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Rural Health
Resources by Topic: Reimbursement and payment models

MedPAC Report to the Congress: Medicare Payment Policy: Hospice Services: Chapter 9
Discusses payment adequacy for hospice and palliative support services. Includes data on average costs by day and aggregate margins by urban and rural status, as well as demographics on Medicare decedents who used hospice during 2010 and between 2018-2022. Compares the actual hospice utilization rates in micropolitan, rural adjacent, rural nonadjacent, and frontier areas to urban hospice utilization rates.
Date: 03/2024
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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MedPAC Report to the Congress: Medicare Payment Policy, 2024
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 Medicare fee-for-service payment systems, Medicare Advantage (MA), and Medicare Part D. Includes two mandated reports on special needs plans for beneficiaries dually eligible for Medicare and Medicaid and the Rural Emergency Hospital (REH) designation.
Date: 03/2024
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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COVID-19 Affected Rural and Urban Hospital Uncompensated Care
Offers data comparing the impact of COVID-19 on uncompensated hospital care on rural and urban facilities using Medicare Cost Report data for acute care hospitals. Discusses uncompensated care trends over time and analyzes operating expenses.
Author(s): Emmaline Keesee
Date: 03/2024
Type: Document
Sponsoring organization: The Cecil G. Sheps Center for Health Services Research
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The 340B Drug Pricing Program: A Small Part of the Prescription Drug Market, Delivering Large Benefits to Patients and Communities
Analyzes impacts of the 340B Drug Pricing Program on access, hospital finance, drug companies, and public expenditures. Discusses how the 340B program is shaped by legislation, policy, finance, prescribing patterns, and market influences. Highlights rural and underserved communities throughout.
Date: 03/2024
Type: Document
Sponsoring organization: American Hospital Association
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Hearing on Enhancing Access to Care at Home in Rural and Underserved Communities
Recording of a March 12, 2024, House Committee on Ways and Means hearing regarding opportunities and challenges to enhance access to care in patients' homes and modernizing care in rural and underserved communities, with a focus on telehealth and health information technology. Features testimony from two rural patients and representatives from Intermountain Health; Cadence, a company with expertise in chronic care management through remote physiologic monitoring; and Harvard Medical School and Beth Israel Deaconess Medical Center.
Additional links: Ateev Mehrotra, Harvard Medical School and Beth Israel Deaconess Medical Center - Testimony, Bell Maddux, Home Dialysis Patient - Testimony, Chris Altchek, Cadence - Testimony, Nathan Starr, Intermountain Health - Testimony, Roy Underhill, Hospital at Home Patient - Testimony
Date: 03/2024
Type: Video/Multimedia
Sponsoring organization: House Ways and Means Committee
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Generic Drug Utilization and Spending Among Medicare Part D Enrollees in 2022
Issue brief on prescriptions for generic drugs filled by Medicare Part D enrollees using 2022 Part D prescription drug event (PDE) data. Covers commonly used prescription drugs, costs, and conditions treated, and includes data breakdowns by plan type, race and ethnicity, and level of rurality throughout. Discusses formulary design to improve access by promoting affordability and reducing confusion among enrollees.
Author(s): Yevgeniy Feyman, Bisma Sayed, Kenneth Finegold, et al.
Date: 03/2024
Type: Document
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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Merit-based Incentive Payment System (MIPS) 2024 Small Practice Eligibility and Participation Frequently Asked Questions
Provides answers to frequently asked questions regarding small practice participation and eligibility for the Merit-based Incentive Payment System (MIPS) for the 2024 performance year. Covers individual and group eligibility, the low-volume threshold, changes to group composition during the performance year, and more.
Date: 03/2024
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Catalog of Value-Based Initiatives for Rural Providers
Summarizes rural-relevant, value-based programs currently or recently implemented by the U.S. Department of Health and Human Services (HHS), including the Centers for Medicare and Medicaid Services (CMS) and the CMS Innovation Center. Designed to help rural healthcare leaders identify HHS value-based programs that are suitable for rural participation. Contains descriptions of each demonstration and provides direct links to the corresponding agency web page.
Date: 03/2024
Type: Document
Sponsoring organization: Rural Health Value
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Rural Health Research Recap: Post-Acute Care in Rural Areas: The Role of Swing Beds and Nursing Homes
Offers statistics on availability of post-acute care in rural areas through skilled nursing facilities, home health agencies, hospice, inpatient rehabilitation facilities, and swing beds. Includes sections on prospective payment system and cost-based reimbursement, and provides statistics on the proportion of nursing home closures in metropolitan and nonmetropolitan areas from 2008-2018.
Author(s): Per Ostmo
Date: 03/2024
Type: Document
Sponsoring organization: Rural Health Research Gateway
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Merit-Based Incentive Payment System (MIPS): 2024 Improvement Activities Performance Category Quick Start Guide
Provides an overview of Merit-based Incentive Payment System (MIPS) requirements, data collection, and data submission for the improvement activities performance category for the 2024 performance year. Includes information about special status scoring for small practices and clinicians located in a rural or Health Professional Shortage Area.
Date: 03/2024
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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