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Rural Health Information Hub

Rural Healthcare Quality – Resources

Selected recent or important resources focusing on Rural Healthcare Quality.

The Codes of Care: How Words and Numbers Have Transformative Power for Rural Healthcare
Describes the process of translating clinical documentation into medical codes and the impact coding has on healthcare quality and population health. Highlights coding issues specific to rural settings. Also discusses graduate medical education efforts addressing clinical documentation and medical coding.
Author(s): Kay Miller Temple
Date: 04/2022
Sponsoring organization: Rural Health Information Hub
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Digital Quality Measurement Strategic Roadmap
Discusses how the interoperability of healthcare data from electronic health records can improve Centers for Medicare & Medicaid Services (CMS) quality measurement systems. Outlines actions in four domains - improving data quality, advancing technology, optimizing data aggregation, and enabling alignment of measures - to advance digital quality measurement.
Date: 03/2022
Sponsoring organization: Centers for Medicare and Medicaid Services
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Quality of Home Health Agencies Serving Rural Medicare Beneficiaries
Describes a study examining the quality of home health agencies (HHAs) that serve rural beneficiaries, based on ratings from the Centers for Medicare and Medicaid Services star rating system. Features statistics including characteristics of HHAs, patient care ratings, and patient experience ratings in 2018 by rural-serving status.
Date: 02/2022
Sponsoring organization: WWAMI Rural Health Research Center
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Quality of Skilled Nursing Facilities Serving Rural Medicare Beneficiaries
Policy paper describing a study examining the quality of skilled nursing facilities (SNFs) that serve rural beneficiaries, based on ratings from the Centers for Medicare and Medicaid Services star rating system. Features statistics including characteristics of SNFs, overall star ratings, and staff star ratings in 2018 by rural-serving status.
Date: 02/2022
Sponsoring organization: WWAMI Rural Health Research Center
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High-Performing Rural Health System
Update to the September 2011 RUPRI Health Panel document "The High Performance Rural Health Care System of the Future." Describes affordable and accessible healthcare for all rural residents through a sustainable system delivering high quality, high value services. Defines pillars of accessibility, affordability, community health, and quality.
Author(s): Andrew Coburn, Alva O. Ferdinand, Alana Knudson, et al.
Date: 01/2022
Sponsoring organization: Rural Policy Research Institute Rural Health Panel
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Rural Telehealth and Healthcare System Readiness Measurement Framework: Final Report
Presents a performance measurement framework to guide quality and performance improvement for healthcare services delivered via telehealth in rural areas in response to disasters. Covers five domains — access to care and technology; costs, business models, and logistics; experience; effectiveness; and equity — rural-specific measurement issues, and potential solutions. Includes recommendations for rural telehealth measurement for time-sensitive emergencies, public health emergencies, and disasters.
Date: 11/2021
Sponsoring organization: National Quality Forum
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Medicare: Information on the Transition to Alternative Payment Models by Providers in Rural, Health Professional Shortage, or Underserved Areas
Describes the participation of providers in rural and health professional shortage areas in Advanced APMs from 2017 through 2019. Discusses challenges providers in rural, shortage, and underserved areas face in transitioning to APMs, as well as actions CMS takes to help these providers transition to APMs. Includes data by practice and provider type.
Additional links: Full Report
Date: 11/2021
Sponsoring organization: Government Accountability Office
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Medicare: Provider Performance and Experiences Under the Merit-Based Incentive Payment System
Examines Centers for Medicare and Medicaid Services (CMS) data on Merit-Based Incentive Payment System (MIPS) performance category scores, final scores, and payment adjustments from performance years 2017 through 2019. Summarizes interviews with 11 stakeholder groups and identifies strengths and challenges of the MIPS program. Presents data on MIPS performance scores and related payment adjustments by practice size, geographic location, method of participation, and specialty.
Additional links: Full Report
Date: 10/2021
Sponsoring organization: Government Accountability Office
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Place Matters: Closing the Gap on Rural Primary Care Quality Improvement Capacity - The Healthy Hearts Northwest Study
Compares the primary care practices in rural and urban settings in Washington, Oregon, and Idaho. Looks at quality improvement capacity, performance metrics, and workforce issues, among other measures.
Author(s): Lyle J. Fagnan, Katrina Ramsey, Caitlin Dickinson, et al.
Citation: The Journal of the American Board of Family Medicine, 34 (4), 753-761
Date: 07/2021
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Leveraging Quality Measurement to Improve Rural Health, Telehealth, and Healthcare System Readiness: Final Environmental Scan Report
Presents the results of an environmental scan of literature related to barriers and facilitators of rural telehealth for healthcare system readiness, as well as a scan of quality measures relevant to rural telehealth during emergencies. Summarizes policies and practices related to telehealth and the healthcare system, with a focus on federal policy changes due to the COVID-19 pandemic.
Date: 07/2021
Sponsoring organization: National Quality Forum
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Last Updated: 1/27/2026