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Rural Health Information Hub

Rural Health
Resources by Topic: Healthcare business and finance

Medicare Payment Basics: Home Health Care Services Payment System
Overview of Medicare payments for home health care services. Includes information on rate-setting and payments for quality reporting and performance. Describes the Patient-Driven Groupings Model (PDGM) and the home health resource groups (HHRGs) based on clinical and functional status.
Date: 11/2025
Sponsoring organization: Medicare Payment Advisory Commission
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Medicare Payment Basics: Durable Medical Equipment Payment System
Overview of Medicare payments for medical equipment used to treat beneficiaries at home. Defines durable medical equipment (DME), details the DME fee schedule, and discusses the competitive bidding program (CBP) for DME. Includes information on adjustments to fee schedule payment rates outside of competitive bidding areas (CBAs).
Date: 11/2025
Sponsoring organization: Medicare Payment Advisory Commission
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Medicare Payment Basics: Ambulance Services Payment System
Provides an overview of Medicare payments for ambulance services. Discusses rural add-on payment policies, geographic categories determining payment rates, super-rural ZIP codes, and ambulance fee schedules.
Date: 11/2025
Sponsoring organization: Medicare Payment Advisory Commission
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Medicare Payment Basics: Accountable Care Organizations Payment Systems
Provides an overview of Medicare's Accountable Care Organization (ACO) programs. Discusses the payment mechanics of ACOs, including the maximum shared savings and losses of Medicare Shared Savings Program ACOs by track and level.
Date: 11/2025
Sponsoring organization: Medicare Payment Advisory Commission
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Medicare Payment Basics: Critical Access Hospitals Payment System
Presents an overview of Medicare payments for Critical Access Hospitals (CAHs). Compares differences in Medicare payments for CAHs, Sole Community Hospitals, and Medicare-Dependent Hospitals.
Date: 11/2025
Sponsoring organization: Medicare Payment Advisory Commission
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Maternity Deserts: The Equality State's Growing Crisis
Highlights maternity healthcare deserts in Wyoming and nationally. Discusses the impact of labor and delivery department closures, maternal mortality and morbidity, and more on access to care. Notes opportunities to improve outcomes including increasing access to care, additional workforce training and facility protocols to improve healthcare quality, and promote networking opportunities to share knowledge. Offers policy recommendations based on report findings. Discusses rural throughout.
Date: 10/2025
Sponsoring organization: Wyoming Women's Action Network
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State Strategies for the Rural Health Transformation Program (RHTP): A Milbank State Leadership Network Convening Recap
Summarizes discussions held by representatives from 24 states regarding opportunities and strategies related to the federal Rural Health Transformation (RHT) Program and identifies areas for priority action. Includes links to resources shared during the discussions.
Author(s): Sofia Espinosa, Mary Louise Gilburg, Morgan McDonald
Date: 10/2025
Sponsoring organization: Milbank Memorial Fund
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Medicare Advantage Enrollees Have Access to About Half of the Physicians Available to Traditional Medicare Beneficiaries
Explores how provider networks vary across Medicare Advantage plans and when compared to traditional Medicare. Examines the share of physicians available to Medicare Advantage enrollees as a share of physicians available to traditional Medicare beneficiaries by analyzing Medicare Advantage provider directories for 2022. Includes information on the availability of physicians to Medicare Advantage enrollees and traditional Medicare beneficiaries in rural counties.
Author(s): Matthew Rae, Jeannie Fuglesten Biniek, Tricia Neuman, Karen Pollitz
Date: 10/2025
Sponsoring organization: KFF
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An Enhanced Method for Identifying Hospital-Based Obstetric Unit Status, Version 2 with Addendum
Results of a study using data from American Hospital Association annual surveys from 2010-2018 to conduct single- and multi-year assessments of obstetric unit status and to identify closures of obstetric units. Compares results obtained through the enhanced method with results of a survey sample of rural hospitals with obstetric units open at the time of the assessment and those with recently closed units. Addendum describes methodology updates since a previously published January 2022 report as well as additional findings using 2010-2023 data.
Additional links: An Enhanced Method for Identifying Hospital-Based Obstetric Unit Status (Version 1, 2022)
Author(s): Julia D. Interrante, Caitlin Carroll, Emily C. Sheffield, et al.
Date: 10/2025
Sponsoring organization: University of Minnesota Rural Health Research Center
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Calendar Year (CY) 2026 Medicare Physician Fee Schedule Final Rule (CMS-1832-F)
Fact sheet providing an overview of the Centers for Medicare & Medicaid Services (CMS) final rule regarding updates and changes to the Medicare payments under the Physician Fee Schedule (PFS) and other Medicare Part B issues for calendar year 2026. Summarizes provisions related to telehealth services; improving care for chronic illness and behavioral health needs; Rural Health Clinic (RHC) and Federally Qualified Health Center (FQHC) care coordination services, services requiring direct supervision, and telecommunication services; and more.
Date: 10/2025
Sponsoring organization: Centers for Medicare and Medicaid Services
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