Rural Health
Resources by Topic: Home and community-based services
Is Medicare Home Health Care Utilization Substituting for Long-Term Care? Evidence From Dual Eligible Beneficiaries
Examines the relationship between Medicaid home and community-based services (HCBS) and Medicare community-initiated home health care (CIHHC). Utilizes 2016-2019 national Medicare and Medicaid claims data of dually enrolled older adults and analyzes the effects of Medicaid HCBS use on the utilization of Medicare CIHHC. Includes comparisons of HCBS users and non-HCBS users with breakdowns by demographics and rural versus urban county classification.
Author(s): Mingyu Qi, Rachel M. Werner, Megan Huisingh-Scheetz, R. Tamara Konetzka
Citation: Health Services Research, 61(2), e70109
Date: 04/2026
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Examines the relationship between Medicaid home and community-based services (HCBS) and Medicare community-initiated home health care (CIHHC). Utilizes 2016-2019 national Medicare and Medicaid claims data of dually enrolled older adults and analyzes the effects of Medicaid HCBS use on the utilization of Medicare CIHHC. Includes comparisons of HCBS users and non-HCBS users with breakdowns by demographics and rural versus urban county classification.
Author(s): Mingyu Qi, Rachel M. Werner, Megan Huisingh-Scheetz, R. Tamara Konetzka
Citation: Health Services Research, 61(2), e70109
Date: 04/2026
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The Importance of Long-Term Services and Supports to a High-Performance Rural Health System: Demographic, Policy and Economic Challenges
Explores the potential impact of The One Big Beautiful Bill Act of 2025 (HR 1) on sustaining long-term services and supports (LTSS) in rural areas as an important element of a high performing rural health system. Describes how the policy landscape affecting LTSS in rural America is undergoing changes in population characteristics, healthcare resources, and financing. Discusses the potential impact of federal policy changes on rural LTSS.
Date: 03/2026
Sponsoring organization: Rural Policy Research Institute Rural Health Panel
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Explores the potential impact of The One Big Beautiful Bill Act of 2025 (HR 1) on sustaining long-term services and supports (LTSS) in rural areas as an important element of a high performing rural health system. Describes how the policy landscape affecting LTSS in rural America is undergoing changes in population characteristics, healthcare resources, and financing. Discusses the potential impact of federal policy changes on rural LTSS.
Date: 03/2026
Sponsoring organization: Rural Policy Research Institute Rural Health Panel
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Report to Congress on Medicaid and CHIP, March 2026
Reports on four aspects of Medicaid of interest to Congress: 1) the home- and community-based services (HCBS) workforce, 2) behavioral health in Medicaid and the State Children's Health Insurance Program (CHIP), 3) Medicaid for justice-involved youth, and 4) Medicaid for children in foster care.
Date: 03/2026
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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Reports on four aspects of Medicaid of interest to Congress: 1) the home- and community-based services (HCBS) workforce, 2) behavioral health in Medicaid and the State Children's Health Insurance Program (CHIP), 3) Medicaid for justice-involved youth, and 4) Medicaid for children in foster care.
Date: 03/2026
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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State-Level Impacts of Key Medicaid Provisions in the One Big Beautiful Bill Act
Explores the potential impacts of 12 healthcare provisions within the One Big Beautiful Bill Act (Public Law 119-21) on Medicaid and state budgets. Presents estimated impacts for each state provision-by-provision and overall. Includes analysis related to Medicaid determination, provider taxes, state-directed payments, work requirements, and the Rural Health Transformation Program.
Author(s): Preethi Rao, Lawrence Baker, Federico Girosi, et al.
Date: 02/2026
Sponsoring organization: RAND Corporation
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Explores the potential impacts of 12 healthcare provisions within the One Big Beautiful Bill Act (Public Law 119-21) on Medicaid and state budgets. Presents estimated impacts for each state provision-by-provision and overall. Includes analysis related to Medicaid determination, provider taxes, state-directed payments, work requirements, and the Rural Health Transformation Program.
Author(s): Preethi Rao, Lawrence Baker, Federico Girosi, et al.
Date: 02/2026
Sponsoring organization: RAND Corporation
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North Dakota Qualified Service Provider Hub Survey Report
Report features findings of a survey of qualified service providers (QSPs) in the state of North Dakota. Discusses findings from individual QSPs and agency QSPs and details information about clients served, services provided, and pay and benefits, including the rural differential rate, among other topics.
Author(s): Karen Bernhardt
Date: 01/2026
Sponsoring organization: North Dakota Qualified Service Provider Hub
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Report features findings of a survey of qualified service providers (QSPs) in the state of North Dakota. Discusses findings from individual QSPs and agency QSPs and details information about clients served, services provided, and pay and benefits, including the rural differential rate, among other topics.
Author(s): Karen Bernhardt
Date: 01/2026
Sponsoring organization: North Dakota Qualified Service Provider Hub
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Closing the Care Gap: Strengthening Long-Term Services and Supports in Rural California
Describes gaps in long-term services and providers for rural older adults in California and offers policy recommendations to address those gaps. Discusses the direct care workforce, aging-related barriers to support, family caregiving support, and workforce education.
Author(s): Pauline DeLange Martinez, Elizabeth Bogumil, Helen Miltiades, et al.
Date: 11/2025
Sponsoring organizations: The SCAN Foundation, UC Davis Health
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Describes gaps in long-term services and providers for rural older adults in California and offers policy recommendations to address those gaps. Discusses the direct care workforce, aging-related barriers to support, family caregiving support, and workforce education.
Author(s): Pauline DeLange Martinez, Elizabeth Bogumil, Helen Miltiades, et al.
Date: 11/2025
Sponsoring organizations: The SCAN Foundation, UC Davis Health
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MedPAC Payment Basics
Series of briefs providing an of Medicare payment systems. Covers payments systems including Accountable Care Organizations (ACO), Critical Access Hospitals (CAH), Federally Qualified Health Centers and Rural Health Clinics, hospital acute inpatient services, and more.
Date: 11/2025
Sponsoring organization: Medicare Payment Advisory Commission
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Series of briefs providing an of Medicare payment systems. Covers payments systems including Accountable Care Organizations (ACO), Critical Access Hospitals (CAH), Federally Qualified Health Centers and Rural Health Clinics, hospital acute inpatient services, and more.
Date: 11/2025
Sponsoring organization: Medicare Payment Advisory Commission
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Utilization of Home- and Community-Based Services among Rural Family Caregivers of Persons with Dementia: The Role of the Area Deprivation Index
Examines the association between utilization of home- and community-based services and area-level factors as measured by the Area Deprivation Index, utilizing survey data of 361 rural family caregivers of people with dementia. Analyzes the relationship between home or community service use and level of area deprivation, U.S. region, and other individual factors.
Author(s): Jasmine Santoyo-Olsson, Kenneth E. Covinsky, Jing Cheng, Dolores Gallagher Thompson, Veronica Yank
Citation: Frontiers in Public Health, 13, 1688161
Date: 10/2025
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Examines the association between utilization of home- and community-based services and area-level factors as measured by the Area Deprivation Index, utilizing survey data of 361 rural family caregivers of people with dementia. Analyzes the relationship between home or community service use and level of area deprivation, U.S. region, and other individual factors.
Author(s): Jasmine Santoyo-Olsson, Kenneth E. Covinsky, Jing Cheng, Dolores Gallagher Thompson, Veronica Yank
Citation: Frontiers in Public Health, 13, 1688161
Date: 10/2025
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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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Missoula Veteran Directed Care Program Supports Veterans and Caregivers
Case study highlighting a partnership between a Montana Area Agency on Aging and the Veterans Administration to provide Veteran Directed Care, a program assisting veterans to manage their own care to promote aging in place. Notes the high rates of Montana veterans in rural areas.
Date: 07/2025
Sponsoring organization: USAging
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Case study highlighting a partnership between a Montana Area Agency on Aging and the Veterans Administration to provide Veteran Directed Care, a program assisting veterans to manage their own care to promote aging in place. Notes the high rates of Montana veterans in rural areas.
Date: 07/2025
Sponsoring organization: USAging
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