Rural Health
Resources by Topic: Medicaid
Bridging the Gap: Examples of Medicaid Innovation Enhancing Health Care Access in Rural America
Describes ways state Medicaid programs can improve access to rural healthcare. Highlights policies implemented in Tennessee, Missouri, and Georgia to fund projects related to improving rural healthcare needs, address social determinants of health, and support rural hospitals that serve large Medicaid and uninsured populations.
Date: 06/2025
Sponsoring organization: National Association of Medicaid Directors
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Describes ways state Medicaid programs can improve access to rural healthcare. Highlights policies implemented in Tennessee, Missouri, and Georgia to fund projects related to improving rural healthcare needs, address social determinants of health, and support rural hospitals that serve large Medicaid and uninsured populations.
Date: 06/2025
Sponsoring organization: National Association of Medicaid Directors
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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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Medicaid Plays A Key Role for Maternal and Infant Health in Rural Communities
Explores the role of Medicaid in covering women of childbearing age - 19 through 44 years old - living in small towns and rural areas. Presents data from the 2023 U.S. Census Bureau's American Community Survey (ACS) Public Use Microdata Sample (PUMS) on the percentage of women of childbearing age in small towns and rural areas have Medicaid coverage by state and compares the share of Medicaid coverage to similar women in metropolitan counties. Describes the percentage of women of childbearing age with Medicaid coverage as a share of non-elderly adults with Medicaid across Medicaid expansion states and non-expansion states. Highlights the 20 small towns and rural areas with the highest share of women of childbearing age covered by Medicaid.
Date: 05/2025
Sponsoring organization: Georgetown University Health Policy Institute
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Explores the role of Medicaid in covering women of childbearing age - 19 through 44 years old - living in small towns and rural areas. Presents data from the 2023 U.S. Census Bureau's American Community Survey (ACS) Public Use Microdata Sample (PUMS) on the percentage of women of childbearing age in small towns and rural areas have Medicaid coverage by state and compares the share of Medicaid coverage to similar women in metropolitan counties. Describes the percentage of women of childbearing age with Medicaid coverage as a share of non-elderly adults with Medicaid across Medicaid expansion states and non-expansion states. Highlights the 20 small towns and rural areas with the highest share of women of childbearing age covered by Medicaid.
Date: 05/2025
Sponsoring organization: Georgetown University Health Policy Institute
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Catalog of Value-Based Initiatives for Rural Providers
Summarizes rural-relevant, value-based programs currently or recently implemented by the U.S. Department of Health and Human Services (HHS), including the Centers for Medicare & Medicaid Services (CMS) and the CMS Innovation Center. Designed to help rural healthcare leaders identify HHS value-based programs that are suitable for rural participation. Contains descriptions of each demonstration and provides direct links to the corresponding agency web page.
Date: 05/2025
Sponsoring organization: Rural Health Value
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Summarizes rural-relevant, value-based programs currently or recently implemented by the U.S. Department of Health and Human Services (HHS), including the Centers for Medicare & Medicaid Services (CMS) and the CMS Innovation Center. Designed to help rural healthcare leaders identify HHS value-based programs that are suitable for rural participation. Contains descriptions of each demonstration and provides direct links to the corresponding agency web page.
Date: 05/2025
Sponsoring organization: Rural Health Value
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Exploring Oral Health and Care Access among Adults with Disabilities
Report discusses the challenges adults with disabilities have accessing oral healthcare. Explores the role of transportation, Medicare and Medicaid coverage, and metro versus non-metro location, among other factors, as barriers to oral healthcare access for people with disabilities.
Author(s): Morgan Santoro, Lisa J. Heaton, Rebecca Preston, et al.
Date: 04/2025
Sponsoring organization: CareQuest Institute for Oral Health
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Report discusses the challenges adults with disabilities have accessing oral healthcare. Explores the role of transportation, Medicare and Medicaid coverage, and metro versus non-metro location, among other factors, as barriers to oral healthcare access for people with disabilities.
Author(s): Morgan Santoro, Lisa J. Heaton, Rebecca Preston, et al.
Date: 04/2025
Sponsoring organization: CareQuest Institute for Oral Health
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Evolving Remote Monitoring: An Evidence-Based Approach to Coverage and Payment
Reports on trends in utilization of remote patient monitoring (RPM) and discusses policy and payment approaches for effectively and efficiently utilizing RPM, particularly via Medicare and Medicaid. Includes data and discussion of rural barriers to RPM access.
Date: 04/2025
Sponsoring organization: Peterson Center on Healthcare
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Reports on trends in utilization of remote patient monitoring (RPM) and discusses policy and payment approaches for effectively and efficiently utilizing RPM, particularly via Medicare and Medicaid. Includes data and discussion of rural barriers to RPM access.
Date: 04/2025
Sponsoring organization: Peterson Center on Healthcare
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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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Sustaining Rural Hospital Access: Adjustments to Medicare Rural Hospital Designations
Describes the history of Medicare rural hospital designations. Discusses how traditional Medicare, Medicare Advantage, and Medicaid impact hospital finances. Outlines policy recommendations to the Secretary of Health and Human Services (HHS) and Congress regarding rural hospitals designations, payment adjustments, Medicare Advantage, and rural ambulance and emergency services.
Author(s): Emma Sheffert, Maya Sandalow
Date: 04/2025
Sponsoring organization: Bipartisan Policy Center
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Describes the history of Medicare rural hospital designations. Discusses how traditional Medicare, Medicare Advantage, and Medicaid impact hospital finances. Outlines policy recommendations to the Secretary of Health and Human Services (HHS) and Congress regarding rural hospitals designations, payment adjustments, Medicare Advantage, and rural ambulance and emergency services.
Author(s): Emma Sheffert, Maya Sandalow
Date: 04/2025
Sponsoring organization: Bipartisan Policy Center
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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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