Rural Health
Resources by Topic: Health insurance
Calendar Year (CY) 2015 Rural Health Clinic (RHC) and Federally Qualified Health Centers (FQHC) Updates: Payment Rate Increases for RHCs and FQHCs Billing Under the All-Inclusive Rate System (AIR), and Urban and Rural Designations for FQHCs Billing Under the AIR
Provides updates for RHCs and FQHCs that are submitting claims to Medicare Administrative Contractors (MACs) for services to Medicare beneficiaries.
Date: 12/2024
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Provides updates for RHCs and FQHCs that are submitting claims to Medicare Administrative Contractors (MACs) for services to Medicare beneficiaries.
Date: 12/2024
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Transforming Oral Health Care in North Carolina
Makes recommendations for improving oral health access, supporting oral care workforce and providers, and promoting oral health quality and equity in North Carolina. Discusses oral health in rural and underserved areas throughout, including coverage of workforce distribution, dental safety net, and access barriers.
Date: 04/2024
Type: Document
Sponsoring organization: North Carolina Institute of Medicine
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Makes recommendations for improving oral health access, supporting oral care workforce and providers, and promoting oral health quality and equity in North Carolina. Discusses oral health in rural and underserved areas throughout, including coverage of workforce distribution, dental safety net, and access barriers.
Date: 04/2024
Type: Document
Sponsoring organization: North Carolina Institute of Medicine
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Medicare and Medicaid Programs: Minimum Staffing Standards for Long-Term Care Facilities and Medicaid Institutional Payment Transparency Reporting Final Rule (CMS 3442-F)
Fact sheet providing an overview of the Centers for Medicare & Medicaid Services (CMS) final rule for minimum staffing standards for long-term care facilities. Details three core staffing proposals: 1) minimum nurse staffing standards; 2) a requirement to have an RN onsite 24 hours a day, seven days a week; and 3) enhanced facility assessment requirements. Outlines a staggered implementation approach, including a later implementation date for rural facilities, and hardship exemption qualification requirements. Also describes Medicaid payment transparency reporting provisions for nursing and intermediate care facilities related to the percentage of Medicaid funds spent on compensation to direct care workers and support staff.
Additional links: External FAQs
Date: 04/2024
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) final rule for minimum staffing standards for long-term care facilities. Details three core staffing proposals: 1) minimum nurse staffing standards; 2) a requirement to have an RN onsite 24 hours a day, seven days a week; and 3) enhanced facility assessment requirements. Outlines a staggered implementation approach, including a later implementation date for rural facilities, and hardship exemption qualification requirements. Also describes Medicaid payment transparency reporting provisions for nursing and intermediate care facilities related to the percentage of Medicaid funds spent on compensation to direct care workers and support staff.
Additional links: External FAQs
Date: 04/2024
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Quality in Motion: Acting on the CMS National Quality Strategy
Provides an overview of the Centers for Medicare & Medicaid Services (CMS) 2022 National Quality Strategy (NQS). Describes actions CMS has taken to meet the eight NQS goals across four priority areas: outcomes and alignment, equity and engagement, safety and resiliency, and interoperability and scientific achievement. Includes rural references throughout.
Date: 04/2024
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Provides an overview of the Centers for Medicare & Medicaid Services (CMS) 2022 National Quality Strategy (NQS). Describes actions CMS has taken to meet the eight NQS goals across four priority areas: outcomes and alignment, equity and engagement, safety and resiliency, and interoperability and scientific achievement. Includes rural references throughout.
Date: 04/2024
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Medicare Accountable Care Organizations: Past Performance and Future Directions
Summarizes research findings about Medicare accountable care organizations (ACOs) from recent peer-reviewed journals, official evaluations of Medicare ACOs, and research organization reports. Describes characteristics of certain ACOs associated with greater savings and factors that limit ACOs' ability to achieve net budgetary savings for the Medicare program. Identifies policy approaches that could increase savings for Medicare through ACOs and the Medicare Shared Savings Program. Includes a brief discussion of challenges facing ACOs in rural and underserved areas.
Date: 04/2024
Type: Document
Sponsoring organization: Congressional Budget Office
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Summarizes research findings about Medicare accountable care organizations (ACOs) from recent peer-reviewed journals, official evaluations of Medicare ACOs, and research organization reports. Describes characteristics of certain ACOs associated with greater savings and factors that limit ACOs' ability to achieve net budgetary savings for the Medicare program. Identifies policy approaches that could increase savings for Medicare through ACOs and the Medicare Shared Savings Program. Includes a brief discussion of challenges facing ACOs in rural and underserved areas.
Date: 04/2024
Type: Document
Sponsoring organization: Congressional Budget Office
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Evaluation of the Maryland Total Cost of Care Model: Progress Report
Provides an overview of the Maryland Total Cost of Care Model and evaluates the first four years of the program, 2019-2022. Explores the effects of the model on Medicare spending; service use, including preventable hospital use; and healthcare quality measures. Estimates the potential impact of switching Maryland to the Medicare prospective payment system (PPS) on Medicare spending and service use, including implications for rural and safety net hospitals.
Additional links: Appendices, Findings at a Glance, Transformation Spotlight
Date: 04/2024
Type: Document
Sponsoring organizations: Centers for Medicare and Medicaid Services, Mathematica
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Provides an overview of the Maryland Total Cost of Care Model and evaluates the first four years of the program, 2019-2022. Explores the effects of the model on Medicare spending; service use, including preventable hospital use; and healthcare quality measures. Estimates the potential impact of switching Maryland to the Medicare prospective payment system (PPS) on Medicare spending and service use, including implications for rural and safety net hospitals.
Additional links: Appendices, Findings at a Glance, Transformation Spotlight
Date: 04/2024
Type: Document
Sponsoring organizations: Centers for Medicare and Medicaid Services, Mathematica
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Medicare Payment for Rural or Geographically Isolated Hospitals
Displays data on Medicare payment adjustments for Sole Community Hospitals, Medicare-Dependent Hospitals, Low-Volume Hospitals, and Critical Access Hospitals. Includes information on the number of qualifying hospitals by state and eligibility criteria.
Date: 04/2024
Type: Document
Sponsoring organization: Congressional Research Service
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Displays data on Medicare payment adjustments for Sole Community Hospitals, Medicare-Dependent Hospitals, Low-Volume Hospitals, and Critical Access Hospitals. Includes information on the number of qualifying hospitals by state and eligibility criteria.
Date: 04/2024
Type: Document
Sponsoring organization: Congressional Research Service
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Protecting, Connecting and Thriving: Rural Public Health and Healthcare
Webinar recording of a panel discussing rural public health topics including rural health disparities, mortality, COVID-19, Medicaid coverage, primary care, graduate medical education, and services for veterans. Transcript is available in the video description.
Date: 04/2024
Type: Video/Multimedia
Sponsoring organizations: The RURAL Study, University of Texas Health Science Center at San Antonio
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Webinar recording of a panel discussing rural public health topics including rural health disparities, mortality, COVID-19, Medicaid coverage, primary care, graduate medical education, and services for veterans. Transcript is available in the video description.
Date: 04/2024
Type: Video/Multimedia
Sponsoring organizations: The RURAL Study, University of Texas Health Science Center at San Antonio
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Merit-Based Incentive Payment System (MIPS): 2024 Merit-Based Incentive Payment (MIPS) Value Pathways (MVPs) Implementation Guide
Provides an overview of the Merit-based Incentive Payment System (MIPS) Value Pathways (MVPs), a voluntary reporting option that can be used to meet MIPS reporting requirements beginning with the 2024 performance year. Describes subgroup reporting, reporting requirements, scoring, performance feedback and public reporting, and how to register to report an MVP. Includes information on considerations and exceptions for small practices and clinicians in a rural or Health Professional Shortage Area.
Date: 04/2024
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Provides an overview of the Merit-based Incentive Payment System (MIPS) Value Pathways (MVPs), a voluntary reporting option that can be used to meet MIPS reporting requirements beginning with the 2024 performance year. Describes subgroup reporting, reporting requirements, scoring, performance feedback and public reporting, and how to register to report an MVP. Includes information on considerations and exceptions for small practices and clinicians in a rural or Health Professional Shortage Area.
Date: 04/2024
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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A Lack of Behavioral Health Providers in Medicare and Medicaid Impedes Enrollees' Access to Care
Examines the availability of behavioral health providers who actively serve Medicare or Medicaid enrollees in 20 counties, 10 urban and 10 rural, across 10 states in 2021. Explores the extent to which traditional Medicare, Medicare Advantage, and Medicaid enrollees received behavioral health services and whether they used telehealth or in-person services. Offers recommendations to encourage more behavioral health providers to serve these enrollees and expand coverage to additional behavioral health provider types. Includes rural and urban comparisons throughout.
Additional links: Report Highlights
Date: 03/2024
Type: Document
Sponsoring organization: Office of Inspector General (HHS)
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Examines the availability of behavioral health providers who actively serve Medicare or Medicaid enrollees in 20 counties, 10 urban and 10 rural, across 10 states in 2021. Explores the extent to which traditional Medicare, Medicare Advantage, and Medicaid enrollees received behavioral health services and whether they used telehealth or in-person services. Offers recommendations to encourage more behavioral health providers to serve these enrollees and expand coverage to additional behavioral health provider types. Includes rural and urban comparisons throughout.
Additional links: Report Highlights
Date: 03/2024
Type: Document
Sponsoring organization: Office of Inspector General (HHS)
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