Contracting With Medicare Advantage Plans: A Brief for Critical Access Hospital Administrators

Contracting With Medicare Advantage Plans: A Brief for Critical Access Hospital Administrators overview This document summarizes the experience of CAH administrators with contracts offered by Medicare Advantage (MA) plans. Telephone surveys were conducted with CAH administrators across the country to learn about their experiences with MA plans. This brief includes information about the contract terms… Read more »

Rural Hospitals’ Experience with the 340B Drug Pricing Program

Overview The 340B Drug Pricing Program (hereafter referred to as the 340B program) enables certain types of safety net organizations to obtain deep discounts on medications delivered during outpatient care, at prices below what is typically offered to Medicaid agencies. Prior to the 2003 Medicare Modernization Act (MMA), few rural hospitals qualified for the 340B… Read more »

One Year In: Sole Community Rural Independent Pharmacies and Medicare Part D

Background The Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) established funding to allow up to 43 million Medicare beneficiaries to enroll in plans providing comprehensive outpatient prescription drug coverage, beginning in January 2006. The new Medicare Part D program changed the means by which Medicare beneficiaries purchase prescription drugs, which affects the… Read more »

Rural-Urban Differences in Characteristics of Local EMS Agencies

BACKGROUND This Findings Brief describes the general characteristics of local rural EMS agencies and important ways that they differ from the characteristics of agencies located in urban areas. The data are from a national survey of 1,425 local EMS directors that was conducted in 2006-07. KEY FINDINGS Rural EMS agencies typically serve a smaller population… Read more »

Key Considerations for a Rural Hospital Assessing Conversion to Rural Emergency Hospital

Based on findings from a literature review and consultation with practitioners, the NC Rural Health Research Program developed a conceptual framework and checklist to organize and guide conversations about key considerations for conversion a Rural Emergency Hospital.  The brief, , describes the methods and the framework. Conceptual framework. The framework includes considerations across five key… Read more »

Rural Hospitals with Long‐term Unprofitability

Overview To remain open, businesses generally need to be profitable (have revenues greater than expenses). Hospitals are no different. Hospitals use profits to pay for new and upgraded buildings, equipment, technology, programs, and other patient care needs. To assess hospital profitability, we often look at total margin. Total margin measures the control of expenses relative… Read more »

Rural/Urban and Regional Variation in the 2019 CMS Hospital Wage Index

Background The Medicare hospital Inpatient Prospective Payment System (IPPS) is designed to pay hospitals for services provided to Medicare beneficiaries based on a national standardized amount adjusted for the patient’s condition and related treatment. Further, Social Security Act Section 1886(d)(3)(E) requires that the standardized amount be adjusted for differences in hospital wage levels, which the… Read more »

What Characteristics Influence Whether Rural Beneficiaries Receiving Care From Urban Hospitals Return Home for Skilled Nursing Care?

Abstract Purpose: Skilled nursing care (SNC) provides Medicare beneficiaries short-term rehabilitation from an acute event. The purpose of this study is to assess beneficiary, market, and hospital factors associated with beneficiaries receiving care near home. Methods: The population includes Medicare beneficiaries who live in a rural area and received acute care from an urban facility in 2013…. Read more »

Predicting Financial Distress and Closure in Rural Hospitals

Abstract Purpose: Annual rates of rural hospital closure have been increasing since 2010, and hospitals that close have poor financial performance relative to those that remain open. This study develops and validates a latent index of financial distress to forecast the probability of financial distress and closure within 2 years for rural hospitals. Methods: Hospital and community… Read more »