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Rural Health Information Hub

Rural Health
Resources by Topic: Healthcare business and finance

Usual Source of Care Among Adults Aged 18-64 Years Post-ACA, 2010-2017
Examines self-reported usual source of care (USC) after Affordable Care Act implementation among various income groups and geographical areas. Utilizes 2010–2017 Medical Expenditure Panel Survey data to analyze USC with breakdowns according to low, middle, and high income as well as rural versus urban location.
Author(s): Sara Shahbazi, John D. Goodson
Citation: Annals of Family Medicine, 23(5), 457-459
Date: 09/2025
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Evaluation of the Rural Community Hospital Demonstration: CCA Extension Final Report (Covering 2016-2021)
Provides an overview of the Rural Community Hospital Demonstration (RCHD), focusing on the 26 hospitals that participated during the extension period authorized by the 21st Century Cures Act (2016-2021). Describes the characteristics of active RCHD participants before they joined the demonstration, the Medicare payments received under the program, and the impact of the RCHD on hospital financial measures.
Additional links: Appendices, At-A-Glance, Executive Summary
Date: 09/2025
Sponsoring organizations: American Institutes for Research, Centers for Medicare and Medicaid Services
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Nursing Homes Failed to Report 43 Percent of Falls With Major Injury and Hospitalization among Their Medicare-Enrolled Residents
Explores the extent to which falls with major injury that resulted in hospitalization among Medicare-enrolled nursing home residents were accurately reported by nursing homes in Minimum Data Set (MDS) assessments between July 2022 and June 2023. Compares the nursing home and patient characteristics associated with higher rates of unreported falls, including nursing home size, ownership structure, rurality, and overall star rating.
Additional links: Report Highlights
Date: 09/2025
Sponsoring organization: Office of Inspector General (HHS)
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Tax-Exempt Hospitals Provided Nearly $149 Billion in Total Benefits to Their Communities
Summarizes the benefits nonprofit hospitals provide their communities based on an analysis of IRS Form 990 Schedule H. Addresses the percent spent on financial assistance, health professions education, medical research, community building activities, and other categories included on Schedule H. Includes data for rural and Critical Access Hospitals.
Date: 09/2025
Sponsoring organization: American Hospital Association
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Sustaining Rural Labor & Delivery Programs: Strategies for Financial Analyses and Considerations for Maintaining Services
A guide for Critical Access Hospital and other rural hospital executives to use when assessing the financial viability of their Labor & Delivery programs. Outlines three strategies that may bring a Labor & Delivery program closer to sustainability and prevent unnecessary closure of services in rural areas.
Author(s): Eric Shell, Dahlia McGrath, Jeff Sommer, et al.
Date: 09/2025
Sponsoring organization: Flex Monitoring Team
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MedPAC Comment on CMS's Proposed Rule on CY 2026 Revisions to Payment Policies Under the Physician Fee Schedule and Other Changes to Part B for Payment Policies
Comment on a July 16, 2025, Federal Register proposed rule revising the physician fee schedule to improve payment systems for physicians and other Medicare Part B revisions. Includes a discussion of a proposal to allow Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs) to provide and bill for medical visits via telehealth and be paid at Physician Fee Schedule (PFS)-equivalent rates through December 2026.
Date: 09/2025
Sponsoring organization: Medicare Payment Advisory Commission
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The 340B Drug Discount Program: Litigation Topics and Trends
Provides an overview of the 340B Drug Discount Program. Discusses litigation surrounding the 340B program, including lawsuits against 340B-covered entities over their use of contract pharmacies to distribute 340B drugs to patients and lawsuits against states that have enacted laws to protect contract pharmacies and covered entities inside their state. Describes courts' interpretation of the 340B statute. Offers considerations for the 119th Congress in light of the litigation and describes several legislative changes that Congress could make to the program if it chose to do so.
Date: 09/2025
Sponsoring organization: Congressional Research Service
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Growth in the 340B Drug Pricing Program
Explores trends in drug purchases through the 340B program between 2010-2021. Discusses drugs purchased through the Prime Vendor Program, factors contributing to growth in the 340B program, and effects of the 340B program on the federal budget. Includes information on the growth of 340B Program participation by hospitals in Medicaid expansion and non-expansion states by Critical Access Hospital designation.
Additional links: Data Underlying Figures
Date: 09/2025
Sponsoring organization: Congressional Budget Office
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September 2025 MedPAC Meeting Transcript
Transcript from the Medicare Payment Advisory Commission's (MedPAC) September 2024 meeting. Covers Medicare payment operations and improving payment accuracy, a discussion with the Comptroller General of the United States regarding the Government Accountability Office's work related to improper payments in the Medicare program and opportunities to improve program sustainability, Medicare's overall financial situation, access to hospice and services under the Medicare hospice benefit for beneficiaries with end-stage renal disease or cancer, and the relationship between changes in Medicare Advantage enrollment and hospital finances.
Date: 09/2025
Sponsoring organization: Medicare Payment Advisory Commission
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An Evaluation of State Flex Program Initiatives to Support Critical Access Hospital-Based Rural Health Clinics
Describes the 16 State Flex Program (SFP) Critical Access Hospital (CAH)-based Rural Health Clinic (RHC) initiatives for the 2023-2024 funding year. Explores the various strategies SFPs have employed to assist CAH-based RHCs by highlighting common activities, challenges, and successes observed across their programs. Summarizes interviews with seven SFPs identifying common themes and notable variations in how they engage with CAH-based RHCs.
Author(s): Bridget Harr, Rebecca Stearns, John Gale
Date: 09/2025
Sponsoring organization: Flex Monitoring Team
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