Rural Health
Resources by Topic: Healthcare facilities
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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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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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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Rural Resource: Availability of Obstetric Simulation Training by State
Explores the availability of simulation training and continuing medical education (CME)/distance learning opportunities for both rural hospitals with obstetric units and those without obstetric units. Presents findings of an environmental scan of national, regional, and state-level obstetric training resources. Offers recommendations for ways State Flex Programs and Critical Access Hospitals can use this resource to identify applicable simulation trainings.
Author(s): Madeleine Pick, Hamdi Abas, Megan Lahr
Date: 09/2025
Sponsoring organization: Flex Monitoring Team
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Explores the availability of simulation training and continuing medical education (CME)/distance learning opportunities for both rural hospitals with obstetric units and those without obstetric units. Presents findings of an environmental scan of national, regional, and state-level obstetric training resources. Offers recommendations for ways State Flex Programs and Critical Access Hospitals can use this resource to identify applicable simulation trainings.
Author(s): Madeleine Pick, Hamdi Abas, Megan Lahr
Date: 09/2025
Sponsoring organization: Flex Monitoring Team
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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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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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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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Comparison of Care in Hospital Outpatient Departments and Independent Physician Offices: Updated Findings for 2019-2024
Examines differences in Medicare payments for services at an independent physician's office (IPO) or a hospital outpatient department (HOPD). Utilizes 2019-2024 data to analyze characteristics of Medicare patients seen in HOPDs and IPOs, including rural versus urban location.
Date: 09/2025
Sponsoring organization: American Hospital Association
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Examines differences in Medicare payments for services at an independent physician's office (IPO) or a hospital outpatient department (HOPD). Utilizes 2019-2024 data to analyze characteristics of Medicare patients seen in HOPDs and IPOs, including rural versus urban location.
Date: 09/2025
Sponsoring organization: American Hospital Association
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Implementing High-Quality Primary Care: A Policy Menu for States
Presents policy strategies utilized by states to strengthen primary care across five priority areas. Strategies cover primary care reimbursement; addressing individual, community, and market-level barriers to care; expanding and supporting the primary care workforce; and supporting practice transformation. Includes rural references throughout.
Date: 09/2025
Sponsoring organizations: Milbank Memorial Fund, National Academy for State Health Policy
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Presents policy strategies utilized by states to strengthen primary care across five priority areas. Strategies cover primary care reimbursement; addressing individual, community, and market-level barriers to care; expanding and supporting the primary care workforce; and supporting practice transformation. Includes rural references throughout.
Date: 09/2025
Sponsoring organizations: Milbank Memorial Fund, National Academy for State Health Policy
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Expiring Health Provisions of the 119th Congress
Outlines the healthcare-related funding and governmental authorities that will expire during the 119th Congress, calendars year 2025-2026, if not extended through congressional action. Highlights similar provisions that expired during the 118th Congress (2023-2024). Includes rural references throughout.
Date: 09/2025
Sponsoring organization: Congressional Research Service
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Outlines the healthcare-related funding and governmental authorities that will expire during the 119th Congress, calendars year 2025-2026, if not extended through congressional action. Highlights similar provisions that expired during the 118th Congress (2023-2024). Includes rural references throughout.
Date: 09/2025
Sponsoring organization: Congressional Research Service
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Skill Mix Versus Flexibility: Decoding Nurse Staffing Impacts on Critical Access Hospitals
Presents a study on the skill mix and flexibility of nurse staffing on the financial stability, care quality, and efficacy of Critical Access Hospitals (CAHs) in Pennsylvania from 2000 to 2023. Correlates skill mix and flexibility with hospital outcomes and controls for hospital-specific, socioeconomic, and demographic factors.
Author(s): Dinesh R Pai, Esmaeil Bahalkeh
Citation: Journal of Rural Health, 41(3), e70075
Date: 08/2025
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Presents a study on the skill mix and flexibility of nurse staffing on the financial stability, care quality, and efficacy of Critical Access Hospitals (CAHs) in Pennsylvania from 2000 to 2023. Correlates skill mix and flexibility with hospital outcomes and controls for hospital-specific, socioeconomic, and demographic factors.
Author(s): Dinesh R Pai, Esmaeil Bahalkeh
Citation: Journal of Rural Health, 41(3), e70075
Date: 08/2025
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Rural & Safety Net Health Facilities in Arizona
Map of Arizona's Critical Access Hospitals, Indian Health Service and Tribal Facilities, Rural Health Clinics, and Federally Qualified Health Centers.
Date: 08/2025
Sponsoring organization: Arizona Center for Rural Health
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Map of Arizona's Critical Access Hospitals, Indian Health Service and Tribal Facilities, Rural Health Clinics, and Federally Qualified Health Centers.
Date: 08/2025
Sponsoring organization: Arizona Center for Rural Health
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