Rural Health
Resources by Topic: Medicaid
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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Operating Status of Adult Day Services Centers in 2022
Author(s): Jessica P. Lendon, Priyanka Singh, Christine Caffrey, Manisha Sengupta, Zhaohui Lu
Date: 03/2025
Sponsoring organization: National Center for Health Statistics
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Offers estimates from the 2022 National Post-acute and Long-term Care Study (NPALS) regarding operating status of adult day service centers as a result of COVID-19 response efforts. Compares U.S. Census Bureau regions, metropolitan and nonmetropolitan statistical areas, Medicaid licensure, and number of enrolled participants.
Author(s): Jessica P. Lendon, Priyanka Singh, Christine Caffrey, Manisha Sengupta, Zhaohui Lu
Date: 03/2025
Sponsoring organization: National Center for Health Statistics
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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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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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Enhancing Rural Access to Medications for Opioid Use Disorder: Policy Brief and Recommendations to the Secretary
Provides an overview of issues related to opioid use disorder (OUD) in rural areas. Discusses access to medication for opioid use disorder (MOUD), MOUD workforce, telehealth to support access to MOUD, and Medicaid 1115 demonstrations that address OUD. Offers policy recommendations related to regulatory barriers, reimbursement flexibility, workforce, and service site expansion to increase access to MOUD in rural areas.
Date: 01/2025
Sponsoring organization: National Advisory Committee on Rural Health and Human Services
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Provides an overview of issues related to opioid use disorder (OUD) in rural areas. Discusses access to medication for opioid use disorder (MOUD), MOUD workforce, telehealth to support access to MOUD, and Medicaid 1115 demonstrations that address OUD. Offers policy recommendations related to regulatory barriers, reimbursement flexibility, workforce, and service site expansion to increase access to MOUD in rural areas.
Date: 01/2025
Sponsoring organization: National Advisory Committee on Rural Health and Human Services
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Medicaid Coverage in Metro and Small Town/Rural Counties, 2023
Presents county-level data for children, non-elderly adults, and seniors insured by Medicaid/CHIP. Utilizes 2023 American Community Survey (ACS) Public Use Microdata Sample (PUMS) data to provide insurance comparisons by county and by state.
Date: 01/2025
Sponsoring organization: Georgetown University Health Policy Institute
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Presents county-level data for children, non-elderly adults, and seniors insured by Medicaid/CHIP. Utilizes 2023 American Community Survey (ACS) Public Use Microdata Sample (PUMS) data to provide insurance comparisons by county and by state.
Date: 01/2025
Sponsoring organization: Georgetown University Health Policy Institute
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Evaluating Access to Psychosocial Services for the Medicaid-Insured Children in Georgia
Assesses mental health workforce supply and demand for psychosocial services for the Medicaid-insured children in Georgia, and examines the impact of policy interventions to increase availability of services for the Medicaid-insured population. Analyzes factors associated with unmet demand, including data on rurality, travel distance, and more.
Author(s): Yujia Xie, Pravara Harati, Janani Rajbhandari-Thapa, Nicoleta Serban
Citation: BMC Public Health, 25, 244
Date: 01/2025
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Assesses mental health workforce supply and demand for psychosocial services for the Medicaid-insured children in Georgia, and examines the impact of policy interventions to increase availability of services for the Medicaid-insured population. Analyzes factors associated with unmet demand, including data on rurality, travel distance, and more.
Author(s): Yujia Xie, Pravara Harati, Janani Rajbhandari-Thapa, Nicoleta Serban
Citation: BMC Public Health, 25, 244
Date: 01/2025
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Postpartum Health Care Use in Medicaid During the COVID-19 Public Health Emergency: Implications for Extending Postpartum Coverage
Examines the impact of Medicaid continuous enrollment during the COVID-19 public health emergency (PHE) on postpartum healthcare utilization. Utilizes 2018-2023 claims data from the Centers for Medicare and Medicaid Services (CMS) Transformed Medicaid Statistical Information System (T-MSIS) to analyze a pre-PHE versus PHE cohort of women. Includes healthcare utilization data with breakdowns according to age, race/ethnicity, eligibility group (Medicaid or other form), rural versus urban location, maternity care desert status, severe maternal morbidity and/or chronic health condition, postpartum month, and state.
Author(s): Amelia Whitman, Anupama Warrier, Sarah Gordon, et al.
Date: 01/2025
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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Examines the impact of Medicaid continuous enrollment during the COVID-19 public health emergency (PHE) on postpartum healthcare utilization. Utilizes 2018-2023 claims data from the Centers for Medicare and Medicaid Services (CMS) Transformed Medicaid Statistical Information System (T-MSIS) to analyze a pre-PHE versus PHE cohort of women. Includes healthcare utilization data with breakdowns according to age, race/ethnicity, eligibility group (Medicaid or other form), rural versus urban location, maternity care desert status, severe maternal morbidity and/or chronic health condition, postpartum month, and state.
Author(s): Amelia Whitman, Anupama Warrier, Sarah Gordon, et al.
Date: 01/2025
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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Behavioral Health Crisis Services Billed to Commercial Insurance, Medicaid, and Medicare
Examines the extent to which three specific crisis service billing codes are used by commercial payors, Medicaid, and Medicare in 2020 in the 11 states and District of Columbia that cover these services in their Medicaid fee-for-service plans. Compares the rate of crisis service claims by state, rurality, and provider type.
Author(s): Crystal Blyler, Amy Edmonds, Allison Wishon, et al.
Date: 01/2025
Sponsoring organizations: HHS Office of the Assistant Secretary for Planning and Evaluation, Mathematica
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Examines the extent to which three specific crisis service billing codes are used by commercial payors, Medicaid, and Medicare in 2020 in the 11 states and District of Columbia that cover these services in their Medicaid fee-for-service plans. Compares the rate of crisis service claims by state, rurality, and provider type.
Author(s): Crystal Blyler, Amy Edmonds, Allison Wishon, et al.
Date: 01/2025
Sponsoring organizations: HHS Office of the Assistant Secretary for Planning and Evaluation, Mathematica
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A Summary of State Innovation Models (SIM) Evaluation Results Across 17 States (2013-2020)
Summarizes evaluation results of the State Innovation Models (SIM), which examined the ability of 17 state governments to implement and test innovative value-based payment (VBP) healthcare models across multiple payers between 2013 and 2020. Presents findings regarding the implementation and impact of 29 delivery and payment models, including patient-centered medical homes, accountable care organizations, behavioral health integration, and more. Covers state contracting and consensus building, practice transformation, pediatric care, behavioral healthcare, beneficiary and provider perspectives, and more. Includes a section on payment model designs tailored to unique state needs, including rural populations, as well as rural references throughout.
Additional links: A Summary of State Innovation Models (SIM): Focus on State-Led Transformation - Findings at a Glance, Executive Summary, Findings at a Glance
Date: 01/2025
Sponsoring organization: Centers for Medicare and Medicaid Services
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Summarizes evaluation results of the State Innovation Models (SIM), which examined the ability of 17 state governments to implement and test innovative value-based payment (VBP) healthcare models across multiple payers between 2013 and 2020. Presents findings regarding the implementation and impact of 29 delivery and payment models, including patient-centered medical homes, accountable care organizations, behavioral health integration, and more. Covers state contracting and consensus building, practice transformation, pediatric care, behavioral healthcare, beneficiary and provider perspectives, and more. Includes a section on payment model designs tailored to unique state needs, including rural populations, as well as rural references throughout.
Additional links: A Summary of State Innovation Models (SIM): Focus on State-Led Transformation - Findings at a Glance, Executive Summary, Findings at a Glance
Date: 01/2025
Sponsoring organization: Centers for Medicare and Medicaid Services
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