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 …
Category Archives: Policy Brief
RUPRI Health Panel Releases New Policy Paper, The Role of Telehealth in Achieving a High Performing Rural Health System: Priorities in a Post-Pandemic System. February 2023.
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 …
RUPRI Health Panel Releases State-Based Recommendations to Support Rural Ambulance Agencies. February 2023.
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 …
RUPRI Health Center Releases Policy Brief on Rural Hospital Affiliations. January 2023
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 …
RUPRI Health Center Releases Analysis on COVID-19 Mortality by Geography & Community Characteristics. January 2023
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 …
National Advisory Committee on Rural Health & Human Services Releases Policy Brief & Recommendations on the Rural Emergency Medical Services
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 …
National Advisory Committee on Rural Health & Human Services Releases Policy Brief & Recommendations on Rural Emergency Hospital Designation
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 …
RUPRI Health Panel Releases New Paper on Payment Policies and Implications for Rural Hospitals. December 2022
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 …
RUPRI Health Center Releases New Report on Health Insurance Marketplaces.
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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RUPRI Health Panel Releases Updated High Performing Rural Health System Brief.
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 Evolving Landscape of National Telehealth Policies during a Public Health Emergency: Responsiveness to Rural Needs
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 …
Considerations for Defining Rural Places in Health Policies and Programs
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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Confirmed COVID-19 Cases, Metropolitan and Nonmetropolitan Counties
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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New Report from RUPRI Rural Health on Effects of the ACA on Coverage and Access to Care
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 …
Assessing the Unintended Consequences of Health Policy on Rural Populations and Places
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 …
Spread of Medicare Accountable Care Organizations in Rural
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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Primer on Rural Long-Term Services and Support
 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 …
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Footloose Jobs & Urbanization
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 …
RUPRI Health Center releases report on the Changing Rural and Urban Enrollment in State Medicaid Programs
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 …
RUPRI Health Center Releases Report on Rural Enrollment in Health Insurance Marketplaces
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 …
Rural Medicare Advantage Market Dynamics and Quality: Historical Context and Current Implications
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, …
RUPRI Health Center Examines Rural Premium Trends in Health Insurance Marketplace
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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RUPRI Health Center Examines Beneficiary Assignment Updates in Medicare ACOs
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 Payment and Delivery System Reform: Challenges and Opportunities for Rural Health Systems
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 …
RUPRI Center for Rural Health Policy Analysis reviews Rural Medicare Advantage Plan Payment in 2015
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 …
Policy Brief: Medicare Value-Based Payment Reform
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 …
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New RUPRI Policy Brief released: Micropolitan America – for the Future of Rural Regional Innovation
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 …
The RUPRI Center has a new policy brief titled, Developmental Strategies and Challenges for Rural Accountable Care Organizations
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 …
Rethinking Federal Investments in Rural Transportation: Rural Considerations Regarding Reauthorization of the Surface Transportation Act. April 2011.
Click Here for Brief
Why Definitions Matter: Rural Definitions and State Poverty Rankings. Data Brief. March 2010.
This Data Brief was authored by Kathleen Miller. Click Here for Data Brief.
Impact of the Patient Protection and Affordable Care Act on Covered Persons. RUPRI Rural Health Panel. December 2009.
Authored by Timothy McBride, PhD Click Here for Report
Medicaid and Its Importance to Rural Health. RUPRI Rural Health Panel. 2008.
Click Here for Brief
Medicare Advantage Plans in Rural America. RUPRI Rural Health Panel. October 2007.
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Bridging Rural Health Research & Policy: Dissemination Strategies. RUPRI Rural Health Panel. August 2007
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Choosing Rural Definitions: Implications for Health Policy. RUPRI Rural Health Panel. March 2007.
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Impacts of the Medicare Modernization Act on Rural Health Systems & Beneficiaries. Rural Health Panel. February 2005.
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Redesigning Medicare: Considerations for Rural Beneficiaries and Health Systems
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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An Update on Medicare+Choice. RUPRI Rural Health Panel. March 2001.
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The Area Wage Index of the Medicare Inpatient Hospital Prospective Payment System
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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Improving Prescription Drug Coverage for Rural Medicare Beneficiaries: Key Rural Considerations and Objectives For Legislative Proposals
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 …
Calculating and Using the Area Wage Index of the Medicare Inpatient Hospital Prospective Payment System
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, …
