Rural Health Policy – Resources
Selected recent or important resources focusing on Rural Health Policy.
The Pennsylvania Rural Health Model (PARHM): Third Annual Evaluation Report
Evaluates the third performance year of the Pennsylvania Rural Health Model (PARHM), an initiative designed to test if global budgets can help rural hospitals improve their financial viability, provide flexibility to meet locally defined community health needs, and reduce overall healthcare spending. Provides an overview of the model and describes the implementation experience of participating hospitals and payers. Presents a descriptive quantitative assessment of financial performance, spending and utilization, access to care, and quality of care outcomes from 2016, the model's baseline, through 2021. Includes three case studies discussing three themes: the recruitment and retention of system-affiliated hospitals, engagement and coordination with community organizations and providers, and exploring service line changes.
Additional links: Appendix, Findings at a Glance
Date: 09/2023
Type: Document
Sponsoring organizations: Centers for Medicare and Medicaid Services, NORC at the University of Chicago
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Evaluates the third performance year of the Pennsylvania Rural Health Model (PARHM), an initiative designed to test if global budgets can help rural hospitals improve their financial viability, provide flexibility to meet locally defined community health needs, and reduce overall healthcare spending. Provides an overview of the model and describes the implementation experience of participating hospitals and payers. Presents a descriptive quantitative assessment of financial performance, spending and utilization, access to care, and quality of care outcomes from 2016, the model's baseline, through 2021. Includes three case studies discussing three themes: the recruitment and retention of system-affiliated hospitals, engagement and coordination with community organizations and providers, and exploring service line changes.
Additional links: Appendix, Findings at a Glance
Date: 09/2023
Type: Document
Sponsoring organizations: Centers for Medicare and Medicaid Services, NORC at the University of Chicago
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Mental Health Matters: Policy Framework on Workforce Mental Health
Policy framework designed to support the development of workforce mental health policies. Discusses nondiscrimination, workplace supports, rural communities, workforce shortages and more.
Date: 08/2023
Type: Document
Sponsoring organization: National Conference of State Legislatures
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Policy framework designed to support the development of workforce mental health policies. Discusses nondiscrimination, workplace supports, rural communities, workforce shortages and more.
Date: 08/2023
Type: Document
Sponsoring organization: National Conference of State Legislatures
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Rural Emergency Hospitals: Legislative and Regulatory Considerations for States
Provides an overview of the Rural Emergency Hospital designation, including licensure and federal requirements for the designation that states must consider before pursuing legislation for REH licensure. Presents a table comparing how 14 states addressed these considerations. Offers legislation to assist states that want to pursue the model.
Additional links: Guide to Legislative and Regulatory Considerations for States
Author(s): Vicki Veltri, Rebekah Falkner
Date: 08/2023
Type: Document
Sponsoring organization: National Academy for State Health Policy
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Provides an overview of the Rural Emergency Hospital designation, including licensure and federal requirements for the designation that states must consider before pursuing legislation for REH licensure. Presents a table comparing how 14 states addressed these considerations. Offers legislation to assist states that want to pursue the model.
Additional links: Guide to Legislative and Regulatory Considerations for States
Author(s): Vicki Veltri, Rebekah Falkner
Date: 08/2023
Type: Document
Sponsoring organization: National Academy for State Health Policy
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A Consensus Panel Approach to Estimating the Start-Up and Annual Service Costs for Rural Ambulance Agencies
Policy brief exploring the costs of running ambulance services for 3 population-based service tiers. Establishes a minimum access standard for ambulances servicing a 25-minute travel time from the ambulance station, and enables policymakers and community stakeholders to develop strategic plans for the financing and provision of ambulance services. Features statistics on number of calls, population ranges of service areas, and fixed, depreciation, variable, and administrative costs.
Author(s): Yvonne Jonk, Gary Wingrove, Nikiah Nudell, Kevin McGinnis
Date: 08/2023
Type: Document
Sponsoring organization: Maine Rural Health Research Center
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Policy brief exploring the costs of running ambulance services for 3 population-based service tiers. Establishes a minimum access standard for ambulances servicing a 25-minute travel time from the ambulance station, and enables policymakers and community stakeholders to develop strategic plans for the financing and provision of ambulance services. Features statistics on number of calls, population ranges of service areas, and fixed, depreciation, variable, and administrative costs.
Author(s): Yvonne Jonk, Gary Wingrove, Nikiah Nudell, Kevin McGinnis
Date: 08/2023
Type: Document
Sponsoring organization: Maine Rural Health Research Center
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Distributional Analysis of Variation in Medicare Advantage Participation Within and Between Metropolitan, Micropolitan, and Noncore Counties
Policy brief identifying penetration rates, number of plans, and enrollment patterns and trends in Medicare Advantage participation in metropolitan and nonmetropolitan counties from 2017-2022. Features statistics with breakdowns by year and metropolitan, micropolitan, and noncore areas.
Author(s): Dan Shane, Ufuoma Ejughemre, Fred Ullrich, Keith Mueller
Date: 08/2023
Type: Document
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Policy brief identifying penetration rates, number of plans, and enrollment patterns and trends in Medicare Advantage participation in metropolitan and nonmetropolitan counties from 2017-2022. Features statistics with breakdowns by year and metropolitan, micropolitan, and noncore areas.
Author(s): Dan Shane, Ufuoma Ejughemre, Fred Ullrich, Keith Mueller
Date: 08/2023
Type: Document
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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FY 2024 Hospital Inpatient Prospective Payment System (IPPS) and Long-Term Care Hospital Prospective Payment System (LTCH PPS) Final Rule — CMS-1785-F and CMS-1788-F Fact Sheet
Fact sheet providing an overview of the Centers for Medicare & Medicaid Services (CMS) fiscal year 2024 hospital inpatient prospective payment system (IPPS) and long-term care hospital prospective payment system (LTCH PPS) final rule. Includes information about the low-wage index hospital policy, Rural Emergency Hospitals (REHs) being allowed to receive Medicare Graduate Medical Education (GME) payments, changes to the rural wage index calculation methodology, and more.
Date: 08/2023
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Fact sheet providing an overview of the Centers for Medicare & Medicaid Services (CMS) fiscal year 2024 hospital inpatient prospective payment system (IPPS) and long-term care hospital prospective payment system (LTCH PPS) final rule. Includes information about the low-wage index hospital policy, Rural Emergency Hospitals (REHs) being allowed to receive Medicare Graduate Medical Education (GME) payments, changes to the rural wage index calculation methodology, and more.
Date: 08/2023
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Evaluation of the Vermont All-Payer Accountable Care Organization Model: Third Evaluation Report
Evaluates the first four and a half performance years of the Vermont All-Payer Accountable Care Organization Model (VTAPM), which aims to assess whether scaling an Accountable Care Organization (ACO) across all payers in the state can reduce program expenditures while preserving or improving care quality. Discusses the implementation of the model, provider engagement, efforts to address population health goals; characteristics of participating hospitals, practitioners, and beneficiaries; and the model's impacts on Medicare spending, utilization, and quality of care. Describes trends in substance use disorder diagnosis and treatment for Medicaid members. Outlines challenges and lessons learned, as well as areas for future research.
Additional links: Findings at a Glance, Technical Appendices
Date: 07/2023
Type: Document
Sponsoring organizations: Centers for Medicare and Medicaid Services, NORC at the University of Chicago
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Evaluates the first four and a half performance years of the Vermont All-Payer Accountable Care Organization Model (VTAPM), which aims to assess whether scaling an Accountable Care Organization (ACO) across all payers in the state can reduce program expenditures while preserving or improving care quality. Discusses the implementation of the model, provider engagement, efforts to address population health goals; characteristics of participating hospitals, practitioners, and beneficiaries; and the model's impacts on Medicare spending, utilization, and quality of care. Describes trends in substance use disorder diagnosis and treatment for Medicaid members. Outlines challenges and lessons learned, as well as areas for future research.
Additional links: Findings at a Glance, Technical Appendices
Date: 07/2023
Type: Document
Sponsoring organizations: Centers for Medicare and Medicaid Services, NORC at the University of Chicago
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Expanded Medical Training Could Help Hospitals in Rural, Underserved Areas
Describes actions taken by states to ensure adequate access to clinical training for medical graduates and address physician shortages in rural and underserved areas. Covers statewide collaboration and appropriations, Medicaid payments, and incentives for rural clinical training.
Author(s): Rachel Woolworth
Date: 07/2023
Type: Document
Sponsoring organization: National Conference of State Legislatures
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Describes actions taken by states to ensure adequate access to clinical training for medical graduates and address physician shortages in rural and underserved areas. Covers statewide collaboration and appropriations, Medicaid payments, and incentives for rural clinical training.
Author(s): Rachel Woolworth
Date: 07/2023
Type: Document
Sponsoring organization: National Conference of State Legislatures
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CY 2024 Medicare Hospital Outpatient Prospective Payment System and Ambulatory Surgical Center Payment System Proposed Rule (CMS 1786-P)
Fact sheet providing an overview of the Centers for Medicare & Medicaid Services (CMS) proposed rule for updates and changes to the Medicare payments for hospital outpatient and Ambulatory Surgical Center (ASC) services for calendar year 2024. Covers proposals regarding changes to the community mental health centers (CMHC) Conditions of Participation (CoPs); payment methodology for Indian Health Service (IHS) and tribal facilities that convert to Rural Emergency Hospital (REH) status; the Hospital Outpatient Quality Reporting (OQR), Ambulatory Surgical Center Quality Reporting (ASCQR), and Rural Emergency Hospital Quality Reporting (REHQR) Programs; and more.
Date: 07/2023
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Fact sheet providing an overview of the Centers for Medicare & Medicaid Services (CMS) proposed rule for updates and changes to the Medicare payments for hospital outpatient and Ambulatory Surgical Center (ASC) services for calendar year 2024. Covers proposals regarding changes to the community mental health centers (CMHC) Conditions of Participation (CoPs); payment methodology for Indian Health Service (IHS) and tribal facilities that convert to Rural Emergency Hospital (REH) status; the Hospital Outpatient Quality Reporting (OQR), Ambulatory Surgical Center Quality Reporting (ASCQR), and Rural Emergency Hospital Quality Reporting (REHQR) Programs; and more.
Date: 07/2023
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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MedPAC Report to the Congress: Medicare and the Health Care Delivery System, June 2023
Evaluates Medicare payment issues and provides recommendations to the U.S. Congress. Chapter 7 presents a report on the use, payment, and quality of telehealth services that Medicare pays for separately under the physician fee schedule (PFS). Also includes chapters on the cost of drugs covered under Medicare Part B, postsale rebates for prescription drugs in Medicare Part D, standardized benefits in Medicare Advantage plans, future directions for Medicare Advantage payment policy, disparities in outcomes for beneficiaries with different social risks, Medicare behavioral health services, the alignment of fee-for-service payment rates across ambulatory settings, and the evaluation of a post-acute care prospective payment system prototype.
Date: 06/2023
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Evaluates Medicare payment issues and provides recommendations to the U.S. Congress. Chapter 7 presents a report on the use, payment, and quality of telehealth services that Medicare pays for separately under the physician fee schedule (PFS). Also includes chapters on the cost of drugs covered under Medicare Part B, postsale rebates for prescription drugs in Medicare Part D, standardized benefits in Medicare Advantage plans, future directions for Medicare Advantage payment policy, disparities in outcomes for beneficiaries with different social risks, Medicare behavioral health services, the alignment of fee-for-service payment rates across ambulatory settings, and the evaluation of a post-acute care prospective payment system prototype.
Date: 06/2023
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Last Updated: 9/14/2023