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Rural Health
Resources by Topic: Post-acute care

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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Report to Congress: Demonstration Project on Community Health Integration Models in Certain Rural Counties - Final Report
Presents findings from the Frontier Community Health Integration Project Demonstration (FCHIP) demonstration project over the 3-year project period. Shares results for the 10 participating Critical Access Hospitals in three states: North Dakota, Montana, and Nevada. The demonstration focused on interventions addressing ambulance services, skilled nursing facility/nursing facility beds, and telehealth. Offers recommendations for legislative and administrative action.
Date: 2020
Type: Document
Sponsoring organization: U.S. Department of Health and Human Services
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Post-Acute Care Virtual Summit
Summarizes a May 2020 virtual summit of key stakeholders that examines the 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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Quality Measures for Critical Access Hospital Swing-Bed Patients
Policy brief describing a study to identify quality measures for Critical Access Hospital (CAH) swing-bed patients, focused on outcome and functional status measures. Includes information from key informant interviews on discharge disposition and 30-day follow-up status.
Author(s): Michelle Casey, Ira Moscovice, Henry Stabler
Date: 10/2019
Type: Document
Sponsoring organization: University of Minnesota Rural Health Research Center
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States' Medicaid Fee-for-Service Nursing Facility Payment Policies
Spreadsheet outlining each state's Medicaid fee-for-service (FFS) nursing facility payment policy. Lists how each state sets the payment rate and any adjustments and supplemental payments. Includes information on rural/urban aspects of setting or adjustment to the payment in each state.
Date: 10/2019
Type: Document
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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Small Rural Hospital Transition (SRHT) Project Guide: A Rural Hospital Guide to Improving Care Management: 2019 Update
A guide for rural hospital leadership that identifies best practices in care management. Addresses care management roles and staffing needs and covers utilization review and discharge planning. Helps identify opportunities for process improvement. Also discusses competencies needed to transition to a value-based reimbursement environment focused on population health.
Author(s): Stroudwater
Date: 08/2019
Type: Document
Sponsoring organization: National Rural Health Resource Center
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Patient Experience and Function, Fall 2018 Cycle: CDP Report
Evaluates 5 new measures related to patient function and experience of care and supports using them for quality improvement efforts and public reporting. Measures focus on care coordination, particularly following discharge in order to reduce hospital readmissions. Includes Critical Access Hospitals under acute care hospitals, with exclusions for swing bed stays.
Date: 08/2019
Type: Document
Sponsoring organization: National Quality Forum
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