Rural Health
Resources by Topic: Medicare
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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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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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 & 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 & Medicaid Services
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Ways and Means Republican Members Share Commitment to Value-Based Health Care and Outline Priorities For Medicare Innovation Hub
An April 2025 letter from the U.S. House Committee on Ways and Means majority members regarding the Centers for Medicare & Medicaid Services (CMS) Innovation Center (CMMI). Offers considerations for new and existing models related to promoting value, improving care in rural and underserved communities, and incorporating public input.
Date: 04/2025
Sponsoring organization: House Ways and Means Committee
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An April 2025 letter from the U.S. House Committee on Ways and Means majority members regarding the Centers for Medicare & Medicaid Services (CMS) Innovation Center (CMMI). Offers considerations for new and existing models related to promoting value, improving care in rural and underserved communities, and incorporating public input.
Date: 04/2025
Sponsoring organization: House Ways and Means Committee
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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 & 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 & Medicaid Services
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April 2025 MedPAC Meeting Transcript
Transcript from the Medicare Payment Advisory Commission's (MedPAC) April 2025 meeting. Covers physician fee schedule updates and improving the accuracy of relative payment rates; structural differences between the stand-alone prescription drug plan (PDP) and Medicare Advantage–Prescription Drug plan (MA–PD) markets; the utilization and delivery of Medicare Advantage supplemental benefits; the effect of Medicare Advantage on rural hospitals; paying for software technologies in Medicare; access to hospice and certain services under the hospice benefit for beneficiaries with end-stage renal disease and beneficiaries with cancer; and regulations, star ratings, and fee-for-service Medicare policies aimed at improving nursing home quality.
Additional links: Exploring the Effect of Medicare Advantage on Rural Hospitals
Date: 04/2025
Sponsoring organization: Medicare Payment Advisory Commission
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Transcript from the Medicare Payment Advisory Commission's (MedPAC) April 2025 meeting. Covers physician fee schedule updates and improving the accuracy of relative payment rates; structural differences between the stand-alone prescription drug plan (PDP) and Medicare Advantage–Prescription Drug plan (MA–PD) markets; the utilization and delivery of Medicare Advantage supplemental benefits; the effect of Medicare Advantage on rural hospitals; paying for software technologies in Medicare; access to hospice and certain services under the hospice benefit for beneficiaries with end-stage renal disease and beneficiaries with cancer; and regulations, star ratings, and fee-for-service Medicare policies aimed at improving nursing home quality.
Additional links: Exploring the Effect of Medicare Advantage on Rural Hospitals
Date: 04/2025
Sponsoring organization: Medicare Payment Advisory Commission
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Are HHC Scores a Reliable Health Status Indicator Across Rural and Urban Areas?
Examines differences in Centers for Medicare & Medicaid Services Hierarchical Condition Category (HCC) risk scores between rural and urban Medicare Fee-for-Service (FFS) beneficiaries and analyzes which factors drive observed differences. Features statistics with breakdowns by urban, large rural, small rural, and isolated rural areas for 4 chronic conditions in 2019-2020.
Author(s): Craig D. Holden, Alana Knudson, Marilyn Klug, Samantha Augenbraun, Shena Popat
Date: 04/2025
Sponsoring organization: ETSU/NORC Rural Health Research Center
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Examines differences in Centers for Medicare & Medicaid Services Hierarchical Condition Category (HCC) risk scores between rural and urban Medicare Fee-for-Service (FFS) beneficiaries and analyzes which factors drive observed differences. Features statistics with breakdowns by urban, large rural, small rural, and isolated rural areas for 4 chronic conditions in 2019-2020.
Author(s): Craig D. Holden, Alana Knudson, Marilyn Klug, Samantha Augenbraun, Shena Popat
Date: 04/2025
Sponsoring organization: ETSU/NORC Rural Health Research Center
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Small Practice After-Action Review: 2023 Performance Year Final Score
Tool for small practices interested in examining their 2023 Merit-based Incentive Payment System (MIPS) final score to identify opportunities to improve performance in 2025.
Additional links: Video: Small Practice Action Planning Tool for MIPS
Date: 04/2025
Sponsoring organization: Centers for Medicare & Medicaid Services
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Tool for small practices interested in examining their 2023 Merit-based Incentive Payment System (MIPS) final score to identify opportunities to improve performance in 2025.
Additional links: Video: Small Practice Action Planning Tool for MIPS
Date: 04/2025
Sponsoring organization: Centers for Medicare & Medicaid Services
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Advancing Value-Based Payment Policies Relevant to Rural Areas – Continued Challenges and New Opportunities
Discusses lessons from the recent public health emergency, rising health care costs, improved quality measurement, and innovative technologies on the transition from volume-based payment to value-based payment. Outlines potential policy opportunities for the Centers for Medicare & Medicaid Services (CMS) Innovation Center model design and CMS program inclusion to expand rural-appropriate opportunities to participate in the transition to value-based care. Builds on the 2020 publication How to Design Value‐based Care Models for Rural Participant Success: A Summit Findings Report.
Date: 04/2025
Sponsoring organization: Rural Health Value
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Discusses lessons from the recent public health emergency, rising health care costs, improved quality measurement, and innovative technologies on the transition from volume-based payment to value-based payment. Outlines potential policy opportunities for the Centers for Medicare & Medicaid Services (CMS) Innovation Center model design and CMS program inclusion to expand rural-appropriate opportunities to participate in the transition to value-based care. Builds on the 2020 publication How to Design Value‐based Care Models for Rural Participant Success: A Summit Findings Report.
Date: 04/2025
Sponsoring organization: Rural Health Value
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Medicare Advantage Reimbursement Remains Top Challenge for RHCs
Summarizes results of a 2025 national survey of over 1,200 Rural Health Clinics. Presents data on the average payer mix, Medicare Advantage (MA) reimbursement relative to traditional Medicare reimbursement, MA contract structures, use and attitude toward telehealth services, and more.
Additional links: NARHC 2025 Policy Survey Results
Date: 03/2025
Sponsoring organization: National Association of Rural Health Clinics
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Summarizes results of a 2025 national survey of over 1,200 Rural Health Clinics. Presents data on the average payer mix, Medicare Advantage (MA) reimbursement relative to traditional Medicare reimbursement, MA contract structures, use and attitude toward telehealth services, and more.
Additional links: NARHC 2025 Policy Survey Results
Date: 03/2025
Sponsoring organization: National Association of Rural Health Clinics
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