Rural Health
Resources by Topic: Policy
Medicare Telehealth: Actions Needed to Strengthen Oversight and Help Providers Educate Patients on Privacy and Security Risks
Analyzes 2019 and 2020 Medicare claims data to explore the utilization of telehealth services before and after the implementation of regulatory flexibilities and waivers in March 2020 in response to the COVID-19 pandemic. Describes efforts taken by the Centers for Medicare & Medicaid Services (CMS) to identify and monitor risks posed by Medicare telehealth waivers, as well as a change made to the enforcement of regulations governing patients' protected health information during the COVID-19 public health emergency. Offers three recommendations to CMS to strengthen oversight and assess the quality of telehealth services and one recommendation regarding assistance to providers to explain the privacy and security risks of telehealth to patients.
Additional links: Full Report
Date: 09/2022
Sponsoring organization: Government Accountability Office
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Analyzes 2019 and 2020 Medicare claims data to explore the utilization of telehealth services before and after the implementation of regulatory flexibilities and waivers in March 2020 in response to the COVID-19 pandemic. Describes efforts taken by the Centers for Medicare & Medicaid Services (CMS) to identify and monitor risks posed by Medicare telehealth waivers, as well as a change made to the enforcement of regulations governing patients' protected health information during the COVID-19 public health emergency. Offers three recommendations to CMS to strengthen oversight and assess the quality of telehealth services and one recommendation regarding assistance to providers to explain the privacy and security risks of telehealth to patients.
Additional links: Full Report
Date: 09/2022
Sponsoring organization: Government Accountability Office
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Landscape of Area-Level Deprivation Measures and Other Approaches to Account for Social Risk and Social Determinants of Health in Health Care Payments
Examines social determinants of health (SDOH) at the community level and their impact on health-related social needs (HRSNs) of the individual. Discusses how policies related to federal payment systems can incentivize screening for HRSNs as well as referrals to appropriate social and behavioral services. Provides an environmental scan of what measures can be used to provide accountability for funding and policy efforts targeted at SDOH. Includes an appendix that defines and describes indices of social risk, such as the social vulnerability index (SVI) and area deprivation index (ADI), as well as payment models that include measures of social risk.
Author(s): Joshua Breslau, Laurie Martin, Justin Timbie, Nabeel Qureshi, Deborah Zajdman
Date: 09/2022
Sponsoring organizations: HHS Office of the Assistant Secretary for Planning and Evaluation, RAND Corporation
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Examines social determinants of health (SDOH) at the community level and their impact on health-related social needs (HRSNs) of the individual. Discusses how policies related to federal payment systems can incentivize screening for HRSNs as well as referrals to appropriate social and behavioral services. Provides an environmental scan of what measures can be used to provide accountability for funding and policy efforts targeted at SDOH. Includes an appendix that defines and describes indices of social risk, such as the social vulnerability index (SVI) and area deprivation index (ADI), as well as payment models that include measures of social risk.
Author(s): Joshua Breslau, Laurie Martin, Justin Timbie, Nabeel Qureshi, Deborah Zajdman
Date: 09/2022
Sponsoring organizations: HHS Office of the Assistant Secretary for Planning and Evaluation, RAND Corporation
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Next Steps for the Rural Emergency Hospital Model
Blog post discussing rural hospital closures and how the Rural Emergency Hospital (REH) model can help financially vulnerable hospitals align their services to the needs of the community. Highlights recommendations to the U.S. Department of Health and Human Services regarding REH Conditions of Participation and payment.
Date: 09/2022
Sponsoring organization: Bipartisan Policy Center
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Blog post discussing rural hospital closures and how the Rural Emergency Hospital (REH) model can help financially vulnerable hospitals align their services to the needs of the community. Highlights recommendations to the U.S. Department of Health and Human Services regarding REH Conditions of Participation and payment.
Date: 09/2022
Sponsoring organization: Bipartisan Policy Center
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September 2022 MACPAC Meeting Transcript
Transcript from the Medicaid and CHIP Payment and Access Commission's (MACPAC) September 2022 meeting. Covers Medicaid race and ethnicity data collection and reporting, state processes and stakeholder engagement for unwinding continuous coverage requirement, countercyclical disproportionate share hospital policies, and integrating care for dually eligible beneficiaries in Medicaid fee-for-services, among other things. Includes rural references throughout.
Date: 09/2022
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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Transcript from the Medicaid and CHIP Payment and Access Commission's (MACPAC) September 2022 meeting. Covers Medicaid race and ethnicity data collection and reporting, state processes and stakeholder engagement for unwinding continuous coverage requirement, countercyclical disproportionate share hospital policies, and integrating care for dually eligible beneficiaries in Medicaid fee-for-services, among other things. Includes rural references throughout.
Date: 09/2022
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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Receipt of Out-of-State Telemedicine Visits Among Medicare Beneficiaries During the COVID-19 Pandemic
Study examining out-of-state telemedicine utilization during the COVID-19 pandemic by Medicare beneficiaries from January to June 2021 based on Medicare fee-for-service claims. Presents patient characteristics, variation in out-of-state telemedicine by geography, and benefits of out-of-state telemedicine access for rural beneficiaries.
Author(s): Ateev Mehrotra, Haiden A. Huskamp, Alok Nimgaonkar, et al.
Citation: JAMA Health Forum, 3(9), e223013
Date: 09/2022
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Study examining out-of-state telemedicine utilization during the COVID-19 pandemic by Medicare beneficiaries from January to June 2021 based on Medicare fee-for-service claims. Presents patient characteristics, variation in out-of-state telemedicine by geography, and benefits of out-of-state telemedicine access for rural beneficiaries.
Author(s): Ateev Mehrotra, Haiden A. Huskamp, Alok Nimgaonkar, et al.
Citation: JAMA Health Forum, 3(9), e223013
Date: 09/2022
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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
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
Sponsoring organization: Rural Policy Research Institute Rural Health Panel
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Medicare's New Rural Emergency Hospital Designation — Considerations for States
Blog post providing an overview of the Rural Emergency Hospital (REH) program. Discusses the REH designation as an alternative to rural hospital closure and REH payment policy. Highlights opportunities for states to develop REH licensure requirements.
Author(s): Rebekah Falkner, Sam Mermin
Date: 09/2022
Sponsoring organization: National Academy for State Health Policy
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Blog post providing an overview of the Rural Emergency Hospital (REH) program. Discusses the REH designation as an alternative to rural hospital closure and REH payment policy. Highlights opportunities for states to develop REH licensure requirements.
Author(s): Rebekah Falkner, Sam Mermin
Date: 09/2022
Sponsoring organization: National Academy for State Health Policy
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Beneficiary Experience, Affordability, Utilization, and Quality in Medicare Advantage and Traditional Medicare: A Review of the Literature
Summarizes the results of a review of 62 studies published between January 1, 2016, and May 1, 2022, that compare Medicare Advantage and traditional Medicare across beneficiary experience, affordability, service utilization, and quality. Includes information on Medicare enrollment patterns in rural areas and identifies gaps in research on rural Medicare beneficiaries and other subgroups. Builds on a literature review that examined studies published between 2000 and early 2014.
Author(s): Nancy Ochieng, Jeannie Fuglesten Biniek
Date: 09/2022
Sponsoring organization: KFF
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Summarizes the results of a review of 62 studies published between January 1, 2016, and May 1, 2022, that compare Medicare Advantage and traditional Medicare across beneficiary experience, affordability, service utilization, and quality. Includes information on Medicare enrollment patterns in rural areas and identifies gaps in research on rural Medicare beneficiaries and other subgroups. Builds on a literature review that examined studies published between 2000 and early 2014.
Author(s): Nancy Ochieng, Jeannie Fuglesten Biniek
Date: 09/2022
Sponsoring organization: KFF
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HHS Roadmap for Behavioral Health Integration
Issue brief describing behavioral healthcare needs, barriers to access, and plans to integrate behavioral health and other forms of healthcare. Offering policy solutions to strengthen system capacity, connect patients to care, and create healthy, supportive environments. Notes rural disparities in mental healthcare access and rural-specific behavioral health training.
Date: 09/2022
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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Issue brief describing behavioral healthcare needs, barriers to access, and plans to integrate behavioral health and other forms of healthcare. Offering policy solutions to strengthen system capacity, connect patients to care, and create healthy, supportive environments. Notes rural disparities in mental healthcare access and rural-specific behavioral health training.
Date: 09/2022
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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Frequently Asked Questions Regarding Licensure & Telehealth
Video addressing frequently asked questions about telehealth licensure, including cross-state issues, COVID-19 licensure waivers, and more. Answers to questions reflect policy as of September 2022.
Additional links: Presentation Slides
Date: 09/2022
Sponsoring organization: Center for Connected Health Policy: The National Telehealth Policy Resource Center
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Video addressing frequently asked questions about telehealth licensure, including cross-state issues, COVID-19 licensure waivers, and more. Answers to questions reflect policy as of September 2022.
Additional links: Presentation Slides
Date: 09/2022
Sponsoring organization: Center for Connected Health Policy: The National Telehealth Policy Resource Center
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