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Rural Health Information Hub

Rural Health
Resources by Topic: Medicare

Rural Hospitals and the Rural Health Transformation Program: What Comes Next
Blog post discussing the rural health transformation program established in the July 2025 budget reconciliation law. Describes potential priorities for states' use of the rural health transformation program funding. Outlines additional steps Congress could take to help rural hospitals serve their communities.
Author(s): Emma Sheffert, Maya Sandalow
Date: 07/2025
Sponsoring organization: Bipartisan Policy Center
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The Rapid Growth Of Medicare Advantage Poses Challenges To Rural Hospitals
Commentary describing key features of Medicare Advantage (MA) and how they may interact with the unique limitations of rural hospitals. Offers policy recommendations to align MA expansion with rural hospital sustainability.
Author(s): James D. Lee, Cody L. Mullens, Adam A. Markovitz, Janice Probst
Citation: Health Affairs Forefront
Date: 07/2025
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Understanding and Navigating Commingling - RHC Edition
Recording of a July 17, 2025, webinar discussing how Rural Health Clinics can share resources and be located in the same space as other Medicare entities and remain compliant with Medicare regulations. Describes common commingling issues and best practices. Part of the Rural Health Clinic Technical Assistance Series.
Additional links: Presentation Slides
Date: 07/2025
Sponsoring organization: National Association of Rural Health Clinics
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The Uncertain Future of Medicare's Stand-Alone Prescription Drug Plan Market and Why It Matters
Discusses the Medicare Part D stand-alone prescription drug plan (PDP) market and the Part D premium stabilization demonstration. Describes the impact of PDP market stability on rural Medicare beneficiaries. Explores the potential effects of the continuation of, or changes to, the premium stabilization program.
Author(s): Juliette Cubanski, Tricia Neuman
Date: 07/2025
Sponsoring organization: KFF
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MedPAC Data Book: Health Care Spending and the Medicare Program, 2025
Provides an overview of Medicare spending and highlights data on Medicare beneficiary demographics, dual-eligible beneficiaries, quality of care provided through the Medicare program, and other payer liability. Examines settings of care, including rural-specific provider sites, as they relate to spending, access to care, and profit margins. Compares rural and urban beneficiaries and providers throughout. Chart 6-2 addresses rural hospital closures and Rural Emergency Hospital conversions.
Date: 07/2025
Sponsoring organization: Medicare Payment Advisory Commission
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Most Medicare Advantage Markets are Dominated by One or Two Insurers
Examines the competitiveness of Medicare Advantage (MA) markets at the county level. Explores how often one or two Medicare Advantage insurers enrolled at least half of all enrollees within a county. Compares data on the share of counties in very concentrated MA markets across urban, rural adjacent, and rural non-adjacent counties.
Author(s): Nicole Zhu, Jeannie Fuglesten Biniek, Nolan Sroczynski, Tricia Neuman
Date: 07/2025
Sponsoring organization: KFF
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Guidance for the Expiration of the COVID-19 Public Health Emergency (PHE)
Outlines the emergency waivers related to the minimum health and safety requirements for long-term care and acute continuing care providers that expired at the end of the COVID-19 public health emergency (PHE). Describes the timelines for certain regulatory requirements issued during the PHE through interim final rules.
Date: 07/2025
Sponsoring organization: Centers for Medicare and Medicaid Services
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Beneficiary and Clinician Perspectives on Medicare and Other Issues: Findings from 2025 Focus Groups in St. Louis, Missouri, and 2021–2025 Rural Focus Groups
Summarizes findings from 8 focus groups of Medicare beneficiaries, Medicare and Medicaid (dual eligible) beneficiaries, and clinicians conducted between April and May 2025, including one virtual focus group of rural Medicare beneficiaries. Compiles findings from 13 focus groups of rural Medicare beneficiaries between 2021 and 2025. Highlights themes that emerged across the focus groups covering Medicare coverage options, access to care, telehealth, organization of care, and prescription drugs.
Date: 06/2025
Sponsoring organizations: Medicare Payment Advisory Commission, NORC at the University of Chicago
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2023 Quality Payment Program Experience Report
Reports on the clinician experience for those participating in the Quality Payment Program in 2023. Presents data on Merit-based Incentive Payment System (MIPS) eligibility and participation rates for clinicians in small practices and rural areas, mean and median final scores for 2023 and 2025 payment adjustments, and payment adjustment trends from 2021 through 2023.
Date: 06/2025
Sponsoring organization: Centers for Medicare and Medicaid Services
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MBQIP Quality Measures National Annual Report - 2023
Summarizes quality measure reporting rates and performance among Critical Access Hospitals (CAHs) in 2023. Presents data on the four Medicare Beneficiary Quality Improvement Project (MBQIP) domains: patient safety/inpatient, outpatient, patient engagement, and care transitions.
Author(s): Megan Lahr, Alyssa Furukawa, Madeleine Pick, Robert Barclay
Date: 06/2025
Sponsoring organization: Flex Monitoring Team
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