Rural Health
Resources by Topic: Health insurance
Marriage and Family Therapist and Mental Health Counselor Workforces in Rural America Under New Medicare Reimbursement Policy
Describes how Medicare reimbursement expanded to cover marriage and family therapists (MFTs) and mental health counselors (MHCs) in January 2024. Examines the change in Medicare-enrolled MFTs and MHCs between the third quarter (Q3) of 2023 and fourth quarter (Q4) of 2024. Presents findings from semi-structured interviews with rural health system and mental health organization leaders regarding practice arrangements, the perceived impacts of MFT and MHC reimbursement, barriers to serving rural Medicare beneficiaries, and considerations for future policies.
Author(s): Janessa M. Graves, Natalia V. Oster, Lisa A. Garberson, Davis G. Patterson, C. Holly A. Andrilla
Date: 06/2026
Sponsoring organization: WWAMI Rural Health Research Center
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Describes how Medicare reimbursement expanded to cover marriage and family therapists (MFTs) and mental health counselors (MHCs) in January 2024. Examines the change in Medicare-enrolled MFTs and MHCs between the third quarter (Q3) of 2023 and fourth quarter (Q4) of 2024. Presents findings from semi-structured interviews with rural health system and mental health organization leaders regarding practice arrangements, the perceived impacts of MFT and MHC reimbursement, barriers to serving rural Medicare beneficiaries, and considerations for future policies.
Author(s): Janessa M. Graves, Natalia V. Oster, Lisa A. Garberson, Davis G. Patterson, C. Holly A. Andrilla
Date: 06/2026
Sponsoring organization: WWAMI Rural Health Research Center
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2026 Annual Report of the Boards of Trustees of the Federal Hospital Insurance and Federal Supplementary Medical Insurance Trust Funds
Report detailing the current state of the Medicare Hospital Insurance (HI) and Supplemental Medical Insurance (SMI) Trust Funds. Discusses Medicare expenditures as a percentage of Gross Domestic Product (GDP) and makes short and long-range sustainability projections based on variable economic, demographic, and healthcare trends. Also explains the actuarial methods used to calculate the estimates. Includes information on Medicare payment policy updates since the 2025 report.
Additional links: Tables and Figures
Date: 06/2026
Sponsoring organization: Board of Trustees, Federal Hospital Insurance and Federal Supplementary Medical Insurance Trust Funds
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Report detailing the current state of the Medicare Hospital Insurance (HI) and Supplemental Medical Insurance (SMI) Trust Funds. Discusses Medicare expenditures as a percentage of Gross Domestic Product (GDP) and makes short and long-range sustainability projections based on variable economic, demographic, and healthcare trends. Also explains the actuarial methods used to calculate the estimates. Includes information on Medicare payment policy updates since the 2025 report.
Additional links: Tables and Figures
Date: 06/2026
Sponsoring organization: Board of Trustees, Federal Hospital Insurance and Federal Supplementary Medical Insurance Trust Funds
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Medicare Hospice: Action Needed to Pay More Efficiently for Routine Home Care
Describes the frequency and characteristics of routine home care visits in 2024 for Medicare beneficiaries enrolled in hospice since 2022 who died or were discharged alive in 2024. Compares estimated per-visit Medicare payment rates for routine home care across hospices with the highest and lowest number of visits per week and to home health per-visit rates. Includes information on the average number of visits per week by rural and urban hospice providers. Offers recommendations to the U.S. Department of Health and Human Services regarding revisions to the hospice payment system.
Additional links: Full Report
Date: 06/2026
Sponsoring organization: Government Accountability Office
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Describes the frequency and characteristics of routine home care visits in 2024 for Medicare beneficiaries enrolled in hospice since 2022 who died or were discharged alive in 2024. Compares estimated per-visit Medicare payment rates for routine home care across hospices with the highest and lowest number of visits per week and to home health per-visit rates. Includes information on the average number of visits per week by rural and urban hospice providers. Offers recommendations to the U.S. Department of Health and Human Services regarding revisions to the hospice payment system.
Additional links: Full Report
Date: 06/2026
Sponsoring organization: Government Accountability Office
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Medicaid Home- and Community-Based Services Rebalancing Is Concentrated in Large Urban Areas
Compares rural and urban utilization of home and community-based services among Medicaid long-term services and supports users, using 2022 Transformed Medicaid Statistical Information System data sourced through an ATI Advisory LTSS user dashboard. Analyzes rural-urban disparities in access by level of rurality and by state.
Author(s): Emmaline Keesee, Laura M. Keohane
Citation: The Journal of the Post-Acute and Long-Term Care Medical Association, 27(6), 106208
Date: 06/2026
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Compares rural and urban utilization of home and community-based services among Medicaid long-term services and supports users, using 2022 Transformed Medicaid Statistical Information System data sourced through an ATI Advisory LTSS user dashboard. Analyzes rural-urban disparities in access by level of rurality and by state.
Author(s): Emmaline Keesee, Laura M. Keohane
Citation: The Journal of the Post-Acute and Long-Term Care Medical Association, 27(6), 106208
Date: 06/2026
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MBQIP Quality Measures National Annual Report - 2024
Summarizes quality measure reporting rates and performance among Critical Access Hospitals (CAHs) in 2024. Presents data on the five Medicare Beneficiary Quality Improvement Project (MBQIP) domains: global measures, patient safety, patient engagement, care coordination, and emergency department.
Date: 06/2026
Sponsoring organization: Flex Monitoring Team
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Summarizes quality measure reporting rates and performance among Critical Access Hospitals (CAHs) in 2024. Presents data on the five Medicare Beneficiary Quality Improvement Project (MBQIP) domains: global measures, patient safety, patient engagement, care coordination, and emergency department.
Date: 06/2026
Sponsoring organization: Flex Monitoring Team
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Medicare Advantage Enrollment Update 2025
Reports on the percentage of rural Medicare beneficiaries enrolled in Medicare Advantage (MA) plans by metropolitan and nonmetropolitan location and plan type, from 2015-2025.
Author(s): Edmer Lazaro, Fred Ullrich, Dan M. Shane, Keith Mueller
Date: 05/2026
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Reports on the percentage of rural Medicare beneficiaries enrolled in Medicare Advantage (MA) plans by metropolitan and nonmetropolitan location and plan type, from 2015-2025.
Author(s): Edmer Lazaro, Fred Ullrich, Dan M. Shane, Keith Mueller
Date: 05/2026
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Billing of Distant Site Telehealth Services in Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs)
Presents instructions on how Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs) should bill distant site telehealth services for services provided on or after October 1, 2026.
Date: 05/2026
Sponsoring organization: Centers for Medicare & Medicaid Services
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Presents instructions on how Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs) should bill distant site telehealth services for services provided on or after October 1, 2026.
Date: 05/2026
Sponsoring organization: Centers for Medicare & Medicaid Services
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2024 QPP Participation and Performance Results: At-a-Glance
Provides an overview of the results of the Quality Payment Program (QPP) for the 2024 performance year. Highlights the percentages of small and rural providers receiving negative, neutral, and positive payment adjustments for 2026.
Date: 05/2026
Sponsoring organization: Centers for Medicare & Medicaid Services
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Provides an overview of the results of the Quality Payment Program (QPP) for the 2024 performance year. Highlights the percentages of small and rural providers receiving negative, neutral, and positive payment adjustments for 2026.
Date: 05/2026
Sponsoring organization: Centers for Medicare & Medicaid Services
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How Do Changes in Medicare Reimbursement for Mental Health Services Impact Access for Rural Older Adults?
Examines how policies allowing marriage and family therapists (MFTs) and mental health counselors (MHCs) to independently bill Medicare have impacted mental healthcare access among Medicare beneficiaries living in rural areas. Utilizes interview data from 14 leaders representing rural health systems and mental health organizations regarding their perceptions on mental healthcare access, Medicare reimbursement policy, and the inclusion of MFTs and MHCs as mental health providers for Medicare recipients.
Author(s): Natalia V. Oster, C. Holly A. Andrilla, Davis G. Patterson, Signe Burchim, Janessa M. Graves
Citation: Journal of Rural Health, 42(2), e70162
Date: 05/2026
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Examines how policies allowing marriage and family therapists (MFTs) and mental health counselors (MHCs) to independently bill Medicare have impacted mental healthcare access among Medicare beneficiaries living in rural areas. Utilizes interview data from 14 leaders representing rural health systems and mental health organizations regarding their perceptions on mental healthcare access, Medicare reimbursement policy, and the inclusion of MFTs and MHCs as mental health providers for Medicare recipients.
Author(s): Natalia V. Oster, C. Holly A. Andrilla, Davis G. Patterson, Signe Burchim, Janessa M. Graves
Citation: Journal of Rural Health, 42(2), e70162
Date: 05/2026
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Tennessee's Community Health Worker Strategy Is Succeeding. Which State Will Be Next?
Discusses the role community health workers (CHWs) can play in improving healthcare outcomes and addressing unmet needs in both rural and urban communities. Details Tennessee's state-funded implementation of a evidence-based CHW infrastructure, and highlights the outcomes over the first two years of the program. Explores how this approach could be implemented in other states.
Author(s): Victor Wu, Brea Burke, Nikayla Boyd, et al.
Citation: Health Affairs Forefront
Date: 05/2026
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Discusses the role community health workers (CHWs) can play in improving healthcare outcomes and addressing unmet needs in both rural and urban communities. Details Tennessee's state-funded implementation of a evidence-based CHW infrastructure, and highlights the outcomes over the first two years of the program. Explores how this approach could be implemented in other states.
Author(s): Victor Wu, Brea Burke, Nikayla Boyd, et al.
Citation: Health Affairs Forefront
Date: 05/2026
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