Rural Health
Resources by Topic: Medicare
Payment Source Shift for Surgical Care Among Veterans Enrolled in Medicare Advantage Plans
Examines the likelihood of veterans enrolled in Medicare Advantage (MA) plans to shift payments for inpatient surgical care from MA to the Veterans Health Administration (VHA). Analyzes 54,754 inpatient surgeries of VHA enrollees to observe payment trends, with data broken down by demographics, insurance characteristics, region, and rurality.
Author(s): Winta T. Mehtsun, Yanlei Ma, Ellen Latsko, et al.
Citation: JAMA Health Forum, 6(6)
Date: 06/2025
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Examines the likelihood of veterans enrolled in Medicare Advantage (MA) plans to shift payments for inpatient surgical care from MA to the Veterans Health Administration (VHA). Analyzes 54,754 inpatient surgeries of VHA enrollees to observe payment trends, with data broken down by demographics, insurance characteristics, region, and rurality.
Author(s): Winta T. Mehtsun, Yanlei Ma, Ellen Latsko, et al.
Citation: JAMA Health Forum, 6(6)
Date: 06/2025
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Key Facts About Medicare Beneficiaries in Rural Areas
Presents information and data about rural Medicare beneficiaries, including demographic and health characteristics, access to healthcare, and satisfaction with care. Compares data on beneficiaries living in urban areas, rural areas adjacent to an urban area, and rural areas not adjacent to an urban area.
Author(s): Nancy Ochieng, Alex Cottrill, Juliette Cubanski, Tricia Neuman
Date: 06/2025
Sponsoring organization: KFF
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Presents information and data about rural Medicare beneficiaries, including demographic and health characteristics, access to healthcare, and satisfaction with care. Compares data on beneficiaries living in urban areas, rural areas adjacent to an urban area, and rural areas not adjacent to an urban area.
Author(s): Nancy Ochieng, Alex Cottrill, Juliette Cubanski, Tricia Neuman
Date: 06/2025
Sponsoring organization: KFF
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Beneficiary and Clinician Perspectives on Medicare and Other Issues: Findings from 2025 Focus Groups in St. Louis, Missouri, and 2021–2025 Rural Focus Groups
Summarizes findings from 8 focus groups of Medicare beneficiaries, Medicare and Medicaid (dual eligible) beneficiaries, and clinicians conducted between April and May 2025, including one virtual focus group of rural Medicare beneficiaries. Compiles findings from 13 focus groups of rural Medicare beneficiaries between 2021 and 2025. Highlights themes that emerged across the focus groups covering Medicare coverage options, access to care, telehealth, organization of care, and prescription drugs.
Date: 06/2025
Sponsoring organizations: Medicare Payment Advisory Commission, NORC at the University of Chicago
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Summarizes findings from 8 focus groups of Medicare beneficiaries, Medicare and Medicaid (dual eligible) beneficiaries, and clinicians conducted between April and May 2025, including one virtual focus group of rural Medicare beneficiaries. Compiles findings from 13 focus groups of rural Medicare beneficiaries between 2021 and 2025. Highlights themes that emerged across the focus groups covering Medicare coverage options, access to care, telehealth, organization of care, and prescription drugs.
Date: 06/2025
Sponsoring organizations: Medicare Payment Advisory Commission, NORC at the University of Chicago
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2023 Quality Payment Program Experience Report
Reports on the clinician experience for those participating in the Quality Payment Program in 2023. Presents data on Merit-based Incentive Payment System (MIPS) eligibility and participation rates for clinicians in small practices and rural areas, mean and median final scores for 2023 and 2025 payment adjustments, and payment adjustment trends from 2021 through 2023.
Date: 06/2025
Sponsoring organization: Centers for Medicare & Medicaid Services
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Reports on the clinician experience for those participating in the Quality Payment Program in 2023. Presents data on Merit-based Incentive Payment System (MIPS) eligibility and participation rates for clinicians in small practices and rural areas, mean and median final scores for 2023 and 2025 payment adjustments, and payment adjustment trends from 2021 through 2023.
Date: 06/2025
Sponsoring organization: Centers for Medicare & Medicaid Services
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MBQIP Quality Measures National Annual Report - 2023
Summarizes quality measure reporting rates and performance among Critical Access Hospitals (CAHs) in 2023. Presents data on the four Medicare Beneficiary Quality Improvement Project (MBQIP) domains: patient safety/inpatient, outpatient, patient engagement, and care transitions.
Author(s): Megan Lahr, Alyssa Furukawa, Madeleine Pick, Robert Barclay
Date: 06/2025
Sponsoring organization: Flex Monitoring Team
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Summarizes quality measure reporting rates and performance among Critical Access Hospitals (CAHs) in 2023. Presents data on the four Medicare Beneficiary Quality Improvement Project (MBQIP) domains: patient safety/inpatient, outpatient, patient engagement, and care transitions.
Author(s): Megan Lahr, Alyssa Furukawa, Madeleine Pick, Robert Barclay
Date: 06/2025
Sponsoring organization: Flex Monitoring Team
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RHPTP HELP Webinar: Medicare's NEW Advanced Primary Care Management Program
Webinar recording discusses the Advanced Primary Care Management (APCM) Program, an initiative to improve the delivery, coordination, and outcomes in primary care services. Explores the process of transitioning from fee-for-service to value-based care models and discusses how Medicare's program fits the APCM model.
Additional links: Webinar Slides
Author(s): Lindsay Corcoran, Amy Graham
Date: 06/2025
Sponsoring organization: National Rural Health Resource Center
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Webinar recording discusses the Advanced Primary Care Management (APCM) Program, an initiative to improve the delivery, coordination, and outcomes in primary care services. Explores the process of transitioning from fee-for-service to value-based care models and discusses how Medicare's program fits the APCM model.
Additional links: Webinar Slides
Author(s): Lindsay Corcoran, Amy Graham
Date: 06/2025
Sponsoring organization: National Rural Health Resource Center
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MedPAC Report to the Congress: Medicare and the Health Care Delivery System, June 2025
Evaluates Medicare payment issues and provides recommendations to the U.S. Congress. Covers proposed reforms to the physician fee schedule updates and the accuracy of relative payment rates; supplemental benefits in Medicare Advantage; home healthcare use among Medicare Advantage enrollees; Part D prescription drug plans for beneficiaries in fee-for-service Medicare and Medicare Advantage; Medicare beneficiaries in nursing homes; the inclusion of rural providers in current Medicare fee-for-service quality reporting programs; and recommendations related to reducing beneficiary cost sharing for outpatient services at Critical Access Hospitals. Includes rural references throughout.
Additional links: Executive Summary
Date: 06/2025
Sponsoring organization: Medicare Payment Advisory Commission
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Evaluates Medicare payment issues and provides recommendations to the U.S. Congress. Covers proposed reforms to the physician fee schedule updates and the accuracy of relative payment rates; supplemental benefits in Medicare Advantage; home healthcare use among Medicare Advantage enrollees; Part D prescription drug plans for beneficiaries in fee-for-service Medicare and Medicare Advantage; Medicare beneficiaries in nursing homes; the inclusion of rural providers in current Medicare fee-for-service quality reporting programs; and recommendations related to reducing beneficiary cost sharing for outpatient services at Critical Access Hospitals. Includes rural references throughout.
Additional links: Executive Summary
Date: 06/2025
Sponsoring organization: Medicare Payment Advisory Commission
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MedPAC Comment on CMS's Proposed Rule on Inpatient Rehabilitation Facility PPS for FY 2026
Comments on an April 30, 2025, Federal Register proposed rule addressing updates to the prospective payment system for inpatient rehabilitation facilities (IRFs) for fiscal year 2026. Includes comments on the potential impact of replacing payment weights on small and rural IRFs.
Date: 06/2025
Sponsoring organization: Medicare Payment Advisory Commission
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Comments on an April 30, 2025, Federal Register proposed rule addressing updates to the prospective payment system for inpatient rehabilitation facilities (IRFs) for fiscal year 2026. Includes comments on the potential impact of replacing payment weights on small and rural IRFs.
Date: 06/2025
Sponsoring organization: Medicare Payment Advisory Commission
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MedPAC Comment on CMS's Proposed Rule on Inpatient Prospective Payment System for FY 2026
Comments on an April 30, 2025, Federal Register proposed rule revising the hospital inpatient and long-term care hospital (LTCH) prospective payment systems (PPS). Discusses proposals to update inpatient prospective payment systems (IPPS) payment rates, update wage index values and policies, modify the Transforming Episode Accountability Model (TEAM), and remove the proposed health-equity adjustment from the Hospital Value-Based Purchasing (VBP) Program.
Date: 06/2025
Sponsoring organization: Medicare Payment Advisory Commission
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Comments on an April 30, 2025, Federal Register proposed rule revising the hospital inpatient and long-term care hospital (LTCH) prospective payment systems (PPS). Discusses proposals to update inpatient prospective payment systems (IPPS) payment rates, update wage index values and policies, modify the Transforming Episode Accountability Model (TEAM), and remove the proposed health-equity adjustment from the Hospital Value-Based Purchasing (VBP) Program.
Date: 06/2025
Sponsoring organization: Medicare Payment Advisory Commission
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Quality Payment Program (QPP) 2023: Participation and Payment Results At-a-Glance
Provides an overview of the results of the Quality Payment Program (QPP) for the 2023 performance year. Highlights the percentages of small and rural providers receiving negative, neutral, and positive payment adjustments for 2025.
Date: 06/2025
Sponsoring organization: Centers for Medicare & Medicaid Services
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Provides an overview of the results of the Quality Payment Program (QPP) for the 2023 performance year. Highlights the percentages of small and rural providers receiving negative, neutral, and positive payment adjustments for 2025.
Date: 06/2025
Sponsoring organization: Centers for Medicare & Medicaid Services
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