Rural Health
Resources by Topic: Medicare
AHEAD CMS-Designed Medicare FFS HGB Calculator Tool for Acute Care Hospitals Demonstration
Provides an overview and demonstration of the CMS-Designed Medicare Fee-for-Service Hospital Global Budget (HGB) Calculator Tool, which aims to support fee-for-service acute care hospitals in understanding the HGB financial methodology for the AHEAD Model. Discusses how an AHEAD Medicare Fee-for-Service Hospital Global Budget is constructed.
Additional links: AHEAD Model CMS-Designed Medicare FFS Acute Care Hospital Global Budget Calculator Tool, AHEAD Model: CMS-Designed Medicare Hospital Global Budget Acute Care Hospital Calculator Tool At-A-Glance
Date: 07/2025
Sponsoring organization: Centers for Medicare and Medicaid Services
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Provides an overview and demonstration of the CMS-Designed Medicare Fee-for-Service Hospital Global Budget (HGB) Calculator Tool, which aims to support fee-for-service acute care hospitals in understanding the HGB financial methodology for the AHEAD Model. Discusses how an AHEAD Medicare Fee-for-Service Hospital Global Budget is constructed.
Additional links: AHEAD Model CMS-Designed Medicare FFS Acute Care Hospital Global Budget Calculator Tool, AHEAD Model: CMS-Designed Medicare Hospital Global Budget Acute Care Hospital Calculator Tool At-A-Glance
Date: 07/2025
Sponsoring organization: Centers for Medicare and Medicaid Services
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AHEAD CMS-Designed Medicare FFS Hospital Global Budget Calculator Tool for Critical Access Hospital
Provides an overview and demonstration of the CMS-Designed Medicare Fee-for-Service Hospital Global Budget (HGB) Calculator Tool for Critical Access Hospitals, which aims to support eligible CAHs in understanding the key elements of the AHEAD Medicare Fee-for-Service (FFS) HGB methodology. Discusses key differences in the hospital global budget construction and methodology for critical access hospitals and fee-for-service hospitals.
Additional links: AHEAD Model CMS-Designed Medicare FFS Critical Access Hospital Global Budget Calculator Tool, AHEAD Model: CMS-Designed Medicare Hospital Global Budget Critical Access Hospital Calculator Tool At-A-Glance
Date: 07/2025
Sponsoring organization: Centers for Medicare and Medicaid Services
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Provides an overview and demonstration of the CMS-Designed Medicare Fee-for-Service Hospital Global Budget (HGB) Calculator Tool for Critical Access Hospitals, which aims to support eligible CAHs in understanding the key elements of the AHEAD Medicare Fee-for-Service (FFS) HGB methodology. Discusses key differences in the hospital global budget construction and methodology for critical access hospitals and fee-for-service hospitals.
Additional links: AHEAD Model CMS-Designed Medicare FFS Critical Access Hospital Global Budget Calculator Tool, AHEAD Model: CMS-Designed Medicare Hospital Global Budget Critical Access Hospital Calculator Tool At-A-Glance
Date: 07/2025
Sponsoring organization: Centers for Medicare and Medicaid Services
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FY 2026 Hospital Inpatient Prospective Payment System (IPPS) and Long-Term Care Hospital Prospective Payment System (LTCH PPS) Final Rule — CMS-1833-F
Fact sheet providing an overview of the Centers for Medicare & Medicaid Services (CMS) fiscal year 2026 hospital inpatient prospective payment system (IPPS) and long-term care hospital prospective payment system (LTCH PPS) final rule. Includes information about the Medicare Promoting Interoperability Program and the discontinuation of the low-wage index hospital policy for FY 2026 and subsequent years.
Date: 07/2025
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) fiscal year 2026 hospital inpatient prospective payment system (IPPS) and long-term care hospital prospective payment system (LTCH PPS) final rule. Includes information about the Medicare Promoting Interoperability Program and the discontinuation of the low-wage index hospital policy for FY 2026 and subsequent years.
Date: 07/2025
Sponsoring organization: Centers for Medicare and Medicaid Services
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Use of Telebehavioral Health Services by Critical Access Hospitals in the United States: A Qualitative Study of the Impacts of Medicare Flexibilities and Future Opportunities
Analyzes interviews with 22 Critical Access Hospital (CAH) administrators and providers to identify how telebehavioral health is used in CAHs, the impact of Medicare billing flexibility, and opportunities and challenges for telebehavioral healthcare moving forward.
Author(s): Christopher M. Shea, Sharita Thomas, Marah Maaita, Heidi O'Connor, Yvonne Jonk
Citation: Digital Health, 11
Date: 07/2025
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Analyzes interviews with 22 Critical Access Hospital (CAH) administrators and providers to identify how telebehavioral health is used in CAHs, the impact of Medicare billing flexibility, and opportunities and challenges for telebehavioral healthcare moving forward.
Author(s): Christopher M. Shea, Sharita Thomas, Marah Maaita, Heidi O'Connor, Yvonne Jonk
Citation: Digital Health, 11
Date: 07/2025
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Merit-Based Incentive Payment System (MIPS): 2025 MIPS Group Participation Guide - Traditional MIPS and MVPs
Provides an overview of traditional Merit-based Incentive Payment System (MIPS) and MIPS Value Pathways (MVP) group participation options for the 2025 performance year. Discusses eligibility; special status designations; the quality, cost, and promoting interoperability performance categories; scoring and payment adjustments; and more. Includes information on group reporting requirements and considerations for small practices and clinicians in a rural or Health Professional Shortage Area.
Date: 07/2025
Sponsoring organization: Centers for Medicare and Medicaid Services
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Provides an overview of traditional Merit-based Incentive Payment System (MIPS) and MIPS Value Pathways (MVP) group participation options for the 2025 performance year. Discusses eligibility; special status designations; the quality, cost, and promoting interoperability performance categories; scoring and payment adjustments; and more. Includes information on group reporting requirements and considerations for small practices and clinicians in a rural or Health Professional Shortage Area.
Date: 07/2025
Sponsoring organization: Centers for Medicare and Medicaid Services
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Rural Hospitals and the Rural Health Transformation Program: What Comes Next
Blog post discussing the rural health transformation program established in the July 2025 budget reconciliation law. Describes potential priorities for states' use of the rural health transformation program funding. Outlines additional steps Congress could take to help rural hospitals serve their communities.
Author(s): Emma Sheffert, Maya Sandalow
Date: 07/2025
Sponsoring organization: Bipartisan Policy Center
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Blog post discussing the rural health transformation program established in the July 2025 budget reconciliation law. Describes potential priorities for states' use of the rural health transformation program funding. Outlines additional steps Congress could take to help rural hospitals serve their communities.
Author(s): Emma Sheffert, Maya Sandalow
Date: 07/2025
Sponsoring organization: Bipartisan Policy Center
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The Rapid Growth Of Medicare Advantage Poses Challenges To Rural Hospitals
Commentary describing key features of Medicare Advantage (MA) and how they may interact with the unique limitations of rural hospitals. Offers policy recommendations to align MA expansion with rural hospital sustainability.
Author(s): James D. Lee, Cody L. Mullens, Adam A. Markovitz, Janice Probst
Citation: Health Affairs Forefront
Date: 07/2025
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Commentary describing key features of Medicare Advantage (MA) and how they may interact with the unique limitations of rural hospitals. Offers policy recommendations to align MA expansion with rural hospital sustainability.
Author(s): James D. Lee, Cody L. Mullens, Adam A. Markovitz, Janice Probst
Citation: Health Affairs Forefront
Date: 07/2025
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Understanding and Navigating Commingling - RHC Edition
Recording of a July 17, 2025, webinar discussing how Rural Health Clinics can share resources and be located in the same space as other Medicare entities and remain compliant with Medicare regulations. Describes common commingling issues and best practices. Part of the Rural Health Clinic Technical Assistance Series.
Additional links: Presentation Slides
Date: 07/2025
Sponsoring organization: National Association of Rural Health Clinics
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Recording of a July 17, 2025, webinar discussing how Rural Health Clinics can share resources and be located in the same space as other Medicare entities and remain compliant with Medicare regulations. Describes common commingling issues and best practices. Part of the Rural Health Clinic Technical Assistance Series.
Additional links: Presentation Slides
Date: 07/2025
Sponsoring organization: National Association of Rural Health Clinics
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The Uncertain Future of Medicare's Stand-Alone Prescription Drug Plan Market and Why It Matters
Discusses the Medicare Part D stand-alone prescription drug plan (PDP) market and the Part D premium stabilization demonstration. Describes the impact of PDP market stability on rural Medicare beneficiaries. Explores the potential effects of the continuation of, or changes to, the premium stabilization program.
Author(s): Juliette Cubanski, Tricia Neuman
Date: 07/2025
Sponsoring organization: KFF
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Discusses the Medicare Part D stand-alone prescription drug plan (PDP) market and the Part D premium stabilization demonstration. Describes the impact of PDP market stability on rural Medicare beneficiaries. Explores the potential effects of the continuation of, or changes to, the premium stabilization program.
Author(s): Juliette Cubanski, Tricia Neuman
Date: 07/2025
Sponsoring organization: KFF
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MedPAC Data Book: Health Care Spending and the Medicare Program, 2025
Provides an overview of Medicare spending and highlights data on Medicare beneficiary demographics, dual-eligible beneficiaries, quality of care provided through the Medicare program, and other payer liability. Examines settings of care, including rural-specific provider sites, as they relate to spending, access to care, and profit margins. Compares rural and urban beneficiaries and providers throughout. Chart 6-2 addresses rural hospital closures and Rural Emergency Hospital conversions.
Date: 07/2025
Sponsoring organization: Medicare Payment Advisory Commission
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Provides an overview of Medicare spending and highlights data on Medicare beneficiary demographics, dual-eligible beneficiaries, quality of care provided through the Medicare program, and other payer liability. Examines settings of care, including rural-specific provider sites, as they relate to spending, access to care, and profit margins. Compares rural and urban beneficiaries and providers throughout. Chart 6-2 addresses rural hospital closures and Rural Emergency Hospital conversions.
Date: 07/2025
Sponsoring organization: Medicare Payment Advisory Commission
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