to healthcare in rural and underserved areas. Covers MedPAC recommendations for policies to target payments to better support rural and vulnerable beneficiaries' access to care, including the Rural Emergency Hospital program and a proposed Medicare Safety-Net Index; changes to the hospital wage index to address geographic inequities; and the alignment of payment rates across ambulatory settings for certain services.
Date: 09/2023
Sponsoring organization: Medicare Payment Advisory Commission
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Assessing the Impact of Medicaid Telehealth Policy Change on Equitable Access to Telehealth Services in North Carolina
Describes the evolution of North Carolina's Medicaid telehealth coverage and reimbursement policies in response to the COVID-19 pandemic. Discusses the impact of these policies on access to care. Compares data on telehealth claims by volume and as a percentage of total claims by race and rural-urban residence between March 2020 and December 2022.
Author(s): Shannon Dowler, Sam Thompson, Michelle Savuto, Jacqueline Marks-Smith, Jared Augenstein
Date: 09/2023
Sponsoring organization: Milbank Memorial Fund
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Will Availability of Over-the-Counter Narcan Increase Access?
Highlights state policies and recent research related to over-the-counter naloxone access. Includes information on the impact of rurality on access. Also discusses insurance coverage and impact of cost.
Author(s): Heather Saunders, Robin Rudowitz
Date: 09/2023
Sponsoring organization: KFF
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