Rural Spotlight

September 3, 2025

Whitepaper: Setting Your Health System up for Cybersecurity Success in the Face of HIPAA Security Rule Changes

Changes to the HIPAA Security Rule are under review, yet the future of these updates is uncertain. What is clear is that healthcare cybersecurity requires a greater amount of standardization to combat the evolving threats and growing risk profile of the modern technology-dependent clinical environment.

With the right examination of the proposed Security Rule update, health systems can gain valuable insights to set their organizations on the right path for both continued compliance, stronger safeguards of patient data, and more efficient approaches to handling cybersecurity priorities.

Learning Points:

• The proposed HIPAA Security Rule changes would increase the demands on health systems to enact cybersecurity best practices with more required procedures, stronger security protocols, and stricter timelines for security testing and incident reporting.
• Medical device technology represents a significant, yet often underexamined, frontier of cybersecurity risk that can carry significant operational and safety consequences in the event of a breach.
• Health systems can leverage information from the proposed Security Rule update to develop a plan of action that improves their ability to comply with C

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August 27, 2025

The 340B Program, Explained

More than three decades ago, Congress created the 340B program to help safety-net hospitals and clinics expand resources and care for underserved communities.

By requiring pharmaceutical companies to offer deep discounts on outpatient drugs, the program has become a hallmark resource to help health systems support vulnerable patients. In recent years, however, the program has drawn scrutiny from federal lawmakers as several drug makers have introduced alternative rebate and drug pricing models, raising questions about the direction of the program.

Hospitals have also faced increased scrutiny in recent years over how they are utilizing 340B savings. This intensified after a Senate report published in April found some of the largest health systems were exploiting the system. According to the report, Cincinnati-based Bon Secours Mercy Health and Cleveland Clinic generated hundreds of millions of dollars by acquiring discounted drugs and then charged patients significantly higher prices. Both health systems defended their participation in the 340B program, telling Becker’s they operated the program in compliance with federal rules.

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August 27, 2025

Urban Hospitals Increasingly Poaching Rural Funds

A regulatory loophole has allowed hundreds of large, urban hospitals to claim rural benefits, raining alarms from lawmakers and experts who warn that taxpayer dollars are being diverted from the very communities Congress intended to protect.

In 2016, CMS revised its regulations in response to two federal court decisions: Geisinger Community Medical Center v. Secretary and Lawrence and Memorial Hospital v. Burwell. The rule change effectively permitted hospitals to use a two-step reclassification process to be designated as both urban and rural for Medicare purposes, a practice CMS had previously prohibited.

The impact was immediate.

According to a study published in Health Affairs in August, the number of urban hospitals claiming rural status jumped from just three in 2017 to 425 in 2023. The number o hospital beds in dual-classified facilities skyrocketed from fewer than 400 in 2017 to more than 162,000 in 2023, representing 61% of all beds in administratively rural hospitals nationwide.

More than 75% were nonprofit organizations, and all of the top 20 highest-revenue facilities with dual status were teaching hospitals, with net patient revenues ranging from $2.9 billion to more than $9 billion. New York City-based New York Presbyterian Hospital, with 2,850 beds and nearly $9.3 billion in patient revenue, topped the list.

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