Rural Health
Resources by Topic: Medicare
March 2025 MedPAC Meeting Transcript
Transcript from the Medicare Payment Advisory Commission's (MedPAC) March 2025 meeting. Covers research and proposals related to reforming physician fee schedule updates and improving the accuracy of relative payment rates, reducing beneficiary cost-sharing for outpatient services at Critical Access Hospitals, Medicare insurance agents, Medigap, payment for ground ambulance services, home healthcare use among Medicare Advantage enrollees, and institutional special needs plans. Includes rural references and considerations throughout.
Additional links: Mandated Report: Payment for Ground Ambulance Services, Reducing Beneficiary Cost-Sharing for Outpatient Services at Critical Access Hospitals
Date: 03/2025
Sponsoring organization: Medicare Payment Advisory Commission
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Transcript from the Medicare Payment Advisory Commission's (MedPAC) March 2025 meeting. Covers research and proposals related to reforming physician fee schedule updates and improving the accuracy of relative payment rates, reducing beneficiary cost-sharing for outpatient services at Critical Access Hospitals, Medicare insurance agents, Medigap, payment for ground ambulance services, home healthcare use among Medicare Advantage enrollees, and institutional special needs plans. Includes rural references and considerations throughout.
Additional links: Mandated Report: Payment for Ground Ambulance Services, Reducing Beneficiary Cost-Sharing for Outpatient Services at Critical Access Hospitals
Date: 03/2025
Sponsoring organization: Medicare Payment Advisory Commission
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Merit-Based Incentive Payment System (MIPS): 2024 Opt-in and Voluntary Reporting Election Process Guide
Discusses the eligibility of clinicians, groups, and Alternative Payment Model (APM) participants that exceed some low-volume threshold criteria to opt-in to the Merit-Based Incentive Payment System (MIPS) and the APM Performance Pathway (APP) for the 2024 performance period. Compares opting in and voluntarily reporting MIPS data and provides an overview of the election process.
Date: 03/2025
Sponsoring organization: Centers for Medicare and Medicaid Services
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Discusses the eligibility of clinicians, groups, and Alternative Payment Model (APM) participants that exceed some low-volume threshold criteria to opt-in to the Merit-Based Incentive Payment System (MIPS) and the APM Performance Pathway (APP) for the 2024 performance period. Compares opting in and voluntarily reporting MIPS data and provides an overview of the election process.
Date: 03/2025
Sponsoring organization: Centers for Medicare and Medicaid Services
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Merit-Based Incentive Payment System (MIPS): Traditional MIPS Scoring Guide for the 2024 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: 02/2025
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: 02/2025
Sponsoring organization: Centers for Medicare and Medicaid Services
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Rural Emergency Hospital (REH) Model Frequently Asked Questions
Provides answers to frequently asked questions regarding the Rural Emergency Hospital (REH) designation. Covers general information, Conditions of Participation, and REH payment policies.
Date: 02/2025
Sponsoring organizations: Mathematica, Rural Health Redesign Center
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Provides answers to frequently asked questions regarding the Rural Emergency Hospital (REH) designation. Covers general information, Conditions of Participation, and REH payment policies.
Date: 02/2025
Sponsoring organizations: Mathematica, Rural Health Redesign Center
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Medicare Telehealth Trends Report
Describes the trends of telehealth utilization among Medicare beneficiaries between January 1, 2020, and September 30, 2024. Presents data on the percentage of Medicare beneficiaries that used a telehealth service by calendar quarter and by Medicaid eligibility, type of Medicare eligibility, demographic characteristics, and rural/urban residence.
Date: 02/2025
Sponsoring organization: Centers for Medicare and Medicaid Services
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Describes the trends of telehealth utilization among Medicare beneficiaries between January 1, 2020, and September 30, 2024. Presents data on the percentage of Medicare beneficiaries that used a telehealth service by calendar quarter and by Medicaid eligibility, type of Medicare eligibility, demographic characteristics, and rural/urban residence.
Date: 02/2025
Sponsoring organization: Centers for Medicare and Medicaid Services
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Current Medicare Beneficiary Quality Improvement Project (MBQIP) Measures
Chart outlining the required and optional MBQIP measures. Measures are broken down into two categories, core and additional, and then into five domains: global measures, patient safety, patient engagement, care coordination, and emergency department. MBQIP is a Medicare Rural Hospital Flexibility (Flex) quality improvement grant program for Critical Access Hospitals.
Date: 02/2025
Sponsoring organization: Rural Quality Improvement Technical Assistance (RQITA) Resource Center
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Chart outlining the required and optional MBQIP measures. Measures are broken down into two categories, core and additional, and then into five domains: global measures, patient safety, patient engagement, care coordination, and emergency department. MBQIP is a Medicare Rural Hospital Flexibility (Flex) quality improvement grant program for Critical Access Hospitals.
Date: 02/2025
Sponsoring organization: Rural Quality Improvement Technical Assistance (RQITA) Resource Center
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Merit-Based Incentive Payment System (MIPS): 2025 Improvement Activities Performance Category Quick Start Guide
Provides an overview of Merit-based Incentive Payment System (MIPS) requirements, data collection, and data submission for the improvement activities performance category for the 2025 performance year. Includes information about special status scoring for small practices and clinicians located in a rural or Health Professional Shortage Area.
Date: 01/2025
Sponsoring organization: Centers for Medicare and Medicaid Services
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Provides an overview of Merit-based Incentive Payment System (MIPS) requirements, data collection, and data submission for the improvement activities performance category for the 2025 performance year. Includes information about special status scoring for small practices and clinicians located in a rural or Health Professional Shortage Area.
Date: 01/2025
Sponsoring organization: Centers for Medicare and Medicaid Services
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Opioid Use Among Rural Medicare Beneficiaries
Examines trends in prescription opioid use among Medicare beneficiaries in rural areas, utilizing 2010-2017 Medicare Current Beneficiary Survey (MCBS) data. Provides data on receipt of opioid prescriptions among community-dwelling and facility-dwelling beneficiaries, associations between prescribing and chronic overlapping pain conditions (COPCs), and prescriptions exceeding CDC guidelines. Includes rural-urban comparisons.
Author(s): Yvonne Jonk, Heidi O'Connor, Karen Pearson, et al.
Date: 01/2025
Sponsoring organization: Maine Rural Health Research Center
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Examines trends in prescription opioid use among Medicare beneficiaries in rural areas, utilizing 2010-2017 Medicare Current Beneficiary Survey (MCBS) data. Provides data on receipt of opioid prescriptions among community-dwelling and facility-dwelling beneficiaries, associations between prescribing and chronic overlapping pain conditions (COPCs), and prescriptions exceeding CDC guidelines. Includes rural-urban comparisons.
Author(s): Yvonne Jonk, Heidi O'Connor, Karen Pearson, et al.
Date: 01/2025
Sponsoring organization: Maine Rural Health Research Center
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January 2025 MedPAC Meeting Transcript
Transcript from the Medicare Payment Advisory Commission's (MedPAC) January 2025 meeting. Covers payment adequacy and updates for physician and other health professional services, hospital inpatient and outpatient services, skilled nursing facility services, home health agency services, inpatient rehabilitation facility services, outpatient dialysis services, and hospice services. Discusses status reports on Medicare Part D, ambulatory surgical centers, and the Medicare Advantage program, as well as policy options for modifying the cost-sharing liability for beneficiaries who receive care at Critical Access Hospitals. Includes rural references and considerations throughout.
Additional links: Reducing Beneficiary Cost-sharing for Outpatient Services at Critical Access Hospitals
Date: 01/2025
Sponsoring organization: Medicare Payment Advisory Commission
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Transcript from the Medicare Payment Advisory Commission's (MedPAC) January 2025 meeting. Covers payment adequacy and updates for physician and other health professional services, hospital inpatient and outpatient services, skilled nursing facility services, home health agency services, inpatient rehabilitation facility services, outpatient dialysis services, and hospice services. Discusses status reports on Medicare Part D, ambulatory surgical centers, and the Medicare Advantage program, as well as policy options for modifying the cost-sharing liability for beneficiaries who receive care at Critical Access Hospitals. Includes rural references and considerations throughout.
Additional links: Reducing Beneficiary Cost-sharing for Outpatient Services at Critical Access Hospitals
Date: 01/2025
Sponsoring organization: Medicare Payment Advisory Commission
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Impact of the Medicare Improvements for Patients And Providers Act on Mental Health Service Utilization And Spending among Older Adults
Examines the impact of the Medicare Improvements for Patients and Providers Act (MIPPA) on outpatient mental healthcare utilization. Utilizes 2008-2017 Medicare claims and administrative data to analyze MIPPA in a pre-implementation phase as well as 4 post-implementation phases. Includes data on mental healthcare outpatient visits by age group, race, dual eligibility status, substance use disorder, comorbidities, and urban, large rural, small rural, or isolated rural location.
Author(s): Matt Toth, Brent Gibbons, Abbie Levinson, 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 the Medicare Improvements for Patients and Providers Act (MIPPA) on outpatient mental healthcare utilization. Utilizes 2008-2017 Medicare claims and administrative data to analyze MIPPA in a pre-implementation phase as well as 4 post-implementation phases. Includes data on mental healthcare outpatient visits by age group, race, dual eligibility status, substance use disorder, comorbidities, and urban, large rural, small rural, or isolated rural location.
Author(s): Matt Toth, Brent Gibbons, Abbie Levinson, et al.
Date: 01/2025
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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