Rural Healthcare Quality – Resources
Selected recent or important resources focusing on Rural Healthcare Quality.
CY 2025 Medicare Hospital Outpatient Prospective Payment System and Ambulatory Surgical Center Payment System Final Rule (CMS 1809-FC)
Fact sheet providing an overview of the Centers for Medicare & Medicaid Services (CMS) final rule regarding updates and changes to the Medicare payments for hospital outpatient and Ambulatory Surgical Center (ASC) services for calendar year 2025. Summarizes provisions regarding changes to Intensive Outpatient Program (IOP) and partial hospital program rate setting; incorporating an add-on payment to the Medicare outpatient hospital all-inclusive rate (AIR) for certain high-cost drugs for people with Medicare who receive care at Indian Health Service (IHS) or tribal hospitals; updates to the Hospital Outpatient Quality Reporting (OQR), Ambulatory Surgical Center Quality Reporting (ASCQR), and Rural Emergency Hospital Quality Reporting (REHQR) Programs; a new Conditions of Participation (CoPs) for hospitals and Critical Access Hospitals (CAHs) for obstetrical services; Medicaid and CHIP continuous eligibility; Medicaid clinic services "four walls" exceptions; and more.
Date: 11/2024
Sponsoring organization: Centers for Medicare and Medicaid Services
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Fact sheet providing an overview of the Centers for Medicare & Medicaid Services (CMS) final rule regarding updates and changes to the Medicare payments for hospital outpatient and Ambulatory Surgical Center (ASC) services for calendar year 2025. Summarizes provisions regarding changes to Intensive Outpatient Program (IOP) and partial hospital program rate setting; incorporating an add-on payment to the Medicare outpatient hospital all-inclusive rate (AIR) for certain high-cost drugs for people with Medicare who receive care at Indian Health Service (IHS) or tribal hospitals; updates to the Hospital Outpatient Quality Reporting (OQR), Ambulatory Surgical Center Quality Reporting (ASCQR), and Rural Emergency Hospital Quality Reporting (REHQR) Programs; a new Conditions of Participation (CoPs) for hospitals and Critical Access Hospitals (CAHs) for obstetrical services; Medicaid and CHIP continuous eligibility; Medicaid clinic services "four walls" exceptions; and more.
Date: 11/2024
Sponsoring organization: Centers for Medicare and Medicaid Services
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Quality Measurement in Rural Health Clinics: Policy Brief and Recommendations to the Secretary
Provides an overview of the Rural Health Clinic (RHC) program, RHC participation in value-based programs and models, and quality reporting challenges. Describes opportunities for growth in RHC quality reporting. Offers two policy recommendations to support RHC participation in value-based care.
Date: 10/2024
Sponsoring organization: National Advisory Committee on Rural Health and Human Services
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Provides an overview of the Rural Health Clinic (RHC) program, RHC participation in value-based programs and models, and quality reporting challenges. Describes opportunities for growth in RHC quality reporting. Offers two policy recommendations to support RHC participation in value-based care.
Date: 10/2024
Sponsoring organization: National Advisory Committee on Rural Health and Human Services
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Hospital Differences in Adult Inpatient Stays with Healthcare-Associated Infections, 2019 and 2021
Examines the rate of adult inpatient hospital stays involving five healthcare-associated infections (HAI) in 2019 and 2021. Presents data from an analysis of 2019 and 2021 State Inpatient Databases (SID) from public, non-federal acute-care hospitals across 38 states by hospital characteristics, including ownership, rural or urban location, safety-net designation, and Critical Access Hospital designation.
Author(s): Melissa A. Miller, Leyi Lin, David P. Calfee, Amy Gehrke, Alex Bohl
Date: 10/2024
Sponsoring organization: Agency for Healthcare Research and Quality
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Examines the rate of adult inpatient hospital stays involving five healthcare-associated infections (HAI) in 2019 and 2021. Presents data from an analysis of 2019 and 2021 State Inpatient Databases (SID) from public, non-federal acute-care hospitals across 38 states by hospital characteristics, including ownership, rural or urban location, safety-net designation, and Critical Access Hospital designation.
Author(s): Melissa A. Miller, Leyi Lin, David P. Calfee, Amy Gehrke, Alex Bohl
Date: 10/2024
Sponsoring organization: Agency for Healthcare Research and Quality
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Merit-Based Incentive Payment System (MIPS): 2025 MIPS Payment Year (2023 Performance Year) - Payment Adjustment User Guide
Provides information on Merit-Based Incentive Payment System (MIPS) payment adjustments for calendar year 2025. Describes how 2023 MIPS scores relate to 2025 payment adjustments and how payment adjustments are applied. Offers answers to frequently asked questions.
Date: 10/2024
Sponsoring organization: Centers for Medicare and Medicaid Services
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Provides information on Merit-Based Incentive Payment System (MIPS) payment adjustments for calendar year 2025. Describes how 2023 MIPS scores relate to 2025 payment adjustments and how payment adjustments are applied. Offers answers to frequently asked questions.
Date: 10/2024
Sponsoring organization: Centers for Medicare and Medicaid Services
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Diagnostic Excellence in U.S. Rural Healthcare: A Call to Action
Issue brief exploring challenges to diagnostic quality in rural healthcare. Provides an overview of the topic of diagnostic errors in rural settings, and provides suggestions related to resource and workforce limitations, access to care, care coordination and other service delivery models, and social determinants of health.
Author(s): Kisha J. Ali, Nick J. Galvez, Sarah Craig, et al.
Date: 09/2024
Sponsoring organization: Agency for Healthcare Research and Quality
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Issue brief exploring challenges to diagnostic quality in rural healthcare. Provides an overview of the topic of diagnostic errors in rural settings, and provides suggestions related to resource and workforce limitations, access to care, care coordination and other service delivery models, and social determinants of health.
Author(s): Kisha J. Ali, Nick J. Galvez, Sarah Craig, et al.
Date: 09/2024
Sponsoring organization: Agency for Healthcare Research and Quality
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September 2024 MedPAC Meeting Transcript
Transcript from the Medicare Payment Advisory Commission's (MedPAC) September 2024 meeting. Covers Medicare's overall financial situation, cost-sharing for outpatient services at Critical Access Hospitals, and experiences and challenges of measuring the quality of care provided by rural providers.
Additional links: Cost Sharing for Outpatient Services at Critical Access Hospitals - Presentation Slides, Medicare's Measurement of Rural Provider Quality - Presentation Slides
Date: 09/2024
Sponsoring organization: Medicare Payment Advisory Commission
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Transcript from the Medicare Payment Advisory Commission's (MedPAC) September 2024 meeting. Covers Medicare's overall financial situation, cost-sharing for outpatient services at Critical Access Hospitals, and experiences and challenges of measuring the quality of care provided by rural providers.
Additional links: Cost Sharing for Outpatient Services at Critical Access Hospitals - Presentation Slides, Medicare's Measurement of Rural Provider Quality - Presentation Slides
Date: 09/2024
Sponsoring organization: Medicare Payment Advisory Commission
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Rurality and Patients' Hospital Experience: A Multisite Analysis from a US Healthcare System
Explores the relationship between the patient experience at a Midwestern hospital system and patients' rurality of residence using data from completed Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) surveys between 2016 and 2019. Analyzes data for global, composite, and individual HCAHPS measures by hospital and patient characteristics.
Author(s): Iman Fawad, Karen M. Fischer, Hanieh Sadat Tabatabaei Yeganeh, et al.
Citation: PLoS One, 19(8), e0308564
Date: 08/2024
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Explores the relationship between the patient experience at a Midwestern hospital system and patients' rurality of residence using data from completed Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) surveys between 2016 and 2019. Analyzes data for global, composite, and individual HCAHPS measures by hospital and patient characteristics.
Author(s): Iman Fawad, Karen M. Fischer, Hanieh Sadat Tabatabaei Yeganeh, et al.
Citation: PLoS One, 19(8), e0308564
Date: 08/2024
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Updated Analysis: Using Population-Based Outcome Measures to Assess the Impact of Telehealth Expansion on Medicare Beneficiaries' Access to Care and Quality of Care
Explores the association between telehealth use, quality of care, and access to care when both telehealth and in-person visits are available to fee-for-service (FFS) Medicare beneficiaries. Compares data from the second half of 2018 and 2019 to the second half of 2022 by the level of telehealth utilization in Hospital Service Areas (HSAs). Describes the effects of telehealth for urban and rural beneficiaries and differentiates between telehealth utilization for behavioral and non-behavioral health services. Updates a June 2023 report that analyzed data from 2021.
Author(s): Tanvi Rao, Angshuman Gooptu, Karin Johnson, Guido Cataife, Steven Susana-Castillo
Date: 06/2024
Sponsoring organizations: American Institutes for Research, Medicare Payment Advisory Commission
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Explores the association between telehealth use, quality of care, and access to care when both telehealth and in-person visits are available to fee-for-service (FFS) Medicare beneficiaries. Compares data from the second half of 2018 and 2019 to the second half of 2022 by the level of telehealth utilization in Hospital Service Areas (HSAs). Describes the effects of telehealth for urban and rural beneficiaries and differentiates between telehealth utilization for behavioral and non-behavioral health services. Updates a June 2023 report that analyzed data from 2021.
Author(s): Tanvi Rao, Angshuman Gooptu, Karin Johnson, Guido Cataife, Steven Susana-Castillo
Date: 06/2024
Sponsoring organizations: American Institutes for Research, Medicare Payment Advisory Commission
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With New EMS Quality Measures, Florida Aims to Have a National Impact on Rural Care
Features the Feasible, Actionable, Impactful and Relevant (FAIR) EMS Measurement Project, an initiative by the Florida Department of Health which developed rural-relevant EMS quality measures for use in the state and nationally.
Author(s): Gretel Kauffman
Citation: Rural Monitor
Date: 05/2024
Sponsoring organization: Rural Health Information Hub
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Features the Feasible, Actionable, Impactful and Relevant (FAIR) EMS Measurement Project, an initiative by the Florida Department of Health which developed rural-relevant EMS quality measures for use in the state and nationally.
Author(s): Gretel Kauffman
Citation: Rural Monitor
Date: 05/2024
Sponsoring organization: Rural Health Information Hub
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Calculation of Overall Hospital Quality Star Ratings With and Without Inclusion of the Peer Grouping Step
Examines potential implications of including a peer grouping step in the calculation of Centers for Medicare & Medicaid Services (CMS) Overall Star Ratings. Uses January 2023 Medicare Care Compare data on 3,076 hospitals that received a star rating to calculate the peer groups based on the number of quality measure groups for which hospitals had 3 or more reported measures. Presents data on the characteristics of each peer group, the distribution of star ratings whether the peer grouping step was used or not used, and the number of hospitals with a higher, lower, or identical star rating when the peer grouping step was applied. Compares data by hospital characteristics, including safety-net status, Critical Access Hospital status, rural or urban location, and more.
Author(s): Cameron J. Gettel, Kyle Bagshaw, Li Qin, et al.
Citation: JAMA Network Open, 7(5), e2411933
Date: 05/2024
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Examines potential implications of including a peer grouping step in the calculation of Centers for Medicare & Medicaid Services (CMS) Overall Star Ratings. Uses January 2023 Medicare Care Compare data on 3,076 hospitals that received a star rating to calculate the peer groups based on the number of quality measure groups for which hospitals had 3 or more reported measures. Presents data on the characteristics of each peer group, the distribution of star ratings whether the peer grouping step was used or not used, and the number of hospitals with a higher, lower, or identical star rating when the peer grouping step was applied. Compares data by hospital characteristics, including safety-net status, Critical Access Hospital status, rural or urban location, and more.
Author(s): Cameron J. Gettel, Kyle Bagshaw, Li Qin, et al.
Citation: JAMA Network Open, 7(5), e2411933
Date: 05/2024
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Last Updated: 10/20/2025