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Rural Health Information Hub

Rural Health
Resources by Topic: Health insurance

Small Practice After-Action Review: 2023 Performance Year Final Score
Tool for small practices interested in examining their 2023 Merit-based Incentive Payment System (MIPS) final score to identify opportunities to improve performance in 2025.
Additional links: Video: Small Practice Action Planning Tool for MIPS
Date: 04/2025
Sponsoring organization: Centers for Medicare and Medicaid Services
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Merit-based Incentive Payment System (MIPS) 2025 Small Practice Eligibility and Participation Frequently Asked Questions
Provides answers to frequently asked questions regarding small practice participation and eligibility for the Merit-based Incentive Payment System (MIPS) for the 2025 performance year. Covers individual and group eligibility, the low-volume threshold, changes to group composition during the performance year, and more.
Date: 04/2025
Sponsoring organization: Centers for Medicare and Medicaid Services
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Merit-Based Incentive Payment System (MIPS): 2025 Reporting MIPS Quality Measures through Medicare Part B Claims Quick Start Guide for Small Practices
Provides details on how small practices can report quality measures through Medicare Part B claims measures. Highlights changes to these measures in 2025, score redistribution policies for small practices, and information for clinicians at Critical Access Hospitals.
Date: 04/2025
Sponsoring organization: Centers for Medicare and Medicaid Services
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The Relationship Between Food and Housing Insecurity and Healthcare Use among Virginia Medicaid Expansion Members: Considering the Neighborhood Context
Examines how rurality and residential segregation impact food and housing insecurity in Medicaid expansion members in Virginia. Analyzes 14,735 individuals in 2019 for food and housing security, with demographic breakdowns by sex, race/ethnicity, age, health status, healthcare usage, income, and urban, suburban, or rural location.
Author(s): Hannah Shadowen, Sarah J. Marks, Olufemi Obembe, et al.
Citation: Health Services Research, 60(S2)
Date: 04/2025
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Advancing Value-Based Payment Policies Relevant to Rural Areas – Continued Challenges and New Opportunities
Discusses lessons from the recent public health emergency, rising health care costs, improved quality measurement, and innovative technologies on the transition from volume-based payment to value-based payment. Outlines potential policy opportunities for the Centers for Medicare & Medicaid Services (CMS) Innovation Center model design and CMS program inclusion to expand rural-appropriate opportunities to participate in the transition to value-based care. Builds on the 2020 publication How to Design Value‐based Care Models for Rural Participant Success: A Summit Findings Report.
Date: 04/2025
Sponsoring organization: Rural Health Value
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Missouri Rural Health Clinic Provider Manual
Provider manual identifying the conditions of participation providing services in Missouri state-funded healthcare programs, including MO HealthNet, Missouri's Medicaid program. Addresses enrollment, eligibility, claim filing, and billing requirements for Rural Health Clinics (RHCs) in Missouri. Includes information on covered telehealth services.
Date: 04/2025
Sponsoring organization: Missouri Department of Social Services
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Use of Medicaid Personal Care Services in 2019 and 2020
Explores the change in the utilization of personal care services (PCS) among Medicaid beneficiaries from 2019 to 2020. Compares the number and characteristics of Medicaid enrollees with comprehensive benefits who received personal care services (PCS) between a pre-COVID-19 pandemic period (March and December of 2019) and a COVID-19 pandemic period (March through December of 2020). Presents data by patient demographic and clinical characteristics.
Author(s): Melissa Sanchez, Zosha Kandel, Andrea Wysocki, et al.
Date: 03/2025
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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Wyoming Medicaid Annual Report SFY 2024
Comprehensive report of Wyoming's Medicaid program, including information and data for the types of services provided, enrollment, cost of services, and service utilization by Rural Health Clinics and Federally Qualified Health Centers.
Date: 03/2025
Sponsoring organization: Wyoming Department of Health
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Merit-based Incentive Payment System (MIPS): Eligibility and Participation in the 2025 Performance Year
Provides an overview of the Merit-Based Incentive Payment System (MIPS) eligibility criteria. Addresses calculation of the low-volume threshold exclusion at the individual and group levels, opt-in and voluntary reporting options, and the impact of special status designations such as rural and small practices.
Date: 03/2025
Sponsoring organization: Centers for Medicare and Medicaid Services
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Medicare Learning Network: Hospital Price Transparency
Contains information on federal hospital price transparency regulations and compliance, what patients need to know, and a list of helpful websites.
Date: 03/2025
Sponsoring organization: Centers for Medicare and Medicaid Services
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