Rural Health
Resources by Topic: Health insurance
Medicare Shared Savings Program: Rule Changes and Implications for Rural Health Care Organizations
Summarizes changes to the Centers for Medicare & Medicaid Services (CMS) Medicare Shared Savings Program (SSP) that take effect in January 2023 for current participants, and in January 2024 for organizations applying for a January 1, 2024 start. Discusses the potential impact of these changes on rural health and participation considerations.
Date: 05/2025
Sponsoring organization: Rural Health Value
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Summarizes changes to the Centers for Medicare & Medicaid Services (CMS) Medicare Shared Savings Program (SSP) that take effect in January 2023 for current participants, and in January 2024 for organizations applying for a January 1, 2024 start. Discusses the potential impact of these changes on rural health and participation considerations.
Date: 05/2025
Sponsoring organization: Rural Health Value
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Exploring Oral Health and Care Access among Adults with Disabilities
Report discusses the challenges adults with disabilities have accessing oral healthcare. Explores the role of transportation, Medicare and Medicaid coverage, and metro versus non-metro location, among other factors, as barriers to oral healthcare access for people with disabilities.
Author(s): Morgan Santoro, Lisa J. Heaton, Rebecca Preston, et al.
Date: 04/2025
Sponsoring organization: CareQuest Institute for Oral Health
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Report discusses the challenges adults with disabilities have accessing oral healthcare. Explores the role of transportation, Medicare and Medicaid coverage, and metro versus non-metro location, among other factors, as barriers to oral healthcare access for people with disabilities.
Author(s): Morgan Santoro, Lisa J. Heaton, Rebecca Preston, et al.
Date: 04/2025
Sponsoring organization: CareQuest Institute for Oral Health
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Evolving Remote Monitoring: An Evidence-Based Approach to Coverage and Payment
Reports on trends in utilization of remote patient monitoring (RPM) and discusses policy and payment approaches for effectively and efficiently utilizing RPM, particularly via Medicare and Medicaid. Includes data and discussion of rural barriers to RPM access.
Date: 04/2025
Sponsoring organization: Peterson Center on Healthcare
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Reports on trends in utilization of remote patient monitoring (RPM) and discusses policy and payment approaches for effectively and efficiently utilizing RPM, particularly via Medicare and Medicaid. Includes data and discussion of rural barriers to RPM access.
Date: 04/2025
Sponsoring organization: Peterson Center on Healthcare
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Assisting Rural Consumers
Offers information and guidance for Navigators and certified application counselors helping rural healthcare consumers. Covers rural-relevant considerations and policy updates regarding Federally-facilitated and State-based Marketplaces, Medicaid/CHIP, and Medicare. Outlines tips for assisters to address barriers to care and conducting outreach in rural areas.
Date: 04/2025
Sponsoring organization: Centers for Medicare and Medicaid Services
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Offers information and guidance for Navigators and certified application counselors helping rural healthcare consumers. Covers rural-relevant considerations and policy updates regarding Federally-facilitated and State-based Marketplaces, Medicaid/CHIP, and Medicare. Outlines tips for assisters to address barriers to care and conducting outreach in rural areas.
Date: 04/2025
Sponsoring organization: Centers for Medicare and Medicaid Services
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Sustaining Rural Hospital Access: Adjustments to Medicare Rural Hospital Designations
Describes the history of Medicare rural hospital designations. Discusses how traditional Medicare, Medicare Advantage, and Medicaid impact hospital finances. Outlines policy recommendations to the Secretary of Health and Human Services (HHS) and Congress regarding rural hospitals designations, payment adjustments, Medicare Advantage, and rural ambulance and emergency services.
Author(s): Emma Sheffert, Maya Sandalow
Date: 04/2025
Sponsoring organization: Bipartisan Policy Center
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Describes the history of Medicare rural hospital designations. Discusses how traditional Medicare, Medicare Advantage, and Medicaid impact hospital finances. Outlines policy recommendations to the Secretary of Health and Human Services (HHS) and Congress regarding rural hospitals designations, payment adjustments, Medicare Advantage, and rural ambulance and emergency services.
Author(s): Emma Sheffert, Maya Sandalow
Date: 04/2025
Sponsoring organization: Bipartisan Policy Center
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Ways and Means Republican Members Share Commitment to Value-Based Health Care and Outline Priorities For Medicare Innovation Hub
An April 2025 letter from the U.S. House Committee on Ways and Means majority members regarding the Centers for Medicare & Medicaid Services (CMS) Innovation Center (CMMI). Offers considerations for new and existing models related to promoting value, improving care in rural and underserved communities, and incorporating public input.
Date: 04/2025
Sponsoring organization: House Ways and Means Committee
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An April 2025 letter from the U.S. House Committee on Ways and Means majority members regarding the Centers for Medicare & Medicaid Services (CMS) Innovation Center (CMMI). Offers considerations for new and existing models related to promoting value, improving care in rural and underserved communities, and incorporating public input.
Date: 04/2025
Sponsoring organization: House Ways and Means Committee
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Federal and State Reimbursement for Youth Behavioral Health Services
Report details Medicaid and Children's Health Insurance Program (CHIP) coverage of behavioral health services for rural people under 21 years of age. Breaks down reimbursement eligibility for behavioral health providers in all 50 states and discusses barriers to access in rural areas.
Date: 04/2025
Sponsoring organization: WWAMI Rural Health Research Center
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Report details Medicaid and Children's Health Insurance Program (CHIP) coverage of behavioral health services for rural people under 21 years of age. Breaks down reimbursement eligibility for behavioral health providers in all 50 states and discusses barriers to access in rural areas.
Date: 04/2025
Sponsoring organization: WWAMI Rural Health Research Center
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Stand-Alone Drug Plans Cover a Larger Share of Medicare Part D Enrollees Living in the Most Rural Areas Than Medicare Advantage Plans
Examines Medicare Part D enrollment in stand-alone Medicare prescription drug plans and Medicare Advantage drug plans in 2025. Presents data by urban, rural adjacent, and rural non-adjacent status nationally and by state.
Author(s): Juliette Cubanski, Tricia Neuman, Anthony Damico
Date: 04/2025
Sponsoring organization: KFF
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Examines Medicare Part D enrollment in stand-alone Medicare prescription drug plans and Medicare Advantage drug plans in 2025. Presents data by urban, rural adjacent, and rural non-adjacent status nationally and by state.
Author(s): Juliette Cubanski, Tricia Neuman, Anthony Damico
Date: 04/2025
Sponsoring organization: KFF
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CMS Bundled Payments for Care Improvement Advanced Model: Sixth Annual Evaluation Report
Sixth annual report of the Bundled Payments for Care Improvement Advanced (BPCI Advanced) Model, which tests whether linking payments for a clinical episode of care can reduce Medicare expenditures while maintaining or improving the quality of care. Examines the impact of BPCI Advanced on episode payments, utilization, and quality of care, as well as estimates of Medicare program savings in Model Year 5. Also explores the impact of the model on accountable care relationships, strengthening primary care, and care for patients eligible for both Medicare and Medicaid. Includes data on the percentage of BPCI Advanced episodes with and without ACO attribution by patient characteristics, including rural residents.
Additional links: Appendices, Executive Summary, Findings at a Glance, Transformation Spotlight
Author(s): The Lewin Group, Abt Associates, GDIT, Telligen
Date: 04/2025
Sponsoring organization: Centers for Medicare and Medicaid Services
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Sixth annual report of the Bundled Payments for Care Improvement Advanced (BPCI Advanced) Model, which tests whether linking payments for a clinical episode of care can reduce Medicare expenditures while maintaining or improving the quality of care. Examines the impact of BPCI Advanced on episode payments, utilization, and quality of care, as well as estimates of Medicare program savings in Model Year 5. Also explores the impact of the model on accountable care relationships, strengthening primary care, and care for patients eligible for both Medicare and Medicaid. Includes data on the percentage of BPCI Advanced episodes with and without ACO attribution by patient characteristics, including rural residents.
Additional links: Appendices, Executive Summary, Findings at a Glance, Transformation Spotlight
Author(s): The Lewin Group, Abt Associates, GDIT, Telligen
Date: 04/2025
Sponsoring organization: Centers for Medicare and Medicaid Services
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Addressing Toxic Stress and Health Care Access in California Farmworker Communities: ACCESS Pilot Project Evaluation
Analyzes feedback from the farmworker community in California on the impact of toxic stress in their lives. Utilizes 482 responses from the farmworker community health survey to investigate issues such as toxic stress, public health outreach and education, healthcare access in rural areas, barriers to insurance coverage, and ways to address toxic stress in farmworker communities.
Author(s): Ingrid Estrada-Darley, Alejandro Roa Contreras, Cristina Alvarez, et al.
Date: 04/2025
Sponsoring organization: RAND Corporation
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Analyzes feedback from the farmworker community in California on the impact of toxic stress in their lives. Utilizes 482 responses from the farmworker community health survey to investigate issues such as toxic stress, public health outreach and education, healthcare access in rural areas, barriers to insurance coverage, and ways to address toxic stress in farmworker communities.
Author(s): Ingrid Estrada-Darley, Alejandro Roa Contreras, Cristina Alvarez, et al.
Date: 04/2025
Sponsoring organization: RAND Corporation
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