Overview The Medicare Dependent Hospital (MDH) program provides enhanced reimbursement to support rural health infrastructure and to support small rural hospitals for which Medicare patients make up a significant percentage of inpatient days or discharges. This greater dependence on Medicare may make these hospitals more financially vulnerable to prospective payment, and the MDH designation is… Read more »
Tagged: Rural Product
Why Use Swing Beds? Conversations with Hospital Administrators and Staff
Overview Swing beds are one option for post-acute skilled care in rural communities; they are more likely to be the only option in the most rural areas.1 How are they being used? What do they mean for the hospital and the community? We explored these issues with hospital staff to inform our analytic studies on… Read more »
Profile of Rural Health Clinics: Medicare Payments & Common Diagnoses
Overview In 1977, Public Law 95-210 created the Rural Health Clinic (RHC) Medicare and Medicaid reimbursement designation for qualified primary care practices. With over 3,900 certified sites located across the county, RHCs are an important component of the rural health care infrastructure.1 RHCs receive cost-based reimbursement for core Medicare services, subject to tests of reasonableness…. Read more »
A comparative study of financial data sources for critical access hospitals: audited financial statements, the Medicare cost report, and the Internal Revenue Service form 990
About this article Purpose Medicare cost reports (MCR), Internal Revenue Service form 990s (IRS 990), and audited financial statements (AFS) vary in their content, detail, purpose, timeliness, and certification. The purpose of this study was to compare selected financial data elements and characterize the extent of differences in financial data and ratios across the MCR,… Read more »
What Does the Allied Health Clinical Doctorate Mean for Rural Areas?
About this project Lead researcher: Jennifer King Project funded: September 2007 Project completed: August 2008 Allied health occupations play a major role in healthcare delivery and comprise a significant proportion of the health care workforce in the United States. Researchers have found empirical evidence of allied health shortages in many states, including reports of rising… Read more »
Office of Rural Health Policy: Cooperative Agreement for Rapid Response to Issue-Specific Rural Research
About this project Office of Rural Health Policy: Cooperative Agreement for Rapid Response to Issue-Specific Rural Research. Lead researcher: Rebecca T. Slifkin, PhD Project funded: January 2006 Project completed: August 2012 Publications 2012-14 Profitability of Urban and Rural Hospitals by Medicare Payment Classification Policy Brief North Carolina Rural Health Research and Policy Analysis Center Date:… Read more »
2021 CMS Hospital Quality Star Ratings of Rural Hospitals
In July of 2016, the Centers for Medicare & Medicaid Services (CMS) released a new Hospital Quality Star Rating system on the Hospital Compare website. Under this system, performance on a series of quality metrics is used to assign between one and five stars to a hospital, with a higher number of stars indicating better… Read more »
How Many Hospitals Might Convert to a Rural Emergency Hospital (REH)?
The Consolidated Appropriations Act of 2021 establishes a Rural Emergency Hospital (REH) designation under the Medicare program. It is difficult to predict rural hospital interest in conversion to REH because conditions of participation through rulemaking and guidance have yet to be established by the Centers for Medicare & Medicaid Services (CMS). However, some first… Read more »
Changes in Provision of Selected Services by Rural and Urban Hospitals between 2009 and 2017
During the past decade, access to health care services provided by rural hospitals has changed in two major ways. First, there has been a substantial increase in the number of rural hospitals that have completely closed or converted (provide some health care services, but not inpatient care). Second, and less understood, many rural hospitals have… Read more »
The Effect of Medicare Payment Standardization Methods on the Perceived Cost of Post-Acute Swing Bed Care in Critical Access Hospitals
The Centers for Medicare & Medicaid (CMS) use standardized payments to compare Medicare resource use across locations and settings. Currently, CMS uses different payment systems to reimburse post-acute care provided in CAH swing beds versus inpatient prospective payment system (IPPS) hospital swing beds or skilled nursing facilities (SNFs). This results in differential payments for theoretically… Read more »
Health System Challenges for Critical Access Hospitals: Findings from a National Survey of CAH Executives
Despite the numerous challenges of operating a CAH, there is little research examining the perspectives of CAH executives on potential community health care options if the CAH were to close. This brief presents a subset of results from a national survey of CAH executive perspectives on pressing challenges. In the brief, , the NC Rural… Read more »
Alternatives to Hospital Closure: Findings from a National Survey of CAH Executives
Despite the numerous challenges of operating a CAH, there is little research examining the perspectives of CAH executives on potential community health care options if the CAH were to close. The NC Rural Health Research Program produced the brief, , to provide rural health policy makers with a better understanding of what CAH executives think… Read more »
Rural Hospitals Have Higher Percentages of Patients with COVID-19 than Urban Hospitals (October-December 2020)
Since the onset of COVID-19, public health leaders have emphasized reducing the rate of viral spread to ensure that hospitals did not become overwhelmed. The U.S. DHHS publishes weekly data on individual hospital’s indicators for management of COVID-19 patients. The NC Rural Health Research Program analyzed these data to compare the percent of hospitalized patients… Read more »
CMS Hierarchical Condition Category (HCC) 2014 Risk Scores Are Lower for Rural Medicare Beneficiaries than for Urban Beneficiaries
The Centers for Medicare & Medicaid Services (CMS) use Hierarchical Condition Categories (HCC) and demographic information to calculate beneficiary risk scores, which predict expected Medicare spending by beneficiaries. CMS-HCC risk scores may be underestimating expected health care utilization among rural beneficiaries compared to urban beneficiaries. Incorrect estimation of expected health care utilization can lead to… Read more »
Association of CMS‐HCC Risk Scores with Health Care Utilization among Rural and Urban Medicare Beneficiaries
The Centers for Medicare & Medicaid Services (CMS) use Hierarchical Condition Categories (HCC) and demographic information to calculate beneficiary risk scores, which predict expected Medicare spending by beneficiaries. CMS-HCC risk scores may be underestimating expected health care utilization among rural beneficiaries compared to urban beneficiaries. Incorrect estimation of expected health care utilization can lead to… Read more »