The Centers for Medicare & Medicaid Services (CMS) issued guidance to state Medicaid offices on implementation of Section 71116 of the One Big Beautiful Bill Act to aid planning efforts until a final rule is announced.  Effective July 4, 2025, Section 71116 limits Medicaid State Directed Payments (SDPs) from managed care plans for inpatient hospital services, outpatient hospital services, nursing facility services, or qualified practitioner services at an academic medical center.  Some existing SDPs may be grandfathered until January 1, 2028.  This policy change may result in lower Medicaid payments to some providers unless the payments meet the criteria for grandfathering.  This information is preliminary. Final policies will depend on the contents of a final rule.

The Health Resources and Services Administration (HRSA) and the Federal Office of Rural Health Policy (FORHP) awarded three Rural Maternity and Obstetrics Management Strategies (Rural MOMS) Networks in Alabama, Arkansas, and Virgina.

These networks join a group of eight existing FORHP-funded Rural MOMS Networks to further community level efforts designed to increase access to maternal and obstetrics care in rural communities.  Rural MOMS awardees build networks to coordinate continuum of care and improve financial sustainability to keep maternal and obstetric services accessible to rural mothers and their families.

To date, the program has awarded 17 networks in 15 states, serving over 25,000 women. Over the four-year project period that begins September 30, 2025, three new FY25 Rural MOMS awardees will implement projects including activities to improve access to care through services such as risk-based telehealth services, and workforce training to increase the number and reach of maternal health care providers in rural areas.

What is the Rural Healthcare Provider Transition Project (RHPTP)?

RHPTP is designed to help strengthen your organization’s foundation in the key elements of value-based care, including but not limited to efficiency, quality, patient experience and safety of care. The goal is to guide, prepare and position rural hospitals and clinics to be effective participants in a health system focused on value.

Did you know there are numerous ways to participate in value-based care? Let us help you navigate strategies that are the right fit for your organization.

Who should apply?

• Small Rural Hospitals
• Certified Rural Health Clinics

How to apply?

The application should take no more than 10 minutes to complete. Apply Now!

When is the deadline?

Applications are accepted on a rolling basis, however the deadline for the 2025-2026 project year is October 10, 2025.

When does technical assistance begin?

Technical assistance for the 2025-2026 project year begins in December 2025 and ends August 31, 2026.

Visit the RHPTP website for eligibility, application and application process, benefits of participation and FAQs. Contact Info: rhptp@ruralcenter.org

The Health Resources and Services Administration (HRSA), Department of Health and Human Services (HHS) provided financial support for this Rural Healthcare Provider Transition Project. The award provided 100% of total costs and totaled $800,000. The contents are those of the author. They may not reflect the policies of HRSA, HHS, or the U.S. Government.

From Becker’s Hospital Review

In less than 18 months, more than 24 million Americans could see their health insurance premiums increase by an average of 93% unless Congress acts to extend federal tax credits established under the ACA, according to Eduardo Conrado, president of St. Louis-based Ascension.

“This is both predictable and preventable,” Mr. Conrado said in a Sept. 5 blog post.

The subsidies — expanded during the pandemic and set to expire in January — have helped millions of working- and middle-class families afford coverage. Their loss would leave families facing painful choices between maintaining insurance or paying for other necessities.

The ACA tax credits have reduced monthly premiums by nearly half, according to Ascension. More than 9 million people currently pay $10 or less per month for health plans, a level of affordability that has stabilized coverage and kept families from falling into medical debt, which is the leading cause of personal bankruptcy in the U.S.

Mr. Conrado said the credits do more than lower costs: they improve health outcomes by expanding access to preventive care. Insured adults are nearly twice as likely to receive recommended cancer screenings, and families with coverage are more likely to access behavioral health services and primary care before conditions worsen.

If the tax credits expire, 5 million people could lose coverage altogether, while those who remain insured would face steep annual premium increases:

• A family of four earning $125,000: +$7,700
• A family of four earning $64,000: +$2,600
• A 60-year-old couple earning $80,000: +$17,500

“These costs will be felt across the healthcare system,” Mr. Conrado wrote, noting that higher premiums will strain family budgets and further destabilize hospitals.

House Republicans have proposed a stopgap funding bill that would keep federal agencies operating through Nov. 21, but the measure does not include an extension of the enhanced ACA premium tax credits. The bill, if passed, would avert a government shutdown on Oct. 1. Republican leaders plan to call a floor vote later this week.

Health system leaders warn the expiration of subsidies would have consequences beyond affordability. Emergency department visits could surge, exacerbating provider burnout and raising costs for all patients, according to Jacquelyn Bombard, associate vice president and chief federal affairs officer for Renton, Wash.-based Providence.

“This isn’t just a policy change that’s going to impact a subset of individuals. It’s going to impact all of us,” Ms. Bombard told Becker’s. “We all have a stake in this because it’s going to upend the health system.”

Providence, a 51-hospital Catholic system, said that in some states it serves — such as California, where 40% of the population is eligible for Medicaid — up to 20% of residents could lose coverage if the subsidies lapse, compounding the effects of proposed Medicaid cuts. Overall, as much as 40% of the population in affected states could lose access, shifting risk pools, driving up premiums, and destabilizing rural hospitals already on thin margins.

“The status quo is not sustainable,” Ms. Bombard said. “If we don’t extend these subsidies, it’s going to dismantle our health system — and every patient, every provider and every community is going to feel that.”

Ascension and Providence both emphasized that more insured patients means less strain on emergency departments, more predictable revenue for providers and healthier communities overall.

“Preserving the healthcare tax credits is not just about policy. It is about protecting families from financial hardship, maintaining continuity of care, and strengthening the health of communities across the country,” Mr. Conrado wrote. “Congress has a choice. Allowing these credits to expire is the same as raising taxes on millions of families while weakening the healthcare system and the communities they serve. Extending them is a key step to support healthier families, stronger communities, and a more stable nation.”

With an estimated upwards of one trillion dollars in cuts to the Medicaid program from the One Big Beautiful Bill, healthcare experts and providers predict significant drop in access to services for rural Americans.

Rural hospitals facing cuts in Medicaid will struggle to figure out how to stay open in the coming years, experts said during a recent rural summit.

Although rural hospitals are working to find ways to address looming cuts in reimbursement, the tipping point to staying open is coming, according to participants in the One Country Project panel titled “Rural Health Care: Doing More with Less is Not Sustainable.”

As part of President Donald Trump’s “One Big Beautiful Bill,” Congress made more than one trillion dollars in cuts to the Medicaid program. Those changes are due to take effect between 2026 and 2028. The bill also includes a carve-out of $50 billion for rural hospitals over six years, but critics have said the money would fall short of what is needed.

Panelists during the session were Dr. Tom Dean, retired family physician and former president of the National Rural Health Association; Kevin Stansbury, CEO of Lincoln Community Hospital and Care Center in Hugo, Colorado; and Jeanne Lambrew, director of Healthcare Reform for the Century Foundation.

Read the full article.