Rural Health
Resources by Topic: Healthcare business and finance
Characteristics and Trends of Critical Access Hospitals That Own or Operate Ambulance Services
Explores trends in the number of Critical Access Hospital (CAH)-based ambulance services between 2017 and 2022. Analyzes Medicare Cost Report data to compare the characteristics of of CAHs that own and operate ambulance services to CAHs that do not. Presents findings from interviews with eight CAH-based ambulance services regarding the challenges of operating these services, including workforce recruitment and retention issues, the role of partnerships and community involvement, and lessons learned.
Author(s): John Gale, Karen Pearson, Rebecca Stearns, Zachariah Croll
Date: 05/2025
Sponsoring organization: Flex Monitoring Team
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Explores trends in the number of Critical Access Hospital (CAH)-based ambulance services between 2017 and 2022. Analyzes Medicare Cost Report data to compare the characteristics of of CAHs that own and operate ambulance services to CAHs that do not. Presents findings from interviews with eight CAH-based ambulance services regarding the challenges of operating these services, including workforce recruitment and retention issues, the role of partnerships and community involvement, and lessons learned.
Author(s): John Gale, Karen Pearson, Rebecca Stearns, Zachariah Croll
Date: 05/2025
Sponsoring organization: Flex Monitoring Team
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CMS Innovation Center Strategic Direction
Describes the vision and strategic objectives for the Center for Medicare and Medicaid Innovation (CMS Innovation Center). Strategic objectives include promoting evidence-based prevention, empowering people to achieve their health goals, and driving choice and competition.
Additional links: Frequently Asked Questions, White Paper: The CMS Innovation Center's Strategy to Make America Healthy Again
Date: 05/2025
Sponsoring organization: Centers for Medicare and Medicaid Services
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Describes the vision and strategic objectives for the Center for Medicare and Medicaid Innovation (CMS Innovation Center). Strategic objectives include promoting evidence-based prevention, empowering people to achieve their health goals, and driving choice and competition.
Additional links: Frequently Asked Questions, White Paper: The CMS Innovation Center's Strategy to Make America Healthy Again
Date: 05/2025
Sponsoring organization: Centers for Medicare and Medicaid Services
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Rural Healthcare Provider Transition Project (RHPTP) Webinar: Quality Improvement (QI) Alignment Across the Hospital and Clinics is Key to Value-Based Payment (VBP) Success
A recorded webinar that discusses strategies to align quality improvement (QI) projects with value-based payment (VBP) across organizational settings. Discusses clinical quality measures and sustainability of QI. Transcript available below description.
Additional links: Slides
Author(s): Lisa Olson, Candy Hanson
Date: 05/2025
Sponsoring organizations: National Rural Health Resource Center, Stratis Health
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A recorded webinar that discusses strategies to align quality improvement (QI) projects with value-based payment (VBP) across organizational settings. Discusses clinical quality measures and sustainability of QI. Transcript available below description.
Additional links: Slides
Author(s): Lisa Olson, Candy Hanson
Date: 05/2025
Sponsoring organizations: National Rural Health Resource Center, Stratis Health
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Evaluation of the Primary Care First Model: Third Annual Report
Provides an overview of the Primary Care First (PCF) model, which aims to enhance primary care and move primary care practitioners toward value-based payment. Describes the PCF model implementation experiences for Cohort 1 and Cohort 2 practices through 2023. Explores the characteristics of practices and payers that continued to participate in the PCF model compared to those who left. Examines the role that the PCF Model's incentives and supports played in the strategies and practices adopted to improve care delivery and how the trajectory of these strategies and activities practices have transformed over time. Estimates the impact of the PCF Model on Medicare fee-for-service (FFS) expenditures and service use, including acute hospitalizations. Estimates the impacts of the model on a set of seven leading indicators to provide an early assessment of whether care delivery changes are resulting in meaningful early outcome changes.
Additional links: Executive Summary, Findings at a Glance
Date: 05/2025
Sponsoring organizations: Centers for Medicare and Medicaid Services, Mathematica
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Provides an overview of the Primary Care First (PCF) model, which aims to enhance primary care and move primary care practitioners toward value-based payment. Describes the PCF model implementation experiences for Cohort 1 and Cohort 2 practices through 2023. Explores the characteristics of practices and payers that continued to participate in the PCF model compared to those who left. Examines the role that the PCF Model's incentives and supports played in the strategies and practices adopted to improve care delivery and how the trajectory of these strategies and activities practices have transformed over time. Estimates the impact of the PCF Model on Medicare fee-for-service (FFS) expenditures and service use, including acute hospitalizations. Estimates the impacts of the model on a set of seven leading indicators to provide an early assessment of whether care delivery changes are resulting in meaningful early outcome changes.
Additional links: Executive Summary, Findings at a Glance
Date: 05/2025
Sponsoring organizations: Centers for Medicare and Medicaid Services, Mathematica
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Merit-based Incentive Payment System (MIPS): 2025 MIPS Promoting Interoperability Performance Category Hardship Exception Application Guide
Provides guidance on how clinicians can apply for a MIPS hardship exception. Highlights guidance for having your MIPS Promoting Interoperability performance category reweighted to 0% in cases of insufficient internet connectivity, decertified electronic health record technology, or other circumstances out of the clinicians' control.
Date: 05/2025
Sponsoring organization: Centers for Medicare and Medicaid Services
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Provides guidance on how clinicians can apply for a MIPS hardship exception. Highlights guidance for having your MIPS Promoting Interoperability performance category reweighted to 0% in cases of insufficient internet connectivity, decertified electronic health record technology, or other circumstances out of the clinicians' control.
Date: 05/2025
Sponsoring organization: Centers for Medicare and Medicaid Services
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2024 National CAH Quality Inventory & Assessment National Report
Presents a high-level summary of key data points from the September-November 2024 National Critical Access Hospital (CAH) Quality Inventory and Assessment. Includes data on CAH system affiliation; median average daily census and emergency department volume; median swing bed admissions and swing bed length of stay; hospital inpatient, behavioral health and specialty care, and outpatient and other service lines; and CAH quality payment model participation.
Date: 05/2025
Sponsoring organization: Flex Monitoring Team
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Presents a high-level summary of key data points from the September-November 2024 National Critical Access Hospital (CAH) Quality Inventory and Assessment. Includes data on CAH system affiliation; median average daily census and emergency department volume; median swing bed admissions and swing bed length of stay; hospital inpatient, behavioral health and specialty care, and outpatient and other service lines; and CAH quality payment model participation.
Date: 05/2025
Sponsoring organization: Flex Monitoring Team
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Assisting Rural Consumers
Offers information and guidance for Navigators and certified application counselors helping rural healthcare consumers. Covers rural-relevant considerations and policy updates regarding Federally-facilitated and State-based Marketplaces, Medicaid/CHIP, and Medicare. Outlines tips for assisters to address barriers to care and conducting outreach in rural areas.
Date: 04/2025
Sponsoring organization: Centers for Medicare and Medicaid Services
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Offers information and guidance for Navigators and certified application counselors helping rural healthcare consumers. Covers rural-relevant considerations and policy updates regarding Federally-facilitated and State-based Marketplaces, Medicaid/CHIP, and Medicare. Outlines tips for assisters to address barriers to care and conducting outreach in rural areas.
Date: 04/2025
Sponsoring organization: Centers for Medicare and Medicaid Services
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Ways and Means Republican Members Share Commitment to Value-Based Health Care and Outline Priorities For Medicare Innovation Hub
An April 2025 letter from the U.S. House Committee on Ways and Means majority members regarding the Centers for Medicare & Medicaid Services (CMS) Innovation Center (CMMI). Offers considerations for new and existing models related to promoting value, improving care in rural and underserved communities, and incorporating public input.
Date: 04/2025
Sponsoring organization: House Ways and Means Committee
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An April 2025 letter from the U.S. House Committee on Ways and Means majority members regarding the Centers for Medicare & Medicaid Services (CMS) Innovation Center (CMMI). Offers considerations for new and existing models related to promoting value, improving care in rural and underserved communities, and incorporating public input.
Date: 04/2025
Sponsoring organization: House Ways and Means Committee
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Federal and State Reimbursement for Youth Behavioral Health Services
Report details Medicaid and Children's Health Insurance Program (CHIP) coverage of behavioral health services for rural people under 21 years of age. Breaks down reimbursement eligibility for behavioral health providers in all 50 states and discusses barriers to access in rural areas.
Date: 04/2025
Sponsoring organization: WWAMI Rural Health Research Center
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Report details Medicaid and Children's Health Insurance Program (CHIP) coverage of behavioral health services for rural people under 21 years of age. Breaks down reimbursement eligibility for behavioral health providers in all 50 states and discusses barriers to access in rural areas.
Date: 04/2025
Sponsoring organization: WWAMI Rural Health Research Center
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Congress Must Act to Bring Needed Reforms to the 340B Drug Pricing Program: Majority Staff Report
Presents findings from a U.S. Senate Committee on Health, Education, Labor & Pensions majority staff report on how covered entities generate and use revenue from the 340B Drug Pricing Program and how patients benefit from the program. Describes data and information collected from hospital covered entities, Bon Secours Mercy Health and Cleveland Clinic; Federally Qualified Health Center (FQHC) covered entities, Sun River Health and Yakima Valley Farm Workers Clinic; contract pharmacies, CVS Health and Walgreens; and drug manufacturers, Eli Lilly and Amgen. Includes rural references throughout.
Date: 04/2025
Sponsoring organization: Senate Committee on Health, Education, Labor & Pensions
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Presents findings from a U.S. Senate Committee on Health, Education, Labor & Pensions majority staff report on how covered entities generate and use revenue from the 340B Drug Pricing Program and how patients benefit from the program. Describes data and information collected from hospital covered entities, Bon Secours Mercy Health and Cleveland Clinic; Federally Qualified Health Center (FQHC) covered entities, Sun River Health and Yakima Valley Farm Workers Clinic; contract pharmacies, CVS Health and Walgreens; and drug manufacturers, Eli Lilly and Amgen. Includes rural references throughout.
Date: 04/2025
Sponsoring organization: Senate Committee on Health, Education, Labor & Pensions
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