This paper describes the EMS-related projects that the 45 states receiving funding from the Medicare Rural Hospital Flexibility (Flex) Program proposed to conduct in fiscal year 2004-2005. Since the first full year of funding, the number and range of EMS improvement activities proposed has increased substantially. Because of the variability across states in the specifics of EMS activities proposed in grant applications, a method was sought that would create a logical framework for classifying activities, in order to better understand the types of EMS challenges that states are trying to address with Flex funding. The project team identified the Rural and Frontier EMS Agenda for the Future (R/F Agenda) as an appropriate guide document for cataloging and describing state proposed activities. The EMS activities were assigned to one or more of fourteen EMS attributes from the R/F Agenda. State Flex grant funds are not sufficient to ameliorate all rural EMS problems. Use of the R/F Agenda for classifying state Flex activities not only allows for identification of EMS problem areas that are most frequently being addressed with the use of Flex grant funds, but also identifies those challenges that likely need to be addressed through other mechanisms. This report will provide the EMS, rural health, and federal policy constituencies with an overview of the extent to which nationally recognized rural EMS challenges are being addressed with Flex program funding.
Cutler Institute for Health and Social Policy
Emergency Medical Services (EMS) Activities Funded by the medicare Rural Hospital Flexibility Program
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Dr. Ziller to speak on Rural Implementation and Impact of Medicaid Expansions
The impact of the ACA Medicaid expansion on health care coverage and access in rural areas is largely unknown and will depend on the different state policy contexts in which the expansions are implemented and on existing system capacity. Understanding how many rural residents are likely to become newly eligible for Medicaid under the ACA, as well as their characteristics and health status, will provide important information to aid policymakers in structuring outreach and enrollment strategies and ensuring that the healthcare infrastructure and delivery systems in rural areas can address the needs of these individuals.
On March 18th, Dr. Ziller, Deputy Director of the Maine Rural Health Research Center at the University of Southern Maine, will present via a SHARE webinar, nationally representative information identifying rural-urban differences among low-income non-elderly adults (18 to 65) in the following areas:
- Medicaid eligibility, pre-ACA
- Medicaid participation, pre-ACA
- New Medicaid eligibility in 2014
Dr. Ziller will also analyze the characteristics associated with any rural-urban differences in the above areas. Characteristics to be considered include age, gender, employment, education, income, Census region, health status, current relationship to primary care provider, primary care supply, and FQHC availability.