Rural Home Health Services resources via the Rural Health Information Hub

Resource: MedPAC Report to the Congress: Medicare Payment Policy: Home Health Care Services: Chapter 8

Thu, 12 Mar 2026 13:32:11 -0500

Discusses payment adequacy for home health care services. Features statistics on Medicare margins for home health agencies between 2019-2024 with breakdowns by urban and rural areas, rates of successful discharge and potentially preventable readmissions in urban and rural areas, and the number of home health periods provided to rural beneficiaries. -- Medicare Payment Advisory Commission

Resource: Home Health Care Chartbook 2025

Fri, 06 Mar 2026 10:52:32 -0600

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. -- National Alliance for Care at Home

Event: 2026 National Alliance for Care at Home Annual Meeting & Exposition

Mon, 22 Dec 2025 09:34:42 -0600

Washington DC
October 27, 2026 -- National Alliance for Care at Home

Resource: Transforming Care: The Impact of COVID-19 on Telehealth Adoption in U.S. Home Health Care Agencies

Tue, 09 Dec 2025 12:24:03 -0600

Surveys 474 home health agencies between November 2022 and March 2024 to identify telehealth use and the perceived impact of COVID-19 policies on telehealth adoption. Includes rural and urban comparisons of telehealth modalities utilized to discuss targeted policies to support rural adoption.

Event: 2026 National Alliance for Care at Home Finance and Technology Summit

Tue, 02 Dec 2025 08:34:15 -0600

Boston MA
July 12, 2026 -- National Alliance for Care at Home

Resource: Comparing Utilization of Home Health Care Between Traditional Medicare and Medicare Advantage Beneficiaries by Rural-Urban Status

Thu, 04 Sep 2025 10:24:55 -0500

Policy report describing differences in utilization of home health care between beneficiaries enrolled in Traditional Medicare (TM) and Medicare Advantage (MA), and by rural or urban status. Examines differences in use of home health overall, provision of specific services, including physical and occupational therapy, and receipt of care from home health agencies by enrollment in TM and MA. Features statistics with breakdowns by urban, large rural, small rural, and isolated rural areas. -- WWAMI Rural Health Research Center

Resource: MedPAC Report to the Congress: Medicare and the Health Care Delivery System, June 2025

Thu, 12 Jun 2025 10:45:22 -0500

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. -- Medicare Payment Advisory Commission

Resource: Home Healthcare Establishments Serving Rural Areas Increased about 36 Percent from 2010 to 2023

Wed, 26 Mar 2025 09:53:50 -0500

Chart showing the change for home healthcare services, assisted living facilities, and skilled nursing facilities in nonmetropolitan areas between 2010 and 2023. -- USDA Economic Research Service

Resource: As Older Rural Population Grew, Ratio of Rural U.S. Eldercare Establishments Fell

Mon, 17 Mar 2025 14:23:58 -0500

Bar chart comparing the number of eldercare establishments per 1,000 adults 65 or older in rural and urban areas between 2010 and 2023. Eldercare establishments include those that provide home health, long-term care, or assisted living services, as noted in the 2024 Rural America At a Glance report. -- USDA Economic Research Service

Resource: MedPAC Report to the Congress: Medicare Payment Policy: Home Health Care Services: Chapter 7

Thu, 13 Mar 2025 16:26:28 -0500

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. -- Medicare Payment Advisory Commission

Organization: National Alliance for Care at Home

Mon, 09 Sep 2024 11:22:07 -0500

Supports advocacy, training, and networking for care providers in the home for people with disabilities, older adults, and the dying. An alliance between the National Association for Home Care & Hospice and the National Hospice and Palliative Care Organization.

Resource: MedPAC Comment on CMS's Proposed Rule on the Home Health Prospective Payment System for CY 2025

Fri, 23 Aug 2024 11:57:26 -0500

Comments on a July 3, 2024, Federal Register proposed rule related to Medicare payment policies for home health agencies. Includes comments regarding permanent and temporary budget-neutrality adjustments, the plan of care development and scope of services home health patients receive, and the proposed adoption of the core-based statistical area (CBSA) delineations for the home health wage index. -- Medicare Payment Advisory Commission

Resource: Fewer Hospitalized Medicare Beneficiaries Are Receiving Recommended Home Health Care

Thu, 25 Jul 2024 13:18:04 -0500

Describes trends in Medicare patients' receipt of recommended home health services following a hospitalization between 2016 and 2022. Presents data on home health referral completion rates by patient characteristics, including rural/urban location. Discusses factors that could influence home health utilization trends and considerations for policymakers. -- Commonwealth Fund

Resource: Standing Technical Expert Panel for the Development, Evaluation, and Maintenance of Post-Acute Care (PAC) and Hospice Quality Reporting Program (QRP) Measurement Sets: Summary Report

Thu, 11 Jul 2024 15:32:45 -0500

Describes a December 15, 2023, Technical Expert Panel (TEP) regarding the development of additional cross-setting measures for the Post-Acute Care (PAC) and Hospice Quality Reporting Programs (QRPs), and filling measurement gaps with the Centers for Medicare & Medicaid Services (CMS) Universal Foundation measures. Summarizes TEP comments on adding measures to PAC and Hospice QRPs in four domains: 1) behavioral and mental health, 2) patient experience of care, 3) pain management, and 4) immunization. Covers panelists' discussions on the appropriateness of the existing measure set and potential new measures, setting-specific considerations, data sources, and other topics related to each domain. Includes rural references throughout. -- Centers for Medicare & Medicaid Services

Resource: CMS State Operations Manual (SOM)

Fri, 31 May 2024 14:47:51 -0500

Provides guidance to state agencies that survey healthcare facilities and providers to determine if they are in compliance with the Medicare Conditions of Participation (CoP). Includes appendices with regulatory information specific to Critical Access Hospitals (Appendix W) and Federally Qualified Health Centers/Rural Health Clinics (Appendix G). Can be used by healthcare facilities as a tool to self-evaluate their compliance with Medicare CoP. -- Centers for Medicare & Medicaid Services

Resource: 2023 Technical Expert Panel Meetings: Expanded Home Health Value-Based Purchasing Model Summary Report

Thu, 04 Jan 2024 10:50:31 -0600

Provides an overview of the Home Health Value-Based Purchasing (HHVBP) Model and the Expanded HHVBP Model. Summarizes discussions and feedback from the Expanded HHVBP Technical Expert Panel in 2023, including health equity approaches, performance measures, measure weights, and performance reporting. Includes rural references and considerations throughout. -- Centers for Medicare & Medicaid Services

Resource: Addressing the Direct Care Workforce Shortage: A Bipartisan Call to Action

Fri, 08 Dec 2023 18:23:23 -0600

Report discusses direct care worker shortages throughout the country. Details shortages of home health aids, certified nursing assistants, and residential care aids, among other direct care workers, and makes recommendations for decreasing shortages. Highlights some of the added barriers faced by rural communities. -- Bipartisan Policy Center

Resource: Aging in Place: The Vital Role of Home Health in Access to Care

Tue, 19 Sep 2023 11:27:57 -0500

Recording of a September 19, 2023, U.S. Senate Committee on Finance Subcommittee on Health Care hearing on access to home health services and the role of home health in supporting aging in place. Features testimony from Carrie Edwards, Director of Home Care Services at Mary Lanning Healthcare in rural Nebraska, and Tracy Mroz, Associate Professor at the University of Washington and Investigator at the WWAMI Rural Health Research Center. -- Senate Committee on Finance, Subcommittee on Health Care

Resource: Evaluation of the Home Health Value-Based Purchasing (HHVBP) Model: Final Report

Wed, 13 Sep 2023 13:21:46 -0500

Evaluates the Home Health Value-Based Purchasing (HHVBP) Model, which tests the impact of providing financial incentives to home health agencies in nine states: Arizona, Florida, Iowa, Massachusetts, Maryland, Nebraska, North Carolina, Tennessee, and Washington. Examines how the financial incentives under the model influenced agency behavior. Describes impacts across key outcomes, including service utilization, quality of care, and patient experience, and examines the model's effects on various access to care and Medicare spending issues. Explores whether the model had unique impacts on access to home health care in rural areas. -- Centers for Medicare & Medicaid Services

Resource: Impact of Higher Payments for Rural Home Health Episodes on Rehospitalizations

Fri, 01 Sep 2023 09:41:35 -0500

Examines the impact of home health rural add-on payments on beneficiary outcomes, specifically on rehospitalizations. Uses Medicare data from 2007 to 2014 to compare rehospitalizations between rural and urban post-acute home health episodes before and after the implementation of the add-on payments in 2010. Discusses the implications of the findings on home health payment policy.

Resource: Rural and Urban Differences in Care Provided by Home Health Agencies in the United States: A Review of the Literature

Tue, 07 Feb 2023 18:20:43 -0600

Explores the differences in care outcomes for rural and urban home health agencies (HHAs). Discusses some of the barriers faced by rural HHAs, such as overcoming long distances, increased costs, and workforce limitations, among others.

Resource: Public Law 117–328: Consolidated Appropriations Act, 2023

Tue, 10 Jan 2023 12:07:40 -0600

Text of the Consolidated Appropriations Act, 2023, Public Law 117-328 (December 29, 2022). Section 4113 extends certain COVID-19 telehealth flexibilities, including the ability of Rural Health Clinics and Federally Qualified Health Centers to serve as distant site providers, through December 31, 2024. Section 4137 authorizes the extension of a 1% add-on payment for home health services provided in high-utilization rural counties through 2023.

Resource: Mandated Analysis of Home Health Service Utilization From January 2016 Through March 2022

Wed, 21 Dec 2022 10:24:20 -0600

Report evaluates the distribution of rural add-on payments for home health claims. Examines the results of the Centers for Medicare and Medicaid Services's new rural add-on methodology aimed at providing higher add-on percentages for "low population density" categories and explores the effect this methodology has had on "high utilization" categories. Makes comments and recommendations as to how this methodology can be adjusted. -- Office of Inspector General (HHS)

Resource: Patterns of Health Care Use among Rural-Urban Medicare Beneficiaries Age 85 and Older, 2010-2017

Mon, 14 Nov 2022 10:00:29 -0600

Policy brief examining how rural and urban Medicare beneficiaries age 85+ differ in terms of their socioeconomic and health characteristics that may inform healthcare use. Features statistics on trends in healthcare use, including inpatient and emergency department care, outpatient and prescription services, specialists and dentists, and home health and durable medical equipment, with breakdowns by urban and rural location. -- Maine Rural Health Research Center

Resource: Home Health Agencies Used Multiple Strategies to Respond to the COVID-19 Pandemic, Although Some Challenges Persist

Tue, 18 Oct 2022 10:17:51 -0500

Presents results of a survey of home health agencies (HHAs) conducted between September through December 2021 to explore the challenges they faced during the COVID-19 pandemic. Discusses challenges related to staffing, infection control, the use of telehealth, and the adequacy of emergency preparedness plans, as well as challenges specific to rural HHAs. Provides recommendations for how the Centers for Medicare & Medicaid Services (CMS) can help HHAs prepare for and respond to current and future infectious disease outbreaks and changes to the home health care landscape. -- Office of Inspector General (HHS)

Resource: Report to Congress: Unified Payment for Medicare-Covered Post-Acute Care

Fri, 08 Jul 2022 10:09:51 -0500

Presents a prototype for a Unified Post-acute Care (PAC) prospective payment system (PPS) that would set payment for PAC services on the basis of the clinical characteristics of the patient rather than the type of provider. Details the structure of the prototype and the data used in the analyses to design and calibrate the PPS. Explores key considerations for unifying PAC payment, such as cost-sharing and value-based payment. Includes data on PAC provider characteristics, including facility size and rural status, as well as rural payment adjustments. -- Centers for Medicare & Medicaid Services

Resource: State Operations Manual Appendix Z - Emergency Preparedness for All Provider and Certified Supplier Types Interpretive Guidance

Tue, 15 Jun 2021 13:33:43 -0500

Interpretive guidelines clarifying several provisions of the emergency preparedness final rule for Medicare- and Medicaid-participating providers, which affects Rural Health Clinics (RHCs), Critical Access Hospitals (CAHs), Federally Qualified Health Centers (FQHCs), and other rural facilities. -- Centers for Medicare & Medicaid Services

Resource: Left Behind Again: Rural Home Health Services in a Medicaid Pediatric Accountable Care Organization

Wed, 12 May 2021 09:46:03 -0500

Examines differences in pediatric home healthcare utilization among rural and urban children in a Medicaid pediatric Accountable Care Organization (ACO) in Ohio. Analyzes overall differences in healthcare use and annual trends in home health use by rurality and Medicaid eligibility group. Discusses how these findings could inform state policies and future research.

Resource: Care Compare

Wed, 18 Nov 2020 10:05:51 -0600

Provides information on the quality of care, cost, volume of services, and other data for Medicare-certified providers. Includes data on doctors and clinicians, hospitals, nursing homes, home health services, hospice care, inpatient rehabilitation facilities, long-term care hospitals, and dialysis facilities. -- Centers for Medicare & Medicaid Services

Resource: There's No Place Like Home: Home Health Care in Rural America

Wed, 12 Feb 2020 10:35:46 -0600

Recording of testimony by providers of rural home health care and representatives of home health and hospice organizations, in a hearing held by the United States Senate Special Committee on Aging on February 12, 2020. Addresses challenges including workforce shortages and limitations in Medicare coverage for needed services.