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Rural Health Information Hub

Rural Health
Resources by Topic: Medicare

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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Medicare Part D Enrollee Vaccine Use After Elimination of Cost Sharing for Recommended Vaccines in 2023
A report from the Inflation Reduction Act (IRA) Research Series that provides data on Medicare Part D enrollees who received vaccinations after the IRA legislated in 2023 that adult vaccinations recommended by the Advisory Committee on Immunization Practices (ACIP) would be provided at no cost. Includes data breakdowns of total and type of vaccinations received and Medicare Part D enrollee demographic characteristics, such as state and urban versus rural/unknown location.
Author(s): Bisma A. Sayed, Yevgeniy Feyman, Kristen L. King, et al.
Date: 05/2024
Type: Document
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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Medicare Advantage Plan Growth in Rural America: Availability of Supplemental Benefits
Examines supplemental benefits of Medicare Advantage (MA) plans, categorized as traditional health benefit, expanded health benefit, and special benefit for the chronically ill. Utilizes 2022 Centers for Medicare & Medicaid Services (CMS) data to analyze availability of and benefits offered in MA plans according to metro, micro, and noncore location. Includes county-level maps of MA data organized by U.S. region.
Author(s): Edmer Lazaro, Dan M. Shane, Fred Ullrich, Keith Mueller
Date: 05/2024
Type: Document
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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The State of Medicare Supplement Coverage: Trends in Enrollment and Demographics
Provides an overview of Medicare Supplement, or Medigap, coverage and coverage options. Examines the demographics of Medicare enrollees with Medicare Supplement policies and enrollment trends. Includes demographic data on rural Medicare Supplement policyholders.
Date: 05/2024
Type: Document
Sponsoring organization: AHIP
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Annual Insurance Update 2024: Health Insurance in Kansas
Reports on health insurance coverage across Kansas and nationwide, including 2009-2022 trends in coverage. Presents 2021 county-level data on uninsured rates by age group and urban/rural classification, as well as Medicaid and Children's Health Insurance Program (CHIP) enrollment by county.
Author(s): Angela S Wu, Kaci Cink, Cynthia Snyder, Wen-Chieh Lin
Date: 04/2024
Type: Document
Sponsoring organization: Kansas Health Institute
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April 2024 MedPAC Meeting Transcript
Transcript from the Medicare Payment Advisory Commission's (MedPAC) April 2024 meeting. Covers telehealth in Medicare, alternative approaches to lowering Medicare payments for select conditions in inpatient rehabilitation facilities, approaches for updating the Medicare physician fee schedule, initial findings from an analysis of Medicare Part B payment rates and 340B ceiling prices, and more. Includes discussion of telehealth in rural areas and data on telehealth use in Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs) between 2020 and 2022.
Additional links: Telehealth in Medicare: Status Report - Presentation Slides
Date: 04/2024
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Survey Emphasizes Scale and Significance of the RHC Program
Summarizes results of a 2024 national survey of 930 Rural Health Clinics. Presents data on the average payer mix, use and attitude toward telehealth services, Medicare Advantage (MA) contract structures, and MA reimbursement relative to traditional Medicare reimbursement, and more.
Additional links: NARHC 2024 Policy Survey Results
Date: 04/2024
Type: Document
Sponsoring organization: National Association of Rural Health Clinics
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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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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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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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