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Rural Health Information Hub

Rural Health
Resources by Topic: Medicare

PACE in Rural Communities: Emerging Evidence on Integrated Care for Older Adults
An interview conversation with Carrie Henning-Smith of the the University of Minnesota School of Public Health (UMN) Rural Health Research Center about All-Inclusive Care for the Elderly (PACE). Covers how PACE supports older adults, the impact of PACE in rural communities as well as potential barriers, and policy and partnership needs.
Author(s): Megan Lisch
Date: 11/2025
Sponsoring organization: Center for Health Care Strategies
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Rural-Urban Differences in Barriers to Care and Utilization of Preventive Care Among Traditional Medicare and Medicare Advantage Beneficiaries
Discusses the differences in barriers to care and preventive care utilization for older adults enrolled in traditional Medicare versus Medicare Advantage and makes a rural-urban comparison. Explores barriers to care, such as quality of care and out-of-pocket costs, as well as care utilization, such as regular vaccinations, cancer screenings, and cholesterol tests, among others.
Author(s): Gawain J. Williams, Dan M. Shane, Whitney E. Zahnd, Keith J. Mueller
Date: 11/2025
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Funding Rural Health: The Role and Reach of Federal Support
A series of briefs and spotlights focused on how the Federal Office of Rural Health Policy (FORHP) supports population health in rural Kansas and the rural United States. Focuses on FORHP funding processes and organizational structure, distribution of funds, the Medicare Rural Hospital Flexibility Program, the Rural Health Care Services Outreach Program, and Rural Communities Opioid Response Program.
Author(s): Shelby C. Rowell, Wyatt J. Beckman, Viktoria Sterkhova
Date: 11/2025
Sponsoring organization: Kansas Health Institute
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Small Practices Guide: Getting Started with Merit-based Incentive Payment System (MIPS) Clinical Quality Measure (CQM) Reporting
Provides an overview of Merit-based Incentive Payment System (MIPS) clinical quality measures (MIPS CQMs). Describes how small practices can report MIPS CQMs, whether participating as an individual clinician, group, subgroup, or Alternative Payment Model (APM) Entity.
Date: 11/2025
Sponsoring organization: Centers for Medicare and Medicaid Services
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Medicare Physician Fee-For-Service Payments: Adjusting for Variation in Geographic Practice Costs and Challenges for Hawaiʻi
Reports on policy approaches to Medicare reimbursement in Hawaii in order to address provider shortages and limited access to care associated with the state's geographic isolation and high cost of living. Discusses how Medicare policy impacts reimbursement and service availability in rural, remote, and frontier areas.
Author(s): Reinie Gerrits-Goh, John Desfor, Diana M.V. Shaw, et al.
Date: 11/2025
Sponsoring organization: University of Hawaiʻi Rural Health Research & Policy Center
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Paying Family Caregivers: Self-direction in Medicaid Personal Care
Compares characteristics of dually eligible older adults receiving caregiving through either self-direction and non-self-direction, including personal demographics, health conditions, healthcare utilization, and rurality. Discusses rural findings in light of workforce shortages in rural communities. Includes analysis of Medicaid data from 6 states with reliable self-direction data as well as analysis of characteristics for 41 states and Washington, D.C.
Author(s): Yiqing Kuang, Katherine E.M. Miller
Citation: Health Affairs Scholar, 3(11)
Date: 11/2025
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Final CY 2026 Medicare Physician Fee Schedule: Fact Sheet
Fact sheet covering the Centers for Medicare & Medicaid Services (CMS) telehealth policy changes for 2026 as outlined in the final calendar year (CY) 2026 Physician Fee Schedule. Covers the process for determining which services can be delivered by telehealth; frequency limitations for inpatient visits, nursing facilities, and critical care consults; direct supervision through the use of live video; payment to Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs); and more.
Date: 11/2025
Sponsoring organization: Center for Connected Health Policy: The National Telehealth Policy Resource Center
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Medicare Waiver Expiration & Telehealth FAQs
Provides answers to frequently asked questions regarding the expiration of Medicare telehealth waivers on September 30, 2025. Covers in-person visit requirements, billing procedures, and the applicability of policies across different care settings, including Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs).
Additional links: Chart: Telehealth Medicare Post-September 30, 2025
Date: 11/2025
Sponsoring organization: Center for Connected Health Policy: The National Telehealth Policy Resource Center
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Medicare Advantage Enrollees Have Access to About Half of the Physicians Available to Traditional Medicare Beneficiaries
Explores how provider networks vary across Medicare Advantage plans and when compared to traditional Medicare. Examines the share of physicians available to Medicare Advantage enrollees as a share of physicians available to traditional Medicare beneficiaries by analyzing Medicare Advantage provider directories for 2022. Includes information on the availability of physicians to Medicare Advantage enrollees and traditional Medicare beneficiaries in rural counties.
Author(s): Matthew Rae, Jeannie Fuglesten Biniek, Tricia Neuman, Karen Pollitz
Date: 10/2025
Sponsoring organization: KFF
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Calendar Year (CY) 2026 Medicare Physician Fee Schedule Final Rule (CMS-1832-F)
Fact sheet providing an overview of the Centers for Medicare & Medicaid Services (CMS) final rule regarding updates and changes to the Medicare payments under the Physician Fee Schedule (PFS) and other Medicare Part B issues for calendar year 2026. Summarizes provisions related to telehealth services; improving care for chronic illness and behavioral health needs; Rural Health Clinic (RHC) and Federally Qualified Health Center (FQHC) care coordination services, services requiring direct supervision, and telecommunication services; and more.
Date: 10/2025
Sponsoring organization: Centers for Medicare and Medicaid Services
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