Rural Health
Resources by Topic: Health insurance
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 & 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 & Medicaid Services
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MedPAC Data Book: Health Care Spending and the Medicare Program, 2025
Provides an overview of Medicare spending and highlights data on Medicare beneficiary demographics, dual-eligible beneficiaries, quality of care provided through the Medicare program, and other payer liability. Examines settings of care, including rural-specific provider sites, as they relate to spending, access to care, and profit margins. Compares rural and urban beneficiaries and providers throughout. Chart 6-2 addresses rural hospital closures and Rural Emergency Hospital conversions.
Date: 07/2025
Sponsoring organization: Medicare Payment Advisory Commission
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Provides an overview of Medicare spending and highlights data on Medicare beneficiary demographics, dual-eligible beneficiaries, quality of care provided through the Medicare program, and other payer liability. Examines settings of care, including rural-specific provider sites, as they relate to spending, access to care, and profit margins. Compares rural and urban beneficiaries and providers throughout. Chart 6-2 addresses rural hospital closures and Rural Emergency Hospital conversions.
Date: 07/2025
Sponsoring organization: Medicare Payment Advisory Commission
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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 & 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 & Medicaid Services
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Understanding and Navigating Commingling - RHC Edition
Recording of a July 17, 2025, webinar discussing how Rural Health Clinics can share resources and be located in the same space as other Medicare entities and remain compliant with Medicare regulations. Describes common commingling issues and best practices. Part of the Rural Health Clinic Technical Assistance Series.
Additional links: Presentation Slides
Date: 07/2025
Sponsoring organization: National Association of Rural Health Clinics
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Recording of a July 17, 2025, webinar discussing how Rural Health Clinics can share resources and be located in the same space as other Medicare entities and remain compliant with Medicare regulations. Describes common commingling issues and best practices. Part of the Rural Health Clinic Technical Assistance Series.
Additional links: Presentation Slides
Date: 07/2025
Sponsoring organization: National Association of Rural Health Clinics
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Guidance for the Expiration of the COVID-19 Public Health Emergency (PHE)
Outlines the emergency waivers related to the minimum health and safety requirements for long-term care and acute continuing care providers that expired at the end of the COVID-19 public health emergency (PHE). Describes the timelines for certain regulatory requirements issued during the PHE through interim final rules.
Date: 07/2025
Sponsoring organization: Centers for Medicare & Medicaid Services
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Outlines the emergency waivers related to the minimum health and safety requirements for long-term care and acute continuing care providers that expired at the end of the COVID-19 public health emergency (PHE). Describes the timelines for certain regulatory requirements issued during the PHE through interim final rules.
Date: 07/2025
Sponsoring organization: Centers for Medicare & Medicaid Services
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Payment Source Shift for Surgical Care Among Veterans Enrolled in Medicare Advantage Plans
Examines the likelihood of veterans enrolled in Medicare Advantage (MA) plans to shift payments for inpatient surgical care from MA to the Veterans Health Administration (VHA). Analyzes 54,754 inpatient surgeries of VHA enrollees to observe payment trends, with data broken down by demographics, insurance characteristics, region, and rurality.
Author(s): Winta T. Mehtsun, Yanlei Ma, Ellen Latsko, et al.
Citation: JAMA Health Forum, 6(6)
Date: 06/2025
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Examines the likelihood of veterans enrolled in Medicare Advantage (MA) plans to shift payments for inpatient surgical care from MA to the Veterans Health Administration (VHA). Analyzes 54,754 inpatient surgeries of VHA enrollees to observe payment trends, with data broken down by demographics, insurance characteristics, region, and rurality.
Author(s): Winta T. Mehtsun, Yanlei Ma, Ellen Latsko, et al.
Citation: JAMA Health Forum, 6(6)
Date: 06/2025
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LTSS Users by State, County, and Setting
Interactive dashboard presenting data on the number of Medicaid enrollees that use long-term services and supports (LTSS) at the national, state, and county-levels in 2022. Includes data on LTSS users, Medicaid Home- and Community-Based Services (HCBS) users, and institutional LTSS users by age, dual-enrollment status, and sex.
Date: 06/2025
Sponsoring organizations: ATI Advisory, The SCAN Foundation
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Interactive dashboard presenting data on the number of Medicaid enrollees that use long-term services and supports (LTSS) at the national, state, and county-levels in 2022. Includes data on LTSS users, Medicaid Home- and Community-Based Services (HCBS) users, and institutional LTSS users by age, dual-enrollment status, and sex.
Date: 06/2025
Sponsoring organizations: ATI Advisory, The SCAN Foundation
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Bridging the Gap: Examples of Medicaid Innovation Enhancing Health Care Access in Rural America
Describes ways state Medicaid programs can improve access to rural healthcare. Highlights policies implemented in Tennessee, Missouri, and Georgia to fund projects related to improving rural healthcare needs, address social determinants of health, and support rural hospitals that serve large Medicaid and uninsured populations.
Date: 06/2025
Sponsoring organization: National Association of Medicaid Directors
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Describes ways state Medicaid programs can improve access to rural healthcare. Highlights policies implemented in Tennessee, Missouri, and Georgia to fund projects related to improving rural healthcare needs, address social determinants of health, and support rural hospitals that serve large Medicaid and uninsured populations.
Date: 06/2025
Sponsoring organization: National Association of Medicaid Directors
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Navigating Natural Disasters: Lessons from North Carolina's Medicaid Response to Hurricane Recovery
Discusses disaster relief in North Carolina with North Carolina's Medicaid Chief Medical Officer, Janelle White. Focuses on preparedness, protecting various populations, problem solving, coordinating relationships, rural providers and agencies, and more.
Author(s): Emily Eelman
Date: 06/2025
Sponsoring organizations: Center for Health Care Strategies, Juniper Peak Consulting
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Discusses disaster relief in North Carolina with North Carolina's Medicaid Chief Medical Officer, Janelle White. Focuses on preparedness, protecting various populations, problem solving, coordinating relationships, rural providers and agencies, and more.
Author(s): Emily Eelman
Date: 06/2025
Sponsoring organizations: Center for Health Care Strategies, Juniper Peak Consulting
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Tobacco Treatment Billing and Tobacco Use Disorder Diagnosis in Healthcare Settings in the United States: An Analysis of South Carolina Medicaid Claims
Examines demographic differences in tobacco use disorder diagnosis and receipt of counseling among Medicaid beneficiaries in South Carolina, utilizing 2019-2022 South Carolina Medicaid administrative claims data. Includes data breakdowns by rural or urban dwelling, among other factors.
Author(s): Kinsey Pebley, Joni D. Nelson, Julie L. Marshall, Alana M. Rojewski
Citation: Substance Abuse Treatment, Prevention, and Policy, 20, 24
Date: 06/2025
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Examines demographic differences in tobacco use disorder diagnosis and receipt of counseling among Medicaid beneficiaries in South Carolina, utilizing 2019-2022 South Carolina Medicaid administrative claims data. Includes data breakdowns by rural or urban dwelling, among other factors.
Author(s): Kinsey Pebley, Joni D. Nelson, Julie L. Marshall, Alana M. Rojewski
Citation: Substance Abuse Treatment, Prevention, and Policy, 20, 24
Date: 06/2025
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