Rural Health
Resources by Topic: Medicare
Ambulatory Care for Individuals Dually Eligible for Medicare and Medicaid
Compares ambulatory services utilization for more than 5.5 million dual and non-dual Medicaid and Medicare individuals. Describes the rural or urban status of the population studied as well as whether services were utilized in a Federally Qualified Health Center (FQHC) or Rural Health Clinic (RHC), among other demographic and service related factors.
Author(s): Joshua M. Liao, Paula Chatterjee, Yueming Zhao, et al.
Citation: Health Affairs Scholar, 3(8)
Date: 08/2025
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Compares ambulatory services utilization for more than 5.5 million dual and non-dual Medicaid and Medicare individuals. Describes the rural or urban status of the population studied as well as whether services were utilized in a Federally Qualified Health Center (FQHC) or Rural Health Clinic (RHC), among other demographic and service related factors.
Author(s): Joshua M. Liao, Paula Chatterjee, Yueming Zhao, et al.
Citation: Health Affairs Scholar, 3(8)
Date: 08/2025
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Barriers to Accessible and Affordable Mental Health and Substance Use Disorder Care for Older Adults
Discusses challenges in accessing healthcare for mental health and substance use disorders for older adults. Challenges discussed include workforce shortages in rural areas, Medicare regulations, stigma, health insurance coverage, and more.
Date: 08/2025
Sponsoring organization: AARP Public Policy Institute
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Discusses challenges in accessing healthcare for mental health and substance use disorders for older adults. Challenges discussed include workforce shortages in rural areas, Medicare regulations, stigma, health insurance coverage, and more.
Date: 08/2025
Sponsoring organization: AARP Public Policy Institute
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Health Provisions in P.L. 119-21, the FY2025 Reconciliation Law
Provides an overview of the healthcare-related provisions of the July 2025 reconciliation law (Public Law 119-21). Offers detailed summaries of provisions that impact Medicaid, the State Children's Health Insurance Program (CHIP), Medicare, private health insurance, and rural health providers. Discusses the Rural Health Transformation Program.
Date: 08/2025
Sponsoring organization: Congressional Research Service
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Provides an overview of the healthcare-related provisions of the July 2025 reconciliation law (Public Law 119-21). Offers detailed summaries of provisions that impact Medicaid, the State Children's Health Insurance Program (CHIP), Medicare, private health insurance, and rural health providers. Discusses the Rural Health Transformation Program.
Date: 08/2025
Sponsoring organization: Congressional Research Service
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Expanding Access to Integrated Medicare-Medicaid Programs in Rural Communities
Discusses the rural population who are dually eligible for Medicare and Medicaid and their unique physical health, mental health, and health-related social needs (HRSNs). Includes information on dual eligibility issues related to access, integrated care, and managed care infrastructure. Provides a literature review and stakeholder interview feedback focused on potential strategies to improve healthcare integration.
Author(s): Molly Knowles, Nida Joseph, Nancy Archibald, Ellen Breslin
Date: 08/2025
Sponsoring organization: Center for Health Care Strategies
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Discusses the rural population who are dually eligible for Medicare and Medicaid and their unique physical health, mental health, and health-related social needs (HRSNs). Includes information on dual eligibility issues related to access, integrated care, and managed care infrastructure. Provides a literature review and stakeholder interview feedback focused on potential strategies to improve healthcare integration.
Author(s): Molly Knowles, Nida Joseph, Nancy Archibald, Ellen Breslin
Date: 08/2025
Sponsoring organization: Center for Health Care Strategies
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FY 2026 Medicare Inpatient Psychiatric Facility Prospective Payment System (IPF PPS) and Quality Reporting (IPFQR) Updates Final Rule (CMS-1831-F)
Fact sheet providing an overview of the Centers for Medicare & Medicaid Services (CMS) fiscal year 2026 inpatient psychiatric facility (IPF) prospective payment system (PPS) final rule. Covers annual updates to the prospective payment rates, outlier threshold, and wage index. Also describes changes to facility-level adjustment factors for teaching status and rural location.
Date: 08/2025
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 inpatient psychiatric facility (IPF) prospective payment system (PPS) final rule. Covers annual updates to the prospective payment rates, outlier threshold, and wage index. Also describes changes to facility-level adjustment factors for teaching status and rural location.
Date: 08/2025
Sponsoring organization: Centers for Medicare and Medicaid Services
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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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