Rural Health Information Hub Latest News

New Rural Health Value Website and Resources Available: Rural VBC–The Payer Perspective and TEAM Model Summary

The Rural Health Value team is pleased to share that we have launched a redesigned website and logo. While we have a new look – you will continue to find trusted resources that facilitate the transition of rural healthcare organizations, payers, and communities from volume-based to value-based health care and payment models. Please take a look! On the new website you will find two new resources.

  • Rural Value-Based Care – The Payer Perspective, Rural Health Value Summit Report. The Rural Health Value team convened professionals and executives from national and regional health care payer organizations to share and explore insights, innovations, successes, and challenges in rural health value-based care (VBC) contracting. This report summarizes challenges and solutions followed by suggestions for rural health care organization leaders from the Summit participants.
  • A one-page summary of CMS’s Transforming Episode Accountability Model (TEAM). TEAM is a mandatory, episode-based, alternative payment model, in which selected acute care hospitals will coordinate care for people with Traditional Medicare undergoing one of the surgical procedures included in the model and assume responsibility for the cost and quality of care from surgery through the first 30 days after the Medicare beneficiary leaves the hospital. Of the 741 hospitals identified for mandatory participation, 124 (16.7%) are in non-metro counties. More from CMS on TEAM.

This summary is part of Rural Health Value’s Catalog of Value-Based Initiatives for Rural Providers. The catalog summarizes rural-relevant, value-based programs currently or recently implemented by the Department of Health and Human Services (HHS), primarily by the Centers for Medicare & Medicaid Services (CMS) and its Center for Medicare & Medicaid Innovation (CMMI).

Rural Health Value facilitates the transition of rural healthcare organizations, payers, and communities from volume-based to value-based health care and payment models. Visit www.ruralhealthvalue.org or contact Clint MacKinney, MD, MS, Co-Principal Investigator, clint-mackinney@uiowa.edu.

Draft Preliminary Recommendations from the Advisory Commission on Additional Licensing Models

– Comments due December 6. The Advisory Commission on Additional Licensing Models has released draft preliminary recommendations for public comment. These recommendations are intended to aid interested state medical boards and policymakers in developing new licensing pathways for internationally trained physicians. The recommendations, which focus on eligibility requirements, are available for feedback until December 6, 2024, with final guidance expected in early 2025.

Medicare Promoting Interoperability Program Hardship Exception Application Deadline for CAHs is November 30, 2024

For the calendar year 2023 reporting period, eligible hospitals and Critical Access Hospitals (CAHs) were required to use 2015 Edition Cures Update certified electronic health record technology (CEHRT) to meet the Medicare Promoting Interoperability Program requirements.  CAHs may apply for a Hardship Exception if complying with this requirement results in significant hardship.  CAHs may submit their application electronically  or contact the Center for Clinical Standards and Quality Service Center (CCSQ) Service Center at (866) 288-8912 to complete a verbal application.

Medicare Finalizes New Standards for Hospital Obstetric Care

Last week, the Centers for Medicare & Medicaid Services (CMS) released the Medicare Outpatient Hospital Prospective Payment System (OPPS) Final Rule for Calendar Year 2025.  In addition to annual updates in outpatient hospital Medicare payment rates, this rule finalizes new standards for hospitals and Critical Access Hospitals (CAHs) with obstetric (OB) units regarding maternal quality assessment and performance improvement, the organization, staffing, and delivery of OB care, and staff training on evidence-based maternal health practices.  For hospitals and CAHs with emergency services, it adds standards on facility readiness in caring for emergency services’ patients, including pregnant, birthing, and postpartum women. The rule also finalizes new transfer policies for hospitals that mirror the current CAH and Rural Emergency Hospital standards. These Conditions of Participation (CoPs) will be phased in over two years.

Medicare Finalizes Changes to Medicare Home Health Program

Effective January 1, 2025.  On November 1, 2024, the Centers for Medicare & Medicaid Services (CMS) issued the Calendar Year (CY) 2025 Home Health Prospective Payment System (HH PPS) Rate Update final rule, which updates the Medicare payment policies and rates for home health agencies (HHAs). CMS projects an increase in aggregate payments by 0.5 percent, and also finalizes a permanent prospective adjustment of -1.975% to the CY 2025 home health payment rate. CMS finalized a new standard for acceptance to service policy in the Home Health Conditions of Participation (HH CoPs) and their proposal with modification to require ongoing respiratory illness reporting for Long-Term Care (LTC) facilities. The rule is effective January 1, 2025.

Trends in the Health Workforce Supply in the Rural U.S

This report from the WWAMI Rural Health Research Center describes trends in the supply and distribution of clinicians in primary care, behavioral health, and obstetrical care, as well as dentists, surgeons, community health workers, and home health aides, in the rural vs. urban U.S. workforce nationally and regionally.

Medical Debt in Collections Among Counties by Rural-Urban Location and Racial-Ethnic Composition

Among key findings from the University of Minnesota Rural Health Research Center:

  • Rural counties have a higher proportion of people with medical debt in collections than urban counties, and this difference is associated with lower average household incomes.
  • The county-level median amount of medical debt in collections held by rural residents is higher compared to their urban counterparts, even after accounting for income differences.
  • The proportion of people with and amount of medical debt in collections are both higher in rural and urban communities of color than in rural and urban communities overall.

HHS: Current Trends and Key Challenges to Health Care in Rural America

A new report evaluates programs at the U.S. Department of Health & Human Services (HHS) and finds that uninsured rates among adults under age 65 in rural areas have fallen substantially since the passage of the Affordable Care Act (ACA), from 23.8 percent in 2010 to 12.6 percent in 2023.  Uninsured rates among rural residents are much higher in states that have not yet expanded Medicaid, and analysts acknowledge ongoing disparities in health outcomes between rural and urban areas.  Research has shown, for instance, disparities in maternal outcomes, behavioral and mental health outcomes, risk factors for chronic disease such as obesity, hypertension, and cardiovascular disease as well as in potentially harmful health behaviors such as smoking and physical inactivity, to name a few.

Biden-Harris Administration’s Inflation Reduction Act Saves Medicare Enrollees Nearly $1 Billion in Just the First Half of 2024

The Department of Health and Human Services (HHS) released new data showing that nearly 1.5 million people with Medicare Part D saved nearly $1 billion in out-of-pocket prescription drugs costs in the first half of 2024 because of the Biden-Harris Administration’s Inflation Reduction Act. Thanks to the Inflation Reduction Act, some people with high drug costs have their out-of-pocket drug costs capped at around $3,500 in 2024. Next year that cap lowers to $2,000 for everyone with Medicare Part D. The report shows that if the $2,000 cap had been in effect this year, 4.6 million enrollees would have hit the cap by June 30 and would not have to pay any more out-of-pocket costs for the rest of the year. Learn more here.