Rural Health
Resources by Topic: Healthcare business and finance
Average Salary Expense in Rural and Urban Hospitals Before and During the Low Wage Index Policy, 2018–2022
Examines and compares wage patterns of Critical Access Hospitals (CAHs), Rural Prospective Payment System (PPS) hospitals, and Urban PPS hospitals as related to the Low Wage Index Policy (LWIP) in effect from 2020-2022. Utilizes hospital data from the Centers for Medicare & Medicaid Services (CMS) Healthcare Cost Report Information System (HCRIS) between 2018 and 2022 and analyzes median salaries. Discusses the impact of Medicare payments and LWIP on hospitals.
Author(s): Saleema Karim, George Pink, Kristie Thompson, Mark Holmes
Date: 04/2026
Sponsoring organization: North Carolina Rural Health Research Program
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Examines and compares wage patterns of Critical Access Hospitals (CAHs), Rural Prospective Payment System (PPS) hospitals, and Urban PPS hospitals as related to the Low Wage Index Policy (LWIP) in effect from 2020-2022. Utilizes hospital data from the Centers for Medicare & Medicaid Services (CMS) Healthcare Cost Report Information System (HCRIS) between 2018 and 2022 and analyzes median salaries. Discusses the impact of Medicare payments and LWIP on hospitals.
Author(s): Saleema Karim, George Pink, Kristie Thompson, Mark Holmes
Date: 04/2026
Sponsoring organization: North Carolina Rural Health Research Program
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Average Salary Expense in Rural and Urban Hospitals in 2022 Compared with 2018, by Hospital Characteristics
Explores how the COVID-19 pandemic may have affected wage disparities across rural and urban hospitals. Describes the median wages by total employee full-time equivalents (FTE) for rural and urban hospitals from 2017-2018 to 2021-2022. Compares the growth in labor cost for rural and urban hospitals by selected hospital characteristics, including system affiliation, hospital ownership, and number of acute care beds.
Date: 04/2026
Sponsoring organization: North Carolina Rural Health Research Program
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Explores how the COVID-19 pandemic may have affected wage disparities across rural and urban hospitals. Describes the median wages by total employee full-time equivalents (FTE) for rural and urban hospitals from 2017-2018 to 2021-2022. Compares the growth in labor cost for rural and urban hospitals by selected hospital characteristics, including system affiliation, hospital ownership, and number of acute care beds.
Date: 04/2026
Sponsoring organization: North Carolina Rural Health Research Program
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Medicaid Home Care Chartbook
Provides an overview of home care services within the Medicaid program, including participant eligibility, types of services delivered, inclusion in managed care arrangements, and provider distribution. Includes data on the percentage of home care recipients and location of providers in 2023 by Rural-Urban Commuting Area (RUCA) Code.
Date: 04/2026
Sponsoring organizations: Health Management Associates, National Alliance for Care at Home, Research Institute for Home Care
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Provides an overview of home care services within the Medicaid program, including participant eligibility, types of services delivered, inclusion in managed care arrangements, and provider distribution. Includes data on the percentage of home care recipients and location of providers in 2023 by Rural-Urban Commuting Area (RUCA) Code.
Date: 04/2026
Sponsoring organizations: Health Management Associates, National Alliance for Care at Home, Research Institute for Home Care
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Value-based Payment Strategies Used by Medicaid Managed Care Organizations
Presents findings from a review of 36 state Medicaid program websites that detail value-based payment (VBP) strategies deployed by state-contracted Managed Care Organizations (MCO). Describes how Medicaid MCOs approach VBP strategies and implications for rural healthcare providers and organizations.
Additional links: Appendix: State Medicaid Programs with VBP Elements
Date: 04/2026
Sponsoring organization: Rural Health Value
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Presents findings from a review of 36 state Medicaid program websites that detail value-based payment (VBP) strategies deployed by state-contracted Managed Care Organizations (MCO). Describes how Medicaid MCOs approach VBP strategies and implications for rural healthcare providers and organizations.
Additional links: Appendix: State Medicaid Programs with VBP Elements
Date: 04/2026
Sponsoring organization: Rural Health Value
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Transforming Rural Health: Value-Based Payment
Presentation slides that discuss state examples related to the Rural Health Transformation Program (RHTP) and value-based payment (VBP) initiatives, with a focus on healthcare delivery systems, use of technology, and the healthcare workforce.
Author(s): Keith J. Mueller
Date: 04/2026
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Presentation slides that discuss state examples related to the Rural Health Transformation Program (RHTP) and value-based payment (VBP) initiatives, with a focus on healthcare delivery systems, use of technology, and the healthcare workforce.
Author(s): Keith J. Mueller
Date: 04/2026
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Early Evaluation of the Rural Emergency Hospital Program
Results of a study conducted January 2023 to December 2025, to assess differences between hospitals that converted to Rural Emergency Hospital (REH) status and eligible rural hospitals that did not. Includes statistics on the financial performance of the hospitals before and after conversion, and hospital features and services provided, with breakdowns by REH or non-REH status.
Author(s): Mitchell Mead, Nina M. Clark, Janice C. Probst, et al.
Citation: JAMA Network Open, 9(4), e269217
Date: 04/2026
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Results of a study conducted January 2023 to December 2025, to assess differences between hospitals that converted to Rural Emergency Hospital (REH) status and eligible rural hospitals that did not. Includes statistics on the financial performance of the hospitals before and after conversion, and hospital features and services provided, with breakdowns by REH or non-REH status.
Author(s): Mitchell Mead, Nina M. Clark, Janice C. Probst, et al.
Citation: JAMA Network Open, 9(4), e269217
Date: 04/2026
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Comparing the Care and Distance Traveled by Rural and Urban Children and Adolescents with Medicaid Insurance and Opioid Use Disorder
Presents a study on the geographic factors that affect access to treatment for youth and adolescents, aged 0-17, with an opioid use disorder (OUD) and enrolled in Medicaid in 2019. Discusses the effects of rurality, travel burden, and residing in a county without a clinician with a DEA waiver, among other measures.
Author(s): Janessa M. Graves, Lisa A. Garberson, Sara C. Woolcock, C. Holly A. Andrilla
Date: 04/2026
Sponsoring organization: WWAMI Rural Health Research Center
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Presents a study on the geographic factors that affect access to treatment for youth and adolescents, aged 0-17, with an opioid use disorder (OUD) and enrolled in Medicaid in 2019. Discusses the effects of rurality, travel burden, and residing in a county without a clinician with a DEA waiver, among other measures.
Author(s): Janessa M. Graves, Lisa A. Garberson, Sara C. Woolcock, C. Holly A. Andrilla
Date: 04/2026
Sponsoring organization: WWAMI Rural Health Research Center
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Rural-Urban Variation in Opioid Use Disorder Treatment Access among Commercially Insured Children and Adolescents
Details a study on the geographic factors that affect access to treatment for youth and adolescents, aged 0-17, with an opioid use disorder (OUD) and covered by commercial insurance in 2019. Discusses the effects of rurality, provider type, travel burden, and residing in a county without a clinician with a DEA waiver, among other measures.
Author(s): C. Holly A. Andrilla, Lisa A. Garberson, Sara C. Woolcock, Janessa M. Graves
Date: 04/2026
Sponsoring organization: WWAMI Rural Health Research Center
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Details a study on the geographic factors that affect access to treatment for youth and adolescents, aged 0-17, with an opioid use disorder (OUD) and covered by commercial insurance in 2019. Discusses the effects of rurality, provider type, travel burden, and residing in a county without a clinician with a DEA waiver, among other measures.
Author(s): C. Holly A. Andrilla, Lisa A. Garberson, Sara C. Woolcock, Janessa M. Graves
Date: 04/2026
Sponsoring organization: WWAMI Rural Health Research Center
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2025 National CAH Quality Inventory & Assessment National Report
Presents a high-level summary of key data points from the September-November 2025 National Critical Access Hospital (CAH) Quality Inventory and Assessment. Includes data on CAH system affiliation; median average daily census and emergency department volume; median swing bed admissions and swing bed length of stay; hospital inpatient, behavioral health and specialty care, and outpatient and other service lines; CAH quality payment model participation; and CAH quality improvement topic priorities.
Author(s): Madeleine Pick, Robert Barclay
Date: 04/2026
Sponsoring organization: Flex Monitoring Team
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Presents a high-level summary of key data points from the September-November 2025 National Critical Access Hospital (CAH) Quality Inventory and Assessment. Includes data on CAH system affiliation; median average daily census and emergency department volume; median swing bed admissions and swing bed length of stay; hospital inpatient, behavioral health and specialty care, and outpatient and other service lines; CAH quality payment model participation; and CAH quality improvement topic priorities.
Author(s): Madeleine Pick, Robert Barclay
Date: 04/2026
Sponsoring organization: Flex Monitoring Team
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April 2026 MACPAC Meeting Transcript
Transcript from the Medicaid and CHIP Payment and Access Commission's (MACPAC) April 2026 meeting. Covers community engagement requirements in Medicaid, state and federal tools for ensuring accountability of Medicaid managed care plans, the role of the state Medicaid agency in the Program of All-Inclusive Care for the Elderly (PACE), pharmacy benefit managers and Medicaid, and more. Includes rural references throughout.
Date: 04/2026
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) April 2026 meeting. Covers community engagement requirements in Medicaid, state and federal tools for ensuring accountability of Medicaid managed care plans, the role of the state Medicaid agency in the Program of All-Inclusive Care for the Elderly (PACE), pharmacy benefit managers and Medicaid, and more. Includes rural references throughout.
Date: 04/2026
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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