RUPRI Health Panel Submits Comments to House Ways & Means Committee on Improving Access to Health Care in Rural and Underserved Areas. October 2023.

The RUPRI Health Panel offers comments in response to the Committee on Ways and Means Request for Information regarding Improving Access to Health Care in Rural and Underserved Areas. The comments focus on all five topics included in the RFI. The five topics include comments on: Geographic Payment Difference: The Panel recommends that changes to …

RUPRI Health Panel Submits Comments to Physician-Focused Payment Model TA Committee. October 2023

The RUPRI Health Panel has offered comments and resources in response to the Physician-Focused Payment Model Request for Information (RFI) regarding rural participation in population-based total cost of care models. The Office of the Assistant Secretary for Planning and Evaluation in HHS convenes the PTAC. Find the Comments Here

RUPRI Health Panel Submits Comments on HHS Smoking Cessation Framework

The RUPRI Health Panel provided comments on the HHS 2023 Smoking Cessation Framework. Read the Comments Here. To be most impactful in rural communities, the Panel recommends a broader approach to tobacco cessation, not just smoking cessation. The prevalence of smokeless tobacco (e.g., snuff, dip, snus, and chewing tobacco) is higher in rural areas than …

RUPRI Health Panel Releases New Policy Paper, The Role of Telehealth in Achieving a High Performing Rural Health System: Priorities in a Post-Pandemic System. February 2023.

The RUPRI Health Panel has released a new brief, The Role of Telehealth in Achieving a High Performing Rural Health System: Priorities in a Post-Pandemic System, as a commentary on the preconditions for the optimum use of telehealth, looking at experiences of telehealth usage during the PHE. KEY CONSIDERATIONThe Panel continues to contribute to discussions …

RUPRI Health Panel Releases State-Based Recommendations to Support Rural Ambulance Agencies. February 2023.

The RUPRI Health Panel has released a new Policy Brief, State-Based Recommendations to Support Rural Ambulance Agencies. State-Based Recommendations• To ensure access to emergency medical services (EMS) for all rural residents, state legislatures should designate EMS as an essential service and provide a portion of the funding necessary to support the costs of maintaining essential …

RUPRI Health Panel Releases New Paper on Payment Policies and Implications for Rural Hospitals. December 2022

The RUPRI Health Panel Releases Evolution of Hospital Designations & Payment in the U.S.: Implications for Rural Hospitals Rural hospital closures have increased over the past few decades, and more are at risk for closure. Medicare hospital payment policies affecting rural hospitals play a significant role in the financial viability of rural hospitals. Programs have …

RUPRI Health Panel Submits Comment Letter on Hospital PPS. September 2022

The RUPRI Health Panel submitted a comment letter to CMS responding to Request For Information CMS-4203-NC: Medicare Program: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems and Quality Reporting Programs… Rural Emergency Hospitals. READ THE COMMENT LETTER HERE

RUPRI Health Panel Submits Comments to CMS RFI 1770-P Medicare and Medicaid Programs; CY 2023 Payment Policies Under the Physician Fee Schedule; Medicare Shared Savings Program Requirements. September 2022.

The RUPRI Health Panel has submitted a response to CMS -17700P Medicare and Medicaid Programs; CY 2023 Payment Policies Under the Physician Fee Schedule and Other Changes to Part B Payment Policies; Medicare Shared Savings Program Requirements. READ THE COMMENT LETTER HERE

RUPRI Health Panel Comment Letter on Medicare Advantage Program

The RUPRI Health Panel has responded to a CMS Request for Information on the Medicare Advantage program. READ COMMENT LETTER HERE Rural Perspective on Medicare AdvantageOur comments and feedback are offered from the rural perspective, where Medicare Advantage is an increasingly important source of health care coverage. As of March 2022, MA accounted for 45.7 …

RUPRI Health Panel Comment Letter on Access to Coverage and Care in Medicaid & CHIP. April 2022

Click Here for Comment Letter The Panel underscores the importance of recognizing the variance in demand for Medicaid access and coverage across non-metro and metro areas. In 2019, the percent of Medicaid coverage in non-metro areas was 22.4 percent, whereas in metro areas the percent of Medicaid coverage was 19.1. The three percent difference signifies …

RUPRI Health Panel Releases Comment Letter to Federal Communications Commission RFI on Promoting Telehealth in Rural America. April 2022

Click Here for Comment Letter on 47 CFR Part 54 The Panel is encouraged by the efforts of the FCC to increase broadband access for rural providers. We encourage FCC to lead an effort to quantify the actual costs of connecting and operating broadband capacity supporting access to healthcare services. With that information subsidies could …

Listen to Dr. Keith Mueller Interview on Rural Health Leadership Radio Podcast. April 2022

Listen to Podcast Here If you could hit the reset button on healthcare policy, what would you change? In this week’s episode, Dr. Keith Mueller shares his thoughts on what he would improve given the chance to hit the policy reset button, particularly in rural healthcare. “The pandemic taught us we need flexibility to move …

RUPRI Health Panel Releases New Report, Meeting The Behavioral Health Needs of Farm Families in Times of Economic Distress. February 2022.

Meeting the Behavioral Health Needs of Farm Families in Times of Economic Distress. Given recent global economic and climate trends, including those induced by the COVID-19 public health emergency, behavioral health consequences related to economic distress will likely continue as a public health concern for the foreseeable future. The RUPRI Health Panel offers guidance for …

RUPRI Health Panel Releases Updated High Performing Rural Health System Brief.

This document updates the RUPRI Health Panel’s framework for a high-performing rural health care system, originally published in 2011. It offers a revised vision statement and updates the high-performing rural health system pillars (access, affordability, community health, and quality), and describes an underlying base of equity considerations. Abstract: This brief presents the RUPRI Health Panel’s …

RUPRI Health Panel Releases Comments on Rural Emergency Hospital RFI

The Panel is pleased to comment in response to the proposed rule for Medicare hospital outpatient prospective payment system (OPPS) program and the Request for Information (RFI) on Rural Emergency Hospitals (REH). Our comments will focus only on the latter, Section XVII of the proposed rule, Federal Register pages 42285 – 42289. We also limit …

RUPRI Releases Comments on Office Of Management & Budget Proposal to Revise Metropolitan and Micropolitan Area Standards. March 2021

RUPRI, led by the Rural Health Panel and the Population and Place Analytics Panel, has released comments on Recommendations from the Metropolitan and Micropolitan Statistical Area Standards Review Committee to Changes in Metropolitan and Micropolitan Area Standards. Read Comments Here In our comments, we recommend that OMB not implement a change in the metropolitan statistical …

Characteristics & Challenges of Rural Ambulance Agencies. RUPRI Health Panel. January 2021.

The RUPRI Health Panel has released a new brief, Characteristics and Challenges of Rural Ambulance Agencies. Every year, nearly 10 million rural Americans receive EMS care. There are 23,272 ambulance agencies in the U.S. and 73 percent of those agencies report serving rural areas. Thus, rural Americans rely on EMS professionals to deliver life-saving emergency …

Advancing Population Health in Rural Places: New from RUPRI Health Panel. January 2021.

The RUPRI Health Panel has released a new paper, Advancing Population Health in Rural Places: Key Lessons and Policy Opportunities. This paper advances policy discussion of population health in rural places, focusing on the role of rural health care organizations. Lessons from ongoing programs provide policy considerations. Medicare and Medicaid programs should prioritize staff and …

The Evolving Landscape of National Telehealth Policies during a Public Health Emergency: Responsiveness to Rural Needs

The coronavirus pandemic precipitated significant but temporary changes in telehealth policy and the use of telehealth services to ensure access to needed health services during a public health emergency (PHE). Extending the temporary policy changes will require statutory and regulatory action. This paper takes stock of current telehealth policies and assesses options for expanding the …

Considerations for Defining Rural Places in Health Policies and Programs

The RUPRI Health Panel has released a new brief that identifies key questions to ask when creating, modifying, or using a definition. Rural definitions in statute and policy are used to direct resources to underserved peoples. But changes in population behavior and Census processes have led to concern about historic methods of defining rural. This …

Behavioral Health in Rural America: Challenges and Opportunities

The prevalence of mental health and substance use diagnoses and unmet treatment needs are not equally distributed, with rural residence being one factor associated with these differences. Moreover, the rural context has proven challenging for ensuring the availability of and access to prevention, diagnosis, treatment, and recovery services in rural areas. This paper reviews the …

Health Panel Comment Letter – Anti-Kickback Statute – December 2019

The Panel is pleased to provide comment on the proposed rule Revisions to Safe Harbors Under the Anti-Kickback Statute, and Civil Monetary Penalty Rules Regarding Beneficiary Inducements. The Panel is encouraged by OIG’s recognition that there are certain circumstances that warranttreating rural providers differently than those in urban geographies. The Panel offers comments ontwo specific …

Health Panel Comment Letter – Stark Law – December 2019

The Panel is pleased to provide comments on the proposed rule Modernizing and Clarifying the Physician Self-Referral Regulations.The Panel is encouraged by CMS’s recognition throughout the proposed rule of the unique ruralhealth care environment. The Panel agrees that circumstances exist in which it is appropriate to treatrural providers differently than other kinds of providers. View …

Health Panel Comment Letter – PFS Proposed Rule 2020 Revisions – September 2019

The Panel is pleased to offer comments in response to the proposed updates to the CY 2020 Revisions to Payment Policies Under the Physician Fee Schedule (PFS) The Panel applauds CMS’s attention to rural issues throughout the proposed rule. CMS hasdemonstrated its commitment to rural areas in considering innovative telehealth care delivery foropioid use disorder …

Policy Opportunities for Advancing Rural Health

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 …

Toward a High Performing Rural Health Care System: Key Issues and Recommendations from Rural Health Care System Innovators. Roundtable with Rural Health Innovators. RUPRI Rural Health Panel. December 2018.

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 …

Health Panel Comment Letter – NQF Draft Report – February 2019

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 …

Health Panel Comment Letter – Medicare, Medicaid & CHIP – January 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 …

Health Panel Comment Letter – Medicare, Part D & Medicaid – December 2018

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, …

Assessing the Unintended Consequences of Health Policy on Rural Populations and Places

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 …

Health Panel Comment Letter – ACO Proposed Rule – October 2018

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 …

RUPRI’s Rural Health Research Findings included in new GAO Report on Rural Hospital Closures

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 …

Health Panel Comment Letter – Outpatient Payment & Interoperability – Septembe 2018

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 …

Webinar – Insuring Rural America: Health Insurance Challenges and Opportunities

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 …

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

Health Panel Comment Letter – Revisions to Physician Payments – September 2018

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 …

Primary Care: The Foundation for a High-Performance Rural Health Care System

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 …

Insuring Rural America: Health Insurance Challenges and Opportunities

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 …

Oral Testimony for the U.S. Senate Committee on Finance

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 …

Written Statement for the U.S. Senate Finance Committee

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 …