This week, the CMS Innovation Center released the final evaluation results of the Accountable Care Organization (ACO) Investment Model (AIM), which operated under the Shared Savings Program (SSP) from 2015 to 2018. AIM provided up-front payments to select ACOs to invest in infrastructure and staffing and targeted small ACOs, many of which were in rural areas. Overall, participating ACOs reduced total Medicare spending and utilization without decreasing quality of care. Read more here.
Advancing Value-Based Care in States
This week, the Centers for Medicare & Medicaid Services (CMS) released guidance to states on pathways they can use to advance value-based care, which seeks to reward providers based on quality of care instead of volume of services. This letter describes several models that can be used across many types of payers, key features of these models, and relevant Medicaid authorities needed for adoption. It includes several models identified in 2019 by Rural Health Value as appropriate for rural clinicians or health care delivery organizations. Read more here.
Comments Requested: Part I of the CY 2022 Advance Notice of Medicare Advantage and Part D Payment Policies—November 13
This week, the Centers for Medicare & Medicaid Services (CMS) released earlier than usual their proposal for contract year 2022 to calculate risk scores for Medicare Advantage (MA) payments using only encounter data submitted by MA organizations and the 2020 CMS Hierarchical Conditions Categories (HCC) model. The intent of risk adjustment is to ensure that payments to MA plans reflect the relative risk, or characteristics and health conditions, of the enrollees. Research has found lower average risk scores for beneficiaries served by rural providers than urban, which is contrary to extensive research showing rural populations are less healthy than urban. Read more here.
HHS Request for Information: Laboratory Testing for COVID-19 – September 21
The U.S. Department of Health and Human Services (HHS) seeks information on the ability of certain commercial, academic, medical center, and public health laboratories to expand diagnostic testing for COVID-19. Read more here.
Obstetric Emergencies in Rural Hospitals: Challenges and Opportunities
This policy brief from the University of Minnesota Rural Health Research Center describes the challenges rural hospitals face in providing emergency obstetric care and highlights resources that could help rural hospitals more safely respond to obstetric emergencies. Read more here.
Public Health Leaders’ Testimony on Vaccinations
Last week, two of the nation’s top leaders in public health delivered testimony to the U.S. Senate Committee on Health, Education, Labor and Pensions (HELP) about the importance of immunizations for children and adults. Written testimony of NIH Director Dr. Francis Collins and Surgeon General VADM Jerome Adams is available here on the HELP Committee’s website, and you may watch a recording of the full three-hour session. Read more here.
CDC: Delay or Avoidance of Medical Care Because of COVID-19-Related Concerns
In its latest Morbidity and Mortality Weekly Report, the Centers for Disease Control and Prevention (CDC) presents findings of a survey conducted in June of this year. Researchers estimate that 41 percent of U.S. adults had delayed or avoided medical care because of concerns about COVID-19. Avoidance of urgent or emergency care was more prevalent among unpaid caregivers for adults, persons with underlying medical conditions, Black adults, Hispanic adults, young adults, and persons with disabilities. The findings indicate missed opportunities for management of chronic conditions, receipt of routine vaccinations, or early detection of new conditions, which might worsen outcomes. Read more here.
HHS Strategy to Distribute COVID-19 Vaccine
The U.S. Department of Health and Human Services (HHS) released its strategy to distribute a COVID-19 vaccine after one has received approval from the Food and Drug Administration. It focuses on four key tasks necessary to ensure access and the requirements for each. The primary task is to engage with state, tribal, territorial, and local partners, other stakeholders, and the public to communicate public health information, before and after distribution begins. Read more here.
Research: Rural Residents Pay Higher Insurance Rates
By Liz Carey
Lack of competition for insurance and healthcare services are two of the likely culprits.
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Strained Rural Water Utilities Buckle Under Pandemic Pressure
By April Simpson
Covid-19 forced many water utilities to maintain service with far less revenue. Two bills making their way through Congress could provide support.
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