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Rural Health Information Hub

Rural Health
Resources by Topic: Healthcare business and finance

Calendar Year (CY) 2015 Rural Health Clinic (RHC) and Federally Qualified Health Centers (FQHC) Updates: Payment Rate Increases for RHCs and FQHCs Billing Under the All-Inclusive Rate System (AIR), and Urban and Rural Designations for FQHCs Billing Under the AIR
Provides updates for RHCs and FQHCs that are submitting claims to Medicare Administrative Contractors (MACs) for services to Medicare beneficiaries.
Date: 12/2024
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Healthcare Cost and Utilization Project (HCUP) Maternal Health Chartbook 2010–2019
Analyzes data from the National Inpatient Sample from between 2010 and 2019 to highlight trends in maternal health related to diabetes, hypertension, mental health disorders, substance use disorders, and severe maternal morbidity. Includes data by expected payer, patient characteristics, and geography. Includes large metropolitan, medium/small metropolitan, and nonmetropolitan comparisons throughout.
Author(s): Lawrence Reid, Kimberly Marin, Jessica Monnet
Date: 10/2024
Type: Document
Sponsoring organization: Agency for Healthcare Research and Quality
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Rural Hospital Service Lines: Changes Over Time and Impacts on Profitability
Analyzes associations between changes in service lines and profitability at rural hospitals, utilizing 2010-2021 Medicare cost report data. Includes data on service lines including Rural Health Clinics (RHCs), traditional clinics, CT scans, MRI scans, delivery rooms, nurseries, anesthesiology, electrocardiology, and more.
Author(s): Brian E. Whitacre, Claudia A. Rhodes, Alison F. Davis
Citation: Journal of Healthcare Management, 69(5), 350-367
Date: 10/2024
Type: Document
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Science by the Slice: Rural Community Health Science, Policy, and the Future: Episode 2
Video podcast episode highlighting the 2024 State of the Science Meeting from the Southeastern Coastal Center for Agricultural Health and Safety featuring 2 speakers at the meeting. Discusses disparities in healthcare access for rural and urban residents including facility closures, access to specialty care, and local leadership. Transcript available in the video description.
Date: 10/2024
Type: Video/Multimedia
Sponsoring organization: Southeastern Coastal Center for Agricultural Health and Safety
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What to Know About Medicare Coverage of Telehealth
Discusses telehealth use by Medicare patients before, during, and after declaration of the COVID-19 public health emergency. Notes temporary telehealth provisions set to expire December 31, 2024, telehealth provisions made permanent, and trends in use since 2020. Includes rural and urban comparisons of telehealth use since 2020. Discusses payment models for Medicare and Medicare Advantage, current policies related to telehealth, fraud, and the cost of coverage through Medicare.
Author(s): Alex Cottrill, Juliette Cubanski, Tricia Neuman
Date: 10/2024
Type: Document
Sponsoring organization: KFF
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An Updated Model of Rural Hospital Financial Distress
Discusses a potential model to predict financial distress in rural hospitals, including negative cash flow margin, negative equity, or closure of facility. Tests 2,311 rural hospitals from 2013 to 2019 with the model and discusses its potential to predict financial distress and create accurate assessments.
Author(s): Tyler L. Malone, George H. Pink, George M. Holmes
Citation: Journal of Rural Health
Date: 10/2024
Type: Document
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Health Care Transparency: CMS Needs More Information on Hospital Pricing Data Completeness and Accuracy
Provides an overview of the Centers for Medicare & Medicaid Services (CMS) hospital price transparency requirements before and after 2024 updates to the requirements. Describes users' experiences with hospital pricing data before the 2024 updates. Examines CMS's enforcement of hospital price transparency requirements and offers recommendations to CMS regarding the sufficiency and accuracy of the data reported. Table 3 compares CMS enforcement actions by hospitals' rural or urban designation between 2021 and 2023.
Additional links: Full Report
Date: 10/2024
Type: Document
Sponsoring organization: Government Accountability Office
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One or Two Health Systems Controlled the Entire Market for Inpatient Hospital Care in Nearly Half of Metropolitan Areas in 2022
Examines the competitiveness of hospital markets in 2022 by analyzing RAND Hospital Data and American Hospital Association (AHA) survey data. Presents data on the share of metropolitan statistical areas (MSAs) controlled by a small number of health systems, the level of market concentration in MSAs, and the share of hospitals affiliated with health systems over time. Compares the share of hospitals affiliated with health systems in rural and non-rural areas.
Author(s): Jamie Godwin, Zachary Levinson, Tricia Neuman
Date: 10/2024
Type: Document
Sponsoring organization: KFF
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Costs of Treat-and-Release Emergency Department Visits in the United States, 2021
Explores the cost of treat-and-release emergency department (ED) visits in the United States in 2021. Describes findings from an analysis of the 2021 Healthcare Cost and Utilization Project (HCUP) Nationwide Emergency Department Sample. Presents data on the aggregate costs, average cost, and number of ED visits by patient and hospital characteristics, including patient age; sex; primary expected payer; community-level income; and metropolitan, micropolitan, or rural status.
Date: 09/2024
Type: Document
Sponsoring organization: Agency for Healthcare Research and Quality
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States Could Better Leverage Coverage and Access Requirements To Promote Maternal Health Care Access in Medicaid Managed Care
Describes challenges to maternal healthcare access. Explores the provider coverage rules and network adequacy standards state Medicaid agencies have set for maternal healthcare in Medicaid managed care. Examines state oversight of quantitative network adequacy standards. Offers recommendations to the Centers for Medicare & Medicaid Services (CMS) to ensure access to pregnancy and postpartum care in Medicaid managed care. Includes rural references throughout.
Additional links: Report in Brief
Date: 09/2024
Type: Document
Sponsoring organization: Office of Inspector General (HHS)
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