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Rural Health Information Hub

Rural Health
Resources by Topic: Health insurance

Rural Emergency Hospital (REH) Model Frequently Asked Questions
Provides answers to frequently asked questions regarding the Rural Emergency Hospital (REH) designation. Covers general information, Conditions of Participation, and REH payment policies.
Date: 04/2025
Sponsoring organizations: Mathematica, Rural Health Redesign Center
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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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Operating Status of Adult Day Services Centers in 2022

Offers estimates from the 2022 National Post-acute and Long-term Care Study (NPALS) regarding operating status of adult day service centers as a result of COVID-19 response efforts. Compares U.S. Census Bureau regions, metropolitan and nonmetropolitan statistical areas, Medicaid licensure, and number of enrolled participants.


Author(s): Jessica P. Lendon, Priyanka Singh, Christine Caffrey, Manisha Sengupta, Zhaohui Lu
Date: 03/2025
Sponsoring organization: National Center for Health Statistics
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2025 MIPS Eligibility Decision Tree
Presents information to determine if providers are eligible to participate in the Merit-Based Incentive Payment System (MIPS) in the 2025 Performance Year. Includes information on the low-volume threshold criteria.
Date: 03/2025
Sponsoring organization: Centers for Medicare and Medicaid Services
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MedPAC Report to the Congress: Medicare Payment Policy: Skilled Nursing Facility Services: Chapter 6
Discusses payment adequacy for skilled nursing facility (SNF) services. Features statistics on SNF care provided by rural hospitals and Critical Access Hospitals (CAHs) via swing beds and Medicare margins for urban, rural, and frontier freestanding SNFs in 2023.
Date: 03/2025
Sponsoring organization: Medicare Payment Advisory Commission
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MedPAC Report to the Congress: Medicare Payment Policy: Home Health Care Services: Chapter 7
Discusses payment adequacy for home health care services. Features statistics on Medicare margins for home health agencies between 2019-2023 with breakdowns by urban and rural areas, a comparison of patient-experience quality measures by urban and rural status, and the number of home health periods provided to rural beneficiaries.
Date: 03/2025
Sponsoring organization: Medicare Payment Advisory Commission
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MedPAC Report to the Congress: Medicare Payment Policy: Hospice Services: Chapter 9
Discusses payment adequacy for hospice and palliative support services. Includes data on average costs by day and aggregate margins by urban and rural status, as well as demographics on Medicare decedents who used hospice during 2010 and between 2019-2023. Compares the actual hospice utilization rates in micropolitan, rural adjacent, rural nonadjacent, and frontier areas to urban hospice utilization rates.
Date: 03/2025
Sponsoring organization: Medicare Payment Advisory Commission
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MedPAC Report to the Congress: Medicare Payment Policy, 2025
Annual review of Medicare payment policies, with recommendations to Congress. Includes discussion on Medicare payment policies directly affecting rural providers and beneficiaries. Addresses payment adequacy for Medicare fee-for-service payment systems, Medicare Advantage (MA), and Medicare Part D.
Date: 03/2025
Sponsoring organization: Medicare Payment Advisory Commission
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Report to Congress on Medicaid and CHIP, March 2025
Reports on three aspects of Medicaid of interest to Congress: 1) improving the usability and transparency of the managed care external quality review process, 2) improvements on timely access to home- and community-based services (HCBS), and 3) ways to streamline Medicaid Section 1915 authorities for home-and community-based services and reduce the administrative burden.
Date: 03/2025
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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