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In March 2010, President Obama signed the Patient Protection and Affordable Care Act, or collectively referred to as the “Affordable Care Act” (ACA), into law. The ACA considerably changes the American health care system.  Debates about the best ways to improve health care now focus on implementation of the law and its effect on health care.

The ACA will continue to have significant impacts on patients, providers, and employers as provisions are implemented. This guide provides selected resources which examine these impacts from the perspective of rural health care.

Related Guides

News

Fate of 'Uninsurables' Hinges on Supreme Court
May 18, 2012 -- Seattle Times, (WA) article reports that State officials who administer the federal pre-existing condition plan in 27 states are trying to make fallback arrangements in case the law is invalidated and coverage suddenly terminates.

More States Work to Implement Health Care Law
May 17, 2012 -- Health and Human Services (HHS) Secretary Kathleen Sebelius announced yesterday that Illinois, Nevada, Oregon, South Dakota, Tennessee and Washington will receive more than $181 million in grants to help implement the new health care law by establishing Affordable Insurance Exchanges.

Health Insurance Issuers Implementing Medical Loss Ratio (MLR) Under the Patient Protection and Affordable Care Act; Correcting Amendment
May 16, 2012 -- This document from the Department of Health and Human Services corrects technical errors that appeared in the interim final rule published in the Federal Register on December 1, 2010, entitled “Health Insurance Issuers Implementing Medical Loss Ratio (MLR) Requirements under the Patient Protection and Affordable Care Act” and in the correction notice published in the Federal Register on December 30, 2010, entitled “Health Insurance Issuers Implementing Medical Loss Ratio (MLR) Requirements Under the Patient Protection and Affordable Care Act; Corrections to the Medical Loss Ratio Interim Final Rule With Request for Comments.”

HHS Launches New Web-Based Tool to Track Performance of Nation’s Health Care System
May 16, 2012 -- Health and Human Services (HHS) Secretary Kathleen Sebelius yesterday announced the launch of a new web-based tool that will make it easier for all Americans to monitor and measure how the nation’s health care system is performing.

Medical Loss Ratio Requirements Under the Patient Protection and Affordable Care Act; Final Rule
May 16, 2012 -- This final rule from the Department of Health and Human Services amends the regulations implementing medical loss ratio (MLR) standards for health insurance issuers under the Public Health Service Act in order to establish notice requirements for issuers in the group and individual markets that meet or exceed the applicable MLR standard in the 2011 MLR reporting year.

HRSA Webinar Announcement: Using Health IT for Care Coordination
May 11, 2012 -- The Health Resources and Services Administration (HRSA) will be holding a webinar on May 18, 2012, that focuses on using health information technology (IT) to help coordinate care among outpatient and inpatient safety net providers.

Proposed Rule; Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long- Term Care Hospital Prospective Payment System and Fiscal Year 2013 Rates; Hospitals’ Resident Caps for Graduate Medical Education Payment Purposes; Quality Reporting Requirements for Specific Providers and for Ambulatory Surgical Centers
May 11, 2012 -- Comments are being requested by the Centers for Medicare and Medicaid Services on a proposal to revise the Medicare hospital inpatient prospective payment systems (IPPS) for operating and capital-related costs of acute care hospitals to implement changes arising from their continuing experience with these systems and to implement certain statutory provisions contained in the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010 (collectively known as the Affordable Care Act) and other legislation.

Health Care Law Increases Payments to Doctors for Primary Care
May 10, 2012 -- Primary care physicians serving Medicaid patients would see their Medicaid payments rise under a proposed rule announced yesterday by Health and Human Services (HHS) Secretary Kathleen Sebelius.

HHS Announces Available Funding for Construction, Renovation of School-Based Health Centers
May 10, 2012 -- Health and Human Services (HHS) Secretary Kathleen Sebelius has announced the availability of funding for the construction and renovation of school-based health centers.

Health Care Increasingly Out of Reach for Millions of Americans
May 8, 2012 -- Kaiser Health News article reports that tens of millions of adults under 65, both those with insurance and those without, saw their access to health care dramatically worsen over the past decade, according to a study released Monday.

We Can't Wait: HHS Announces First 26 Health Care Innovation Awards
May 8, 2012 -- Health and Human Services (HHS) Secretary Kathleen Sebelius today announced the first batch of organizations for Health Care Innovation awards that will support 26 innovative projects nationwide that will save money, deliver high quality medical care and enhance the health care workforce.

Health Care Law Helps Community Health Centers Build, Renovate Facilities, Serve More Patients
May 1, 2012 -- New funding of more than $728 million from the Affordable Care Act will help build and expand community health centers, create jobs, and expand access to an additional 860,000 patients, according to Health and Human Services (HHS) Secretary Kathleen Sebelius.

Affordable Care Act Saved People on Medicare Over $3.4 Billion on Prescription Drugs
Apr 30, 2012 -- Due to the Affordable Care Act, seniors and people with disabilities with Medicare have saved a total of $3.4 billion on prescription drugs from the enactment of the law through March of 2012, according to recently released data from the Centers for Medicare & Medicaid Services (CMS).

HHS Announces New Affordable Care Act Options for Community Based Care
Apr 27, 2012 -- New opportunities in Medicaid and Medicare that will allow people to more easily receive care and services in their communities rather than being admitted to a hospital or nursing home were announced yesterday by Health and Human Services Secretary Kathleen Sebelius.

Rebates for Those Who Bought Their Own Insurance to Average $127 Per Person
Apr 27, 2012 -- Kaiser Health News brings together a variety of articles discussing how millions of consumers and small businesses will receive an estimated $1.3 billion in rebates from their health plans this summer under a provision of the health care law that requires insurance companies to pay refunds if they don't spend a high enough percentage of premium dollars on health care costs.

Commission of Leading Experts Unveils Plan to Improve Care for Chronically Ill Patients and Reduce Health Spending By $184 Billion Over the Next Decade
Apr 26, 2012 -- Noting the "unprecedented opportunity" provided under the Affordable Care Act, the Health Information Technology for Economic and Clinical Health (HITECH) Act, and other recently enacted federal laws, the Commonwealth Fund Commission on a High Performance Health System today unveiled a community-based plan to enhance health and reduce spending by improving care for chronically ill patients and targeting quality improvement efforts to conditions that can yield the greatest benefit in a relatively short time.

Report Shows Lower Costs in Medicare Due to the Affordable Care Act
Apr 24, 2012 -- The Medicare Program will save over $200 billion through 2016 due to the Affordable Care Act, and beneficiaries in traditional Medicare will enjoy $59.4 billion in lower costs, according to a report released yesterday by the Centers for Medicare & Medicaid Services (CMS).

Disparities Report Highlights Health Care Challenges for Racial and Ethnic Minorities
Apr 23, 2012 -- The latest National Healthcare Disparities Report released by the Agency for Healthcare Research and Quality (AHRQ) shows that access to health care was not improving for most racial and ethnic groups in the years 2002 through 2008 leading up to enactment of the Affordable Care Act.

Regulations, Forms & Other Useful Documents

Rural Implications of Geographic Rating of Health Insurance Premiums
Author(s): Andrew Coburn, Erika Ziller, Zach Croll, Elizabeth Kilbreth
Sponsoring organization: State Health Access Reform Evaluation
Examines how and to what extent states allow health plans to vary premiums by geographic rating area. Discusses strategies that federal and state policymakers might use to help ensure that premium variations based on geography are justified.
Date: 05 / 2012

Rural Relevance Under Healthcare Reform: A Performance-Based Assessment of Rural Health Care in America
Highlights the rural healthcare delivery systems using the latest Medicare shared Savings data files, the first nationwide hospital rating system to evaluate rural hospitals, and the industry’s largest proprietary rural Emergency Department database.
Date: 04 / 2012

Affordable Care Act: Real Help for Real Rural People
Author(s): Jon Bailey
Sponsoring organization: Center for Rural Affairs
Outlines how many rural residents and families have used or benefited from Affordable Care Act provisions.
Date: 04 / 2012

Mixed Methods Study of Management of Health Conditions in Rural Low-income Families: Implications for Health Care Policy in the USA
Author(s): Leigh Ann Simmons, Catherine Huddleston-Casas, Kari Morgan, Derek Feldman
Examines the health issues and health management strategies utilized by rural low-income women and their families. Explains how health care reform measures may improve individual health status and reduce rural health disparities if they are carefully implemented.
Journal citation: Rural and Remote Health Volume 12 Issue 1879
Date: 04 / 2012

Health Reform: What's in It?: Medicaid and Rural America
Author(s): Jon Bailey
Sponsoring organization: Center for Rural Affairs
Explains the different Medicaid programs and their importance to rural citizens. Describes Medicaid expansion under the Affordable Care Act.
Date: 02 / 2012

Income Divide in Health Care: How the Affordable Care Act Will Help Restore Fairness to the U.S. Health System
Author(s): Sara R. Collins, Ruth Robertson, Tracy Garber, Michelle M. Doty
Sponsoring organization: Commonwealth Fund
Presents results from a survey revealing data on uninsured adults and children living in poverty. Describes how the Affordable Care Act (ACA) will work to reduce these uninsured rates.
Date: 02 / 2012

Explaining Health Care Reform: How Will the Affordable Care Act Affect Small Businesses and Their Employees?
Sponsoring organization: Kaiser Family Foundation
Describes ACA initiatives that will be implemented between now and the year 2016 and affect small businesses in terms of insurance exchanges, penalties for not providing affordable coverage, tax credits, and grants for wellness programs.
Date: 01 / 2012

Modernizing Rural Health Care: Coverage, Quality and Innovation
Sponsoring organization: UnitedHealth Center for Health Reform and Modernization
Examines health needs of rural populations, and how well the health care system addresses them. Presents new data on rural care quality; on the views of people living in rural areas; rural networks; rural telemedicine; and what their physicians see as the major challenges to overcome. This is the sixth in a series of working papers by UnitedHealth Group focusing on health reform topics.
Date: 07 / 2011

Affordable Care Act, What's in it?: Rural Young Adults
Author(s): Alyssa Charney
Sponsoring organization: Center for Rural Affairs
Examines how the Affordable Care Act benefits young adults, specifically those in rural areas, with provisions that include the ability to remain on their parents’ policies, the creation of health insurance marketplaces, the elimination of pre-existing conditions, and incentives for employers to provide coverage.
Date: 06 / 2011

Opportunities and Challenges: Implementation of the Patient Protection and Affordable Care Act and the U.S. Pacific Territories
Sponsoring organization: Asian & Pacific Islander American Health Forum
Describes provisions in the Affordable Care Act that will benefit Americans living in the U.S. Territories by increasing access, ensuring quality and advancing prevention and public health.
Date: 05 / 2011

2011 Annual Report of the Boards of Trustees of the Federal Hospital Insurance and Federal Supplementary Medical Insurance Trust Funds
Author(s): Timothy F. Geithner, Hilda L. Solis, Kathleen Sebelius, Michael J. Astrue, Charles P. Blahous, Robert D. Reischauer, Donald M. Berwick
Presents the report to Congress on the financial and actuarial status of Medicare's Health Insurance (HI) and Supplementary Medical Insurance (SMI) trust funds. Includes provisions of the new Affordable Care Act (ACA) that affect Medicare and rural areas.
Date: 05 / 2011

Telemedicine: An Essential Technology for Reformed Healthcare
Describes the history of telemedicine in the U.S. and examines the role telemedicine plays in health system reform efforts nationally and internationally, including how it reduces barriers to care in rural areas.
Date: 05 / 2011

Realizing Health Reform's Potential: Maintaining Coverage, Affordability, and Shared Responsibility When Income and Employment Change
Author(s): Pamela Farley Short, Katherine Swartz, Namrata Uberoi, Deborah Graffe
Sponsoring organization: Commonwealth Fund
Describes four policy challenges related to the Affordable Care Act's (ACA) health insurance exchanges and subsidies: adjusting premium and cost-sharing subsidies when incomes change; coordinating eligibility for premium credits, Medicaid, and the Children’s Health Insurance Program (CHIP); encouraging and facilitating continuous coverage; and minimizing transitions between individual and small-business exchanges.
Date: 05 / 2011

High Performance Accountable Care: Building on Success and Learning from Experience
Author(s): Stuart Guterman, Stephen C. Schoenbaum, Karen Davis, et al.
Sponsoring organization: Commonwealth Fund
Describes accountable care organizations (ACOs) and the Medicare Shared Savings Program, a provision of the Affordable Care Act (ACA). Provides recommendations for ensuring the successful implementation and spread of ACOs to achieve the goals of a high performance health system.
Date: 04 / 2011

Opportunities and Challenges for Rural Hospitals in an Era of Health Reform
Sponsoring organization: American Hospital Association
Examines the challenges, including financial and workforce resources, facing rural hospitals as they implement the Patient Protection and Affordable Care Act.
Journal citation: TrendWatch
Date: 04 / 2011

Summary of New Health Reform Law
Sponsoring organization: Kaiser Family Foundation
Summarizes the provisions to expand coverage, control health care costs, and improve health care delivery system aspects of the Patient Protection and Affordable Care Act, and the changes made to the law by subsequent legislation. Aspects specific to rural and frontier areas are also included in this summary, which was last modified April 15, 2011.
Date: 04 / 2011

Report to Congress: National Strategy for Quality Improvement in Health Care
Sponsoring organization: U.S. Department of Health and Human Services
Discusses the National Strategy for Quality Improvement in Health Care (the National Quality Strategy) plan, which is required by law. Report describes the initial strategy and plans for implementation.
Date: 03 / 2011

Affordable Care Act, What's in It?: Health Insurance Exchanges That Work for Rural
Author(s): Jon M. Bailey
Sponsoring organization: Center for Rural Affairs
Examines rural issues and considerations in health insurance exchanges, an initiative of the Affordable Care Act (ACA). An exchange is an insurance marketplace for helping individuals and small businesses access affordable and quality health insurance.
Date: 03 / 2011

States and the Affordable Care Act: More Funding, More Flexibility
Sponsoring organization: U.S. Department of Health and Human Services
Argues that the Affordable Care Act provides states with significant flexibility and resources to improve health care benefits and protect consumers.
Date: 02 / 2011

Health Insurance Premiums: Past High Costs Will Become the Present and the Future Without Health Reform
Sponsoring organization: U.S. Department of Health and Human Services
Demonstrates how much families and businesses can save on health insurance premiums and out-of-pocket costs under the Affordable Care Act in 2014.
Date: 01 / 2011

Fact Sheet: What the New Health Care Law Means for People in Rural Areas
Sponsoring organization: AARP
Highlights provisions in the new health care law that are particularly important to those living in rural areas.
Date: 2011

Securing High Quality Health Care in Rural America: The Impetus for Change in the Affordable Care Act
Author(s): A. Clinton MacKinney, Jennifer P. Lundblad, Andrew F. Coburn, Timothy D. McBride, Keith J. Mueller
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
The ACA calls for the development of a National Health Care Quality Strategy and Plan (National Quality Strategy) that will affect health care that is delivered to millions of Americans who live in rural areas and thousands of health care providers who care for them. The goal of this paper is to answer the question, “What rural considerations should be addressed in a National Quality Strategy?”
Date: 12 / 2010

State Implementation of National Health Reform: Harnessing Federal Resources to Meet State Policy Goals
Author(s): Stan Dorn
Sponsoring organization: Urban Institute
Shows how certain policy approaches would use the Patient Protection and Affordable Care Act (PPACA) to achieve state goals and policy objectives, such as increasing the use of tele-medicine to serve rural Medicaid beneficiaries.
Date: 09 / 2010

How Health Reform Helps American Indians and Alaska Natives
Author(s): Sherice Perry, Jonay Foster
Sponsoring organization: Families USA
Describes how health reform will address the unique needs of American Indians and Alaska Natives.
Date: 09 / 2010

Health Care Reform, What’s in It?: Rural Individuals and Families
Author(s): Jon M. Bailey
Sponsoring organization: Center for Rural Affairs
Looks at how provisions in health care legislation will benefit rural individuals and families.
Date: 09 / 2010

Starting on the Path to a High Performance Health System: Analysis of the Payment and System Reform Provisions in the Patient Protection and Affordable Care Act of 2010
Author(s): Karen Davis, Stuart Guterman, Sara R. Collins, Kristof Stremikis, Sheila Rustgi, Rachel Nuzum
Sponsoring organization: Commonwealth Fund
Report analyzes the new health reform law's provisions that will affect health care providers’ financial incentives, the organization and delivery of health services, investment in prevention and population health, and the capacity to achieve the best health care and health outcomes for all Americans.
Date: 09 / 2010

Are Rural Health Clinics Part of the Rural Safety Net? (Policy Brief)
Author(s): David Hartley, John Gale, Al Leighton, Stuart Bratesman
Sponsoring organization: Maine Rural Health Research Center
Since Rural Health Clinics (RHCs) are located in underserved rural areas and serve vulnerable populations, many consider them to be safety net providers. Reports that 86% of independent Rural Health Clinics offer free care, sliding fee scales, or both; 97% were currently accepting new Medicaid/SCHIP patients; RHCs' patient mix has a higher proportion of Medicaid/SCHIP patients in counties not served by a federally funded Community Health Center (CHC).
Date: 09 / 2010

Patient Protection and Affordable Care Act of 2010: Impacts on Rural People, Places, and Providers: A First Look
Author(s): Andrew F. Coburn, Jennifer P. Lundblad, A. Clinton MacKinney, Timothy D. McBride, Keith J. Mueller
Sponsoring organization: Rural Policy Research Institute Rural Health Panel
Summarizes six issue areas of the Affordable Care Act (ACA) and discusses implications for access to services and improving the health status of rural residents. These issue areas are: health insurance coverage; Medicare and Medicaid payment; quality, financing, and delivery system reform; public health; healthcare workforce; and long-term care.
Date: 09 / 2010

Health Reform and Communities of Color: Implications for Racial and Ethnic Health Disparities
Sponsoring organization: Kaiser Family Foundation
Issue brief examines the key provisions of the 2010 health reform law that will expand health coverage and are likely to improve access to care for people of color, rural communities, and underserved areas.
Date: 09 / 2010

Realizing Health Reform's Potential: Small Businesses and the Affordable Care Act of 2010
Author(s): Sara R. Collins, Karen Davis, Jennifer L. Nicholson, Kristof Stremikis
Sponsoring organization: Commonwealth Fund
This issue brief examines the provisions set forth in the Patient Protection and Affordable Care Act (ACA) that help small businesses pay for and maintain health insurance for their workers. Describes the affects these provisions will have over the next ten years and includes data about insured and uninsured employees.
Date: 09 / 2010

Quick Health Facts 2010: Selected State Data on Older Americans
Author(s): Leigh Purvis
Sponsoring organization: AARP Public Policy Institute
Presents major health system characteristics for each state and the District of Columbia. Reflects current health care priorities, with a particular focus on data that is relevant to the provisions of the recently passed health care reform legislation. State data sheets includes rural population in percent of total.
Date: 08 / 2010

Community Health Centers: Opportunities and Challenges of Health Reform
Author(s): Sara Rosenbaum, Emily Jones, Peter Shin, Jennifer Tolbert
Sponsoring organization: Kaiser Family Foundation
Examines the role that community health centers will play in implementing health reform and providing access to care for millions of Americans who will gain insurance coverage under the new law.
Date: 08 / 2010

Health Care Reform, What’s in It?: Rural Communities and Rural Medical Care
Author(s): Jon M. Bailey
Sponsoring organization: Center for Rural Affairs
Summarizes access-related provisions in the Affordable Care Act directly targeted to rural communities, rural medical care and the expansion of the health care workforce.
Date: 07 / 2010

Public Health, Workforce, Quality, and Related Provisions in the Patient Protection and Affordable Care Act (PPACA)
Author(s): Erin D. Williams, C. Stephen Redhead
Sponsoring organization: Congressional Research Service
One in a series of CRS products on PPACA (as amended by HCERA), summarizes the new law’s workforce, public health, quality, and related provisions. Covers provision implications on rural and underserved areas.
Date: 06 / 2010

Expanding Health Centers Under Health Care Reform: Doubling Patient Capacity and Bringing Down Costs
Sponsoring organization: National Association of Community Health Centers
Defines how $11 billion from the health reform package will fund new health centers, plus expand and modernize existing health centers.
Date: 06 / 2010

Strengthening Primary Care to Bend the Cost Curve: The Expansion of Community Health Centers Through Health Reform
Author(s): Leighton Ku, Patrick Richard, Avi Dor, Ellen Tan, Peter Shin, Sara Rosenbaum
Sponsoring organization: George Washington University Department of Health Policy
Examines the impact of the Patient Protection and Affordable Care Act (PPACA) on the number of patients who will receive primary care services at community health centers and the effect of the service expansions on overall health care costs, including federal and state Medicaid expenditures.
Date: 06 / 2010

Health Care Shortage Designations: HPSA, MUA, and TBD
Author(s): Eileen Salinsky
Sponsoring organization: National Health Policy Forum
Reviews the methodologies utilized in the Health Professional Shortage Area (HPSA) and the Medically Underserved Area (MUA) designations, identifies federal programs that use these designations to allocate resources, describes proposals to consolidate and improve these designations, and discusses the Affordable Care Act provision to harmonize the two designations.
Date: 06 / 2010

New Era in American Health Care: Realizing the Potential of Reform
Author(s): Karen Davis
Sponsoring organization: Commonwealth Fund
Outlines the key features of the new reform law, discusses who will be most helped and how, and describes the ways in which the health care system will begin to provide more patient-centered, accessible, and coordinated care to all Americans. Also discusses the challenges that will need to be overcome as the law’s provisions are implemented over the coming months and years.
Date: 06 / 2010

Patient Protection and Affordable Care Act: A Summary of Provisions Important to Rural Health Care Delivery
Author(s): Keith Mueller
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
Provides a summary of legislative provisions contained in P.L. 111-148 (the Patient Protection and Affordability Act of 2010) that have particular meaning to rural residents and to the delivery of services in rural areas.
Date: 06 / 2010

Health Reform and Local Health Departments: Opportunities for the Centers for Disease Control and Prevention
Sponsoring organization: Public Health Institute
Reports on local health departments (LHDs), including rural, the forces shaping their services and roles, their strategies for the future, their perspectives on the role of public health in a reforming health care system and finally how the CDC can support LHDs in the future.
Date: 05 / 2010

Medicaid Coverage and Spending in Health Reform: National and State-by-State Results for Adults at or Below 133% FPL (Executive Summary)
Author(s): John Holahan, Irene Headen
Sponsoring organization: Kaiser Commission on Medicaid and the Uninsured
Analysis, performed by the Urban Institute, shows that the expansion of Medicaid under the health reform law will significantly increase the number of people covered by the program and reduce the uninsured in states across the country, with the federal government picking up the vast majority of the cost. Explains the impact on all 50 states and the District of Columbia, and the distribution of new Medicaid enrollees and costs.
Date: 05 / 2010

Implications of Health Reform for Community-Based Organizations
Sponsoring organization: Georgia Health Policy Center
This third brief in a series on the Patient Protection and Affordable Care Act, addresses provisions that apply to community health initiatives.
Date: 05 / 2010

Confronting America’s Childhood Obesity Epidemic: How the Health Care Reform Law Will Help Prevent and Reduce Obesity
Author(s): Ellen-Marie Whelan, Lesley Russell, Sonia Sekhar
Sponsoring organization: Center for American Progress
Summarizes statistics involving childhood obesity and outlines provisions from the new health care reform law that can help reverse the obesity epidemic. Describes Community Transformation Grants and how they apply to rural and frontier areas.
Date: 05 / 2010

Health Care Reform, What's in It?: Small Business
Author(s): Jon M. Bailey
Sponsoring organization: Center for Rural Affairs
Describes the prevalence of small businesses in rural areas and summarizes provisions in the new health care reform law that will have an effect on small businesses.
Date: 05 / 2010

What Will Happen Under Health Reform - and What’s Next?
Sponsoring organization: Commonwealth Fund
Answers key questions about health reform and provides a timeline of reform milestones.
Date: 05 / 2010

Health Care Reform and the Health Workforce: Workforce Provisions Included in the Patient Protection and Affordable Care Act
Sponsoring organization: Association of American Medical Colleges
Summarizes health workforce-related provisions of the new health reform legislation, including those pertaining to rural and underserved areas.
Date: 04 / 2010

Patient Protection and Affordable Care Act - Positive Steps for Rural
Sponsoring organization: National Rural Health Association
Examines the provisions in the Patient Protection and Affordable Care Act, and the subsequent Reconciliation Package that contains building blocks to improve the access to health care crisis faced by rural patients. Improvements include provisions to help resolve the workforce shortage crisis in rural areas and to eliminate long-standing payment inequities for rural providers.
Date: 04 / 2010

Health Centers and Health Care Reform: Accountable Care Organizations and Medical Homes
Sponsoring organization: National Association of Community Health Centers
Summarizes the new programs and demonstration projects from the Patient Protection and Affordable Care Act (PPACA) that promote patient-centered, quality, primary care delivery in a medical home setting.
Date: 04 / 2010

Health Centers and Health Care Reform: Medicare Reimbursement for Health Centers
Sponsoring organization: National Association of Community Health Centers
Examines the changes to Federally Qualified Health Center (FQHC) services and the associated Medicare reimbursements as dictated in the Patient Protection and Affordable Care Act (PPACA).
Date: 04 / 2010

Health Centers and Health Care Reform: Public Insurance Programs
Sponsoring organization: National Association of Community Health Centers
Describes the expansion of Medicaid, the expansion of Medicare reimbursement rates, and the maintenance of the Children's Health Insurance Program (CHIP) income eligibility levels as dictated in the Patient Protection and Affordable Care Act (PPACA).
Date: 04 / 2010

Health Centers and Health Care Reform: Payment and Participation
Sponsoring organization: National Association of Community Health Centers
Defines an exchange plan and describes how the new health law ensures that health center patients are included in new insurance products, and that health centers continue to provide affordable, accessible, quality health care.
Date: 04 / 2010

Health Centers and Health Care Reform: Health Center Funding Growth
Sponsoring organization: National Association of Community Health Centers
Outlines how dedicated, direct funding through a new Trust Fund and a permanent authorization will significantly grow the Health Centers program over the coming years. Based on the Reconciliation Act of 2010 changes to the Patient Protection and Affordable Care Act (PPACA).
Date: 04 / 2010

Timeline for Health Care Reform Implementation: Health Insurance Provisions
Sponsoring organization: Commonwealth Fund
Presents a timeline, which outlines when the various health insurance provisions will go into effect, from 2010 - 2018.
Date: 04 / 2010

Medicaid and CHIP Health Reform Implementation Timeline
Sponsoring organization: Kaiser Family Foundation
Highlights the implementation dates for provisions in the new health reform law that are related to Medicaid and the Children's Health Insurance Program.
Date: 04 / 2010

Expanding Medicaid under Health Reform: A Look at Adults at or below 133% of Poverty
Sponsoring organization: Kaiser Commission on Medicaid and the Uninsured
Examines the key characteristics of the 17.1 million nonelderly, uninsured adults who have incomes that qualify for health coverage through an expansion of the Medicaid program as outlined in the health reform law.
Date: 04 / 2010

Indian Health Care Improvement Act Provisions in the Patient Protection and Affordable Care Act (P.L. 111-148)
Author(s): Elayne J. Heisler, Roger Walke
Sponsoring organization: Congressional Research Service
Summarizes some of the key changes made in the reauthorization of Indian Health Care Improvement Act (IHCIA) including the ACA provisions related to American Indians and Alaska Natives enrolled in and receiving services from Medicare, Medicaid, and the Children’s Health Insurance Program (CHIP).
Date: 03 / 2010

Reducing Racial and Ethnic Health Disparities: Key Health Equity Provisions
Sponsoring organization: Families USA
Identifies how health reform presents an opportunity to address fundamental inequities in the health care system and among communities by helping to reduce racial and ethnic disparities.
Date: 03 / 2010

Health Insurance Reform at a Glance: Rural America
Sponsoring organization: U.S. House of Representatives
Outlines aspects of the new health reform act and describes the impact on rural America. Prepared by the House Committees on Ways and Means, Energy and Commerce, and Education and Labor on March 20, 2010.
Date: 03 / 2010

Explaining Health Care Reform: Key Changes to the Medicare Part D Drug Benefit Coverage Gap
Sponsoring organization: Kaiser Commission on Medicaid and the Uninsured
Discusses several key changes to the Medicare Part D drug benefit as a result of the health reform law to reduce Part D enrollees’ out-of-pocket liability when they reach the coverage gap, known as the “doughnut hole”.
Date: 03 / 2010

Patient Protection and Affordable Care Act
Sponsoring organization: U.S. Government Printing Office
Includes the entire text of the 2010 health care reform law - The Patient Protection and Affordable Care Act, commonly referred to as the Affordable Care Act (ACA).
Date: 01 / 2010

Focus on Health Reform: Summary of Key Changes to Medicare in 2010 Health Reform Law
Sponsoring organization: Kaiser Family Foundation
Provides a detailed look at the improvements in Medicare benefits, changes to payments for providers and Medicare Advantage plans, various demonstration projects, and other Medicare provisions in the law.
Date: 2010

State Roles in Delivery System Reform
Sponsoring organization: National Governor's Association
Outlines the evidence in health system reforms, and the opportunities for governors to lead these efforts. Provides tools and levers available to states to create a more efficient and effective health care system in both rural and urban environments and in accordance with the Affordable Care Act.
Date: 2010

Challenges for Improving Health Care Access in Rural America: A Compendium of Research and Policy Analysis Studies of Rural Health Research and Policy Analysis Centers 2009-2010
Sponsoring organization: Office of Rural Health Policy
Released in July 2010, the compendium is a collection of twenty-four research and policy analysis studies on health care access in rural America from the Office of Rural Health Policy Rural Health Research and Policy Analysis Centers.
Date: 2010

Frequently Asked Questions: Health Centers and Health Reform
Sponsoring organization: National Association of Community Health Centers
Lists questions with answers surrounding community health centers and the Patient Protection and Affordable Care Act as of May 2010.
Date: 2010

Health Center Related Provisions in Health Reform Legislation
Sponsoring organization: National Association of Community Health Centers
Identifies rural community health center provisions within the new Patient Protection and Affordable Care Act and the reconciliation bill. Uses a table to compare proposals by the Senate and House committees. This newest version was released to the Web in mid-April.
Date: 2010

Cost of Inaction to Rural Communities: The Urgent Need for Health Care Reform Walthall County, Mississippi
Author(s): Anh Nguyen, Kelly Shaw-Sutherland, Keith Mueller
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
Focuses on Walthall County, a small county located in southwestern Mississippi, which is dealing with the health care crisis.
Date: 08 / 2009

Cost of Inaction to Rural Communities: The Urgent Need for Health Care Reform Nemaha County, Nebraska
Author(s): Anh Nguyen, Kelly Shaw-Sutherland, Keith Mueller
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
Identifies the health care challenges for rural communities, such as those in Nemaha County, Nebraska, which have been amplified by the current economic downturn.
Date: 08 / 2009

Cost of Inaction to Rural Communities: The Urgent Need for Health Care Reform Leake County, Mississippi
Author(s): Kelly Shaw-Sutherland, Anh Nguyen, Keith Mueller
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
Examines Leake County, a rural Mississippi county, which embodies many of the problems of the U.S. health care crisis.
Date: 08 / 2009

Community Health Centers and Health Reform: Summary of Key Health Center Provisions
Sponsoring organization: National Association of Community Health Centers
Summarizes key provisions of the Patient Protection and Affordable Care Act of 2010 (ACA) that directly or indirectly impact community health centers.

Health Centers and Health Care Reform: National Health Service Corps
Sponsoring organization: National Association of Community Health Centers
Outlines the Patient Protection and Affordable Care Act's (ACA) five-year expenditure plan for the National Health Service Corps.

Tools

ACA and You: How to Anticipate Changes in Rural Places (Webinar)
Other
Webinar, presented by Keith Mueller, discusses the Patient Protection and Affordable Care Act (PPACA) or (ACA) and how it could affect rural residents, providers and their communities.
Sponsoring organization: Rural Assistance Center

Data & Research: Health Care Reform Resources
Web site
Contains commentary updates on health reform as it relates to rural America. Lists links to health reform products and resources from RUPRI (Rural Policy Research Institute) and from other entities.
Sponsoring organization: Rural Policy Research Institute

Federal Health Reform: State Legislative Tracking Database
Web site
Searchable database on bills from 2011 and 2012 legislation filed in response to the Affordable Care Act by state, year, topic, keyword, status, and/or primary sponsor.
Sponsoring organization: National Conference of State Legislatures

Frequently Asked Questions Section 6411(a) of the Affordable Care Act
Web site
Collection of common questions covering general information on the Medicaid RAC (Recovery Audit Contractor) and operational guidance to States.
Sponsoring organization: Centers for Medicare and Medicaid Services

Health Policy Education: Health Reform
Tutorial
Web page offers multimedia presentations on the Affordable Care Act (ACA).
Sponsoring organization: Kaiser Family Foundation

Health Reform and Medicare: Overview of Key Provisions
Tutorial
Presents an audio-visual tutorial that describes provisions of the Affordable Care Act (ACA) that affect the many Medicare programs.
Sponsoring organization: Kaiser Family Foundation

Health Reform Fact Sheets
Web site
Offers customized fact sheets for each state, together with a directory of topics providing background information on the impacts health reform may have on the states and D.C.
Sponsoring organization: Kaiser Family Foundation

Health Reform GPS
Web site
Designed to help people understand the Affordable Care Act legislation and its implementation. Information is geared toward federal and state legislative and public agency staff, private organizations and interest groups involved in implementation, health policy researchers, and the press.

Health Reform Implementation Timeline
Web site
Interactive tool designed to explain how and when the provisions of the health reform law will be implemented over the next several years. View provisions by year or topic.
Sponsoring organization: Kaiser Family Foundation

Health Reform in Action
Web site
Offers information about the Affordable Care Act, including state-level actions and stories.
Sponsoring organization: White House

Health Reform Resource Center
Web site
A tool for exploring and understanding the provisions of the Affordable Care Act. Includes a time line for specific provisions by year, category, and/or stakeholder group.
Sponsoring organization: Commonwealth Fund

HHS Office of Intergovernmental Affairs Regional Offices
Web site
Ensures the Department maintains close contact with state, local & tribal partners and addresses the needs of communities and individuals served through HHS programs and policies. Provides comprehensive information on the Affordable Care Act. Website provides a map of regions and their points of contact.
Sponsoring organization: U.S. Department of Health and Human Services

HRSA: Office of Regional Operations
Web site
HRSA’s Office of Regional Operations (ORO) website that includes a directory of the ten regional offices and key staff working to improve health care systems and safety net, increase access to quality care, reduce disparities, and advance public health.
Sponsoring organization: Health Resources and Services Administration

NACHC Health Reform Hub
Web site
Serves as a clearinghouse for the latest information about health reform and health centers, including updates on key legislative and regulatory issues, fact sheets, as well as tools to help health centers implement health reform.
Sponsoring organization: National Association of Community Health Centers

NRHA: Health Reform and You
Web site
Contains news items and resources about health reform as it relates to rural America. Describes the National Rural Health Association's (NRHA) stance and thoughts on rural health issues and provides information on the Affordable Care Act.
Sponsoring organization: National Rural Health Association

Research on Health Care for Rural People
Web site
Presents various reports related to the Affordable Care Act to help people in rural areas better understand the new law.
Sponsoring organization: Center for Rural Affairs

Rural Health Voices
Web site
This blog, sponsored by the National Rural Health Association (NRHA), offers news and opinion postings related to health care in rural America.
Sponsoring organization: National Rural Health Association

Side-by-Side Comparison of Major Health Care Reform Proposals
Web site
Provides interactive summaries of the Affordable Care Act, as well as other proposals put forward during the year-long reform debate in Congress.
Sponsoring organization: Kaiser Family Foundation

Funding

Affordable Care Act - Grants for School-Based Health Center Capital (SBHCC) Program
Grants to support school-based health center efforts to expand capacity to provide primary healthcare services to school-aged children.

Rural Health System Analysis and Technical Assistance Cooperative Agreement
Grants to inform policy makers and rural health care providers about how changes in the health care delivery system may affect them, and to provide technical assistance to rural providers in identifying potential new approaches to health care delivery.

Inactive Funding

Inactive Funding Opportunities - Lists additional funding programs for this topic that are not currently accepting applications. Programs that are inactive may be offered again in the future.

Organizations

National Institute for Health Care Reform (NIHCR)
National organization
Conducts research, analyzes policy, and informs policy makers on issues related to the delivery, financing, and organization of health care.

Small Business Majority
National organization
Serves as an advocacy organization focused on solving the single biggest problem facing America’s small businesses: the cost of providing healthcare to employees.

White House Office of Health Reform
Federal government
Tasked with coordinating relevant executive branch agencies, reaching out to state and local officials, working with Congress to enact health reform legislation and overseeing implementation of any eventual policy changes.

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Page last updated 5/18/2012
Topic last reviewed 11/22/2011

Events
May 23, 2012
Managing a Medical Practice in a Complex Environment
Wisconsin Medical Society
Country Springs Hotel
Waukesha, WI
Contact:
  866.442.3820
  communications@wismed.org


May 24, 2012
Managing a Medical Practice in a Complex Environment
Wisconsin Medical Society
Tundra Lodge
Green Bay, WI
Contact:
  866.442.3820
  communications@wismed.org


May 30, 2012
Keeping a Focus on Children in Health Care Reform
National Academy for State Health Policy
1:30 - 3:00 PM Eastern
Webinar

Jun 12, 2012
Innovating within Healthcare Reform: The Rural Response to Changing Payment and Delivery Models
Colorado Rural Health Center
11:00 AM - 12:00 PM Mountain
Webinar

Jun 21 - 23, 2012
2012 North Carolina Primary Care Conference
North Carolina Community Health Center Association
Pathways to Success: Strategies for a New Health Care Environment
Renaissance Asheville Hotel
Asheville, NC
Contact:
  Rose Navarro
  919.297.0014
  navarror@ncchca.org


Jul 13 - 17, 2012
2012 77th Annual NACo Conference and Exposition
National Association of Counties
David L. Lawrence Convention Center
Pittsburgh, PA
Contact:
  Kim Struble
  202.942.4288
  kstruble@naco.org


Aug 6 - 9, 2012
2012 NCSL Legislative Summit
National Conference of State Legislatures
McCormick Place Convention Center
Chicago, IL
Contact:
  303.364.7700
  events@ncsl.org


About this Page
Credits

Thanks goes to: Jocelyn Richgels, Associate Director, National Policy Programs
Rural Policy Research Institute

Created by:
Aubrey Madler
aubrey@raconline.org



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Funding for this project was supported by Grant Number U56RH05539 from the Office of Rural Health Policy, Health Resources and Services Administration, U.S. Department of Health and Human Services. The contents of this website are solely the responsibility of the authors and do not necessarily represent the official views of the funder.