Rural Health
Resources by Topic: Medicare
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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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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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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Quality Payment Program (QPP) 2023: Participation and Payment Results At-a-Glance
Provides an overview of the results of the Quality Payment Program (QPP) for the 2023 performance year. Highlights the percentages of small and rural providers receiving negative, neutral, and positive payment adjustments for 2025.
Date: 06/2025
Sponsoring organization: Centers for Medicare & Medicaid Services
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Provides an overview of the results of the Quality Payment Program (QPP) for the 2023 performance year. Highlights the percentages of small and rural providers receiving negative, neutral, and positive payment adjustments for 2025.
Date: 06/2025
Sponsoring organization: Centers for Medicare & Medicaid Services
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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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Medicare Claims Processing Manual: Chapter 9 - Rural Health Clinics/Federally Qualified Health Centers
Describes the differences between Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs). Identifies the rules and regulations for processing Medicare claims.
Date: 06/2025
Sponsoring organization: Centers for Medicare & Medicaid Services
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Describes the differences between Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs). Identifies the rules and regulations for processing Medicare claims.
Date: 06/2025
Sponsoring organization: Centers for Medicare & Medicaid Services
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Medicare Care Management Billing Strategies
Webinar recording featuring speakers from Eide Bailly and the NORC Walsh Center for Rural Health Analysis discussing new 2025 Medicare care management billing codes and how they can be used to support care coordination to improve care quality for Medicare beneficiaries
Additional links: Audio Recording, Webinar Slides
Date: 05/2025
Sponsoring organization: Rural Health Information Hub
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Webinar recording featuring speakers from Eide Bailly and the NORC Walsh Center for Rural Health Analysis discussing new 2025 Medicare care management billing codes and how they can be used to support care coordination to improve care quality for Medicare beneficiaries
Additional links: Audio Recording, Webinar Slides
Date: 05/2025
Sponsoring organization: Rural Health Information Hub
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Annual Insurance Update 2025: Health Insurance in Kansas
Reports on health insurance coverage across Kansas and nationwide, including 2009-2023 trends in coverage. Presents 2022 county-level data on uninsured rates by age group and urban/rural classification, as well as Medicaid and Children's Health Insurance Program (CHIP) enrollment by county.
Author(s): Angela S. Wu, Kaci Cink, Viktoria Sterkhova, et al.
Date: 05/2025
Sponsoring organization: Kansas Health Institute
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Reports on health insurance coverage across Kansas and nationwide, including 2009-2023 trends in coverage. Presents 2022 county-level data on uninsured rates by age group and urban/rural classification, as well as Medicaid and Children's Health Insurance Program (CHIP) enrollment by county.
Author(s): Angela S. Wu, Kaci Cink, Viktoria Sterkhova, et al.
Date: 05/2025
Sponsoring organization: Kansas Health Institute
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Delaying Screening Until Covered? Changes in Lung Cancer Screening at the Age of Nearly-Universal Medicare Insurance
Examines the impact of first-time screening of lung cancer at age 65, the age of nearly universal Medicare insurance coverage. Utilizes 2015-2020 American College of Radiology's Lung Cancer Screening Registry data to analyze differences in screening rates between ages 60-64 and 65-69. Includes additional data breakdowns such as patient demographics, smoking behaviors, eligibility for screening, and rural versus non-rural patient location.
Author(s): Marcelo C. Perraillon, Adam Warren, Lenka Goldman, Jamie L. Studts, Rebecca M. Myerson
Citation: Health Services Research
Date: 05/2025
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Examines the impact of first-time screening of lung cancer at age 65, the age of nearly universal Medicare insurance coverage. Utilizes 2015-2020 American College of Radiology's Lung Cancer Screening Registry data to analyze differences in screening rates between ages 60-64 and 65-69. Includes additional data breakdowns such as patient demographics, smoking behaviors, eligibility for screening, and rural versus non-rural patient location.
Author(s): Marcelo C. Perraillon, Adam Warren, Lenka Goldman, Jamie L. Studts, Rebecca M. Myerson
Citation: Health Services Research
Date: 05/2025
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Community Health Centers Are Increasingly Important to Medicare Beneficiaries
Presents data on health center Medicare patient characteristics, service utilization, and revenue between 2019-2023. Compares sociodemographic and health characteristics of health center patients with those of the general Medicare population. Discusses the impact of managed care plans on health center finances.
Author(s): Elizabeth Dutta, Marsha Regenstein, Feygele Jacobs
Date: 05/2025
Sponsoring organization: Geiger Gibson Program in Community Health
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Presents data on health center Medicare patient characteristics, service utilization, and revenue between 2019-2023. Compares sociodemographic and health characteristics of health center patients with those of the general Medicare population. Discusses the impact of managed care plans on health center finances.
Author(s): Elizabeth Dutta, Marsha Regenstein, Feygele Jacobs
Date: 05/2025
Sponsoring organization: Geiger Gibson Program in Community Health
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