Rural Health
Resources by Topic: Healthcare business and finance
Strategies for Critical Access Hospital Financial and Operational Performance Improvement: A Systematic Review
Summarizes findings from a systematic review of peer-reviewed and grey literature published since 2000 regarding financial and operational performance improvement interventions implemented by Critical Access Hospitals (CAHs) and rural hospitals in the United States and in other developed countries. Identifies key intervention areas, including service line optimization, revenue and cost management, and technology adoption, among others. Describes how State Flex Programs and hospital administrators can use these findings to inform decision-making and resource allocation.
Author(s): Angelina Budko, Laura Bozovich McFadyen, Carrie Baldwin-SoRelle, et al.
Date: 04/2026
Sponsoring organization: Flex Monitoring Team
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Summarizes findings from a systematic review of peer-reviewed and grey literature published since 2000 regarding financial and operational performance improvement interventions implemented by Critical Access Hospitals (CAHs) and rural hospitals in the United States and in other developed countries. Identifies key intervention areas, including service line optimization, revenue and cost management, and technology adoption, among others. Describes how State Flex Programs and hospital administrators can use these findings to inform decision-making and resource allocation.
Author(s): Angelina Budko, Laura Bozovich McFadyen, Carrie Baldwin-SoRelle, et al.
Date: 04/2026
Sponsoring organization: Flex Monitoring Team
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April 2026 MedPAC Meeting Transcript
Transcript from the Medicare Payment Advisory Commission's (MedPAC) April 2026 meeting. Covers Medicare payment incentives, regional benchmarks and benchmark-plan availability in the Part D prescription drug plan (PDP) market, preferred networks and pharmacy access in Medicare Part D, the estimated association between Medicare Advantage enrollment and hospitals' and post-acute care providers' finances, information sources that beneficiaries use to make Medicare enrollment decisions, and institutional special-needs plans. Includes a mandated report on the assessment of the Medicare ground ambulance data collection system. Includes rural references and considerations throughout.
Additional links: Advising the Congress on Medicare Issues Preferred Networks and Pharmacy Access in Part D, Mandated Report: Assessment of the Medicare Ground Ambulance Data Collection System
Date: 04/2026
Sponsoring organization: Medicare Payment Advisory Commission
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Transcript from the Medicare Payment Advisory Commission's (MedPAC) April 2026 meeting. Covers Medicare payment incentives, regional benchmarks and benchmark-plan availability in the Part D prescription drug plan (PDP) market, preferred networks and pharmacy access in Medicare Part D, the estimated association between Medicare Advantage enrollment and hospitals' and post-acute care providers' finances, information sources that beneficiaries use to make Medicare enrollment decisions, and institutional special-needs plans. Includes a mandated report on the assessment of the Medicare ground ambulance data collection system. Includes rural references and considerations throughout.
Additional links: Advising the Congress on Medicare Issues Preferred Networks and Pharmacy Access in Part D, Mandated Report: Assessment of the Medicare Ground Ambulance Data Collection System
Date: 04/2026
Sponsoring organization: Medicare Payment Advisory Commission
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Trends Among Medicare Special Needs Plan Enrollment in Metropolitan and Nonmetropolitan Areas
Examines enrollment trends from 2016-2025 in Medicare Advantage plans that provide benefits and services to people with specific conditions or healthcare needs, or who also have Medicaid. Features statistics with breakdowns by year and by metropolitan or nonmetropolitan location.
Author(s): Edmer Lazaro, Fred Ullrich, Keith Mueller
Date: 04/2026
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Examines enrollment trends from 2016-2025 in Medicare Advantage plans that provide benefits and services to people with specific conditions or healthcare needs, or who also have Medicaid. Features statistics with breakdowns by year and by metropolitan or nonmetropolitan location.
Author(s): Edmer Lazaro, Fred Ullrich, Keith Mueller
Date: 04/2026
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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The State of Medicare Supplement Coverage: Trends in Enrollment and Demographics
Provides an overview of Medicare Supplement, or Medigap, coverage and coverage options. Examines the demographics of Medicare enrollees with Medicare Supplement policies in 2024 and enrollment trends. Includes demographic data on rural Medicare Supplement policyholders in 2023.
Date: 04/2026
Sponsoring organization: AHIP
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Provides an overview of Medicare Supplement, or Medigap, coverage and coverage options. Examines the demographics of Medicare enrollees with Medicare Supplement policies in 2024 and enrollment trends. Includes demographic data on rural Medicare Supplement policyholders in 2023.
Date: 04/2026
Sponsoring organization: AHIP
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Impact of Rural Hospital Closures on Survival among Medicare Beneficiaries Diagnosed with Colorectal, Lung, Breast, and Prostate Cancer
Presents a study on the effect rural hospital closures have on mortality rates of patients with colorectal, lung, breast, and prostate cancer using 2000-2020 data from the National Cancer Institute. Breaks down data by closure year and patient demographics, such as age, rural status, and cancer stage, among others.
Author(s): Zhaoli Liu, Daoqi Gao, Tara Martin, et al.
Citation: Journal of Rural Health, 42(2), e70148
Date: 04/2026
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Presents a study on the effect rural hospital closures have on mortality rates of patients with colorectal, lung, breast, and prostate cancer using 2000-2020 data from the National Cancer Institute. Breaks down data by closure year and patient demographics, such as age, rural status, and cancer stage, among others.
Author(s): Zhaoli Liu, Daoqi Gao, Tara Martin, et al.
Citation: Journal of Rural Health, 42(2), e70148
Date: 04/2026
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Trends in Inpatient Revenue and Volume Among Critical Access Hospitals
Examines trends in Critical Access Hospital (CAH) revenue and volume between 2017 and 2024. Presents data on average outpatient-to-total revenue and mean average daily census among CAHs each year by CAH urban or rural location, region, profit status, and system affiliation.
Author(s): Tyler Malone, Angelina Budko
Date: 04/2026
Sponsoring organization: Flex Monitoring Team
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Examines trends in Critical Access Hospital (CAH) revenue and volume between 2017 and 2024. Presents data on average outpatient-to-total revenue and mean average daily census among CAHs each year by CAH urban or rural location, region, profit status, and system affiliation.
Author(s): Tyler Malone, Angelina Budko
Date: 04/2026
Sponsoring organization: Flex Monitoring Team
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A Chartbook on the Characteristics and Needs of Frontier Critical Access Hospitals
Summarizes findings from a 2025 national survey of executives from 117 Critical Access Hospitals (CAHs) in frontier counties. Includes data on the distribution and characteristics of frontier CAHs. Identifies themes related to financial and operational challenges, service availability, and access to care in frontier settings.
Author(s): John A. Gale, Rebecca Stearns, Zachariah Croll, Jayne Foley
Date: 04/2026
Sponsoring organization: Flex Monitoring Team
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Summarizes findings from a 2025 national survey of executives from 117 Critical Access Hospitals (CAHs) in frontier counties. Includes data on the distribution and characteristics of frontier CAHs. Identifies themes related to financial and operational challenges, service availability, and access to care in frontier settings.
Author(s): John A. Gale, Rebecca Stearns, Zachariah Croll, Jayne Foley
Date: 04/2026
Sponsoring organization: Flex Monitoring Team
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Is Medicare Home Health Care Utilization Substituting for Long-Term Care? Evidence From Dual Eligible Beneficiaries
Examines the relationship between Medicaid home and community-based services (HCBS) and Medicare community-initiated home health care (CIHHC). Utilizes 2016-2019 national Medicare and Medicaid claims data of dually enrolled older adults and analyzes the effects of Medicaid HCBS use on the utilization of Medicare CIHHC. Includes comparisons of HCBS users and non-HCBS users with breakdowns by demographics and rural versus urban county classification.
Author(s): Mingyu Qi, Rachel M. Werner, Megan Huisingh-Scheetz, R. Tamara Konetzka
Citation: Health Services Research, 61(2), e70109
Date: 04/2026
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Examines the relationship between Medicaid home and community-based services (HCBS) and Medicare community-initiated home health care (CIHHC). Utilizes 2016-2019 national Medicare and Medicaid claims data of dually enrolled older adults and analyzes the effects of Medicaid HCBS use on the utilization of Medicare CIHHC. Includes comparisons of HCBS users and non-HCBS users with breakdowns by demographics and rural versus urban county classification.
Author(s): Mingyu Qi, Rachel M. Werner, Megan Huisingh-Scheetz, R. Tamara Konetzka
Citation: Health Services Research, 61(2), e70109
Date: 04/2026
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Telehealth Resource Center Skills Matrix
Outlines the technical assistance and subject matter expertise of the 14 federally funded Telehealth Resource Centers in specific telehealth topics, clinical specialties, and areas of telehealth implementation.
Date: 04/2026
Sponsoring organization: National Consortium of Telehealth Resource Centers
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Outlines the technical assistance and subject matter expertise of the 14 federally funded Telehealth Resource Centers in specific telehealth topics, clinical specialties, and areas of telehealth implementation.
Date: 04/2026
Sponsoring organization: National Consortium of Telehealth Resource Centers
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Merit-based Incentive Payment System (MIPS): Traditional MIPS Scoring Guide for the 2026 Performance Year
Provides details on how scores are calculated for the Merit-based Incentive Payment System (MIPS), one of two tracks under the Medicare Quality Payment Program. Explains the four performance categories that affect Medicare Physician Fee Schedule payments: quality, cost, improvement activities, and promoting interoperability. Includes information for small practices.
Date: 03/2026
Sponsoring organization: Centers for Medicare & Medicaid Services
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Provides details on how scores are calculated for the Merit-based Incentive Payment System (MIPS), one of two tracks under the Medicare Quality Payment Program. Explains the four performance categories that affect Medicare Physician Fee Schedule payments: quality, cost, improvement activities, and promoting interoperability. Includes information for small practices.
Date: 03/2026
Sponsoring organization: Centers for Medicare & Medicaid Services
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