Rural Health
Resources by Topic: Healthcare business and finance
Factors Influencing Rural Hospitals to Participate and Remain in Accountable Care Organizations
Examines factors that impact rural hospital participation in Medicare and accountable care organization (ACO) models. Utilizes interview feedback from rural hospital executives regarding ACO participation and discusses themes such as financial incentives, value-based reimbursement, population health, healthcare quality, and more.
Author(s): Emily J. Lawton, Jenah McCarty, Thomas E. Vaughn, Fred Ullrich, Keith J. Mueller
Citation: Journal of Rural Health, 42(2), e70179
Date: 06/2026
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Examines factors that impact rural hospital participation in Medicare and accountable care organization (ACO) models. Utilizes interview feedback from rural hospital executives regarding ACO participation and discusses themes such as financial incentives, value-based reimbursement, population health, healthcare quality, and more.
Author(s): Emily J. Lawton, Jenah McCarty, Thomas E. Vaughn, Fred Ullrich, Keith J. Mueller
Citation: Journal of Rural Health, 42(2), e70179
Date: 06/2026
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How Has Insurer Participation in the ACA Marketplaces Changed in 2026?
Presents data on health insurer participation in the ACA Marketplace, including the average number of ACA Marketplace insurers by state between 2014 and 2026. Includes interactive maps displaying state- and county-level data on the number of participating Marketplace insurers in 2026 and the change in the number of insurers between 2025 and 2026.
Author(s): Jared Ortaliza, Justin Lo, Matt McGough, Cynthia Cox
Date: 06/2026
Sponsoring organization: KFF
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Presents data on health insurer participation in the ACA Marketplace, including the average number of ACA Marketplace insurers by state between 2014 and 2026. Includes interactive maps displaying state- and county-level data on the number of participating Marketplace insurers in 2026 and the change in the number of insurers between 2025 and 2026.
Author(s): Jared Ortaliza, Justin Lo, Matt McGough, Cynthia Cox
Date: 06/2026
Sponsoring organization: KFF
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2026 Annual Report of the Boards of Trustees of the Federal Hospital Insurance and Federal Supplementary Medical Insurance Trust Funds
Report detailing the current state of the Medicare Hospital Insurance (HI) and Supplemental Medical Insurance (SMI) Trust Funds. Discusses Medicare expenditures as a percentage of Gross Domestic Product (GDP) and makes short and long-range sustainability projections based on variable economic, demographic, and healthcare trends. Also explains the actuarial methods used to calculate the estimates. Includes information on Medicare payment policy updates since the 2025 report.
Additional links: Tables and Figures
Date: 06/2026
Sponsoring organization: Board of Trustees, Federal Hospital Insurance and Federal Supplementary Medical Insurance Trust Funds
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Report detailing the current state of the Medicare Hospital Insurance (HI) and Supplemental Medical Insurance (SMI) Trust Funds. Discusses Medicare expenditures as a percentage of Gross Domestic Product (GDP) and makes short and long-range sustainability projections based on variable economic, demographic, and healthcare trends. Also explains the actuarial methods used to calculate the estimates. Includes information on Medicare payment policy updates since the 2025 report.
Additional links: Tables and Figures
Date: 06/2026
Sponsoring organization: Board of Trustees, Federal Hospital Insurance and Federal Supplementary Medical Insurance Trust Funds
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Marriage and Family Therapist and Mental Health Counselor Workforces in Rural America Under New Medicare Reimbursement Policy
Describes how Medicare reimbursement expanded to cover marriage and family therapists (MFTs) and mental health counselors (MHCs) in January 2024. Examines the change in Medicare-enrolled MFTs and MHCs between the third quarter (Q3) of 2023 and fourth quarter (Q4) of 2024. Presents findings from semi-structured interviews with rural health system and mental health organization leaders regarding practice arrangements, the perceived impacts of MFT and MHC reimbursement, barriers to serving rural Medicare beneficiaries, and considerations for future policies.
Author(s): Janessa M. Graves, Natalia V. Oster, Lisa A. Garberson, Davis G. Patterson, C. Holly A. Andrilla
Date: 06/2026
Sponsoring organization: WWAMI Rural Health Research Center
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Describes how Medicare reimbursement expanded to cover marriage and family therapists (MFTs) and mental health counselors (MHCs) in January 2024. Examines the change in Medicare-enrolled MFTs and MHCs between the third quarter (Q3) of 2023 and fourth quarter (Q4) of 2024. Presents findings from semi-structured interviews with rural health system and mental health organization leaders regarding practice arrangements, the perceived impacts of MFT and MHC reimbursement, barriers to serving rural Medicare beneficiaries, and considerations for future policies.
Author(s): Janessa M. Graves, Natalia V. Oster, Lisa A. Garberson, Davis G. Patterson, C. Holly A. Andrilla
Date: 06/2026
Sponsoring organization: WWAMI Rural Health Research Center
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'Good Stewards': Rural Healthcare Experts Discuss Governance Board Best Practices
Provides an overview of hospital and health center boards, with insights from rural CEOs and board members in Colorado, Missouri, North Dakota, and Oklahoma and experts from national organizations. Discusses board orientation and ongoing education, as well as ways to improve board governance.
Author(s): Allee Mead
Citation: Rural Monitor
Date: 06/2026
Sponsoring organization: Rural Health Information Hub
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Provides an overview of hospital and health center boards, with insights from rural CEOs and board members in Colorado, Missouri, North Dakota, and Oklahoma and experts from national organizations. Discusses board orientation and ongoing education, as well as ways to improve board governance.
Author(s): Allee Mead
Citation: Rural Monitor
Date: 06/2026
Sponsoring organization: Rural Health Information Hub
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Medicare Hospice: Action Needed to Pay More Efficiently for Routine Home Care
Describes the frequency and characteristics of routine home care visits in 2024 for Medicare beneficiaries enrolled in hospice since 2022 who died or were discharged alive in 2024. Compares estimated per-visit Medicare payment rates for routine home care across hospices with the highest and lowest number of visits per week and to home health per-visit rates. Includes information on the average number of visits per week by rural and urban hospice providers. Offers recommendations to the U.S. Department of Health and Human Services regarding revisions to the hospice payment system.
Additional links: Full Report
Date: 06/2026
Sponsoring organization: Government Accountability Office
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Describes the frequency and characteristics of routine home care visits in 2024 for Medicare beneficiaries enrolled in hospice since 2022 who died or were discharged alive in 2024. Compares estimated per-visit Medicare payment rates for routine home care across hospices with the highest and lowest number of visits per week and to home health per-visit rates. Includes information on the average number of visits per week by rural and urban hospice providers. Offers recommendations to the U.S. Department of Health and Human Services regarding revisions to the hospice payment system.
Additional links: Full Report
Date: 06/2026
Sponsoring organization: Government Accountability Office
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Medicaid Home- and Community-Based Services Rebalancing Is Concentrated in Large Urban Areas
Compares rural and urban utilization of home and community-based services among Medicaid long-term services and supports users, using 2022 Transformed Medicaid Statistical Information System data sourced through an ATI Advisory LTSS user dashboard. Analyzes rural-urban disparities in access by level of rurality and by state.
Author(s): Emmaline Keesee, Laura M. Keohane
Citation: The Journal of the Post-Acute and Long-Term Care Medical Association, 27(6), 106208
Date: 06/2026
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Compares rural and urban utilization of home and community-based services among Medicaid long-term services and supports users, using 2022 Transformed Medicaid Statistical Information System data sourced through an ATI Advisory LTSS user dashboard. Analyzes rural-urban disparities in access by level of rurality and by state.
Author(s): Emmaline Keesee, Laura M. Keohane
Citation: The Journal of the Post-Acute and Long-Term Care Medical Association, 27(6), 106208
Date: 06/2026
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MBQIP Quality Measures National Annual Report - 2024
Summarizes quality measure reporting rates and performance among Critical Access Hospitals (CAHs) in 2024. Presents data on the five Medicare Beneficiary Quality Improvement Project (MBQIP) domains: global measures, patient safety, patient engagement, care coordination, and emergency department.
Date: 06/2026
Sponsoring organization: Flex Monitoring Team
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Summarizes quality measure reporting rates and performance among Critical Access Hospitals (CAHs) in 2024. Presents data on the five Medicare Beneficiary Quality Improvement Project (MBQIP) domains: global measures, patient safety, patient engagement, care coordination, and emergency department.
Date: 06/2026
Sponsoring organization: Flex Monitoring Team
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Medicare Advantage Enrollment Update 2025
Reports on the percentage of rural Medicare beneficiaries enrolled in Medicare Advantage (MA) plans by metropolitan and nonmetropolitan location and plan type, from 2015-2025.
Author(s): Edmer Lazaro, Fred Ullrich, Dan M. Shane, Keith Mueller
Date: 05/2026
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Reports on the percentage of rural Medicare beneficiaries enrolled in Medicare Advantage (MA) plans by metropolitan and nonmetropolitan location and plan type, from 2015-2025.
Author(s): Edmer Lazaro, Fred Ullrich, Dan M. Shane, Keith Mueller
Date: 05/2026
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Sustaining Rural Labor & Delivery Programs: Strategies & Considerations Webinar
A recorded webinar that discusses strategies to improve financial sustainability of rural hospitals and Critical Access Hospitals (CAHs). Focuses on financial performance, reimbursement opportunities, and operational models identified in the Sustaining Rural Labor & Delivery Programs report. Transcript available below transcription.
Author(s): Eric Shell, Kristin L. Reiter, Madeleine Pick
Date: 05/2026
Sponsoring organization: Stroudwater Associates
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A recorded webinar that discusses strategies to improve financial sustainability of rural hospitals and Critical Access Hospitals (CAHs). Focuses on financial performance, reimbursement opportunities, and operational models identified in the Sustaining Rural Labor & Delivery Programs report. Transcript available below transcription.
Author(s): Eric Shell, Kristin L. Reiter, Madeleine Pick
Date: 05/2026
Sponsoring organization: Stroudwater Associates
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