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Rural Health
Resources by Topic: Post-acute care

Medicare Payment Basics: Skilled Nursing Facility Services Payment System
Overview of Medicare payments for skilled nursing and rehabilitation services. Describes what constitutes a skilled nursing facility and how small, rural hospitals and critical access hospitals may be used to provide these services with CMS approval. Compares Medicare daily base rates for urban and rural skilled nursing facilities.
Date: 10/2020
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Medicare Payment Basics: Inpatient Rehabilitation Facilities Payment System
Overview of Medicare's payment system for inpatient rehabilitation services in freestanding facilities or within acute care hospitals. Demonstrates how payment rates are adjusted to account for certain facility characteristics including facilities in rural areas.
Date: 10/2020
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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MedPAC Data Book: Health Care Spending and the Medicare Program, 2020
Provides an overview of Medicare spending and highlights data on Medicare beneficiary demographics, dual-eligible beneficiaries, quality of care provided through the Medicare program, and other payer liability. Examines settings of care, including rural specific provider sites, as they relate to spending, access to care, and profit margins. Compares rural and urban beneficiaries and providers throughout. Chart 6-2 addresses rural hospital closures.
Date: 07/2020
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Post-Acute Skilled Nursing Care Availability in Rural United States
Policy brief focusing on availability of post-acute skilled nursing care in rural areas, through swing bed programs in Critical Access Hospitals, short-term general hospitals, and skilled nursing facilities. Examines characteristics of counties with and without post-acute skilled nursing care, and what factors are associated with counties without this type of care. Features statistics with breakdowns by micropolitan, noncore, and all rural county locations.
Author(s): Darcy McMaughan, Ifedioranma O. Anikpo, Scott Horel, Jennifer Ozmetin
Date: 07/2020
Type: Document
Sponsoring organization: Southwest Rural Health Research Center
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MedPAC Comment on CMS's Proposed Rule on the Inpatient Rehabilitation Facility PPS for FY 2021
Comments on an April 21, 2020, Federal Register proposed rule addressing updates to the prospective payment system for inpatient rehabilitation facilities (IRFs) for fiscal year 2021. Includes comments on the adoption of the Office of Management and Budget's geographic area delineations to determine wage index values.
Date: 05/2020
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Estimated Reduction in CAH Profitability from Loss of Cost-Based Reimbursement for Swing Beds
Examines the impact of proposed legislation recommending changes to swing bed reimbursements for Critical Access Hospitals (CAHs) from cost-based to the Skilled Nursing Facility Prospective Payment System (SNF PPS). Estimates CAH profitability using reimbursement formulas from Medicare cost reports and discusses the characteristics of CAHs most affected by a change in swing bed reimbursement.
Author(s): Drake M. Broussard, Kristin L. Reiter
Date: 05/2020
Type: Document
Sponsoring organization: North Carolina Rural Health Research Program
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MedPAC Report to the Congress: Medicare Payment Policy, 2020
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: 03/2020
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Assessment of Rural-Urban Differences in Postacute Care Utilization and Outcomes Among Older US Adults
Results of a study of 2,044,231 Medicare beneficiaries who were hospitalized in 2011-2015 for pneumonia, stroke, heart failure, hip fracture, or COPD. Examines the frequency, type, and duration of postacute care, as well as readmission and mortality rates in people discharged to a community or to postacute care. Features statistics with breakdowns by urban area, rural community adjacent to urban area, or rural community nonadjacent to urban area.
Author(s): Cyrus M. Kosar, Lacey Loomer, Nasim B. Ferdows, et al.
Citation: JAMA Network Open, 3(1)
Date: 01/2020
Type: Document
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Post-Acute Care Virtual Summit
Summarizes a May 2020 virtual summit of key stakeholders that examines the current state of post-acute care (PAC) in rural America. Discusses issues, challenges, and strategies related to the integration of rural acute and post-acute care. Explores how state Flex Programs can help rural providers address PAC. Includes a collection of PAC best practices.
Date: 2020
Type: Document
Sponsoring organizations: National Rural Health Resource Center, Stroudwater Associates
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Challenges in Managing Acute Cardiovascular Diseases and Follow Up Care in Rural Areas: A Narrative Review
Explores the challenges of acute coronary syndrome (ACS) management and follow up care in rural areas. Details access and workforce issues that make ACS care challenging in rural and remote areas.
Author(s): Sandra C. Thompson, Lee Nedkoff, Judith Katzenellenbogen, et al.
Citation: International Journal of Environmental Research and Public Health, 16(24), 5126
Date: 12/2019
Type: Document
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