Rural Health
Resources by Topic: Medicaid
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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Iowa Community Health Centers and Value-Based Care
Describes how Iowa Primary Care Association (Iowa PCA) and two sister organizations, IowaHealth+ and INConcertCare, pursued value-based care opportunities before joining the Medicare Shared Savings Program. Discusses the network's Medicaid value-based care contract; a partnership with Main Street Health to expand value-based contracting and provide more comprehensive, integrated primary care to patients with Medicare Advantage; data analytics; strategic planning and roadmaps; and next steps.
Date: 06/2025
Sponsoring organization: Rural Health Value
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Describes how Iowa Primary Care Association (Iowa PCA) and two sister organizations, IowaHealth+ and INConcertCare, pursued value-based care opportunities before joining the Medicare Shared Savings Program. Discusses the network's Medicaid value-based care contract; a partnership with Main Street Health to expand value-based contracting and provide more comprehensive, integrated primary care to patients with Medicare Advantage; data analytics; strategic planning and roadmaps; and next steps.
Date: 06/2025
Sponsoring organization: Rural Health Value
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Assisting Rural Consumers
Offers information and guidance for Navigators and certified application counselors helping rural healthcare consumers. Covers rural-relevant considerations and policy updates regarding Federally-facilitated and State-based Marketplaces, Medicaid/CHIP, and Medicare. Outlines tips for assisters to address barriers to care and conducting outreach in rural areas.
Date: 04/2025
Sponsoring organization: Centers for Medicare and Medicaid Services
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Offers information and guidance for Navigators and certified application counselors helping rural healthcare consumers. Covers rural-relevant considerations and policy updates regarding Federally-facilitated and State-based Marketplaces, Medicaid/CHIP, and Medicare. Outlines tips for assisters to address barriers to care and conducting outreach in rural areas.
Date: 04/2025
Sponsoring organization: Centers for Medicare and Medicaid Services
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Federal and State Reimbursement for Youth Behavioral Health Services
Report details Medicaid and Children's Health Insurance Program (CHIP) coverage of behavioral health services for rural people under 21 years of age. Breaks down reimbursement eligibility for behavioral health providers in all 50 states and discusses barriers to access in rural areas.
Date: 04/2025
Sponsoring organization: WWAMI Rural Health Research Center
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Report details Medicaid and Children's Health Insurance Program (CHIP) coverage of behavioral health services for rural people under 21 years of age. Breaks down reimbursement eligibility for behavioral health providers in all 50 states and discusses barriers to access in rural areas.
Date: 04/2025
Sponsoring organization: WWAMI Rural Health Research Center
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CMS Bundled Payments for Care Improvement Advanced Model: Sixth Annual Evaluation Report
Sixth annual report of the Bundled Payments for Care Improvement Advanced (BPCI Advanced) Model, which tests whether linking payments for a clinical episode of care can reduce Medicare expenditures while maintaining or improving the quality of care. Examines the impact of BPCI Advanced on episode payments, utilization, and quality of care, as well as estimates of Medicare program savings in Model Year 5. Also explores the impact of the model on accountable care relationships, strengthening primary care, and care for patients eligible for both Medicare and Medicaid. Includes data on the percentage of BPCI Advanced episodes with and without ACO attribution by patient characteristics, including rural residents.
Additional links: Appendices, Executive Summary, Findings at a Glance, Transformation Spotlight
Author(s): The Lewin Group, Abt Associates, GDIT, Telligen
Date: 04/2025
Sponsoring organization: Centers for Medicare and Medicaid Services
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Sixth annual report of the Bundled Payments for Care Improvement Advanced (BPCI Advanced) Model, which tests whether linking payments for a clinical episode of care can reduce Medicare expenditures while maintaining or improving the quality of care. Examines the impact of BPCI Advanced on episode payments, utilization, and quality of care, as well as estimates of Medicare program savings in Model Year 5. Also explores the impact of the model on accountable care relationships, strengthening primary care, and care for patients eligible for both Medicare and Medicaid. Includes data on the percentage of BPCI Advanced episodes with and without ACO attribution by patient characteristics, including rural residents.
Additional links: Appendices, Executive Summary, Findings at a Glance, Transformation Spotlight
Author(s): The Lewin Group, Abt Associates, GDIT, Telligen
Date: 04/2025
Sponsoring organization: Centers for Medicare and Medicaid Services
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Operating Status of Adult Day Services Centers in 2022
Author(s): Jessica P. Lendon, Priyanka Singh, Christine Caffrey, Manisha Sengupta, Zhaohui Lu
Date: 03/2025
Sponsoring organization: National Center for Health Statistics
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Offers estimates from the 2022 National Post-acute and Long-term Care Study (NPALS) regarding operating status of adult day service centers as a result of COVID-19 response efforts. Compares U.S. Census Bureau regions, metropolitan and nonmetropolitan statistical areas, Medicaid licensure, and number of enrolled participants.
Author(s): Jessica P. Lendon, Priyanka Singh, Christine Caffrey, Manisha Sengupta, Zhaohui Lu
Date: 03/2025
Sponsoring organization: National Center for Health Statistics
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Report to Congress on Medicaid and CHIP, March 2025
Reports on three aspects of Medicaid of interest to Congress: 1) improving the usability and transparency of the managed care external quality review process, 2) improvements on timely access to home- and community-based services (HCBS), and 3) ways to streamline Medicaid Section 1915 authorities for home-and community-based services and reduce the administrative burden.
Date: 03/2025
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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Reports on three aspects of Medicaid of interest to Congress: 1) improving the usability and transparency of the managed care external quality review process, 2) improvements on timely access to home- and community-based services (HCBS), and 3) ways to streamline Medicaid Section 1915 authorities for home-and community-based services and reduce the administrative burden.
Date: 03/2025
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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February 2025 MACPAC Meeting Transcript
Transcript from the Medicaid and CHIP Payment and Access Commission's (MACPAC) February 2025 meeting. Covers transitions of care for children and youth with special healthcare needs (CYSHCN), hospital non-disproportionate share hospital supplemental payments and directed payment targeting, improving access to medications for opioid use disorder, healthcare access for children in foster care, and more. Includes rural references throughout.
Additional links: Hospital Non-DSH Supplemental Payment and Directed Payment Targeting Analyses
Date: 02/2025
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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Transcript from the Medicaid and CHIP Payment and Access Commission's (MACPAC) February 2025 meeting. Covers transitions of care for children and youth with special healthcare needs (CYSHCN), hospital non-disproportionate share hospital supplemental payments and directed payment targeting, improving access to medications for opioid use disorder, healthcare access for children in foster care, and more. Includes rural references throughout.
Additional links: Hospital Non-DSH Supplemental Payment and Directed Payment Targeting Analyses
Date: 02/2025
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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Enhancing Rural Access to Medications for Opioid Use Disorder: Policy Brief and Recommendations to the Secretary
Provides an overview of issues related to opioid use disorder (OUD) in rural areas. Discusses access to medication for opioid use disorder (MOUD), MOUD workforce, telehealth to support access to MOUD, and Medicaid 1115 demonstrations that address OUD. Offers policy recommendations related to regulatory barriers, reimbursement flexibility, workforce, and service site expansion to increase access to MOUD in rural areas.
Date: 01/2025
Sponsoring organization: National Advisory Committee on Rural Health and Human Services
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Provides an overview of issues related to opioid use disorder (OUD) in rural areas. Discusses access to medication for opioid use disorder (MOUD), MOUD workforce, telehealth to support access to MOUD, and Medicaid 1115 demonstrations that address OUD. Offers policy recommendations related to regulatory barriers, reimbursement flexibility, workforce, and service site expansion to increase access to MOUD in rural areas.
Date: 01/2025
Sponsoring organization: National Advisory Committee on Rural Health and Human Services
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Medicaid Coverage in Metro and Small Town/Rural Counties, 2023
Presents county-level data for children, non-elderly adults, and seniors insured by Medicaid/CHIP. Utilizes 2023 American Community Survey (ACS) Public Use Microdata Sample (PUMS) data to provide insurance comparisons by county and by state.
Date: 01/2025
Sponsoring organization: Georgetown University Health Policy Institute
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Presents county-level data for children, non-elderly adults, and seniors insured by Medicaid/CHIP. Utilizes 2023 American Community Survey (ACS) Public Use Microdata Sample (PUMS) data to provide insurance comparisons by county and by state.
Date: 01/2025
Sponsoring organization: Georgetown University Health Policy Institute
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