Rural Health
Resources by Topic: Healthcare facilities
The Impact of High Hospital Fixed-Cost Ratios on Rural Populations
Explores how rurality relates to hospital cost structures as categorized by Urban Influence Codes (UICs). Describes the characteristics of hospitals at different fixed-to-total-cost ratio levels, the demographics associated with hospitals at different ratio levels, and the share of nonmetropolitan hospitals that have Critical Access Hospital (CAH) or Low-Volume Hospital (LVH) designations. Discusses how findings could be used to refine hospital payment policies.
Author(s): Abigail Barker, Eliot Jost, Timothy McBride, Keith Mueller
Date: 06/2025
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Explores how rurality relates to hospital cost structures as categorized by Urban Influence Codes (UICs). Describes the characteristics of hospitals at different fixed-to-total-cost ratio levels, the demographics associated with hospitals at different ratio levels, and the share of nonmetropolitan hospitals that have Critical Access Hospital (CAH) or Low-Volume Hospital (LVH) designations. Discusses how findings could be used to refine hospital payment policies.
Author(s): Abigail Barker, Eliot Jost, Timothy McBride, Keith Mueller
Date: 06/2025
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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MBQIP Quality Measures National Annual Report - 2023
Summarizes quality measure reporting rates and performance among Critical Access Hospitals (CAHs) in 2023. Presents data on the four Medicare Beneficiary Quality Improvement Project (MBQIP) domains: patient safety/inpatient, outpatient, patient engagement, and care transitions.
Author(s): Megan Lahr, Alyssa Furukawa, Madeleine Pick, Robert Barclay
Date: 06/2025
Sponsoring organization: Flex Monitoring Team
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Summarizes quality measure reporting rates and performance among Critical Access Hospitals (CAHs) in 2023. Presents data on the four Medicare Beneficiary Quality Improvement Project (MBQIP) domains: patient safety/inpatient, outpatient, patient engagement, and care transitions.
Author(s): Megan Lahr, Alyssa Furukawa, Madeleine Pick, Robert Barclay
Date: 06/2025
Sponsoring organization: Flex Monitoring Team
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National Health Center Financial and Operational Performance Analysis: 2020–2023
Examines financial and operational characteristics of Federally Qualified Health Centers (FQHCs) from 2020-2023. Explores FQHC growth and expansion, patient and payer mix, revenue and growth mix, staffing and productivity, operational trends, financial performance, and more. Compares data on rural FQHCs to urban and national FQHC data. Requires name, email address, and organization information to download.
Date: 06/2025
Sponsoring organization: Capital Link
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Examines financial and operational characteristics of Federally Qualified Health Centers (FQHCs) from 2020-2023. Explores FQHC growth and expansion, patient and payer mix, revenue and growth mix, staffing and productivity, operational trends, financial performance, and more. Compares data on rural FQHCs to urban and national FQHC data. Requires name, email address, and organization information to download.
Date: 06/2025
Sponsoring organization: Capital Link
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CAHMPAS Technical Bulletin: Revised Benchmarks and Data Exclusion Rules
Describes a review of 12 Critical Access Hospital Measurement and Performance Assessment System (CAHMPAS) benchmarks to reflect current operating conditions. Details which benchmarks were revised, unchanged, discontinued, or added. Also discusses revisions to the data exclusion rules to improve data quality.
Author(s): Aditya R. Pillutla, Kristie W. Thompson, George Pink, Kristin L. Reiter
Date: 06/2025
Sponsoring organization: Flex Monitoring Team
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Describes a review of 12 Critical Access Hospital Measurement and Performance Assessment System (CAHMPAS) benchmarks to reflect current operating conditions. Details which benchmarks were revised, unchanged, discontinued, or added. Also discusses revisions to the data exclusion rules to improve data quality.
Author(s): Aditya R. Pillutla, Kristie W. Thompson, George Pink, Kristin L. Reiter
Date: 06/2025
Sponsoring organization: Flex Monitoring Team
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MedPAC Report to the Congress: Medicare and the Health Care Delivery System, June 2025
Evaluates Medicare payment issues and provides recommendations to the U.S. Congress. Covers proposed reforms to the physician fee schedule updates and the accuracy of relative payment rates; supplemental benefits in Medicare Advantage; home healthcare use among Medicare Advantage enrollees; Part D prescription drug plans for beneficiaries in fee-for-service Medicare and Medicare Advantage; Medicare beneficiaries in nursing homes; the inclusion of rural providers in current Medicare fee-for-service quality reporting programs; and recommendations related to reducing beneficiary cost sharing for outpatient services at Critical Access Hospitals. Includes rural references throughout.
Additional links: Executive Summary
Date: 06/2025
Sponsoring organization: Medicare Payment Advisory Commission
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Evaluates Medicare payment issues and provides recommendations to the U.S. Congress. Covers proposed reforms to the physician fee schedule updates and the accuracy of relative payment rates; supplemental benefits in Medicare Advantage; home healthcare use among Medicare Advantage enrollees; Part D prescription drug plans for beneficiaries in fee-for-service Medicare and Medicare Advantage; Medicare beneficiaries in nursing homes; the inclusion of rural providers in current Medicare fee-for-service quality reporting programs; and recommendations related to reducing beneficiary cost sharing for outpatient services at Critical Access Hospitals. Includes rural references throughout.
Additional links: Executive Summary
Date: 06/2025
Sponsoring organization: Medicare Payment Advisory Commission
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Addendum to HCUP Statistical Brief #308: Rural and Urban Hospital Differences in Inpatient Stays Involving Sepsis, 2019 and 2021, Addition of 2022 Data
Explores inpatient hospital stays related to sepsis using the 2019 and 2022 State Inpatient Databases (SID) for 47 States and the District of Columbia. Presents data on the percentage of stays related to sepsis, lengths of stay, costs of stay, and outcomes for sepsis stays for over 4,200 community hospitals. Compares data for rural and urban hospitals by ownership, bed size, teaching hospital status, and safety net designation. Updates an August 2024 report to include data for 2022.
Author(s): Joanna Jiang, Lan Liang, Meghana Chandra, Sai Loganathan
Date: 06/2025
Sponsoring organization: Agency for Healthcare Research and Quality
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Explores inpatient hospital stays related to sepsis using the 2019 and 2022 State Inpatient Databases (SID) for 47 States and the District of Columbia. Presents data on the percentage of stays related to sepsis, lengths of stay, costs of stay, and outcomes for sepsis stays for over 4,200 community hospitals. Compares data for rural and urban hospitals by ownership, bed size, teaching hospital status, and safety net designation. Updates an August 2024 report to include data for 2022.
Author(s): Joanna Jiang, Lan Liang, Meghana Chandra, Sai Loganathan
Date: 06/2025
Sponsoring organization: Agency for Healthcare Research and Quality
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Report to Congress on Medicaid and CHIP, June 2025
Semi-annual report to Congress from the Medicaid and CHIP Payment and Access Commission (MACPAC). Covers recommendations related to transitions from pediatric to adult care for Medicaid-covered children and youth with special health care needs (CYSHCN). Also discusses appropriate access to residential behavioral health treatment services for children, findings from MACPAC's analytic work on access to medications for opioid use disorder (MOUD) in Medicaid, an overview on the Program of All-Inclusive Care for the Elderly, and self-direction for Medicaid home- and community-based services. Includes rural references throughout.
Date: 06/2025
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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Semi-annual report to Congress from the Medicaid and CHIP Payment and Access Commission (MACPAC). Covers recommendations related to transitions from pediatric to adult care for Medicaid-covered children and youth with special health care needs (CYSHCN). Also discusses appropriate access to residential behavioral health treatment services for children, findings from MACPAC's analytic work on access to medications for opioid use disorder (MOUD) in Medicaid, an overview on the Program of All-Inclusive Care for the Elderly, and self-direction for Medicaid home- and community-based services. Includes rural references throughout.
Date: 06/2025
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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MedPAC Comment on CMS's Proposed Rule on Inpatient Rehabilitation Facility PPS for FY 2026
Comments on an April 30, 2025, Federal Register proposed rule addressing updates to the prospective payment system for inpatient rehabilitation facilities (IRFs) for fiscal year 2026. Includes comments on the potential impact of replacing payment weights on small and rural IRFs.
Date: 06/2025
Sponsoring organization: Medicare Payment Advisory Commission
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Comments on an April 30, 2025, Federal Register proposed rule addressing updates to the prospective payment system for inpatient rehabilitation facilities (IRFs) for fiscal year 2026. Includes comments on the potential impact of replacing payment weights on small and rural IRFs.
Date: 06/2025
Sponsoring organization: Medicare Payment Advisory Commission
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MedPAC Comment on CMS's Proposed Rule on Inpatient Prospective Payment System for FY 2026
Comments on an April 30, 2025, Federal Register proposed rule revising the hospital inpatient and long-term care hospital (LTCH) prospective payment systems (PPS). Discusses proposals to update inpatient prospective payment systems (IPPS) payment rates, update wage index values and policies, modify the Transforming Episode Accountability Model (TEAM), and remove the proposed health-equity adjustment from the Hospital Value-Based Purchasing (VBP) Program.
Date: 06/2025
Sponsoring organization: Medicare Payment Advisory Commission
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Comments on an April 30, 2025, Federal Register proposed rule revising the hospital inpatient and long-term care hospital (LTCH) prospective payment systems (PPS). Discusses proposals to update inpatient prospective payment systems (IPPS) payment rates, update wage index values and policies, modify the Transforming Episode Accountability Model (TEAM), and remove the proposed health-equity adjustment from the Hospital Value-Based Purchasing (VBP) Program.
Date: 06/2025
Sponsoring organization: Medicare Payment Advisory Commission
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Organizational Factors Associated with Using Telehealth Services: Perspectives from Leaders of Rural Health Clinics and Federally Qualified Health Centers
Research and policy brief examining organizational factors influencing telehealth use in Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs). Summarizes interviews with RHC and FQHC key informants to discuss perceptions of telehealth, implementation challenges, operational challenges, and opportunities for innovation. Provides suggestions for policy and reimbursement approaches to improve telehealth provision and access.
Author(s): Constance van Eeghen, John A. Gale, Erika Ziller, Yvonne Jonk
Date: 06/2025
Sponsoring organization: Rural Telehealth Research Center
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Research and policy brief examining organizational factors influencing telehealth use in Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs). Summarizes interviews with RHC and FQHC key informants to discuss perceptions of telehealth, implementation challenges, operational challenges, and opportunities for innovation. Provides suggestions for policy and reimbursement approaches to improve telehealth provision and access.
Author(s): Constance van Eeghen, John A. Gale, Erika Ziller, Yvonne Jonk
Date: 06/2025
Sponsoring organization: Rural Telehealth Research Center
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