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Rural Health Information Hub

Rural Health
Resources by Topic: Health insurance

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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March 2025 MedPAC Meeting Transcript
Transcript from the Medicare Payment Advisory Commission's (MedPAC) March 2025 meeting. Covers research and proposals related to reforming physician fee schedule updates and improving the accuracy of relative payment rates, reducing beneficiary cost-sharing for outpatient services at Critical Access Hospitals, Medicare insurance agents, Medigap, payment for ground ambulance services, home healthcare use among Medicare Advantage enrollees, and institutional special needs plans. Includes rural references and considerations throughout.
Additional links: Mandated Report: Payment for Ground Ambulance Services, Reducing Beneficiary Cost-Sharing for Outpatient Services at Critical Access Hospitals
Date: 03/2025
Sponsoring organization: Medicare Payment Advisory Commission
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Merit-Based Incentive Payment System (MIPS): 2024 Opt-in and Voluntary Reporting Election Process Guide
Discusses the eligibility of clinicians, groups, and Alternative Payment Model (APM) participants that exceed some low-volume threshold criteria to opt-in to the Merit-Based Incentive Payment System (MIPS) and the APM Performance Pathway (APP) for the 2024 performance period. Compares opting in and voluntarily reporting MIPS data and provides an overview of the election process.
Date: 03/2025
Sponsoring organization: Centers for Medicare and Medicaid Services
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Rural Hospital Experiences in the Colorado Hospital Transformation Program
Provides an overview of the Colorado Hospital Transformation Program (CO HTP), a 5-year program that ties Medicaid supplemental payments to hospitals' ability to meet performance targets through September 2026. Describes the experiences of three Critical Access Hospitals (CAHs) and explores how CO HTP impacts rural hospitals. Covers planning and community engagement, quality of care, and healthcare costs.
Date: 03/2025
Sponsoring organization: Rural Health Value
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February 2025 MACPAC Meeting Transcript
Transcript from the Medicaid and CHIP Payment and Access Commission's (MACPAC) February 2025 meeting. Covers transitions of care for children and youth with special healthcare needs (CYSHCN), hospital non-disproportionate share hospital supplemental payments and directed payment targeting, improving access to medications for opioid use disorder, healthcare access for children in foster care, and more. Includes rural references throughout.
Additional links: Hospital Non-DSH Supplemental Payment and Directed Payment Targeting Analyses
Date: 02/2025
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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Rural Health Disparities and Differences in Definitions of Rurality
Examines health disparities and differences in healthcare characteristics between rural and nonrural counties using data from the 2023 County Health Rankings and 2021-2022 Area Health Resources Files. Compares community health and healthcare characteristics by two county-level urban-rural classification systems: Rural-Urban Continuum Codes (RUCC) and Core Based Statistical Areas (CBSAs). Explores the degree to which four county-level classification systems - RUCC, CBSA, the National Center for Health Statistics (NCHS) Urban-Rural Classification Scheme for Counties, and Urban Influence Codes (UIC) - agree regarding which counties are designated as rural.
Date: 02/2025
Sponsoring organizations: HHS Office of the Assistant Secretary for Planning and Evaluation, NORC at the University of Chicago
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Medicare Telehealth Trends Report
Describes the trends of telehealth utilization among Medicare beneficiaries between January 1, 2020, and September 30, 2024. Presents data on the percentage of Medicare beneficiaries that used a telehealth service by calendar quarter and by Medicaid eligibility, type of Medicare eligibility, demographic characteristics, and rural/urban residence.
Date: 02/2025
Sponsoring organization: Centers for Medicare and Medicaid Services
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Current Medicare Beneficiary Quality Improvement Project (MBQIP) Measures
Chart outlining the required and optional MBQIP measures. Measures are broken down into two categories, core and additional, and then into five domains: global measures, patient safety, patient engagement, care coordination, and emergency department. MBQIP is a Medicare Rural Hospital Flexibility (Flex) quality improvement grant program for Critical Access Hospitals.
Date: 02/2025
Sponsoring organization: Rural Quality Improvement Technical Assistance (RQITA) Resource Center
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Enhancing Rural Access to Medications for Opioid Use Disorder: Policy Brief and Recommendations to the Secretary
Provides an overview of issues related to opioid use disorder (OUD) in rural areas. Discusses access to medication for opioid use disorder (MOUD), MOUD workforce, telehealth to support access to MOUD, and Medicaid 1115 demonstrations that address OUD. Offers policy recommendations related to regulatory barriers, reimbursement flexibility, workforce, and service site expansion to increase access to MOUD in rural areas.
Date: 01/2025
Sponsoring organization: National Advisory Committee on Rural Health and Human Services
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Opioid Use Among Rural Medicare Beneficiaries
Examines trends in prescription opioid use among Medicare beneficiaries in rural areas, utilizing 2010-2017 Medicare Current Beneficiary Survey (MCBS) data. Provides data on receipt of opioid prescriptions among community-dwelling and facility-dwelling beneficiaries, associations between prescribing and chronic overlapping pain conditions (COPCs), and prescriptions exceeding CDC guidelines. Includes rural-urban comparisons.
Author(s): Yvonne Jonk, Heidi O'Connor, Karen Pearson, et al.
Date: 01/2025
Sponsoring organization: Maine Rural Health Research Center
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