Rural Health
Resources by Topic: Health insurance
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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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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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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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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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 and 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 and 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 and 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 and Medicaid Services
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Environmental Scan on Reducing Barriers to Participation in Population-Based Total Cost of Care (PB-TCOC) Models and Supporting Primary and Specialty Care Transformation
Presents results of an environmental scan on reducing barriers to participation in population-based total cost of care (PB-TCOC) models and supporting primary and specialty care transformation. Discusses identifying pathways for maximizing participation of different kinds of organizations in PB-TCOC models; an assessment of and approaches to reducing organization-level barriers; approaches to support primary and specialty care transformation; an assessment of factors that influence the ability of PB-TCOC models to be competitive; and a summary of relevant features in previously submitted Physician-Focused Payment Model Technical Advisory Committee (PTAC) proposals. Includes rural references throughout.
Date: 05/2025
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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Presents results of an environmental scan on reducing barriers to participation in population-based total cost of care (PB-TCOC) models and supporting primary and specialty care transformation. Discusses identifying pathways for maximizing participation of different kinds of organizations in PB-TCOC models; an assessment of and approaches to reducing organization-level barriers; approaches to support primary and specialty care transformation; an assessment of factors that influence the ability of PB-TCOC models to be competitive; and a summary of relevant features in previously submitted Physician-Focused Payment Model Technical Advisory Committee (PTAC) proposals. Includes rural references throughout.
Date: 05/2025
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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