Rural Health
Resources by Topic: Medicare
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
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
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
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
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
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
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
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
Sponsoring organization: KFF
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Advancing Health Care 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 and ensure affordable healthcare for people living in rural, tribal, and geographically isolated communities. Covers 6 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
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 and ensure affordable healthcare for people living in rural, tribal, and geographically isolated communities. Covers 6 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
Sponsoring organization: Centers for Medicare and Medicaid Services
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Calendar Year (CY) 2025 Medicare Physician Fee Schedule Final Rule
Fact sheet providing an overview of the Centers for Medicare & Medicaid Services (CMS) final rule regarding updates and changes to the Medicare payments under the Physician Fee Schedule (PFS) and other Medicare Part B issues for calendar year 2025. Summarizes provisions related to telehealth services; advanced primary care management services; behavioral health services; opioid treatment programs; dental and oral health services; Rural Health Clinic (RHC) and Federally Qualified Health Center (FQHC) care coordination services, telecommunication services, intensive outpatient program (IOP) services, and payment for vaccine costs; and more.
Date: 11/2024
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 under the Physician Fee Schedule (PFS) and other Medicare Part B issues for calendar year 2025. Summarizes provisions related to telehealth services; advanced primary care management services; behavioral health services; opioid treatment programs; dental and oral health services; Rural Health Clinic (RHC) and Federally Qualified Health Center (FQHC) care coordination services, telecommunication services, intensive outpatient program (IOP) services, and payment for vaccine costs; and more.
Date: 11/2024
Sponsoring organization: Centers for Medicare and Medicaid Services
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CY 2025 Medicare Hospital Outpatient Prospective Payment System and Ambulatory Surgical Center Payment System Final Rule (CMS 1809-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 2025. Summarizes provisions regarding changes to Intensive Outpatient Program (IOP) and partial hospital program rate setting; incorporating an add-on payment to the Medicare outpatient hospital all-inclusive rate (AIR) for certain high-cost drugs for people with Medicare who receive care at Indian Health Service (IHS) or tribal hospitals; updates to the Hospital Outpatient Quality Reporting (OQR), Ambulatory Surgical Center Quality Reporting (ASCQR), and Rural Emergency Hospital Quality Reporting (REHQR) Programs; a new Conditions of Participation (CoPs) for hospitals and Critical Access Hospitals (CAHs) for obstetrical services; Medicaid and CHIP continuous eligibility; Medicaid clinic services "four walls" exceptions; and more.
Date: 11/2024
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 2025. Summarizes provisions regarding changes to Intensive Outpatient Program (IOP) and partial hospital program rate setting; incorporating an add-on payment to the Medicare outpatient hospital all-inclusive rate (AIR) for certain high-cost drugs for people with Medicare who receive care at Indian Health Service (IHS) or tribal hospitals; updates to the Hospital Outpatient Quality Reporting (OQR), Ambulatory Surgical Center Quality Reporting (ASCQR), and Rural Emergency Hospital Quality Reporting (REHQR) Programs; a new Conditions of Participation (CoPs) for hospitals and Critical Access Hospitals (CAHs) for obstetrical services; Medicaid and CHIP continuous eligibility; Medicaid clinic services "four walls" exceptions; and more.
Date: 11/2024
Sponsoring organization: Centers for Medicare and Medicaid Services
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2024 Rural-Urban Disparities in Health Care in Medicare
Examines rural/urban differences in the quality of healthcare received by Medicare beneficiaries in 2023, with breakdowns by race and ethnicity. Describes trends in quality of care for rural and urban residents between 2017 and 2023.
Date: 11/2024
Sponsoring organizations: Centers for Medicare and Medicaid Services, RAND Corporation
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Examines rural/urban differences in the quality of healthcare received by Medicare beneficiaries in 2023, with breakdowns by race and ethnicity. Describes trends in quality of care for rural and urban residents between 2017 and 2023.
Date: 11/2024
Sponsoring organizations: Centers for Medicare and Medicaid Services, RAND Corporation
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Final CY 2025 Medicare Physician Fee Schedule: Fact Sheet
Fact sheet covering Centers for Medicare & Medicaid Services (CMS) telehealth policy changes for 2025 as outlined in the final calendar year (CY) 2025 Physician Fee Schedule. Covers audio-only telehealth; eligible services that can be delivered by telehealth; frequency limitations for inpatient visits, nursing facilities, and critical care consults; direct supervision through the use of live video; payment to Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs); opioid treatment programs; and more.
Date: 11/2024
Sponsoring organization: Center for Connected Health Policy: The National Telehealth Policy Resource Center
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Fact sheet covering Centers for Medicare & Medicaid Services (CMS) telehealth policy changes for 2025 as outlined in the final calendar year (CY) 2025 Physician Fee Schedule. Covers audio-only telehealth; eligible services that can be delivered by telehealth; frequency limitations for inpatient visits, nursing facilities, and critical care consults; direct supervision through the use of live video; payment to Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs); opioid treatment programs; and more.
Date: 11/2024
Sponsoring organization: Center for Connected Health Policy: The National Telehealth Policy Resource Center
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Accountable Health Communities (AHC) Model Evaluation: Third Evaluation Report
Provides an overview of the Accountable Health Communities (ACH) Model, which tests whether identifying and addressing core health-related social needs (HRSNs) of community-dwelling beneficiaries improves health outcomes, reduces healthcare costs, and reduces unnecessary healthcare utilization. Explores which bridge organization and community characteristics were associated with better implementation outcomes, and the beneficiary-level characteristics were associated with a greater probability of accepting navigation, having at least one HRSN resolved, or having all HRSNs resolved. Examines the extent to which bridge organizations met model requirements. Includes information on the availability and quality of community resources to address HRSNs in rural communities.
Additional links: Appendices, Findings at a Glance
Date: 11/2024
Sponsoring organizations: Centers for Medicare and Medicaid Services, RTI International
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Provides an overview of the Accountable Health Communities (ACH) Model, which tests whether identifying and addressing core health-related social needs (HRSNs) of community-dwelling beneficiaries improves health outcomes, reduces healthcare costs, and reduces unnecessary healthcare utilization. Explores which bridge organization and community characteristics were associated with better implementation outcomes, and the beneficiary-level characteristics were associated with a greater probability of accepting navigation, having at least one HRSN resolved, or having all HRSNs resolved. Examines the extent to which bridge organizations met model requirements. Includes information on the availability and quality of community resources to address HRSNs in rural communities.
Additional links: Appendices, Findings at a Glance
Date: 11/2024
Sponsoring organizations: Centers for Medicare and Medicaid Services, RTI International
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