The RUPRI Health Panel has released a new brief, Rural Hospitals’ Perspectives on Health System Affiliation. This brief explores the current trend in hospital affiliation from a rural perspective and offers guidance to rural hospital leaders in navigating a potential affiliation. With an understanding of the rural context and challenges facing rural hospitals, risks and …
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 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 …
Meeting the Behavioral Health Needs of Farm Families in Times of Economic Distress. Given recent global economic and climate trends, including those induced by the COVID-19 public health emergency, behavioral health consequences related to economic distress will likely continue as a public health concern for the foreseeable future. The RUPRI Health Panel offers guidance for …
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 RUPRI Health Panel has released a new brief, Characteristics and Challenges of Rural Ambulance Agencies. Every year, nearly 10 million rural Americans receive EMS care. There are 23,272 ambulance agencies in the U.S. and 73 percent of those agencies report serving rural areas. Thus, rural Americans rely on EMS professionals to deliver life-saving emergency …
The RUPRI Health Panel has released a new paper, Advancing Population Health in Rural Places: Key Lessons and Policy Opportunities. This paper advances policy discussion of population health in rural places, focusing on the role of rural health care organizations. Lessons from ongoing programs provide policy considerations. Medicare and Medicaid programs should prioritize staff and …
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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 prevalence of mental health and substance use diagnoses and unmet treatment needs are not equally distributed, with rural residence being one factor associated with these differences. Moreover, the rural context has proven challenging for ensuring the availability of and access to prevention, diagnosis, treatment, and recovery services in rural areas. This paper reviews the …
Toward a High Performing Rural Health Care System: Key Issues and Recommendations from Rural Health Care System Innovators View Report On December 6-7, 2018, the Rural Health Policy Research Institute’s (RUPRI) Health Panel convened a meeting in Washington, DC, of rural health leaders from around the country to discuss strategies and models for rural health …
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 …
This paper will review elements of a robust rural primary care system, including development and maintenance of a high performance rural primary care system and workforce as well as policy considerations and opportunities that address the sustainability of rural primary care. Written by Keith J. Mueller (PhD), Charlie Alfero (MA), Andrew F. Coburn (PhD), Jennifer …
This paper discusses the realities and challenges of designing a market structure that will result in affordable health insurance being offered in rural markets, and reviews the rural implications of policies affecting rural health insurance markets and health systems. Written by Keith J. Mueller (PhD), Charlie Alfero (MA), Andrew F. Coburn (PhD), Jennifer P. Lundblad …
This paper examines the progress of health system transformation and the gaps that remain as they affect rural people, places, and providers. The health system transformation activities examined here are not limited to the Patient Protection and Affordable Care Act of 2010 (PPACA), but also touch upon activities undertaken by states, insurance plans, and public …
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 …
The RUPRI Health Panel describes opportunities for rural communities to develop a high-performance rural health system after hospital closure, including three case studies that describe real-world transitions from a hospital-based locus of care to new models of care delivery in rural places. After Hospital Closure: Pursuing High Performance Rural Health System without Inpatient Care This paper describes …
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 …
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 …
View Report | Related: View Policy Brief In recognition of unsustainable healthcare cost growth and sub-optimal delivery system performance, the Patient Protection and Affordable Care Act of 2010 (ACA) contains provisions that redesign healthcare payment and delivery. ACA payment change provisions are driving delivery system reform by making healthcare organizations more accountable for patients’ health …
This joint paper was authored by members of both the Health and Human Services Panel in June 2015. The paper presents a case for the viability of Accountable Care Community (ACC) models in rural communities, including in rural Humboldt County, California. Accountable Care Communities reflect a unified approach to improving the health and reducing the …
In Advancing the Transition to a High-Performance Rural Health System, the RUPRI Health Panel discusses strategies and options for creating a pathway to a transformed, high-performing rural health system. This paper builds on the RUPRI Health Panel’s earlier paper that conceptually defined the core elements of a high-performance rural health system. We have also incorporated …
This report reviews important access definitions and frameworks from the literature. The review serves as a concept map to create a unique synthesis of perspectives that may be used by researches and policy makers to design or clarify access to health care providers. Prepared in August 2014 by the RUPRI Health Panel: A. Clinton MacKinney, …
These two policy documents from 2010 and 2014 take a first and second look at the implementation of the Patient Protection and Affordable Care Act of 2010 and how it contributes to reshaping the health care delivery landscape, particularly in rural areas. Prepared in September 2010 and April 2014 by the RUPRI Health Panel: Andrew …
This brief outlines and describes the current Medicaid program and its importance to rural America. It also discusses rural implications of program expansion, including whether and how states choose to implement changes. View Report This report was written by Health Panel Members Keith Mueller, Andrew Coburn, Jennifer Lundblad, A. Clinton MacKinney, Timothy McBride, Sidney Watson …
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The RUPRI Health Panel offers an aspirational vision, for a highperformance rural health care system. The RUPRI Health Panel envisions rural health care that is affordable andaccessible for rural residents through a sustainable health system thatdelivers high quality, high value services. A high performance rural healthcare system informed by the needs of each unique rural …
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Place-Based Policies and Public Health: The Road to Healthy Rural People and Places View Report This joint paper by the RUPRI Health Panel and Human Service Panel examines how effective place-based policies can influence how rural and metropolitan areas develop, how well they function as places to live, work, operate a business, preserve heritage, and …
View Report The ACA calls for the development of a National Health Care Quality Strategy and Plan (National Quality Strategy) that, by definition, 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 …
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View Report This Policy Paper assesses legislative proposals to add an outpatient prescription drug benefit to the Medicare program and their implications for the delivery of services and the welfare of beneficiaries in rural areas. Included are comments on five proposals introduced in the 107th Congress: one that was passed by the House of Representatives, …
View Policy Paper The Rural Health Panel is publishing this policy paper to provide a foundation for a discussion of the recommendations and findings presented in the June 2001 report (Report) of the Medicare Payment Advisory Commission (MedPAC), Medicare in Rural America. In this paper, the Panel comments on MedPAC’s recommendations and offers a critique …
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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View Report This paper summarizes provisions of the Medicare, Medicaid, and SCHIP Benefits Improvement and Protection Act of 2000 (BIPA) and assesses the impact of those provisions on rural health care delivery. Congress passed BIPA on December 15, 2000, and President Clinton signed it on December 21. This report was written by Health Panel members: …
View Report This paper was jointly prepared by the Maine Rural Health Research Center and the RUPRI (Rural Policy Research Institute) Rural Health Panel to offer a rural perspective on the current debate over the design and implementation of a Medicare prescription drug benefit. Background information on rural Medicare beneficiaries’ need for, and access to, …
View Draft Report The enactment of the Balanced Budget Act of 1997 (BBA) changed dramatically the context for discussions of Medicare policy. Policy discussions since the BBA have sharpened two major pathways for dialogue/debate: appropriate and equitable payment for services, either through traditional Medicare fee-for-service payments or through Medicare+Choice monthly premiums; and appropriate and necessary …
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