Rural Health
Resources by Topic: Health insurance
MBQIP Quality Measures National Annual Report - 2023
Summarizes quality measure reporting rates and performance among Critical Access Hospitals (CAHs) in 2023. Presents data on the four Medicare Beneficiary Quality Improvement Project (MBQIP) domains: patient safety/inpatient, outpatient, patient engagement, and care transitions.
Author(s): Megan Lahr, Alyssa Furukawa, Madeleine Pick, Robert Barclay
Date: 06/2025
Sponsoring organization: Flex Monitoring Team
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Summarizes quality measure reporting rates and performance among Critical Access Hospitals (CAHs) in 2023. Presents data on the four Medicare Beneficiary Quality Improvement Project (MBQIP) domains: patient safety/inpatient, outpatient, patient engagement, and care transitions.
Author(s): Megan Lahr, Alyssa Furukawa, Madeleine Pick, Robert Barclay
Date: 06/2025
Sponsoring organization: Flex Monitoring Team
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RHPTP HELP Webinar: Medicare's NEW Advanced Primary Care Management Program
Webinar recording discusses the Advanced Primary Care Management (APCM) Program, an initiative to improve the delivery, coordination, and outcomes in primary care services. Explores the process of transitioning from fee-for-service to value-based care models and discusses how Medicare's program fits the APCM model.
Additional links: Webinar Slides
Author(s): Lindsay Corcoran, Amy Graham
Date: 06/2025
Sponsoring organization: National Rural Health Resource Center
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Webinar recording discusses the Advanced Primary Care Management (APCM) Program, an initiative to improve the delivery, coordination, and outcomes in primary care services. Explores the process of transitioning from fee-for-service to value-based care models and discusses how Medicare's program fits the APCM model.
Additional links: Webinar Slides
Author(s): Lindsay Corcoran, Amy Graham
Date: 06/2025
Sponsoring organization: National Rural Health Resource Center
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National Health Center Financial and Operational Performance Analysis: 2020–2023
Examines financial and operational characteristics of Federally Qualified Health Centers (FQHCs) from 2020-2023. Explores FQHC growth and expansion, patient and payer mix, revenue and growth mix, staffing and productivity, operational trends, financial performance, and more. Compares data on rural FQHCs to urban and national FQHC data. Requires name, email address, and organization information to download.
Date: 06/2025
Sponsoring organization: Capital Link
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Examines financial and operational characteristics of Federally Qualified Health Centers (FQHCs) from 2020-2023. Explores FQHC growth and expansion, patient and payer mix, revenue and growth mix, staffing and productivity, operational trends, financial performance, and more. Compares data on rural FQHCs to urban and national FQHC data. Requires name, email address, and organization information to download.
Date: 06/2025
Sponsoring organization: Capital Link
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MedPAC Report to the Congress: Medicare and the Health Care Delivery System, June 2025
Evaluates Medicare payment issues and provides recommendations to the U.S. Congress. Covers proposed reforms to the physician fee schedule updates and the accuracy of relative payment rates; supplemental benefits in Medicare Advantage; home healthcare use among Medicare Advantage enrollees; Part D prescription drug plans for beneficiaries in fee-for-service Medicare and Medicare Advantage; Medicare beneficiaries in nursing homes; the inclusion of rural providers in current Medicare fee-for-service quality reporting programs; and recommendations related to reducing beneficiary cost sharing for outpatient services at Critical Access Hospitals. Includes rural references throughout.
Additional links: Executive Summary
Date: 06/2025
Sponsoring organization: Medicare Payment Advisory Commission
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Evaluates Medicare payment issues and provides recommendations to the U.S. Congress. Covers proposed reforms to the physician fee schedule updates and the accuracy of relative payment rates; supplemental benefits in Medicare Advantage; home healthcare use among Medicare Advantage enrollees; Part D prescription drug plans for beneficiaries in fee-for-service Medicare and Medicare Advantage; Medicare beneficiaries in nursing homes; the inclusion of rural providers in current Medicare fee-for-service quality reporting programs; and recommendations related to reducing beneficiary cost sharing for outpatient services at Critical Access Hospitals. Includes rural references throughout.
Additional links: Executive Summary
Date: 06/2025
Sponsoring organization: Medicare Payment Advisory Commission
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Report to Congress on Medicaid and CHIP, June 2025
Semi-annual report to Congress from the Medicaid and CHIP Payment and Access Commission (MACPAC). Covers recommendations related to transitions from pediatric to adult care for Medicaid-covered children and youth with special health care needs (CYSHCN). Also discusses appropriate access to residential behavioral health treatment services for children, findings from MACPAC's analytic work on access to medications for opioid use disorder (MOUD) in Medicaid, an overview on the Program of All-Inclusive Care for the Elderly, and self-direction for Medicaid home- and community-based services. Includes rural references throughout.
Date: 06/2025
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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Semi-annual report to Congress from the Medicaid and CHIP Payment and Access Commission (MACPAC). Covers recommendations related to transitions from pediatric to adult care for Medicaid-covered children and youth with special health care needs (CYSHCN). Also discusses appropriate access to residential behavioral health treatment services for children, findings from MACPAC's analytic work on access to medications for opioid use disorder (MOUD) in Medicaid, an overview on the Program of All-Inclusive Care for the Elderly, and self-direction for Medicaid home- and community-based services. Includes rural references throughout.
Date: 06/2025
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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MedPAC Comment on CMS's Proposed Rule on Inpatient Rehabilitation Facility PPS for FY 2026
Comments on an April 30, 2025, Federal Register proposed rule addressing updates to the prospective payment system for inpatient rehabilitation facilities (IRFs) for fiscal year 2026. Includes comments on the potential impact of replacing payment weights on small and rural IRFs.
Date: 06/2025
Sponsoring organization: Medicare Payment Advisory Commission
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Comments on an April 30, 2025, Federal Register proposed rule addressing updates to the prospective payment system for inpatient rehabilitation facilities (IRFs) for fiscal year 2026. Includes comments on the potential impact of replacing payment weights on small and rural IRFs.
Date: 06/2025
Sponsoring organization: Medicare Payment Advisory Commission
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MedPAC Comment on CMS's Proposed Rule on Inpatient Prospective Payment System for FY 2026
Comments on an April 30, 2025, Federal Register proposed rule revising the hospital inpatient and long-term care hospital (LTCH) prospective payment systems (PPS). Discusses proposals to update inpatient prospective payment systems (IPPS) payment rates, update wage index values and policies, modify the Transforming Episode Accountability Model (TEAM), and remove the proposed health-equity adjustment from the Hospital Value-Based Purchasing (VBP) Program.
Date: 06/2025
Sponsoring organization: Medicare Payment Advisory Commission
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Comments on an April 30, 2025, Federal Register proposed rule revising the hospital inpatient and long-term care hospital (LTCH) prospective payment systems (PPS). Discusses proposals to update inpatient prospective payment systems (IPPS) payment rates, update wage index values and policies, modify the Transforming Episode Accountability Model (TEAM), and remove the proposed health-equity adjustment from the Hospital Value-Based Purchasing (VBP) Program.
Date: 06/2025
Sponsoring organization: Medicare Payment Advisory Commission
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Quality Payment Program (QPP) 2023: Participation and Payment Results At-a-Glance
Provides an overview of the results of the Quality Payment Program (QPP) for the 2023 performance year. Highlights the percentages of small and rural providers receiving negative, neutral, and positive payment adjustments for 2025.
Date: 06/2025
Sponsoring organization: Centers for Medicare & Medicaid Services
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Provides an overview of the results of the Quality Payment Program (QPP) for the 2023 performance year. Highlights the percentages of small and rural providers receiving negative, neutral, and positive payment adjustments for 2025.
Date: 06/2025
Sponsoring organization: Centers for Medicare & Medicaid Services
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Iowa Community Health Centers and Value-Based Care
Describes how Iowa Primary Care Association (Iowa PCA) and two sister organizations, IowaHealth+ and INConcertCare, pursued value-based care opportunities before joining the Medicare Shared Savings Program. Discusses the network's Medicaid value-based care contract; a partnership with Main Street Health to expand value-based contracting and provide more comprehensive, integrated primary care to patients with Medicare Advantage; data analytics; strategic planning and roadmaps; and next steps.
Date: 06/2025
Sponsoring organization: Rural Health Value
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Describes how Iowa Primary Care Association (Iowa PCA) and two sister organizations, IowaHealth+ and INConcertCare, pursued value-based care opportunities before joining the Medicare Shared Savings Program. Discusses the network's Medicaid value-based care contract; a partnership with Main Street Health to expand value-based contracting and provide more comprehensive, integrated primary care to patients with Medicare Advantage; data analytics; strategic planning and roadmaps; and next steps.
Date: 06/2025
Sponsoring organization: Rural Health Value
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Medicare Claims Processing Manual: Chapter 9 - Rural Health Clinics/Federally Qualified Health Centers
Describes the differences between Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs). Identifies the rules and regulations for processing Medicare claims.
Date: 06/2025
Sponsoring organization: Centers for Medicare & Medicaid Services
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Describes the differences between Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs). Identifies the rules and regulations for processing Medicare claims.
Date: 06/2025
Sponsoring organization: Centers for Medicare & Medicaid Services
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