Rural Health
Resources by Topic: Health insurance
MedPAC Report to the Congress: Medicare Payment Policy: Skilled Nursing Facility Services: Chapter 6
Discusses payment adequacy for skilled nursing facility (SNF) services. Features statistics on SNF care provided by rural hospitals and Critical Access Hospitals (CAHs) via swing beds and Medicare margins for urban, rural, and frontier freestanding SNFs in 2023.
Date: 03/2025
Sponsoring organization: Medicare Payment Advisory Commission
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Discusses payment adequacy for skilled nursing facility (SNF) services. Features statistics on SNF care provided by rural hospitals and Critical Access Hospitals (CAHs) via swing beds and Medicare margins for urban, rural, and frontier freestanding SNFs in 2023.
Date: 03/2025
Sponsoring organization: Medicare Payment Advisory Commission
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MedPAC Report to the Congress: Medicare Payment Policy: Home Health Care Services: Chapter 7
Discusses payment adequacy for home health care services. Features statistics on Medicare margins for home health agencies between 2019-2023 with breakdowns by urban and rural areas, a comparison of patient-experience quality measures by urban and rural status, and the number of home health periods provided to rural beneficiaries.
Date: 03/2025
Sponsoring organization: Medicare Payment Advisory Commission
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Discusses payment adequacy for home health care services. Features statistics on Medicare margins for home health agencies between 2019-2023 with breakdowns by urban and rural areas, a comparison of patient-experience quality measures by urban and rural status, and the number of home health periods provided to rural beneficiaries.
Date: 03/2025
Sponsoring organization: Medicare Payment Advisory Commission
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MedPAC Report to the Congress: Medicare Payment Policy: Hospice Services: Chapter 9
Discusses payment adequacy for hospice and palliative support services. Includes data on average costs by day and aggregate margins by urban and rural status, as well as demographics on Medicare decedents who used hospice during 2010 and between 2019-2023. Compares the actual hospice utilization rates in micropolitan, rural adjacent, rural nonadjacent, and frontier areas to urban hospice utilization rates.
Date: 03/2025
Sponsoring organization: Medicare Payment Advisory Commission
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Discusses payment adequacy for hospice and palliative support services. Includes data on average costs by day and aggregate margins by urban and rural status, as well as demographics on Medicare decedents who used hospice during 2010 and between 2019-2023. Compares the actual hospice utilization rates in micropolitan, rural adjacent, rural nonadjacent, and frontier areas to urban hospice utilization rates.
Date: 03/2025
Sponsoring organization: Medicare Payment Advisory Commission
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MedPAC Report to the Congress: Medicare Payment Policy, 2025
Annual review of Medicare payment policies, with recommendations to Congress. Includes discussion on Medicare payment policies directly affecting rural providers and beneficiaries. Addresses payment adequacy for Medicare fee-for-service payment systems, Medicare Advantage (MA), and Medicare Part D.
Date: 03/2025
Sponsoring organization: Medicare Payment Advisory Commission
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Annual review of Medicare payment policies, with recommendations to Congress. Includes discussion on Medicare payment policies directly affecting rural providers and beneficiaries. Addresses payment adequacy for Medicare fee-for-service payment systems, Medicare Advantage (MA), and Medicare Part D.
Date: 03/2025
Sponsoring organization: Medicare Payment Advisory Commission
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Report to Congress on Medicaid and CHIP, March 2025
Reports on three aspects of Medicaid of interest to Congress: 1) improving the usability and transparency of the managed care external quality review process, 2) improvements on timely access to home- and community-based services (HCBS), and 3) ways to streamline Medicaid Section 1915 authorities for home-and community-based services and reduce the administrative burden.
Date: 03/2025
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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Reports on three aspects of Medicaid of interest to Congress: 1) improving the usability and transparency of the managed care external quality review process, 2) improvements on timely access to home- and community-based services (HCBS), and 3) ways to streamline Medicaid Section 1915 authorities for home-and community-based services and reduce the administrative burden.
Date: 03/2025
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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March 2025 MedPAC Meeting Transcript
Transcript from the Medicare Payment Advisory Commission's (MedPAC) March 2025 meeting. Covers research and proposals related to reforming physician fee schedule updates and improving the accuracy of relative payment rates, reducing beneficiary cost-sharing for outpatient services at Critical Access Hospitals, Medicare insurance agents, Medigap, payment for ground ambulance services, home healthcare use among Medicare Advantage enrollees, and institutional special needs plans. Includes rural references and considerations throughout.
Additional links: Mandated Report: Payment for Ground Ambulance Services, Reducing Beneficiary Cost-Sharing for Outpatient Services at Critical Access Hospitals
Date: 03/2025
Sponsoring organization: Medicare Payment Advisory Commission
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Transcript from the Medicare Payment Advisory Commission's (MedPAC) March 2025 meeting. Covers research and proposals related to reforming physician fee schedule updates and improving the accuracy of relative payment rates, reducing beneficiary cost-sharing for outpatient services at Critical Access Hospitals, Medicare insurance agents, Medigap, payment for ground ambulance services, home healthcare use among Medicare Advantage enrollees, and institutional special needs plans. Includes rural references and considerations throughout.
Additional links: Mandated Report: Payment for Ground Ambulance Services, Reducing Beneficiary Cost-Sharing for Outpatient Services at Critical Access Hospitals
Date: 03/2025
Sponsoring organization: Medicare Payment Advisory Commission
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Merit-Based Incentive Payment System (MIPS): 2024 Opt-in and Voluntary Reporting Election Process Guide
Discusses the eligibility of clinicians, groups, and Alternative Payment Model (APM) participants that exceed some low-volume threshold criteria to opt-in to the Merit-Based Incentive Payment System (MIPS) and the APM Performance Pathway (APP) for the 2024 performance period. Compares opting in and voluntarily reporting MIPS data and provides an overview of the election process.
Date: 03/2025
Sponsoring organization: Centers for Medicare and Medicaid Services
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Discusses the eligibility of clinicians, groups, and Alternative Payment Model (APM) participants that exceed some low-volume threshold criteria to opt-in to the Merit-Based Incentive Payment System (MIPS) and the APM Performance Pathway (APP) for the 2024 performance period. Compares opting in and voluntarily reporting MIPS data and provides an overview of the election process.
Date: 03/2025
Sponsoring organization: Centers for Medicare and Medicaid Services
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Rural Emergency Hospital (REH) Model Frequently Asked Questions
Provides answers to frequently asked questions regarding the Rural Emergency Hospital (REH) designation. Covers general information, Conditions of Participation, and REH payment policies.
Date: 03/2025
Sponsoring organizations: Mathematica, Rural Health Redesign Center
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Provides answers to frequently asked questions regarding the Rural Emergency Hospital (REH) designation. Covers general information, Conditions of Participation, and REH payment policies.
Date: 03/2025
Sponsoring organizations: Mathematica, Rural Health Redesign Center
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February 2025 MACPAC Meeting Transcript
Transcript from the Medicaid and CHIP Payment and Access Commission's (MACPAC) February 2025 meeting. Covers transitions of care for children and youth with special healthcare needs (CYSHCN), hospital non-disproportionate share hospital supplemental payments and directed payment targeting, improving access to medications for opioid use disorder, healthcare access for children in foster care, and more. Includes rural references throughout.
Additional links: Hospital Non-DSH Supplemental Payment and Directed Payment Targeting Analyses
Date: 02/2025
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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Transcript from the Medicaid and CHIP Payment and Access Commission's (MACPAC) February 2025 meeting. Covers transitions of care for children and youth with special healthcare needs (CYSHCN), hospital non-disproportionate share hospital supplemental payments and directed payment targeting, improving access to medications for opioid use disorder, healthcare access for children in foster care, and more. Includes rural references throughout.
Additional links: Hospital Non-DSH Supplemental Payment and Directed Payment Targeting Analyses
Date: 02/2025
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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Rural Health Disparities and Differences in Definitions of Rurality
Examines health disparities and differences in healthcare characteristics between rural and nonrural counties using data from the 2023 County Health Rankings and 2021-2022 Area Health Resources Files. Compares community health and healthcare characteristics by two county-level urban-rural classification systems: Rural-Urban Continuum Codes (RUCC) and Core Based Statistical Areas (CBSAs). Explores the degree to which four county-level classification systems - RUCC, CBSA, the National Center for Health Statistics (NCHS) Urban-Rural Classification Scheme for Counties, and Urban Influence Codes (UIC) - agree regarding which counties are designated as rural.
Date: 02/2025
Sponsoring organizations: HHS Office of the Assistant Secretary for Planning and Evaluation, NORC at the University of Chicago
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Examines health disparities and differences in healthcare characteristics between rural and nonrural counties using data from the 2023 County Health Rankings and 2021-2022 Area Health Resources Files. Compares community health and healthcare characteristics by two county-level urban-rural classification systems: Rural-Urban Continuum Codes (RUCC) and Core Based Statistical Areas (CBSAs). Explores the degree to which four county-level classification systems - RUCC, CBSA, the National Center for Health Statistics (NCHS) Urban-Rural Classification Scheme for Counties, and Urban Influence Codes (UIC) - agree regarding which counties are designated as rural.
Date: 02/2025
Sponsoring organizations: HHS Office of the Assistant Secretary for Planning and Evaluation, NORC at the University of Chicago
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