Rural Health
Resources by Topic: Post-acute care
MedPAC Report to the Congress: Medicare and the Health Care Delivery System, June 2026
Evaluates Medicare payment issues and provides recommendations to the U.S. Congress. Covers payment incentives in Medicare, the complexity of Medicare enrollment decisions for beneficiaries, Medicare payment operations and their role in identifying improper payments, the estimated association between Medicare Advantage (MA) enrollment and hospitals' and post-acute care providers' finances, and access to hospice and certain complex palliative services for beneficiaries with end-stage renal disease or cancer. Includes a mandated report regarding the Medicare Ground Ambulance Data Collection System. Includes rural references throughout.
Additional links: Executive Summary
Date: 06/2026
Sponsoring organization: Medicare Payment Advisory Commission
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Evaluates Medicare payment issues and provides recommendations to the U.S. Congress. Covers payment incentives in Medicare, the complexity of Medicare enrollment decisions for beneficiaries, Medicare payment operations and their role in identifying improper payments, the estimated association between Medicare Advantage (MA) enrollment and hospitals' and post-acute care providers' finances, and access to hospice and certain complex palliative services for beneficiaries with end-stage renal disease or cancer. Includes a mandated report regarding the Medicare Ground Ambulance Data Collection System. Includes rural references throughout.
Additional links: Executive Summary
Date: 06/2026
Sponsoring organization: Medicare Payment Advisory Commission
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Rural-Urban Disparity in Postacute Care and 1-Year Outcomes After Ischemic Stroke
Examines how postacute stroke care varies among rural and urban-dwelling ischemic stroke patients, and how mortality, readmission, and home time varied at 1 year. Uses 2017-2022 Medicare beneficiary data.
Author(s): Shumei Man, Jie-Lena Sun, Brooke Alhanti, et al.
Citation: Stroke, 57(7), 2138-2149
Date: 05/2026
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Examines how postacute stroke care varies among rural and urban-dwelling ischemic stroke patients, and how mortality, readmission, and home time varied at 1 year. Uses 2017-2022 Medicare beneficiary data.
Author(s): Shumei Man, Jie-Lena Sun, Brooke Alhanti, et al.
Citation: Stroke, 57(7), 2138-2149
Date: 05/2026
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MedPAC Comment on CMS's Proposed Rule on Inpatient Rehabilitation Facility for FY 2027
Comments on an April 6, 2026, 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 creation of an IRF-specific wage index and refinements to the IRF payment system, such as changes to IRF patient clinical classification. Includes rural considerations throughout.
Date: 04/2026
Sponsoring organization: Medicare Payment Advisory Commission
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Comments on an April 6, 2026, 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 creation of an IRF-specific wage index and refinements to the IRF payment system, such as changes to IRF patient clinical classification. Includes rural considerations throughout.
Date: 04/2026
Sponsoring organization: Medicare Payment Advisory Commission
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2025 National CAH Quality Inventory & Assessment National Report
Presents a high-level summary of key data points from the September-November 2025 National Critical Access Hospital (CAH) Quality Inventory and Assessment. Includes data on CAH system affiliation; median average daily census and emergency department volume; median swing bed admissions and swing bed length of stay; hospital inpatient, behavioral health and specialty care, and outpatient and other service lines; CAH quality payment model participation; and CAH quality improvement topic priorities.
Author(s): Madeleine Pick, Robert Barclay
Date: 04/2026
Sponsoring organization: Flex Monitoring Team
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Presents a high-level summary of key data points from the September-November 2025 National Critical Access Hospital (CAH) Quality Inventory and Assessment. Includes data on CAH system affiliation; median average daily census and emergency department volume; median swing bed admissions and swing bed length of stay; hospital inpatient, behavioral health and specialty care, and outpatient and other service lines; CAH quality payment model participation; and CAH quality improvement topic priorities.
Author(s): Madeleine Pick, Robert Barclay
Date: 04/2026
Sponsoring organization: Flex Monitoring Team
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MedPAC Report to the Congress: Medicare Payment Policy, 2026
Annual review of Medicare payment policies, with recommendations to Congress. Includes discussion on Medicare payment policies directly affecting rural providers and beneficiaries. Addresses payment adequacy for Medicare fee-for-service payment systems, Medicare Advantage (MA), and Medicare Part D. Includes mandated reports on the impact of regulatory changes to the home health prospective payment system and dual-eligible special needs plans.
Date: 03/2026
Sponsoring organization: Medicare Payment Advisory Commission
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Annual review of Medicare payment policies, with recommendations to Congress. Includes discussion on Medicare payment policies directly affecting rural providers and beneficiaries. Addresses payment adequacy for Medicare fee-for-service payment systems, Medicare Advantage (MA), and Medicare Part D. Includes mandated reports on the impact of regulatory changes to the home health prospective payment system and dual-eligible special needs plans.
Date: 03/2026
Sponsoring organization: Medicare Payment Advisory Commission
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MedPAC Report to the Congress: Medicare Payment Policy: Skilled Nursing Facility Services: Chapter 7
Discusses payment adequacy for skilled nursing facility (SNF) services. Features statistics on SNF care provided by rural hospitals and Critical Access Hospitals (CAHs) via swing beds and Medicare margins for urban, rural, and frontier freestanding SNFs in 2024.
Date: 03/2026
Sponsoring organization: Medicare Payment Advisory Commission
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Discusses payment adequacy for skilled nursing facility (SNF) services. Features statistics on SNF care provided by rural hospitals and Critical Access Hospitals (CAHs) via swing beds and Medicare margins for urban, rural, and frontier freestanding SNFs in 2024.
Date: 03/2026
Sponsoring organization: Medicare Payment Advisory Commission
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Home Health Care Chartbook 2025
Provides an overview of home health, including patient demographics and clinical profiles, organizational trends, the economic contribution of home health agencies, and patient outcomes. Includes charts and graphs throughout, as well as state-by-state data. Slide 11 highlights the rural-urban distribution of home health users.
Date: 02/2026
Sponsoring organizations: KNG Health Consulting, National Alliance for Care at Home, Research Institute for Home Care
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Provides an overview of home health, including patient demographics and clinical profiles, organizational trends, the economic contribution of home health agencies, and patient outcomes. Includes charts and graphs throughout, as well as state-by-state data. Slide 11 highlights the rural-urban distribution of home health users.
Date: 02/2026
Sponsoring organizations: KNG Health Consulting, National Alliance for Care at Home, Research Institute for Home Care
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2025-2026 Pre-Rulemaking Measure Review Final Recommendations Report
Reviews the 24 pre-rulemaking quality measures the Battelle's Partnership for Quality Measurement (PQM) considered during the 2025-2026 Pre-Rulemaking Measure Review (PRMR) cycle. Discusses measures for clinician, hospital, and post-acute care/long-term care programs. Includes rural references and considerations throughout.
Date: 02/2026
Sponsoring organization: Partnership for Quality Measurement
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Reviews the 24 pre-rulemaking quality measures the Battelle's Partnership for Quality Measurement (PQM) considered during the 2025-2026 Pre-Rulemaking Measure Review (PRMR) cycle. Discusses measures for clinician, hospital, and post-acute care/long-term care programs. Includes rural references and considerations throughout.
Date: 02/2026
Sponsoring organization: Partnership for Quality Measurement
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A Comparison of Independent and System-Affiliated Rural Hospitals
Compares independent and system-affiliated rural hospitals by organizational characteristics, financial performance, and county characteristics. Presents Medicare Cost Report data from 2023-2024 on the number and percentage of independent and system-affiliated rural hospitals by state, ownership characteristics, Medicare payment classification, use of swing beds, financial distress, and more.
Author(s): Aditya R. Pillutla, Sruthi Malavika Srinivasan, Kristie Thompson, George Pink, Tyler Malone
Date: 02/2026
Sponsoring organization: North Carolina Rural Health Research Program
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Compares independent and system-affiliated rural hospitals by organizational characteristics, financial performance, and county characteristics. Presents Medicare Cost Report data from 2023-2024 on the number and percentage of independent and system-affiliated rural hospitals by state, ownership characteristics, Medicare payment classification, use of swing beds, financial distress, and more.
Author(s): Aditya R. Pillutla, Sruthi Malavika Srinivasan, Kristie Thompson, George Pink, Tyler Malone
Date: 02/2026
Sponsoring organization: North Carolina Rural Health Research Program
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December 2025 MedPAC Meeting Transcript
Transcript from the Medicare Payment Advisory Commission's (MedPAC) December 2025 meeting. Covers payment adequacy and updates for physician and other health professional services, hospital inpatient and outpatient services, Rural Emergency Hospitals (REHs), post-acute care, skilled nursing facility services, inpatient rehabilitation facility services, home health services, hospice services, and outpatient dialysis services. Includes discussions on improving Medicare payment approaches and mandated reports on the impact of recent changes to the home health prospective payment system and an assessment of the Medicare ground ambulance data collection system.
Additional links: Assessing Payment Adequacy and Updating Payments: Hospital Inpatient and Outpatient Services; Mandated Report on Rural Emergency Hospitals; And Update on Site-neutral Payments - Presentation Slides, Mandated Report: Assessment of the Medicare Ground Ambulance Data Collection System - Presentation Slides
Date: 12/2025
Sponsoring organization: Medicare Payment Advisory Commission
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Transcript from the Medicare Payment Advisory Commission's (MedPAC) December 2025 meeting. Covers payment adequacy and updates for physician and other health professional services, hospital inpatient and outpatient services, Rural Emergency Hospitals (REHs), post-acute care, skilled nursing facility services, inpatient rehabilitation facility services, home health services, hospice services, and outpatient dialysis services. Includes discussions on improving Medicare payment approaches and mandated reports on the impact of recent changes to the home health prospective payment system and an assessment of the Medicare ground ambulance data collection system.
Additional links: Assessing Payment Adequacy and Updating Payments: Hospital Inpatient and Outpatient Services; Mandated Report on Rural Emergency Hospitals; And Update on Site-neutral Payments - Presentation Slides, Mandated Report: Assessment of the Medicare Ground Ambulance Data Collection System - Presentation Slides
Date: 12/2025
Sponsoring organization: Medicare Payment Advisory Commission
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