Rural Health
Resources by Topic: Reimbursement and payment models
MedPAC Report to the Congress: Medicare Payment Policy, 2025
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.
Date: 03/2025
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.
Date: 03/2025
Sponsoring organization: Medicare Payment Advisory Commission
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MedPAC Report to the Congress: Medicare Payment Policy: Skilled Nursing Facility Services: Chapter 6
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 2023.
Date: 03/2025
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 2023.
Date: 03/2025
Sponsoring organization: Medicare Payment Advisory Commission
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MedPAC Report to the Congress: Medicare Payment Policy: Home Health Care Services: Chapter 7
Discusses payment adequacy for home health care services. Features statistics on Medicare margins for home health agencies between 2019-2023 with breakdowns by urban and rural areas, a comparison of patient-experience quality measures by urban and rural status, and the number of home health periods provided to rural beneficiaries.
Date: 03/2025
Sponsoring organization: Medicare Payment Advisory Commission
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Discusses payment adequacy for home health care services. Features statistics on Medicare margins for home health agencies between 2019-2023 with breakdowns by urban and rural areas, a comparison of patient-experience quality measures by urban and rural status, and the number of home health periods provided to rural beneficiaries.
Date: 03/2025
Sponsoring organization: Medicare Payment Advisory Commission
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March 2025 MedPAC Meeting Transcript
Transcript from the Medicare Payment Advisory Commission's (MedPAC) March 2025 meeting. Covers research and proposals related to reforming physician fee schedule updates and improving the accuracy of relative payment rates, reducing beneficiary cost-sharing for outpatient services at Critical Access Hospitals, Medicare insurance agents, Medigap, payment for ground ambulance services, home healthcare use among Medicare Advantage enrollees, and institutional special needs plans. Includes rural references and considerations throughout.
Additional links: Mandated Report: Payment for Ground Ambulance Services, Reducing Beneficiary Cost-Sharing for Outpatient Services at Critical Access Hospitals
Date: 03/2025
Sponsoring organization: Medicare Payment Advisory Commission
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Transcript from the Medicare Payment Advisory Commission's (MedPAC) March 2025 meeting. Covers research and proposals related to reforming physician fee schedule updates and improving the accuracy of relative payment rates, reducing beneficiary cost-sharing for outpatient services at Critical Access Hospitals, Medicare insurance agents, Medigap, payment for ground ambulance services, home healthcare use among Medicare Advantage enrollees, and institutional special needs plans. Includes rural references and considerations throughout.
Additional links: Mandated Report: Payment for Ground Ambulance Services, Reducing Beneficiary Cost-Sharing for Outpatient Services at Critical Access Hospitals
Date: 03/2025
Sponsoring organization: Medicare Payment Advisory Commission
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Rural Hospital Experiences in the Colorado Hospital Transformation Program
Provides an overview of the Colorado Hospital Transformation Program (CO HTP), a 5-year program that ties Medicaid supplemental payments to hospitals' ability to meet performance targets through September 2026. Describes the experiences of three Critical Access Hospitals (CAHs) and explores how CO HTP impacts rural hospitals. Covers planning and community engagement, quality of care, and healthcare costs.
Date: 03/2025
Sponsoring organization: Rural Health Value
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Provides an overview of the Colorado Hospital Transformation Program (CO HTP), a 5-year program that ties Medicaid supplemental payments to hospitals' ability to meet performance targets through September 2026. Describes the experiences of three Critical Access Hospitals (CAHs) and explores how CO HTP impacts rural hospitals. Covers planning and community engagement, quality of care, and healthcare costs.
Date: 03/2025
Sponsoring organization: Rural Health Value
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The Growing Impact of Medicare Advantage on Rural Hospitals Across America
Examines the impact of Medicare Advantage (MA) on rural hospitals. Discusses payment and reimbursement, healthcare access, hospital finance and patient data, hospital case examples, and more.
Date: 02/2025
Sponsoring organization: American Hospital Association
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Examines the impact of Medicare Advantage (MA) on rural hospitals. Discusses payment and reimbursement, healthcare access, hospital finance and patient data, hospital case examples, and more.
Date: 02/2025
Sponsoring organization: American Hospital Association
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Medicare Advantage Penetration and the Financial Distress of Rural Hospitals
Examines county-level Medicare Advantage (MA) penetration rates and the financial impact on rural hospitals. Utilizes 2014-2020 American Hospital Association data to analyze Medicare and non-Medicare inpatient days paid by the plans, with data breakdowns according to patient demographics, rural versus urban location, timing of inpatient stay, and more.
Author(s): Guido Cataife, Siying Liu
Citation: Health Economics Review, 15, 9
Date: 02/2025
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Examines county-level Medicare Advantage (MA) penetration rates and the financial impact on rural hospitals. Utilizes 2014-2020 American Hospital Association data to analyze Medicare and non-Medicare inpatient days paid by the plans, with data breakdowns according to patient demographics, rural versus urban location, timing of inpatient stay, and more.
Author(s): Guido Cataife, Siying Liu
Citation: Health Economics Review, 15, 9
Date: 02/2025
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The State of Rural Healthcare: Research and Outlook for 2025
Presents results of a survey of 75 rural healthcare regarding their financial health and strategic priorities. Identifies the top challenges identified by the surveyed organizations. Discusses how providers are addressing strategic priorities in 2025, including cybersecurity and the adoption of digital and artificial intelligence (AI) tools. Requires name, email address, and organization information to download.
Date: 02/2025
Sponsoring organization: Wipfli, LLP
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Presents results of a survey of 75 rural healthcare regarding their financial health and strategic priorities. Identifies the top challenges identified by the surveyed organizations. Discusses how providers are addressing strategic priorities in 2025, including cybersecurity and the adoption of digital and artificial intelligence (AI) tools. Requires name, email address, and organization information to download.
Date: 02/2025
Sponsoring organization: Wipfli, LLP
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Instability Continues to Threaten Rural Health Safety Net: Reduced Reimbursements, Dwindling Access to Care and Deteriorating Population Health Status
Examines factors contributing to the instability of the rural healthcare safety net, including policy-related reimbursement cuts and changes to payer mixes. Presents data on rural hospitals that have stopped offering obstetrics and chemotherapy services. Explores aspects of rural population health and social drivers of health as they relate to rural healthcare delivery challenges.
Date: 02/2025
Sponsoring organization: Chartis Center for Rural Health
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Examines factors contributing to the instability of the rural healthcare safety net, including policy-related reimbursement cuts and changes to payer mixes. Presents data on rural hospitals that have stopped offering obstetrics and chemotherapy services. Explores aspects of rural population health and social drivers of health as they relate to rural healthcare delivery challenges.
Date: 02/2025
Sponsoring organization: Chartis Center for Rural Health
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2025 Stability of the Rural Health Safety Net: State and National Data Tables
Provides links to national and state data tables showing the financial impact of federal policies such as sequestration and bad debt reimbursement on rural hospital revenues, jobs, and gross domestic product. Presented at the February 2025 National Rural Health Association Policy Institute.
Date: 02/2025
Sponsoring organization: Chartis Center for Rural Health
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Provides links to national and state data tables showing the financial impact of federal policies such as sequestration and bad debt reimbursement on rural hospital revenues, jobs, and gross domestic product. Presented at the February 2025 National Rural Health Association Policy Institute.
Date: 02/2025
Sponsoring organization: Chartis Center for Rural Health
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