The RUPRI Center for Rural Health Policy Analysis has released a new brief on Medicare Advantage Plan Growth in Rural America: Availability of Supplemental Benefits Key Findings Include READ THE BRIEF HERE
The RUPRI Center for Rural Health Policy Analysis has released a new policy brief Partnerships to Address Social Needs across Metropolitan and Non-Metropolitan Prospective Payment System Hospitals and Critical Access Hospitals PurposePartnerships between hospitals and other organizations, such as public health departments and social service organizations, are essential to address monumental challenges like managing pandemics, …
The National Advisory Committee on Rural Health & Human Services (NACRHHS) has released a new policy brief, Childcare Need & Availability in Rural Areas. The NACRHHS advises the Secretary of the Department of Health & Human Services on health & human service challenges in rural America. The Committee members offer the following policy recommendations for …
The RUPRI Health Panel has released a new brief, The Role of Telehealth in Achieving a High Performing Rural Health System: Priorities in a Post-Pandemic System, as a commentary on the preconditions for the optimum use of telehealth, looking at experiences of telehealth usage during the PHE. KEY CONSIDERATIONThe Panel continues to contribute to discussions …
The RUPRI Health Panel has released a new Policy Brief, State-Based Recommendations to Support Rural Ambulance Agencies. State-Based Recommendations• To ensure access to emergency medical services (EMS) for all rural residents, state legislatures should designate EMS as an essential service and provide a portion of the funding necessary to support the costs of maintaining essential …
The RUPRI Center for Rural Health Policy Analysis has released a new brief on Changes in Service Offerings Post-System Affiliation in Rural Hospitals. Affiliations between rural hospitals and regional and national health systems have increased from 10 to 30 per year in the 2000s to approximately 30 to 70 per year in the 2010s. This …
The RUPRI Center for Rural Health Policy Analysis has released a new policy brief COVID-19 Mortality Rates across Noncore, Micropolitan, and Metropolitan Counties by Community Characteristics, December 2020-January 2021. This policy brief examines differences in COVID-19 mortality rates across rural-urban designations and stratifications by geography, county-level sociodemographic factors, and county-level health care factors. Between December …
The National Advisory Committee on Rural Health & Human Services (NACRHHS) released a policy brief and recommendations to the Secretary of HHS on Rural Emergency Medical Services. Read the Brief Here The NACRHHS examines pertinent issues that affect the health and well-being of rural Americans through discussions with rural stakeholders. Following each meeting, the Committee …
The National Advisory Committee on Rural Health & Human Services (NACRHHS) released a policy brief and recommendations to the Secretary of HHS on the Rural Emergency Hospital Designation. Read the Brief Here The NACRHHS examines pertinent issues that affect the health and well-being of rural Americans through discussions with rural stakeholders. Following each meeting, the …
The RUPRI Health Panel Releases Evolution of Hospital Designations & Payment in the U.S.: Implications for Rural Hospitals Rural hospital closures have increased over the past few decades, and more are at risk for closure. Medicare hospital payment policies affecting rural hospitals play a significant role in the financial viability of rural hospitals. Programs have been …
The RUPRI Center for Rural Health Policy Analysis has released an update on Health Insurance Marketplaces: Issuer Participation Trends in Non-Metropolitan Places, 2014-22. Read the Report Here. Key Findings Include: Non-metropolitan counties (counties classified as either micropolitan or noncore using urban influence codes) have had less marketplace participation than metropolitan counties since their implementation in …
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This document updates the RUPRI Health Panel’s framework for a high-performing rural health care system, originally published in 2011. It offers a revised vision statement and updates the high-performing rural health system pillars (access, affordability, community health, and quality), and describes an underlying base of equity considerations. Abstract: This brief presents the RUPRI Health Panel’s …
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The coronavirus pandemic precipitated significant but temporary changes in telehealth policy and the use of telehealth services to ensure access to needed health services during a public health emergency (PHE). Extending the temporary policy changes will require statutory and regulatory action. This paper takes stock of current telehealth policies and assesses options for expanding the …
The RUPRI Health Panel has released a new brief that identifies key questions to ask when creating, modifying, or using a definition. Rural definitions in statute and policy are used to direct resources to underserved peoples. But changes in population behavior and Census processes have led to concern about historic methods of defining rural. This …
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The presence of COVID-19 cases impacts rural and metropolitan areas differently – a small number of cases creates stress for low capacity systems just as a large volume of cases creates stress for larger capacity systems. This RUPRI data brief shows the current nonmetropolitan and metropolitan spread of the disease, and the associated map shows …
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A new policy brief from the RUPRI Center for Rural Health Policy & Analysis shows that access to health insurance coverage has changed significantly following changes in public and private insurance due to the Patient Protection and Affordable Care Act (PPACA). From 2013-2016, the PPACA led to an overall increase in coverage rates of nearly 13 and …
The RUPRI Rural Health Panel, through the support of the Federal Office of Rural Health Policy (FORHP) in the Department of Health and Human Services, has released a new Policy Brief, Assessing the Unintended Consequences of Health Policy on Rural Populations and Places. The purpose of this paper is to illuminate the unintended consequences of health …
Accountable care organization (ACO) models are the most widely adopted value-based payment initiatives from the Centers for Medicare & Medicaid Services. The Shared Savings Program, started in 2011, is the most commonly adopted Medicare ACO model. This policy brief updates findings from previous RUPRI Center reports. It shows that there is continued growth in the …
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 Rural Long-Term Services and Supports: A Primer provides policymakers and other interested stakeholders a primer on rural long-term services and supports (LTSS): (1) the fundamentals of the rural LTSS system, (2) rural access to and use of LTSS, and (3) discussion of the opportunities within and limitations of current Federal and State LTSS policy for advancing …
Footloose Jobs & Urbanization: Recent History and Policy Considerations for Indiana This policy brief outlines the recent history of footloose and non-footloose jobs in Indiana, including regional changes in rural and urban employment. We also examine economic development policy and suggest future models for consideration. Written by Michael J. Hicks, PhD (Center for Business and …
The RUPRI Center for Rural Health Policy Analysis has analyzed Medicaid enrollment in a new brief, Changing Rural and Urban Enrollment in State Medicaid Programs and found that growth was happened in most states, but was largest in expansion states and metropolitan areas generally had higher growth than micropolitan and rural areas. County-level data on Medicaid enrollment …
The RUPRI Center for Rural Health Policy Analysis has released a brief, 2016 Rural Enrollment in Health Insurance Marketplaces, by State. The data shows that about half of all states had higher enrollment growth in non-metropolitan areas than metropolitan areas. In this brief, cumulative county-level enrollment in Health Insurance Marketplaces (HIMs) through March 2016 is presented …
In this policy brief, we assess variation in Medicare’s star quality ratings of Medicare Advantage (MA) plans that are available to rural beneficiaries. Evidence from the recent Centers for Medicare & Medicaid Services (CMS) quality demonstration suggests that market dynamics, i.e., firms entering and exiting the MA marketplace, play a role in quality improvement. Therefore, …
Health Insurance Marketplaces: Premium Trends in Rural Areas Since 2014, when the Health Insurance Marketplaces (HIMs) authorized by the Patient Protection and Affordable Care Act (ACA) were implemented, considerable premium changes have been observed in the marketplaces. This policy brief from the RUPRI Center for Rural Health Policy Analysis assesses the changes in average HIM …
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Medicare Accountable Care Organizations: Beneficiary Assignment Update This brief updates Brief No. 2014-3 and explains changes in the Centers for Medicare & Medicaid Services (CMS) Accountable Care Organization (ACO) regulations issued in June 2015 pertaining to beneficiary assignment for Medicare Shared Savings Program ACOs. Overall, the regulatory changes are intended to (1) encourage ACOs to …
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Medicaid has grown significantly in its importance to rural health systems and communities; a higher proportion (22 percent) of rural residents was enrolled in Medicaid than Medicare (20 percent) in 2014. At the same time, the use of payment and delivery innovations has grown significantly, but varies across the U.S. As a result of expansions …
Payment to Medicare Advantage (MA) plans was fundamentally altered by the Patient Protection and Affordable Care Act of 2010 (ACA). This brief finds that while plans operating in both rural and urban areas have experienced a reduction in MA payment, the reduction in rural payment overall has been less significant. In addition, MA plans have …
Medicare Value-Based Payment Reform: Priorities for Transforming Rural Health Systems View Policy Brief | Related: View Full Report In January 2015, Department of Health and Human Services (HHS) Secretary Burwell announced new goals and timelines for moving Medicare reimbursement from fee-for-service to value-based payment. These payment changes are driving delivery system reforms by making healthcare …
Over one-half of the population of nonmetropolitan statistical areas of the United States live in a subset of nonmetropolitan geographies classified as Micropolitan areas. Over 27 million people live in these larger rural places, which are often anchor communities serving as regional hubs for commerce, employment and services. However, these areas are largely unexplored and …
This Policy Brief shares insights into initial strategic decisions and challenges of four Accountable Care Organizations (ACOs) with a rural presence, one from each census region (West, Midwest, Northeast, and South). Semi-structured on-site interviews were conducted with ACO leaders and key stakeholder group representatives (e.g., board members, physicians). The four ACOs were formed as a …
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View report The enactment of the Balanced Budget Act of 1997 (BBA) dramatically changed the context for discussions of Medicare policy. Two major pathways for discussion were identified: Appropriate and equitable payment for services, either through traditional fee-for service (FFS) Medicare payments or through Medicare+Choice monthly premiums; and Appropriate and necessary changes to the program …
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The Area Wage Index of the Medicare Inpatient Hospital Prospective Payment System: Perspectives, Policies, and Choices View Policy Paper This policy paper discusses the positions of various rural health advocates on the wage index and recording the actions taken by Congress and the Health Care Financing Administration (HCFA) to improve the wage index.Finally, it outlines …
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View Policy Paper This Policy Paper combines the work from current projects of the Maine Rural Health Research Center (MRHRC) and the Rural Health Panel of the Rural Policy Research Institute (RUPRI) to provide a statement of specific rural considerations and objectives for any proposal that would add a prescription drug benefit to the Medicare …
View policy brief This policy brief explains how the area wage index is calculated and used, and identifies the major unresolved issues related to its calculation and use. This report was written by Anthony Wellever (Delta Rural Health Consulting and Research) in collaboration with RUPRI Health Panel Members: Andrew Coburn, Charles Fluharty, J. Patrick Hart, …
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