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Rural Home Health Services – Resources

Selected recent or important resources focusing on Rural Home Health Services.

Impact of Higher Payments for Rural Home Health Episodes on Rehospitalizations
Examines the impact of home health rural add-on payments on beneficiary outcomes, specifically on rehospitalizations. Uses Medicare data from 2007 to 2014 to compare rehospitalizations between rural and urban post-acute home health episodes before and after the implementation of the add-on payments in 2010. Discusses the implications of the findings on home health payment policy.
Author(s): Lacey Loomer, Momotazur Rahman, Tracy M. Mroz, Pedro L. Gozalo, Vincent Mor
Citation: Journal of Rural Health, 39(3), 604-610
Date: 06/2023
Type: Document
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Home Health Agencies: CMS Flexibilities to Fight COVID-19
Outlines specific regulatory waivers and Medicare flexibilities for home health agencies issued in response to the COVID-19 pandemic. Includes information on whether each waiver or flexibility has been terminated, will end at the conclusion of the public health emergency, or has become permanent.
Date: 05/2023
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Public Law 117–328: Consolidated Appropriations Act, 2023
Text of the Consolidated Appropriations Act, 2023, Public Law 117-328 (December 29, 2022). Section 4113 extends certain COVID-19 telehealth flexibilities, including the ability of Rural Health Clinics and Federally Qualified Health Centers to serve as distant site providers, through December 31, 2024. Section 4137 authorizes the extension of a 1% add-on payment for home health services provided in high-utilization rural counties through 2023.
Date: 12/2022
Type: Document
Sponsoring organization: U.S. Congress
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Mandated Analysis of Home Health Service Utilization From January 2016 Through March 2022
Report evaluates the distribution of rural add-on payments for home health claims. Examines the results of the Centers for Medicare and Medicaid Services's new rural add-on methodology aimed at providing higher add-on percentages for "low population density" categories and explores the effect this methodology has had on "high utilization" categories. Makes comments and recommendations as to how this methodology can be adjusted.
Additional links: Report in Brief
Date: 12/2022
Type: Document
Sponsoring organization: Office of Inspector General (HHS)
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Who Will Care for Rural Older Adults? Measuring the Direct Care Workforce in Rural Areas
Policy brief examining existing disparities in the supply of home health aides and nursing assistants in rural areas compared to urban areas. Features statistics on the ratio of home health aides and nursing assistants relative to the population of adults age 65 and above, with breakdowns by urban and rural areas and by census region.
Author(s): Janette Dill, Carrie Henning-Smith, Rongxuan Zhu, Elizabeth Vomacka
Date: 11/2022
Type: Document
Sponsoring organization: University of Minnesota Rural Health Research Center
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Patterns of Health Care Use among Rural-Urban Medicare Beneficiaries Age 85 and Older, 2010-2017
Policy brief examining how rural and urban Medicare beneficiaries age 85+ differ in terms of their socioeconomic and health characteristics that may inform healthcare use. Features statistics on trends in healthcare use, including inpatient and emergency department care, outpatient and prescription services, specialists and dentists, and home health and durable medical equipment, with breakdowns by urban and rural location.
Author(s): Yvonne Jonk, Heidi O'Connor, Amanda Burgess, Carly Milkowski
Date: 11/2022
Type: Document
Sponsoring organization: Maine Rural Health Research Center
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Rural and Urban Differences in Care Provided by Home Health Agencies in the United States: A Review of the Literature
Explores the differences in care outcomes for rural and urban home health agencies (HHAs). Discusses some of the barriers faced by rural HHAs, such as overcoming long distances, increased costs, and workforce limitations, among others.
Author(s): Denise D. Quigley, Ashley M. Chastain, Jung A. Kang, et al.
Citation: The Journal of Post-Acute and Long-Term Care Medicine, 23(10), 1653.e1-1653.e13
Date: 10/2022
Type: Document
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Home Health Agencies Used Multiple Strategies to Respond to the COVID-19 Pandemic, Although Some Challenges Persist
Presents results of a survey of home health agencies (HHAs) conducted between September through December 2021 to explore the challenges they faced during the COVID-19 pandemic. Discusses challenges related to staffing, infection control, the use of telehealth, and the adequacy of emergency preparedness plans, as well as challenges specific to rural HHAs. Provides recommendations for how the Centers for Medicare & Medicaid Services (CMS) can help HHAs prepare for and respond to current and future infectious disease outbreaks and changes to the home health care landscape.
Date: 10/2022
Type: Document
Sponsoring organization: Office of Inspector General (HHS)
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Availability of Home Health Services in Minoritized Racial/Ethnic Group Areas
Explores the availability of home health care nationwide across ZIP Code Tabulation Areas (ZCTAs) categorized by rurality and racial and ethnic composition. Provides data on the characteristics of home health agencies that serve rural areas and a high proportion of minoritized ethnic and racial groups, as well as the percent of ZCTAs served by one or no home health agencies by Rural-Urban Commuting Area (RUCA) Code.
Author(s): Janice C. Probst, Gabriel Benavidez, Nicholas Yell, Jan Eberth, Melinda Merrell
Date: 08/2022
Type: Document
Sponsoring organization: Rural and Minority Health Research Center (formerly the South Carolina Rural Health Research Center)
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Report to Congress: Unified Payment for Medicare-Covered Post-Acute Care
Presents a prototype for a Unified Post-acute Care (PAC) prospective payment system (PPS) that would set payment for PAC services on the basis of the clinical characteristics of the patient rather than the type of provider. Details the structure of the prototype and the data used in the analyses to design and calibrate the PPS. Explores key considerations for unifying PAC payment, such as cost-sharing and value-based payment. Includes data on PAC provider characteristics, including facility size and rural status, as well as rural payment adjustments.
Additional links: Appendices
Author(s): Benjamin Silver, Anne Deutsch, Nicole Coomer, et al.
Date: 07/2022
Type: Document
Sponsoring organizations: Centers for Medicare and Medicaid Services, RTI International
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Last Updated: 4/22/2024