Rural Health
Resources by Topic: Healthcare quality
Skill Mix Versus Flexibility: Decoding Nurse Staffing Impacts on Critical Access Hospitals
Presents a study on the skill mix and flexibility of nurse staffing on the financial stability, care quality, and efficacy of Critical Access Hospitals (CAHs) in Pennsylvania from 2000 to 2023. Correlates skill mix and flexibility with hospital outcomes and controls for hospital-specific, socioeconomic, and demographic factors.
Author(s): Dinesh R. Pai, Esmaeil Bahalkeh
Citation: Journal of Rural Health, 41(3), e70075
Date: 08/2025
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Presents a study on the skill mix and flexibility of nurse staffing on the financial stability, care quality, and efficacy of Critical Access Hospitals (CAHs) in Pennsylvania from 2000 to 2023. Correlates skill mix and flexibility with hospital outcomes and controls for hospital-specific, socioeconomic, and demographic factors.
Author(s): Dinesh R. Pai, Esmaeil Bahalkeh
Citation: Journal of Rural Health, 41(3), e70075
Date: 08/2025
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End-Stage Renal Disease Treatment Choices (ETC) Model: Third Annual Evaluation Report, Calendar Years 2021-2023
Evaluation of the End-Stage Renal Disease Treatment Choices (ETC) Model, incorporating analyses of home dialysis use, waitlisting for a kidney transplant, living donor and deceased donor transplantation, utilization of services, Medicare payments, and quality of care. Features results from interviews and surveys involving model participants and beneficiaries, and examines impacts of the first three years of the ETC Model, 2021-2023. Explores if the impacts of the ETC Model differed by patient subgroup, including rural residence.
Additional links: Appendices, Executive Summary, Findings at a Glance
Date: 08/2025
Sponsoring organizations: Centers for Medicare & Medicaid Services, The Lewin Group
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Evaluation of the End-Stage Renal Disease Treatment Choices (ETC) Model, incorporating analyses of home dialysis use, waitlisting for a kidney transplant, living donor and deceased donor transplantation, utilization of services, Medicare payments, and quality of care. Features results from interviews and surveys involving model participants and beneficiaries, and examines impacts of the first three years of the ETC Model, 2021-2023. Explores if the impacts of the ETC Model differed by patient subgroup, including rural residence.
Additional links: Appendices, Executive Summary, Findings at a Glance
Date: 08/2025
Sponsoring organizations: Centers for Medicare & Medicaid Services, The Lewin Group
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CAH Quality Inventory & Assessment Resources
Provides a list of resources for Critical Access Hospitals (CAHs) to use to complete the 2025 CAH Quality Inventory and Assessment (Assessment). Includes resources regarding the background and components of the Assessment and instructions for each question.
Author(s): Megan Lahr, Robert Barclay, Madeleine Pick
Date: 08/2025
Sponsoring organization: Flex Monitoring Team
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Provides a list of resources for Critical Access Hospitals (CAHs) to use to complete the 2025 CAH Quality Inventory and Assessment (Assessment). Includes resources regarding the background and components of the Assessment and instructions for each question.
Author(s): Megan Lahr, Robert Barclay, Madeleine Pick
Date: 08/2025
Sponsoring organization: Flex Monitoring Team
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HCAHPS Toolkit for Critical Access Hospitals
Designed to assist Critical Access Hospitals (CAHs) in reporting and utilizing Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) data. Provides a detailed description of HCAHPS as a Medicare Beneficiary Quality Improvement Project (MBQIP) core measure, strategies for improving HCAHPS survey response rates, and answers to common HCAHPS questions. Offers recommendations for utilizing HCAHPS data reports from vendors and the Flex Monitoring Team (FMT) and improving HCAHPS scores.
Date: 08/2025
Sponsoring organization: Flex Monitoring Team
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Designed to assist Critical Access Hospitals (CAHs) in reporting and utilizing Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) data. Provides a detailed description of HCAHPS as a Medicare Beneficiary Quality Improvement Project (MBQIP) core measure, strategies for improving HCAHPS survey response rates, and answers to common HCAHPS questions. Offers recommendations for utilizing HCAHPS data reports from vendors and the Flex Monitoring Team (FMT) and improving HCAHPS scores.
Date: 08/2025
Sponsoring organization: Flex Monitoring Team
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FY 2026 Medicare Inpatient Psychiatric Facility Prospective Payment System (IPF PPS) and Quality Reporting (IPFQR) Updates Final Rule (CMS-1831-F)
Fact sheet providing an overview of the Centers for Medicare & Medicaid Services (CMS) fiscal year 2026 inpatient psychiatric facility (IPF) prospective payment system (PPS) final rule. Covers annual updates to the prospective payment rates, outlier threshold, and wage index. Also describes changes to facility-level adjustment factors for teaching status and rural location.
Date: 08/2025
Sponsoring organization: Centers for Medicare & Medicaid Services
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Fact sheet providing an overview of the Centers for Medicare & Medicaid Services (CMS) fiscal year 2026 inpatient psychiatric facility (IPF) prospective payment system (PPS) final rule. Covers annual updates to the prospective payment rates, outlier threshold, and wage index. Also describes changes to facility-level adjustment factors for teaching status and rural location.
Date: 08/2025
Sponsoring organization: Centers for Medicare & Medicaid Services
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Adult Ratings of Neighborhood Medical Care Availability in Nonmetropolitan and Metropolitan Areas, United States 2021
Statistical brief examining perceptions of medical care availability and quality in nonmetropolitan and metropolitan areas, utilizing 2021 AHRQ Medical Expenditure Panel Survey Household Component (MEPS-HC) data. Includes data breakdowns by level of rurality and age group, insurance status, physical health status, and more.
Author(s): Sandra L. Decker, Xue Wu
Date: 07/2025
Sponsoring organization: Agency for Healthcare Research and Quality
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Statistical brief examining perceptions of medical care availability and quality in nonmetropolitan and metropolitan areas, utilizing 2021 AHRQ Medical Expenditure Panel Survey Household Component (MEPS-HC) data. Includes data breakdowns by level of rurality and age group, insurance status, physical health status, and more.
Author(s): Sandra L. Decker, Xue Wu
Date: 07/2025
Sponsoring organization: Agency for Healthcare Research and Quality
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AHEAD CMS-Designed Medicare FFS HGB Calculator Tool for Acute Care Hospitals Demonstration
Provides an overview and demonstration of the CMS-Designed Medicare Fee-for-Service Hospital Global Budget (HGB) Calculator Tool, which aims to support fee-for-service acute care hospitals in understanding the HGB financial methodology for the AHEAD Model. Discusses how an AHEAD Medicare Fee-for-Service Hospital Global Budget is constructed.
Additional links: AHEAD Model CMS-Designed Medicare FFS Acute Care Hospital Global Budget Calculator Tool, AHEAD Model: CMS-Designed Medicare Hospital Global Budget Acute Care Hospital Calculator Tool At-A-Glance
Date: 07/2025
Sponsoring organization: Centers for Medicare & Medicaid Services
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Provides an overview and demonstration of the CMS-Designed Medicare Fee-for-Service Hospital Global Budget (HGB) Calculator Tool, which aims to support fee-for-service acute care hospitals in understanding the HGB financial methodology for the AHEAD Model. Discusses how an AHEAD Medicare Fee-for-Service Hospital Global Budget is constructed.
Additional links: AHEAD Model CMS-Designed Medicare FFS Acute Care Hospital Global Budget Calculator Tool, AHEAD Model: CMS-Designed Medicare Hospital Global Budget Acute Care Hospital Calculator Tool At-A-Glance
Date: 07/2025
Sponsoring organization: Centers for Medicare & Medicaid Services
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AHEAD CMS-Designed Medicare FFS Hospital Global Budget Calculator Tool for Critical Access Hospital
Provides an overview and demonstration of the CMS-Designed Medicare Fee-for-Service Hospital Global Budget (HGB) Calculator Tool for Critical Access Hospitals, which aims to support eligible CAHs in understanding the key elements of the AHEAD Medicare Fee-for-Service (FFS) HGB methodology. Discusses key differences in the hospital global budget construction and methodology for Critical Access Hospitals and fee-for-service hospitals.
Additional links: AHEAD Model CMS-Designed Medicare FFS Critical Access Hospital Global Budget Calculator Tool, AHEAD Model: CMS-Designed Medicare Hospital Global Budget Critical Access Hospital Calculator Tool At-A-Glance
Date: 07/2025
Sponsoring organization: Centers for Medicare & Medicaid Services
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Provides an overview and demonstration of the CMS-Designed Medicare Fee-for-Service Hospital Global Budget (HGB) Calculator Tool for Critical Access Hospitals, which aims to support eligible CAHs in understanding the key elements of the AHEAD Medicare Fee-for-Service (FFS) HGB methodology. Discusses key differences in the hospital global budget construction and methodology for Critical Access Hospitals and fee-for-service hospitals.
Additional links: AHEAD Model CMS-Designed Medicare FFS Critical Access Hospital Global Budget Calculator Tool, AHEAD Model: CMS-Designed Medicare Hospital Global Budget Critical Access Hospital Calculator Tool At-A-Glance
Date: 07/2025
Sponsoring organization: Centers for Medicare & Medicaid Services
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FY 2026 Hospital Inpatient Prospective Payment System (IPPS) and Long-Term Care Hospital Prospective Payment System (LTCH PPS) Final Rule — CMS-1833-F
Fact sheet providing an overview of the Centers for Medicare & Medicaid Services (CMS) fiscal year 2026 hospital inpatient prospective payment system (IPPS) and long-term care hospital prospective payment system (LTCH PPS) final rule. Includes information about the Medicare Promoting Interoperability Program and the discontinuation of the low-wage index hospital policy for FY 2026 and subsequent years.
Date: 07/2025
Sponsoring organization: Centers for Medicare & Medicaid Services
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Fact sheet providing an overview of the Centers for Medicare & Medicaid Services (CMS) fiscal year 2026 hospital inpatient prospective payment system (IPPS) and long-term care hospital prospective payment system (LTCH PPS) final rule. Includes information about the Medicare Promoting Interoperability Program and the discontinuation of the low-wage index hospital policy for FY 2026 and subsequent years.
Date: 07/2025
Sponsoring organization: Centers for Medicare & Medicaid Services
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Merit-Based Incentive Payment System (MIPS): 2025 MIPS Group Participation Guide - Traditional MIPS and MVPs
Provides an overview of traditional Merit-based Incentive Payment System (MIPS) and MIPS Value Pathways (MVP) group participation options for the 2025 performance year. Discusses eligibility; special status designations; the quality, cost, and promoting interoperability performance categories; scoring and payment adjustments; and more. Includes information on group reporting requirements and considerations for small practices and clinicians in a rural or Health Professional Shortage Area.
Date: 07/2025
Sponsoring organization: Centers for Medicare & Medicaid Services
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Provides an overview of traditional Merit-based Incentive Payment System (MIPS) and MIPS Value Pathways (MVP) group participation options for the 2025 performance year. Discusses eligibility; special status designations; the quality, cost, and promoting interoperability performance categories; scoring and payment adjustments; and more. Includes information on group reporting requirements and considerations for small practices and clinicians in a rural or Health Professional Shortage Area.
Date: 07/2025
Sponsoring organization: Centers for Medicare & Medicaid Services
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