Rural Health
Resources by Topic: Medicare
Data Book: Beneficiaries Dually Eligible for Medicare and Medicaid
Provides an overview of dual-eligible beneficiaries who receive benefits from both Medicare and Medicaid. Analyzes data from calendar year 2022 to examine beneficiary demographics, eligibility pathways, utilization and spending patterns, and more. Exhibit 6 on page 15 includes a breakdown of beneficiaries based on urban or rural residence.
Date: 12/2025
Sponsoring organizations: Medicaid and CHIP Payment and Access Commission, Medicare Payment Advisory Commission
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Provides an overview of dual-eligible beneficiaries who receive benefits from both Medicare and Medicaid. Analyzes data from calendar year 2022 to examine beneficiary demographics, eligibility pathways, utilization and spending patterns, and more. Exhibit 6 on page 15 includes a breakdown of beneficiaries based on urban or rural residence.
Date: 12/2025
Sponsoring organizations: Medicaid and CHIP Payment and Access Commission, Medicare Payment Advisory Commission
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Merit-Based Incentive Payment System (MIPS): Traditional MIPS Scoring Guide for the 2025 Performance Year
Provides details on how scores are calculated for the Merit-Based Incentive Payment System (MIPS), one of two tracks under the Medicare Quality Payment Program. Explains the four performance categories that affect Medicare Physician Fee Schedule payments: quality, cost, improvement activities, and promoting interoperability. Includes information for small practices.
Date: 12/2025
Sponsoring organization: Centers for Medicare and Medicaid Services
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Provides details on how scores are calculated for the Merit-Based Incentive Payment System (MIPS), one of two tracks under the Medicare Quality Payment Program. Explains the four performance categories that affect Medicare Physician Fee Schedule payments: quality, cost, improvement activities, and promoting interoperability. Includes information for small practices.
Date: 12/2025
Sponsoring organization: Centers for Medicare and Medicaid Services
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Merit-Based Incentive Payment System (MIPS): 2025 Merit-Based Incentive Payment (MIPS) Value Pathways (MVPs) Implementation Guide
Provides an overview of the Merit-based Incentive Payment System (MIPS) Value Pathways (MVPs), a voluntary reporting option that can be used to meet MIPS reporting requirements for the 2025 performance year. Describes subgroup reporting, reporting requirements, scoring, performance feedback and public reporting, and how to register to report an MVP. Includes information on considerations and exceptions for small practices and clinicians in a rural or Health Professional Shortage Area.
Date: 12/2025
Sponsoring organization: Centers for Medicare and Medicaid Services
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Provides an overview of the Merit-based Incentive Payment System (MIPS) Value Pathways (MVPs), a voluntary reporting option that can be used to meet MIPS reporting requirements for the 2025 performance year. Describes subgroup reporting, reporting requirements, scoring, performance feedback and public reporting, and how to register to report an MVP. Includes information on considerations and exceptions for small practices and clinicians in a rural or Health Professional Shortage Area.
Date: 12/2025
Sponsoring organization: Centers for Medicare and Medicaid Services
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Telehealth FAQ Calendar Year 2026
Provides information on Medicare telehealth regulations and payment policy for calendar year 2026. Includes information on audio-only services, behavioral health services, direct supervision, and more. Highlights changes that take effect on January 31, 2026 under current law.
Date: 11/2025
Sponsoring organization: Centers for Medicare and Medicaid Services
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Provides information on Medicare telehealth regulations and payment policy for calendar year 2026. Includes information on audio-only services, behavioral health services, direct supervision, and more. Highlights changes that take effect on January 31, 2026 under current law.
Date: 11/2025
Sponsoring organization: Centers for Medicare and Medicaid Services
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Calendar Year 2026 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center Final Rule (CMS-1834-FC)
Fact sheet providing an overview of the Centers for Medicare & Medicaid Services (CMS) final rule regarding updates and changes to the Medicare payments for hospital outpatient and Ambulatory Surgical Center (ASC) services for calendar year 2026. Summarizes provisions regarding changes to hospital price transparency; Intensive Outpatient Program (IOP) and partial hospital program rate setting; updates to the Hospital Outpatient Quality Reporting (OQR), Ambulatory Surgical Center Quality Reporting (ASCQR), and Rural Emergency Hospital Quality Reporting (REHQR) Programs; hospital quality start ratings; and more.
Date: 11/2025
Sponsoring organization: Centers for Medicare and Medicaid Services
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Fact sheet providing an overview of the Centers for Medicare & Medicaid Services (CMS) final rule regarding updates and changes to the Medicare payments for hospital outpatient and Ambulatory Surgical Center (ASC) services for calendar year 2026. Summarizes provisions regarding changes to hospital price transparency; Intensive Outpatient Program (IOP) and partial hospital program rate setting; updates to the Hospital Outpatient Quality Reporting (OQR), Ambulatory Surgical Center Quality Reporting (ASCQR), and Rural Emergency Hospital Quality Reporting (REHQR) Programs; hospital quality start ratings; and more.
Date: 11/2025
Sponsoring organization: Centers for Medicare and Medicaid Services
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RHCs and CAHs Participating in the Medicare Shared Savings Program (MSSP): Characteristics of the Providers and Communities
Describes the characteristics of Rural Health Clinics (RHCs) and Critical Access Hospitals (CAHs) currently participating in the Medicare Shared Savings Program (MSSP) in 2023. Compares CAH and RHC characteristics by MSSP participation, ownership status, and free-standing versus provider-based RHC status.
Author(s): Edmer Lazaro, Dan Shane, Fred Ullrich, Keith Mueller
Date: 11/2025
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Describes the characteristics of Rural Health Clinics (RHCs) and Critical Access Hospitals (CAHs) currently participating in the Medicare Shared Savings Program (MSSP) in 2023. Compares CAH and RHC characteristics by MSSP participation, ownership status, and free-standing versus provider-based RHC status.
Author(s): Edmer Lazaro, Dan Shane, Fred Ullrich, Keith Mueller
Date: 11/2025
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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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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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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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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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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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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