Rural Health
Resources by Topic: Healthcare business and finance
Many Medicare Advantage and Medicaid Managed Care Plans Have Limited Behavioral Health Provider Networks and Inactive Providers
Examines the availability of behavioral health providers in selected Medicare Advantage (MA) and Medicaid managed care networks in 2023. Analyzes provider network lists and MA and Medicaid encounter data for four MA and two Medicaid managed care plans from 10 selected urban and rural counties across five states. Describes the proportion of the behavioral health workforce in each county included in the plans' networks. Discusses the extent to which managed care plans had inactive providers in their network and why these providers did not deliver services to enrollees. Includes data on the percentage of inactive providers in rural and urban counties. Offers recommendations to monitor and improve the accuracy of provider networks.
Additional links: Report Highlights
Date: 10/2025
Sponsoring organization: Office of Inspector General (HHS)
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Examines the availability of behavioral health providers in selected Medicare Advantage (MA) and Medicaid managed care networks in 2023. Analyzes provider network lists and MA and Medicaid encounter data for four MA and two Medicaid managed care plans from 10 selected urban and rural counties across five states. Describes the proportion of the behavioral health workforce in each county included in the plans' networks. Discusses the extent to which managed care plans had inactive providers in their network and why these providers did not deliver services to enrollees. Includes data on the percentage of inactive providers in rural and urban counties. Offers recommendations to monitor and improve the accuracy of provider networks.
Additional links: Report Highlights
Date: 10/2025
Sponsoring organization: Office of Inspector General (HHS)
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Transforming Rural Health Care Through Medicaid Innovation: Tip Sheet Series
Informational tip sheets discussing the use of Medicaid innovations to assist states in creating their Rural Health Transformation (RHT) Program applications. Covers issues such as behavioral health, school-based services, integrated care access, community health workers, community paramedicine, specialty care, and healthcare technology. Provides examples, strategies, Medicaid policy information, and resources.
Additional links: Improving Access to Integrated Care for Dually Eligible Individuals in Rural Areas, Leveraging Community Health Workers to Address Rural Health Care Needs, Leveraging Community Paramedicine to Address Rural Health Needs, Leveraging Peers and Lay Counselors to Address Behavioral Health Care Workforce Shortages in Rural Areas, Using Project ECHO to Deliver Specialty Care in Rural Areas, Using School-Based Services to Improve Access to Preventive Health Care for Children in Rural Areas, Using Tech-Enabled Solutions to Improve Care Quality and Access in Rural Areas
Author(s): Molly Knowles, Nancy Archibald, Karla Silverman, Lauren Scannelli Jacobs
Date: 10/2025
Sponsoring organization: Center for Health Care Strategies
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Informational tip sheets discussing the use of Medicaid innovations to assist states in creating their Rural Health Transformation (RHT) Program applications. Covers issues such as behavioral health, school-based services, integrated care access, community health workers, community paramedicine, specialty care, and healthcare technology. Provides examples, strategies, Medicaid policy information, and resources.
Additional links: Improving Access to Integrated Care for Dually Eligible Individuals in Rural Areas, Leveraging Community Health Workers to Address Rural Health Care Needs, Leveraging Community Paramedicine to Address Rural Health Needs, Leveraging Peers and Lay Counselors to Address Behavioral Health Care Workforce Shortages in Rural Areas, Using Project ECHO to Deliver Specialty Care in Rural Areas, Using School-Based Services to Improve Access to Preventive Health Care for Children in Rural Areas, Using Tech-Enabled Solutions to Improve Care Quality and Access in Rural Areas
Author(s): Molly Knowles, Nancy Archibald, Karla Silverman, Lauren Scannelli Jacobs
Date: 10/2025
Sponsoring organization: Center for Health Care Strategies
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Rural Emergency Hospital (REH) Model Frequently Asked Questions
Provides answers to frequently asked questions regarding the Rural Emergency Hospital (REH) designation. Covers general information, Conditions of Participation, and REH payment policies.
Date: 10/2025
Sponsoring organizations: Mathematica, Rural Health Redesign Center
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Provides answers to frequently asked questions regarding the Rural Emergency Hospital (REH) designation. Covers general information, Conditions of Participation, and REH payment policies.
Date: 10/2025
Sponsoring organizations: Mathematica, Rural Health Redesign Center
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Unfairness Toward Rural Beneficiaries in Medicare's Hierarchical Conditions Categories Score
Evaluates the Centers for Medicare & Medicaid Services (CMS) Hierarchical Condition Category (HCC) to determine its usefulness in accurately predicting risk for rural and urban patients. Assesses rural and urban risk by mortality rates and compares findings with HCC's measure of spending to identify risk. Discusses implications of findings related to reimbursement rates, healthcare access, social determinants of health, and Medicare Advantage enrollment. Offers potential solutions to address study findings.
Author(s): Ravi B. Parikh, Kristin A. Linn, Junning Liang, et al
Citation: Health Affairs Scholar, 3(9)
Date: 09/2025
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Evaluates the Centers for Medicare & Medicaid Services (CMS) Hierarchical Condition Category (HCC) to determine its usefulness in accurately predicting risk for rural and urban patients. Assesses rural and urban risk by mortality rates and compares findings with HCC's measure of spending to identify risk. Discusses implications of findings related to reimbursement rates, healthcare access, social determinants of health, and Medicare Advantage enrollment. Offers potential solutions to address study findings.
Author(s): Ravi B. Parikh, Kristin A. Linn, Junning Liang, et al
Citation: Health Affairs Scholar, 3(9)
Date: 09/2025
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Shifting Care Patterns: How Medicaid Policies Shape Family and Formal Care Use
Analyzes the impacts of Medicaid 1915(c) waivers on likelihood of receiving formal versus family care among adults aged 70 years and older with functional limitations, utilizing 2011-2019 National Health and Aging Trends Study (NHATS) data. Highlights the significance of waiver payments for family caregiving for population subgroups including Medicaid beneficiaries, rural residents, and people living with dementia.
Author(s): Johanna Thunell, Elise M. Parrish, Katherine E.M. Miller
Citation: Alzheimer's & Dementia, 21(9), e70715
Date: 09/2025
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Analyzes the impacts of Medicaid 1915(c) waivers on likelihood of receiving formal versus family care among adults aged 70 years and older with functional limitations, utilizing 2011-2019 National Health and Aging Trends Study (NHATS) data. Highlights the significance of waiver payments for family caregiving for population subgroups including Medicaid beneficiaries, rural residents, and people living with dementia.
Author(s): Johanna Thunell, Elise M. Parrish, Katherine E.M. Miller
Citation: Alzheimer's & Dementia, 21(9), e70715
Date: 09/2025
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Health Insurance Coverage in Rural and Urban Areas in the U.S., 2023
Describes the health insurance status of United States residents in 2023, with breakdowns by age groups and urban or rural location. Uses data from the 2024 American Community Survey.
Author(s): Sarah Eisenstein, Xiaoyu Huang, Timothy McBride, Keith Mueller
Date: 09/2025
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Describes the health insurance status of United States residents in 2023, with breakdowns by age groups and urban or rural location. Uses data from the 2024 American Community Survey.
Author(s): Sarah Eisenstein, Xiaoyu Huang, Timothy McBride, Keith Mueller
Date: 09/2025
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Supporting Rural Health Facilities
Discusses strategies pursued by states to strengthen the financial stability of rural hospitals and expand access to primary care, behavioral healthcare, and emergency care. Describes state policies related to technical assistance, financial stabilization grants, payment models, Rural Health Clinics (RHCs), health centers, Certified Community Behavioral Health Clinics (CCBHCs), and free-standing emergency departments.
Date: 09/2025
Sponsoring organization: National Conference of State Legislatures
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Discusses strategies pursued by states to strengthen the financial stability of rural hospitals and expand access to primary care, behavioral healthcare, and emergency care. Describes state policies related to technical assistance, financial stabilization grants, payment models, Rural Health Clinics (RHCs), health centers, Certified Community Behavioral Health Clinics (CCBHCs), and free-standing emergency departments.
Date: 09/2025
Sponsoring organization: National Conference of State Legislatures
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Best Practices for Implementing the Continuum of Crisis Services Under Medicaid and CHIP
Provides guidance for states to maintain a continuum of behavioral health crisis care for patients covered by Medicaid and CHIP. Details core elements of the continuum of crisis care and how Medicaid and CHIP function within that framework. Highlights considerations for rural communities.
Date: 09/2025
Sponsoring organizations: Centers for Medicare and Medicaid Services, Substance Abuse and Mental Health Services Administration
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Provides guidance for states to maintain a continuum of behavioral health crisis care for patients covered by Medicaid and CHIP. Details core elements of the continuum of crisis care and how Medicaid and CHIP function within that framework. Highlights considerations for rural communities.
Date: 09/2025
Sponsoring organizations: Centers for Medicare and Medicaid Services, Substance Abuse and Mental Health Services Administration
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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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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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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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