Author: dianawinder

Final Outpatient Hospital Payment Rule Released, Effective January 1

December 11, 2025

Final Outpatient Hospital Payment Rule Released, Effective January 1

In November, the Centers for Medicare & Medicaid Services (CMS) issued updates to Medicare payment policies and rates for hospital outpatient services under the Hospital Outpatient Prospective Payment System (OPPS) for calendar year (CY) 2026.

In addition to finalizing the payment rates, this year’s rule includes an update to the methodology used to calculate the Overall Hospital Quality Star Rating to emphasize the Safety of Care measure group in hospitals’ star ratings. It finalizes a new payment for drug administration services provided in off-campus outpatient departments, eliminates the ‘inpatient only’ list, changes the hospital price transparency requirements, and changes to the Hospital Outpatient Quality Reporting (OQR) and Rural Emergency Hospital Quality Reporting (REHQR) programs.

CMS is not finalizing their proposal to increase the annual offset amount for non-drug items and services per the 340B Remedy Rule at this time.  CMS anticipates finalizing a larger reduction (such as 2 percent or other reduction greater than 0.5 percent) beginning in CY 2027; CMS will instead implement the previously finalized 0.5 percent reduction for CY 2026.

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Medicare Survey on Hospital Outpatient Drug Costs Begins January 1

December 11, 2025

Medicare Survey on Hospital Outpatient Drug Costs Begins January 1

Per an Executive Order and the 2026 Hospital Outpatient Prospective Payment System (OPPS) final rule, the Centers for Medicare and Medicaid Services (CMS) will survey hospitals to find out how much they pay for outpatient drugs.

This survey runs from January 1 through March 31, 2026. The results will help shape Medicare payment policies starting in 2027.

Hospitals that received OPPS payments for outpatient drugs between July 1, 2o24 and June 30, 2025, must complete the survey.

Hospitals should confirm their Point of Contact by emailing OPPSDrugSurvey@cms.hhs.gov as soon as possible.

CMS is offering training webinars on December 1.

Click Here to Register for Webinar

Rural Health Research Alert: Rural-Urban Differences in Barriers to Care and Utilization of Preventive Care Among Traditional Medicare and Medicare Advantage Beneficiaries

December 11, 2025

Rural Health Research Alert: Rural-Urban Differences in Barriers to Care and Utilization of Preventive Care Among Traditional Medicare and Medicare Advantage Beneficiaries

This policy brief examined rural and urban differences in barriers to care and use of preventive care services among enrollees in traditional Medicare and Medicare Advantage. Medicare Current Beneficiary Survey data was used to examine barriers to care, such as flu shots and cholesterol tests, comparing rural and urban Medicare Advantage enrollees, rural and urban traditional Medicare enrollees, and rural traditional and Medicare Advantage enrollees.

Key Findings:

  • Rural Medicare Advantage enrollees faced more barriers in accessing health services due to cost, compared to their urban counterparts and to all traditional Medicare enrollees, urban and rural.
  • A lower proportion of rural enrollees in both traditional Medicare and Medicare Advantage received a flu shot compared to their urban counterparts.
  • Female traditional Medicare enrollees living in rural areas were the least likely to utilize health care services compared to both their urban counterparts and Medicare Advantage enrollees.

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Rural Health Research Alert: Availability of Higher-Level Neonatal Care Services in Rural U.S. Counties, 2010-2022

December 11, 2025

Rural Health Research Alert: Availability of Higher-Level Neonatal Care Services in Rural U.S. Counties, 2010-2022

Infant mortality is elevated in rural, compared with urban, communities. Neonatal health care includes basic well-infant/level 1 services, available at health care facilities that offer childbirth services, as well as higher-level care (neonatal intermediate and intensive care services, at level II or higher).

Access to higher-level neonatal care can be lifesaving for infants with high acuity clinical needs, and access to childbirth-related care has been declining in rural communities.

The purpose of this policy brief is to show the changes in the availability of higher-level neonatal care in rural United States (U.S.) counties from 2010 to 2022, and how this availability differs by rural county type (micropolitan vs. noncore).

Key Findings:

  • Researchers examined availability of higher-level neonatal care (intermediate level II or intensive level III or IV care) at short-term acute care hospitals in rural counties of the U.S., including all hospitals not involved in mergers between 2010 and 2022.
  • In the U.S., availability of any higher-level neonatal care declined from 2010-2022 in rural counties. Overall, 7.5% of rural counties (147/1958) had higher-level neonatal care in 2010, and 6.9% of rural counties (136/1958) had this care in 2022. In 2022, 93.1% of rural counties (1822/1958) had no higher-level neonatal care.
  • Among rural counties, researchers distinguished between noncore and micropolitan counties. Among noncore counties, the percentage with higher-level neonatal care declined from 2.1% (27/1300) in 2010 to 1.2% (16/1300) in 2022. In 2010, 18.2% of micropolitan counties (120/658) had higher-level neonatal care, remaining similar in 2022 (18.2%; 120/658).
  • Only about 1% of noncore rural counties had higher-level neonatal care availability in 2022; 20 of the 27 noncore counties that had higher-level neonatal care in 2010 lost this service by 2022.

Click Here to Read Full Brief

RHIhub This Week

December 11, 2025

RHIhub This Week

RHIhub This Week keeps you informed of the latest rural news, funding opportunities, publications and events.

Click Here to Read RHIhub

Webinar: RestorixHealth Critical Access Program Solutions, December 16

December 10, 2025

Webinar: RestorixHealth Critical Access Program Solutions, December 16

The Missouri Department of Health and Senior Services, Office of Rural Health is partnering with RestorixHealth to offer this free webinar.

You are invited to join this webinar to learn about how RestorixHealth works with hospitals to create outpatient wound care programs. They offer turnkey, custom solutions specifically designed for critical access and rural hospitals.

High points of the critical access model

  • Provider based, procedure driven,
  • Can be part time… based on demand
  • RestorixHealth can furnish all the operational pieces (nursing, administrative, revenue cycle support, marketing and education, clinical policies, and procedures, and
  • Minimal financial risk (no start-up capital needed from hospital, fees tied to patient volume, fees set so that program should be profitable from day 1)

Upside of Model:

  • Can prevent outward migration of patients,
  • Drives volume to other services,
  • Valuable clinical resource for community, and
  • Excellent clinical outcomes…94% heal rate and 28 median days to heal

RestorixHealth can evaluate what a wound care program would look like for your hospital and develop market analysis to quantify demand along with providing a financial pro forma.

Click Here to Learn More about RestorixHealth Critical Access Program

Cost: Free

When: Tuesday, December 16, 12:00 p.m. – 1:00 p.m.

Click Here to Join Meeting when it is time

MRHA Webinar: Beyond Broadband; Uncovering the Hidden Barriers to Rural Telehealth Equity, January 22

December 5, 2025

MRHA Webinar: Beyond Broadband; Uncovering the Hidden Barriers to Rural Telehealth Equity, January 22

Telehealth has transformed rural healthcare by expanding access and reducing travel barriers, but not all communities benefit equally. Persistent socioeconomic and infrastructural challenges continue to limit who can fully participate in telehealth services.

This session, presented by Southern Illinois University, explores findings from a comprehensive narrative review examining how broadband access, digital literacy, and affordability shape telehealth adoption in rural areas.

Participants will gain insight into successful models such as Project ECHO and Avera eCARE, which demonstrate practical, evidence -based approaches to improving access and outcomes. Attendees will leave with actionable strategies for strengthening telehealth equity and closing the digital divide in Missouri’s rural healthcare systems.

Target Audience:

  • Rural health professionals,
  • Hospital and clinic administrators,
  • Public health practitioners,
  • Researchers, policymakers,
  • Health equity advocates, and
  • Students in health-related disciplines

Cost: Free

When: Thursday, January 22, 2026

Click Here to Register

Webinar: Social Media + Youth Mental Health: What Every Behavioral Health Leader Should Know, December 12

December 5, 2025

Webinar: Social Media + Youth Mental Health: What Every Behavioral Health Leader Should Know, December 12

Pediatric behavioral health demand is rising, and social media use is increasingly part of the clinical picture. From anxiety and sleep disruption to attention and engagement issues, care teams are encountering new challenges tied to digital habits.

Without clear frameworks, early signs of social media-related distress often go unrecognized, leading to delayed intervention and increased clinical complexity.

This session offers an evidence-based look at how behavioral health organizations can integrate digital risk factors into care delivery. Leaders will gain practical guidance to help teams assess, respond to and support healthier social media use among youth.

Key Takeaways Include:

  • A data-informed view of adolescent social media use and mental health trends,
  • Clinical guidance to help care teams recognize at-risk behaviors earlier, and
  • Strategies to support family education, prevention and healthier digital behavior.

Cost: Free

When: Friday, December 12, 12:00 p.m. – 1:00 p.m.

Click Here to Register

Webinar: Workplace Violence + $61k Turnover Costs: 1 Strategy to Tackle Both, December 11

December 5, 2025

Webinar: Workplace Violence + $61k Turnover Costs: 1 Strategy to Tackle Both, December 11

Violence against healthcare workers has reached a crisis point and hospitals are paying the price. With workplace violence costing billions and turnover averaging $61,110 per departure, the stakes are too high to treat safety and retention as separate challenges.

Forward-thinking systems are reframing visitor management as a strategic platform, one that reduces violence, builds staff trust and supports broader workforce stability.

In this session, learn how leading hospitals are achieving up to a 64% drop in violent incidents and an 81% reduction in staff reported stress by addressing root causes at the front door.

Key Takeaways:

  • How visitor management influences workforce wellbeing and organizational risk,
  • Scenarios and metrics that resonate with executive stakeholders, and
  • A blueprint for aligning safety strategy with retention goals.

Cost: Free

When: Thursday, December 11, 1:00 p.m. – 2:00 p.m.

MRHA Webinar: Ending the Transfer of Dialysis Patients, December 4

December 2, 2025

MRHA Webinar: Ending the Transfer of Dialysis Patients, December 4

Rural hospitals often face no choice but to transfer dialysis patients out of their communities due to a lack of nephrologists or dialysis infrastructure, costing the U.S. healthcare system an estimated $3 billion annually and shifting ongoing care (and revenue) away from local facilities.

This session will feature the Chief Nursing Officer of a critical access hospital who implemented a tele-nephrology program with a team that had no prior dialysis experience. Within the first year4, the hospital successfully cared for over 100 chronic kidney disease patients locally, patients who would have previously been transferred elsewhere.

Learn how this innovative approach not only kept care close to home but also improved hospital finances and community trust.

Cost: Free

When: Thursday December 4, 12:00 p.m. – 1:00 p.m.

Click Here to Register