Rural Health
Resources by Topic: Medicare
Hospital Margins Rebounded in 2023, But Rural Hospitals and Those With High Medicaid Shares Were Struggling More Than Others
Examines hospital margins for non-federal general short-term hospitals in the U.S. from 2018 through 2023, with a focus on operating margins. Analyzes RAND Hospital Data to explore the extent to which hospitals profited or lost money on patient care and other operating activities. Discusses differences in operating margins by hospital characteristics, including hospital ownership type, commercial share, size, rural or urban location, and Medicare rural payment designation.
Date: 12/2024
Type: Document
Sponsoring organization: KFF
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Examines hospital margins for non-federal general short-term hospitals in the U.S. from 2018 through 2023, with a focus on operating margins. Analyzes RAND Hospital Data to explore the extent to which hospitals profited or lost money on patient care and other operating activities. Discusses differences in operating margins by hospital characteristics, including hospital ownership type, commercial share, size, rural or urban location, and Medicare rural payment designation.
Date: 12/2024
Type: Document
Sponsoring organization: KFF
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Critical Access Hospital Financial Sustainability Guide
Provides guidance and assistance to state Medicare Rural Hospital Flexibility (Flex) Program personnel, leaders of Critical Access Hospitals (CAHs), and others helping CAHs manage long-term financial stability. Presents potential interventions CAHs may use to address ongoing and systemic financial challenges in rural healthcare.
Date: 12/2024
Type: Document
Sponsoring organizations: EideBailly, National Rural Health Resource Center
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Provides guidance and assistance to state Medicare Rural Hospital Flexibility (Flex) Program personnel, leaders of Critical Access Hospitals (CAHs), and others helping CAHs manage long-term financial stability. Presents potential interventions CAHs may use to address ongoing and systemic financial challenges in rural healthcare.
Date: 12/2024
Type: Document
Sponsoring organizations: EideBailly, National Rural Health Resource Center
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Center for Medicare and Medicaid Innovation: 2024 Report to Congress
Reports to Congress on payment and service delivery models and initiatives tested or announced by the Center for Medicare and Medicaid Innovation between October 2022 and September 2024. Includes summaries and updates on multiple rural-relevant models and initiatives, including the Accountable Care Organization Realizing Equity, Access, and Community Health (ACO REACH) Model, the Transforming Maternal Health Model, the Pennsylvania Rural Health Model (PARHM), the Vermont All-Payer Accountable Care Organization Model, and more.
Date: 12/2024
Type: Document
Sponsoring organizations: Centers for Medicare and Medicaid Services, U.S. Department of Health and Human Services
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Reports to Congress on payment and service delivery models and initiatives tested or announced by the Center for Medicare and Medicaid Innovation between October 2022 and September 2024. Includes summaries and updates on multiple rural-relevant models and initiatives, including the Accountable Care Organization Realizing Equity, Access, and Community Health (ACO REACH) Model, the Transforming Maternal Health Model, the Pennsylvania Rural Health Model (PARHM), the Vermont All-Payer Accountable Care Organization Model, and more.
Date: 12/2024
Type: Document
Sponsoring organizations: Centers for Medicare and Medicaid Services, U.S. Department of Health and Human Services
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Calendar Year (CY) 2015 Rural Health Clinic (RHC) and Federally Qualified Health Centers (FQHC) Updates: Payment Rate Increases for RHCs and FQHCs Billing Under the All-Inclusive Rate System (AIR), and Urban and Rural Designations for FQHCs Billing Under the AIR
Provides updates for RHCs and FQHCs that are submitting claims to Medicare Administrative Contractors (MACs) for services to Medicare beneficiaries.
Date: 12/2024
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Provides updates for RHCs and FQHCs that are submitting claims to Medicare Administrative Contractors (MACs) for services to Medicare beneficiaries.
Date: 12/2024
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Federally Qualified Health Centers and Performance of Medicare Accountable Care Organizations
Explores the association between participation of Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs) in Medicare Shared Savings Program Accountable Care Organizations (ACOs) with ACOs' beneficiary characteristics, utilization, expenditure, and quality. Features statistics including estimated changes in Medicare Shared Savings Program ACO-assigned beneficiaries, utilization, and expenditure, with breakdowns by FQHC and RHC visits and other types of visits.
Author(s): Kun Li, Yucheng Hou, Frank McStay, Jonathan Gonzalez-Smith, Robert S. Saunders
Citation: JAMA Network Open, 7(11), e2445536
Date: 11/2024
Type: Document
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Explores the association between participation of Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs) in Medicare Shared Savings Program Accountable Care Organizations (ACOs) with ACOs' beneficiary characteristics, utilization, expenditure, and quality. Features statistics including estimated changes in Medicare Shared Savings Program ACO-assigned beneficiaries, utilization, and expenditure, with breakdowns by FQHC and RHC visits and other types of visits.
Author(s): Kun Li, Yucheng Hou, Frank McStay, Jonathan Gonzalez-Smith, Robert S. Saunders
Citation: JAMA Network Open, 7(11), e2445536
Date: 11/2024
Type: Document
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RHC Regulatory Changes in 2025 - Medicare Physician Fee Schedule Updates You Need to Know!
Recording of a November 18, 2024, webinar providing an overview of telehealth payment rates for Rural Health Clinics (RHCs) and other regulatory updates and potential changes for 2025. Covers Medicare vaccine reimbursement changes, the elimination of productivity standards, lab requirement changes, intensive outpatient program (IOP) services, telehealth regulations, and more. Part of the Rural Health Clinic Technical Assistance Series.
Additional links: Presentation Slides
Date: 11/2024
Type: Video/Multimedia
Sponsoring organization: National Association of Rural Health Clinics
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Recording of a November 18, 2024, webinar providing an overview of telehealth payment rates for Rural Health Clinics (RHCs) and other regulatory updates and potential changes for 2025. Covers Medicare vaccine reimbursement changes, the elimination of productivity standards, lab requirement changes, intensive outpatient program (IOP) services, telehealth regulations, and more. Part of the Rural Health Clinic Technical Assistance Series.
Additional links: Presentation Slides
Date: 11/2024
Type: Video/Multimedia
Sponsoring organization: National Association of Rural Health Clinics
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State Telehealth Laws and Reimbursement Policies Report, Fall 2024
Provides an overview of state telehealth policies as of early September 2024. Covers Medicaid reimbursement, private payer laws, and professional requirements.
Additional links: Executive Summary, Infographic, State Summary Chart
Date: 11/2024
Type: Document
Sponsoring organization: Center for Connected Health Policy: The National Telehealth Policy Resource Center
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Provides an overview of state telehealth policies as of early September 2024. Covers Medicaid reimbursement, private payer laws, and professional requirements.
Additional links: Executive Summary, Infographic, State Summary Chart
Date: 11/2024
Type: Document
Sponsoring organization: Center for Connected Health Policy: The National Telehealth Policy Resource Center
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January 2025 Annual Rural Emergency Hospital (REH) Monthly Facility Payment Amount
Presents the monthly Rural Emergency Hospital (REH) monthly facility payment amount for Calendar Year 2025.
Date: 11/2024
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Presents the monthly Rural Emergency Hospital (REH) monthly facility payment amount for Calendar Year 2025.
Date: 11/2024
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Medicare Advantage 2025 Spotlight: A First Look at Plan Offerings
Offers an overview of Medicare Advantage plan availability across the country for 2025. Discusses how many plans are available, who is offering plans, and costs. Offers data for metropolitan, micropolitan, and rural areas as well as county-level data.
Author(s): Meredith Freed, Jeannie Fuglesten Biniek, Anthony Damico, Tricia Neuman
Date: 11/2024
Type: Document
Sponsoring organization: KFF
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Offers an overview of Medicare Advantage plan availability across the country for 2025. Discusses how many plans are available, who is offering plans, and costs. Offers data for metropolitan, micropolitan, and rural areas as well as county-level data.
Author(s): Meredith Freed, Jeannie Fuglesten Biniek, Anthony Damico, Tricia Neuman
Date: 11/2024
Type: Document
Sponsoring organization: KFF
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Advancing Health Equity in Rural, Tribal, and Geographically Isolated Communities: FY2024 Year in Review
Summarizes Centers for Medicare & Medicaid Services (CMS) activities in fiscal year 2024 to advance health equity for people living in rural, tribal, and geographically isolated communities. Covers six priority focus areas: applying a community-informed geographic lens; increasing the collection and use of standardized data; strengthening and supporting healthcare professionals; optimizing medical and communication technology; expanding access to comprehensive healthcare coverage, benefits, and services and supports; and driving innovation and value-based care.
Date: 11/2024
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Summarizes Centers for Medicare & Medicaid Services (CMS) activities in fiscal year 2024 to advance health equity for people living in rural, tribal, and geographically isolated communities. Covers six priority focus areas: applying a community-informed geographic lens; increasing the collection and use of standardized data; strengthening and supporting healthcare professionals; optimizing medical and communication technology; expanding access to comprehensive healthcare coverage, benefits, and services and supports; and driving innovation and value-based care.
Date: 11/2024
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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