Rural Health
Resources by Topic: Policy
State Medicaid Telehealth Policies Before and During the COVID-19 Public Health Emergency: 2022 Update
Examines state Medicaid telehealth coverage, policies, and utilization before and after the COVID-19 public health emergency (PHE). Describes the types of Medicaid services that were allowed to be delivered by telehealth and the types of telehealth modality covered before the PHE, in May 2020, and in January 2022. Outlines the status of state Medicaid telehealth flexibilities based on state executive orders and Medicaid agency guidance. Builds on a July 2021 analysis of state Medicaid telehealth coverage, policies, and utilization before and after the COVID-19 PHE.
Author(s): Jacquelyn Rudich, Ann B. Conmy, Rose C. Chum, et al
Date: 11/2022
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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Examines state Medicaid telehealth coverage, policies, and utilization before and after the COVID-19 public health emergency (PHE). Describes the types of Medicaid services that were allowed to be delivered by telehealth and the types of telehealth modality covered before the PHE, in May 2020, and in January 2022. Outlines the status of state Medicaid telehealth flexibilities based on state executive orders and Medicaid agency guidance. Builds on a July 2021 analysis of state Medicaid telehealth coverage, policies, and utilization before and after the COVID-19 PHE.
Author(s): Jacquelyn Rudich, Ann B. Conmy, Rose C. Chum, et al
Date: 11/2022
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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Bridging the Digital Divide: Advancing Telehealth Equity
Describes the rise in telehealth use in Massachusetts since the onset of the COVID-19 pandemic and disparities in use across populations. Summarizes the access, quality, and experience factors associated with telehealth from the perspective of patients, providers, and community leaders. Identifies barriers and factors that promoted telehealth use. Offers recommendations for health plans to advance telehealth equity by addressing the root causes of the digital divide, promoting digital inclusion, removing structural and financial barriers to telehealth access, and supporting higher quality and more inclusive care delivery.
Date: 11/2022
Sponsoring organizations: Department of Population Medicine at Harvard Medical School, Harvard Pilgrim Health Care Institute, Massachusetts Association of Health Plans, Massachusetts Health Quality Partners
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Describes the rise in telehealth use in Massachusetts since the onset of the COVID-19 pandemic and disparities in use across populations. Summarizes the access, quality, and experience factors associated with telehealth from the perspective of patients, providers, and community leaders. Identifies barriers and factors that promoted telehealth use. Offers recommendations for health plans to advance telehealth equity by addressing the root causes of the digital divide, promoting digital inclusion, removing structural and financial barriers to telehealth access, and supporting higher quality and more inclusive care delivery.
Date: 11/2022
Sponsoring organizations: Department of Population Medicine at Harvard Medical School, Harvard Pilgrim Health Care Institute, Massachusetts Association of Health Plans, Massachusetts Health Quality Partners
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Fifth Evaluation Report: Next Generation Accountable Care Organization Model Evaluation
Reports on changes to the Next Generation Accountable Care Organization (NGACO) Model in response to the COVID-19 public health emergency (PHE). Presents information on cumulative model-wide impacts on Medicare spending, utilization, and quality of care, as well as impacts observed in 2020, the model's fifth performance year. The appendices include data on community characteristics, including rurality.
Additional links: Technical Appendices
Date: 11/2022
Sponsoring organizations: Centers for Medicare and Medicaid Services, NORC at the University of Chicago
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Reports on changes to the Next Generation Accountable Care Organization (NGACO) Model in response to the COVID-19 public health emergency (PHE). Presents information on cumulative model-wide impacts on Medicare spending, utilization, and quality of care, as well as impacts observed in 2020, the model's fifth performance year. The appendices include data on community characteristics, including rurality.
Additional links: Technical Appendices
Date: 11/2022
Sponsoring organizations: Centers for Medicare and Medicaid Services, NORC at the University of Chicago
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Measuring Rurality in Health Services Research: A Scoping Review
Analyzes peer-reviewed journals between 2010 and 2020 to provide a scoping review of the different methods of rurality defined and used in health services research. Examines 103 full-text studies across various journals to observe different measures of rurality. Includes discussion about the benefits and drawbacks of the respective measures of rurality and how inconsistent use of measures impacts federal funding and the study of rural health disparities.
Author(s): Robin Danek, Justin Blackburn, Marion Greene, Olena Mazurenko, Nir Menachemi
Citation: BMC Health Services Research, 22, 1340
Date: 11/2022
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Analyzes peer-reviewed journals between 2010 and 2020 to provide a scoping review of the different methods of rurality defined and used in health services research. Examines 103 full-text studies across various journals to observe different measures of rurality. Includes discussion about the benefits and drawbacks of the respective measures of rurality and how inconsistent use of measures impacts federal funding and the study of rural health disparities.
Author(s): Robin Danek, Justin Blackburn, Marion Greene, Olena Mazurenko, Nir Menachemi
Citation: BMC Health Services Research, 22, 1340
Date: 11/2022
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CMS Framework for Advancing Health Care in Rural, Tribal, and Geographically Isolated Communities
Report outlines the Centers for Medicare & Medicaid Services (CMS) plan for improving health equity and health outcomes across the U.S. for rural, tribal, and geographically isolated communities. Details a 6 priority framework emphasizing the application of a community-informed geographic lens; the collection and use of standardized data; support for healthcare professionals; the optimization of medical and communication technology; the expansion of access to comprehensive healthcare coverage, benefits, and services and supports; and innovation and value-based care. Highlights examples of activities CMS is undertaking in support of each priority and recent CMS efforts that align with each priority.
Date: 11/2022
Sponsoring organization: Centers for Medicare and Medicaid Services
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Report outlines the Centers for Medicare & Medicaid Services (CMS) plan for improving health equity and health outcomes across the U.S. for rural, tribal, and geographically isolated communities. Details a 6 priority framework emphasizing the application of a community-informed geographic lens; the collection and use of standardized data; support for healthcare professionals; the optimization of medical and communication technology; the expansion of access to comprehensive healthcare coverage, benefits, and services and supports; and innovation and value-based care. Highlights examples of activities CMS is undertaking in support of each priority and recent CMS efforts that align with each priority.
Date: 11/2022
Sponsoring organization: Centers for Medicare and Medicaid Services
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Veterans Community Care Program: VA Needs to Strengthen Its Oversight and Improve Data on Its Community Care Network Providers
Describes how the U.S. Department of Veterans Affairs (VA) monitors contractor compliance with the Veterans Community Care Program network adequacy standards and related requirements. Examines the extent to which the VA's contractors are meeting network adequacy standards. Discusses the experiences of VA medical facility officials when scheduling routine appointments for veterans. Offers recommendations to ensure that contractors report complete performance data and increase the accuracy of community provider information.
Additional links: Full Report
Date: 11/2022
Sponsoring organization: Government Accountability Office
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Describes how the U.S. Department of Veterans Affairs (VA) monitors contractor compliance with the Veterans Community Care Program network adequacy standards and related requirements. Examines the extent to which the VA's contractors are meeting network adequacy standards. Discusses the experiences of VA medical facility officials when scheduling routine appointments for veterans. Offers recommendations to ensure that contractors report complete performance data and increase the accuracy of community provider information.
Additional links: Full Report
Date: 11/2022
Sponsoring organization: Government Accountability Office
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A Global Equity Model (GEM) for the Advancement of Community Health and Health Equity
Provides an overview of existing and emerging payment systems and their roles in promoting community health and health equity. Proposes a global payment model for health systems' inpatient, emergency department (ED), and outpatient sites of care with community health and health equity as its organizing features. Includes information on the Pennsylvania Rural Health Model, the ACO REACH model, and other rural-relevant payment models.
Author(s): Anaeze C. Offodile II, Jason B. Gibbons, Samantha Murrell, Donna Kinzer, Joshua M. Sharfstein
Date: 11/2022
Sponsoring organization: National Academy of Medicine
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Provides an overview of existing and emerging payment systems and their roles in promoting community health and health equity. Proposes a global payment model for health systems' inpatient, emergency department (ED), and outpatient sites of care with community health and health equity as its organizing features. Includes information on the Pennsylvania Rural Health Model, the ACO REACH model, and other rural-relevant payment models.
Author(s): Anaeze C. Offodile II, Jason B. Gibbons, Samantha Murrell, Donna Kinzer, Joshua M. Sharfstein
Date: 11/2022
Sponsoring organization: National Academy of Medicine
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Person-Centered Innovation – An Update on the Implementation of the CMS Innovation Center's Strategy
Provides an update on the Centers for Medicare and Medicaid Services' (CMS) Innovation Center's progress in the implementation of the strategy refresh announced in 2021. Describes accomplishments from the first year of implementing the strategy refresh and outlines areas of focus for the upcoming year across the five strategic objectives: driving accountable care, advancing health equity, supporting innovation, addressing affordability, and partnering to achieve healthcare system transformation. Includes information on the Accountable Care Organization Realizing Equity, Access, and Community Health (ACO REACH) Model and the Community Health Access and Rural Transformation (CHART) Model.
Additional links: Supplemental Document
Date: 11/2022
Sponsoring organization: Centers for Medicare and Medicaid Services
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Provides an update on the Centers for Medicare and Medicaid Services' (CMS) Innovation Center's progress in the implementation of the strategy refresh announced in 2021. Describes accomplishments from the first year of implementing the strategy refresh and outlines areas of focus for the upcoming year across the five strategic objectives: driving accountable care, advancing health equity, supporting innovation, addressing affordability, and partnering to achieve healthcare system transformation. Includes information on the Accountable Care Organization Realizing Equity, Access, and Community Health (ACO REACH) Model and the Community Health Access and Rural Transformation (CHART) Model.
Additional links: Supplemental Document
Date: 11/2022
Sponsoring organization: Centers for Medicare and Medicaid Services
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The Path to Coordinated Federal Leadership to Strengthen Primary Health Care
Discusses the potential of a Secretary's Council on Primary Care within the U.S. Department of Health and Human Services. Describes primary care's role in addressing policy challenges related to health equity, payment, workforce training, pandemic recovery and resilience, the opioid crisis, and mental health. Offers recommendations to include and strengthen high-quality primary care as part of a long-term vision of a high-value healthcare system. Includes rural references throughout.
Author(s): Robert L. Phillips Jr., Christopher Koller, Alice Hm Chen
Date: 11/2022
Sponsoring organization: Milbank Memorial Fund
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Discusses the potential of a Secretary's Council on Primary Care within the U.S. Department of Health and Human Services. Describes primary care's role in addressing policy challenges related to health equity, payment, workforce training, pandemic recovery and resilience, the opioid crisis, and mental health. Offers recommendations to include and strengthen high-quality primary care as part of a long-term vision of a high-value healthcare system. Includes rural references throughout.
Author(s): Robert L. Phillips Jr., Christopher Koller, Alice Hm Chen
Date: 11/2022
Sponsoring organization: Milbank Memorial Fund
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Child Nutrition Program Operations Study (CN-OPS-II): School Year 2017-18
Reports on policy, administrative, and operational issues in Child Nutrition (CN) programs in the United States. Analyzes 2,000 State agencies (SAs) and School Food Authorities (SFAs) to provide a nationally representative sample with 2017-2018 data on finances and eligibility related to school meals, meeting nutritional standards, implementation of policies to purchase local food, and more. Includes breakdown of data by SFA size, urbanicity, U.S. region, and percent of children approved for free or reduced price (F/RP) meals.
Additional links: Summary
Author(s): Jim Murdoch, Steven Garasky, Susan Ullrich, et al.
Date: 11/2022
Sponsoring organization: USDA Food and Nutrition Service
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Reports on policy, administrative, and operational issues in Child Nutrition (CN) programs in the United States. Analyzes 2,000 State agencies (SAs) and School Food Authorities (SFAs) to provide a nationally representative sample with 2017-2018 data on finances and eligibility related to school meals, meeting nutritional standards, implementation of policies to purchase local food, and more. Includes breakdown of data by SFA size, urbanicity, U.S. region, and percent of children approved for free or reduced price (F/RP) meals.
Additional links: Summary
Author(s): Jim Murdoch, Steven Garasky, Susan Ullrich, et al.
Date: 11/2022
Sponsoring organization: USDA Food and Nutrition Service
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