Skip to main content
Rural Health Information Hub

Rural Health
Resources by Topic: Health insurance

Calendar Year (CY) 2015 Rural Health Clinic (RHC) and Federally Qualified Health Centers (FQHC) Updates: Payment Rate Increases for RHCs and FQHCs Billing Under the All-Inclusive Rate System (AIR), and Urban and Rural Designations for FQHCs Billing Under the AIR
Provides updates for RHCs and FQHCs that are submitting claims to Medicare Administrative Contractors (MACs) for services to Medicare beneficiaries.
Date: 12/2024
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
view details
Medicare Accountable Care Organizations: Past Performance and Future Directions
Summarizes research findings about Medicare accountable care organizations (ACOs) from recent peer-reviewed journals, official evaluations of Medicare ACOs, and research organization reports. Describes characteristics of certain ACOs associated with greater savings and factors that limit ACOs' ability to achieve net budgetary savings for the Medicare program. Identifies policy approaches that could increase savings for Medicare through ACOs and the Medicare Shared Savings Program. Includes a brief discussion of challenges facing ACOs in rural and underserved areas.
Date: 04/2024
Type: Document
Sponsoring organization: Congressional Budget Office
view details
Evaluation of the Maryland Total Cost of Care Model: Progress Report
Provides an overview of the Maryland Total Cost of Care Model and evaluates the first four years of the program, 2019-2022. Explores the effects of the model on Medicare spending; service use, including preventable hospital use; and healthcare quality measures. Estimates the potential impact of switching Maryland to the Medicare prospective payment system (PPS) on Medicare spending and service use, including implications for rural and safety net hospitals.
Additional links: Appendices, Findings at a Glance, Transformation Spotlight
Date: 04/2024
Type: Document
Sponsoring organizations: Centers for Medicare and Medicaid Services, Mathematica
view details
Medicare Payment for Rural or Geographically Isolated Hospitals
Displays data on Medicare payment adjustments for Sole Community Hospitals, Medicare-Dependent Hospitals, Low-Volume Hospitals, and Critical Access Hospitals. Includes information on the number of qualifying hospitals by state and eligibility criteria.
Date: 04/2024
Type: Document
Sponsoring organization: Congressional Research Service
view details
Protecting, Connecting and Thriving: Rural Public Health and Healthcare
Webinar recording of a panel discussing rural public health topics including rural health disparities, mortality, COVID-19, Medicaid coverage, primary care, graduate medical education, and services for veterans. Transcript is available in the video description.
Date: 04/2024
Type: Video/Multimedia
Sponsoring organizations: The RURAL Study, University of Texas Health Science Center at San Antonio
view details
Merit-Based Incentive Payment System (MIPS): 2024 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 beginning with the 2024 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: 04/2024
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
view details
A Lack of Behavioral Health Providers in Medicare and Medicaid Impedes Enrollees' Access to Care
Examines the availability of behavioral health providers who actively serve Medicare or Medicaid enrollees in 20 counties, 10 urban and 10 rural, across 10 states in 2021. Explores the extent to which traditional Medicare, Medicare Advantage, and Medicaid enrollees received behavioral health services and whether they used telehealth or in-person services. Offers recommendations to encourage more behavioral health providers to serve these enrollees and expand coverage to additional behavioral health provider types. Includes rural and urban comparisons throughout.
Additional links: Report Highlights
Date: 03/2024
Type: Document
Sponsoring organization: Office of Inspector General (HHS)
view details
2024 Annual Disability Infographic: Experiences of People with Disabilities in Rural America
Infographic on disability in rural America using American Community Survey data. Includes data on prevalence, employment, poverty for children, and insurance coverage.
Date: 03/2024
Type: Document
Sponsoring organizations: Center for Research on Disability, Research and Training Center on Disability in Rural Communities
view details
ADSC Compendium: Part of the 2024 Annual Disability Statistics Collection
Presents statistics on Americans with disabilities across key social and economic indicators derived from American Community Survey (ACS) data, including employment, educational attainment, health and healthcare, and more. Section 10 presents data on people with disabilities in rural areas, and compares the prevalence of disability, demographic characteristics, employment status, income, and insurance coverage status across metropolitan, micropolitan, and noncore areas.
Additional links: Annual Report on People with Disabilities in America 2024
Date: 03/2024
Type: Document
Sponsoring organization: Center for Research on Disability
view details
Environmental Scan on Developing and Implementing Performance Measures for Population-Based Total Cost of Care (PB-TCOC) Models
Presents results of an environmental scan regarding the development and implementation of population-based total cost of care (PB-TCOC) payment models. Describes types of performance measures used in value-based payment models and pay-for-reporting programs, data sources used for constructing performance measures, features of PB-TCOC models, challenges in developing and implementing performance measures and opportunities for Alternative Payment Models (APMs) and PB-TCOC models to address these challenges, trends in existing performance measures across several Center for Medicare and Medicaid Innovation (CMMI) models and Medicare value-based care programs, and more. Includes rural references and considerations throughout.
Date: 03/2024
Type: Document
Sponsoring organizations: HHS Office of the Assistant Secretary for Planning and Evaluation, NORC at the University of Chicago
view details