This presentation describes the transformation in the finance and delivery of health systems as well as exploring social determinants of health. High-performance rural health systems are influenced by policy actions. Presented by Keith Mueller (PhD), Andrew Coburn (PhD), Jennifer Lundblad (PhD), Timothy McBride (PhD) at the Annual Conference of the National Rural Health Association in …
Continue reading “Policy Opportunities for Advancing Rural Health”
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 Panel welcomes the opportunity to submit comments on Addressing the Low Case-Volume Challenge in Healthcare Performance Measurement of Rural Providers: Recommendations from the MAP Rural Health Technical Expert Panel. The RUPRI Health Panel strongly supports the NQF Measure Applications Partnership Rural Health Workgroup. Valid and reliable quality performance measures are critically important to rural …
Continue reading “Health Panel Comment Letter – NQF Draft Report – February 2019”
RE: 42 CFR Parts 438 and 457 – Medicaid Program; Medicaid and Children’s Health Insurance Plan (CHIP)Managed Care The Panel welcomes the opportunity to submit comments on the Medicare Advantage, Medicare Prescription Drug Benefit, Program of All-Inclusive Care for the Elderly (PACE), Medicaid Fee-for-Service, and Medicaid Managed Care Programs for years 2020 and 2021 proposed …
Continue reading “Health Panel Comment Letter – Medicare, Medicaid & CHIP – January 2019”
RE: 42 CFR Parts 422, 423, 438, and 498: Medicare and Medicaid Programs; Policy and Technical Changes tothe Medicare Advantage, Medicare Prescription Drug Benefit, Program of All-Inclusive Care for the Elderly(PACE), Medicaid Fee-for-Service, and Medicaid Managed Care Programs for Years 2020 and 2021 The Panel welcomes the opportunity to submit comments on the Medicare Advantage, …
Continue reading “Health Panel Comment Letter – Medicare, Part D & Medicaid – December 2018”
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 …
RE: 42 CFR Part 414 and 425: Medicare Program; Medicare Shared Savings Program; Accountable CareOrganizations – Pathways to Success The Panel is pleased to offer comments in response to this particular proposed rule. Our comments are limited to rural-specific issues and are structured to parallel questions posed, or issues stated, by CMS (not technical comments …
Continue reading “Health Panel Comment Letter – ACO Proposed Rule – October 2018”
The United States Government Accountability Office was asked by Members of Congress to examine Rural Hospital Closures and the Number and Characteristics of Affected Hospitals and Contributing Factors. Research and policy considerations from the RUPRI Health Panel, the RUPRI Center for Rural Health Policy Analysis and Rural Health Value, in partnership with Stratis Health, were included in the report. GAO’s analysis …
RE: 42 CFR Part 416 and 419: Medicare Program; Proposed Changes to Hospital Outpatient ProspectivePayment and Ambulatory Surgical Center Payment Systems and Quality Reporting Programs; Requests forInformation on Promoting Interoperability and Electronic Health Care Information, Price Transparency, andLeveraging Authority for the Competitive Acquisition Program for Part B Drugs and Biologicals for a PotentialCMS Innovation Center …
September 17, 2018 @ 12:00 pm – 1:00 pm Current U.S. policy utilizes various market-based models within Medicare, Medicaid, and Health Insurance Marketplaces to ensure access to health insurance coverage, but access is increasingly uneven and unaffordable, especially in some rural areas. After giving an overview of some of the relevant economic theory, this webinar will take …
Continue reading “Webinar – Insuring Rural America: Health Insurance Challenges and Opportunities”
This presentation discusses the economic theory and the potential of regulated markets as well as rural-specific issues such as network information and adequacy. Policy opportunities and recommendations are also touched upon. Presented by Timothy D. McBride (PhD) and Abigail R. Barker (PhD) from the Rural Policy Research Institute on September 17, 2018. View Presentation
RE: 42 CFR Part 405, 410, 411, 414, 415, and 495: Medicare Program; Revisions to Payment Policies Under thePhysician Fee Schedule and Other Revisions to Part B for CY 2019; Medicare Shared Savings ProgramRequirements; Quality Payment Program; and Medicaid Promoting Interoperability Program The Panel is pleased to offer comments in response to the proposed rules …
Continue reading “Health Panel Comment Letter – Revisions to Physician Payments – September 2018”
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 testimony focuses on three areas of particular relevance, rural experience with Medicare’s accountable care organization and use of Telehealth. It will conclude with general observations about future directions in rural health policy. Spoken by Keith J. Mueller (PhD) (Interim Dean, College of Public Health; Director, RUPRI Center for Rural Health Policy Analysis; Chair, RUPRI …
Continue reading “Oral Testimony for the U.S. Senate Committee on Finance”
This statement focuses on three areas of particular relevance, rural experience with Medicare’s accountable care organization and use of Telehealth. It will conclude with general observations about future directions in rural health policy. Written by Keith J. Mueller (PhD) (Interim Dean, College of Public Health; Director, RUPRI Center for Rural Health Policy Analysis; Chair, RUPRI …
Continue reading “Written Statement for the U.S. Senate Finance Committee”
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 …
Promoting Telehealth in Rural America 47 CFR Part 54 The Panel is pleased to offer comments in response to the proposed rule for Promoting Telehealth in Rural America, specifically the Federal Communications Commission (FCC) Rural Healthcare (RHC) Program. View Comment Letter
January 17, 2018 Wednesday, January 17, 2018 9:30 a.m. to 11:00 a.m. ETBipartisan Policy Center, 1225 Eye St NW, Suite 1000, Washington, DC, 20005 To better understand the challenges and opportunities rural communities face with health care delivery and infrastructure, the Bipartisan Policy Center led an effort over the past 6 months to learn from …
RUPRI Health Panel Provided Comments to CMS-9930-P Proposed Rule: Patient Protection and Affordable Care Act; HHS Notice of Benefit and Payment Parameters for 2019. November 27th, 2017. Read Comment Letter Here
 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 …
This presentation explains the concepts of affordability and availability as well as broadening network of participating local organizations to include social services. It also discusses the future of health homes and behavioral health services. Presented by Keith J. Mueller, PhD (College of Public Health, University of Iowa) at the National Academies on November 14, 2017. …
Continue reading “Accessing Behavioral Health Services in Rural Communities”
This presentation discusses the transformation underway as a result of payer policies designed to improve the value and outcomes of health care while attempting to slow cost growth. It also touches on gaps affecting rural people, places, and providers. Presented by Jennifer P. Lundblad, PhD (President and CEO, Stratis Health; Member RUPRI Health Panel) on …
Continue reading “Rural Health and the Law: Emerging Issues and Trends”
RUPRI Health Panel Provided Comments to CMS-5522-P Proposed Rule: Medicare Program; CY 2018 Updates to the Quality Payment Program. August 11th, 2017. Read Comment Letter Here
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 …
RUPRI Health Panel Provided Comments to CMS-1677-P Proposed Rule: Medicaid Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and Proposed Policy Changes and Fiscal Year 2018 Rates. May 18th, 2017. Read Comment Letter Here
In a recent Rural Monitor article for the Rural Health Information Hub, Jennifer Lundblad, CEO of Stratis Health and a member of the RUPRI Health Panel, discusses the economic impact of antibiotic stewardship (AS) programs for rural hospitals. She also referenced a RUPRI Health Panel public comment letter on a proposed rule from the Centers on Medicare and Medicaid that would require …
RUPRI Health Panel Provided Comments to CMS-2404-NC Request for Information (RFI): Federal Government Interventions to Ensure the Provision of Timely and Quality Home and Community Based Services. January 9th, 2017. Read Comment Letter Here
RUPRI Health Panel Provided Comments to CMS-5517-FC Finalized Rule with Comment Period: Medicare Program; Merit-Based Incentive Payment System (MIPS) and Alternative Payment Model (APM) Incentive Under the Physician Fee Schedule, and Criteria for Physician-Focused Payment Models. December 14th, 2016. Read Comment Letter Here
RUPRI Health Panel Provided Comments to CMS-1631-P Proposed Rule: Patient Protection and Affordable Care Act; HHS Notice of Benefit and Payment Parameters for 2018. October 4th, 2016. Read Comment Letter Here
RUPRI Health Panel Provided Comments to CMS–3295–P Proposed Rule: Medicare and Medicaid Programs; Hospital and Critical Access Hospital (CAH) Changes to Promote Innovation, Flexibility, and Improvement in Patient Care. August 9th, 2016. Read Comment Letter Here
In Health & Hospitals Networks latest publication, Jennifer Lundblad, RUPRI Health Panel Member and president and CEO of Stratis Health, discusses how rural hospitals and rural communities are well-positioned to create innovative population health and wellness programs. “A rural environment lends itself to population health and wellness,” she says. “Providers probably know the patient and their family, they …
Continue reading “RUPRI Health Panel member, Jennifer Lundblad, discusses rural hospital innovation”
RUPRI Health Panel Provides Comments to CMS-1631-P Proposed Rule: Medicare Program; Revisions to Payment Policies Under the Physician Fee Schedule and Other Revisions to Part B for CY 2017 (Part II). July 22nd, 2016. Read Comment Letter Here
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 Health Panel Provided Comments to CMS Request for Information on Concepts for Regional Multi-Payer Prospective Budgets. May 13th, 2016. Read Comment Letter Here
Jennifer is the President and CEO of Stratis Health, a non-profit based in Minnesota that focuses on collaboration and innovation in health care quality and safety. She has been a member of the RUPRI Health Panel since 2009, in addition to Stratis Health and RURPI partnering on a national Rural Health Value Project that focuses …
RUPRI Health Panel Provided Comments to CMS–2328–NC Request for Information (RFI): Medicaid Program; Data Metrics and Alternative Processes for Access to Care in the Medicaid Program. January 4th, 2016. Read Comment Letter Here
RUPRI Health Panel Provided Comments to CMS-9937-P Proposed Rule: Patient Protection and Affordable Care Act; HHS Notice of Benefit and Payment Parameters for 2017; Network Adequacy. December 21st, 2015. Read Comment Letter Here
RUPRI Health Panel Provided Comments to CMS-9933-IFC Interim Final Rule: The Consumer Operated and Oriented Plan Program. December 21st, 2015. Read Comment Letter Here
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 …
RUPRI Health Panel Provided Comments to CMS–3321–NC Request for Information Regarding Implementation of the Merit-Based Incentive Payment System, Promotion of Alternative Payment Models, and Incentive Payments for Participation in Eligible Alternative Payment Models. November 2nd, 2015. Read Comment Letter Here
RUPRI Health Panel Provided Comments to CMS-1631-P Proposed Rule: Revisions to Payment Policies Under the Physician Fee Schedule and Other Revisions to Part B for CY 2016. August 25th, 2015. Read Comment Letter Here
RUPRI Health Panel Provided Comments to CMS-2367-P Proposed Rule: Medicaid and Children’s Health Insurance (CHIP) Programs; Medicaid Managed Care. July 27th, 2015. Read Comment Letter Here
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 …
RUPRI Health Panel Provided Comments to CMS-1461-P [42 CFR Part 425] Proposed Rule Medicare Program; Medicare Shared Savings Program: Accountable Care Organizations. February 6th, 2015. Read Comment Letter Here
This presentation discusses how hospitals should respond and why response should be other than incremental adjustment. It will touch base on change and how it creates opportunities as well as threats. Presented by Keith J. Mueller, PhD (Director, RUPRI Center for Rural Health Policy Analysis) and Charles W. Fluharty, M. Div. (President, Rural Policy Research …
Continue reading “Transitioning to a High Performance Rural Health System”
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 …
Rural Policy Research Institute
The University of Iowa
College of Public Health
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