The Rural Health Value (RHV) team is pleased to announce the release of a new brief  “Value-based payment strategies used by Medicaid Managed Care Organizations.” This brief presents findings from a review of state Medicaid program websites that include descriptions of value-based payment (VBP) strategies deployed by Managed Care Organizations (MCO) and implications for rural healthcare organizations. An accompanying Appendix provides an overview of how individual states are incorporating value-based payment (VBP) in their Medicaid MCO arrangements.

Related resources on the Rural Health Value website:

• Rural Hospital Participation in Missouri HealthNet’s Transformation of Rural Community Health (ToRCH) Program. Six rural hospitals are participating in ToRCH, a new Missouri Medicaid program integrating healthcare and social services in rural areas with hospitals serving as community care hubs, working in partnership with primary care and behavioral health teams and community-based organizations. (2025)
• Catalog of Value-Based Initiatives for Rural Providers. One-page summaries of Health and Human Services (HHS) value-based programs that might be appropriate for rural participation. (2026)

Rural Health Value facilitates the transition of rural healthcare organizations, payers, and communities from volume-based to value-based health care and payment models. Visit www.ruralhealthvalue.org.  Contact Clint MacKinney, MD, MS, Co-Principal Investigator, clint-mackinney@uiowa.edu

The Pennsylvania Health Care Cost Containment Council (PHC4) released a new set of County-Level Utilization Reports, displaying the total number of ambulatory/outpatient cases and inpatient hospitalizations for Pennsylvania residents in Q3 of 2025.

These County-Level Utilization Reports foster a data-driven approach to health care and are especially supportive to those who are charged with allocating resources effectively, and ensuring access to quality care is available to patients in Pennsylvania. Barry D. Buckingham, PHC4’s Executive Director, believes these quarterly County-Level Utilization Reports are among the timeliest datasets in the Commonwealth. “These reports are invaluable tools for local communities, health care professionals, and policymakers,” said Buckingham. He went on to state these reports include a variety of care settings, displaying data from acute care, long-term acute care, rehabilitation, psychiatric, and specialty hospitals, in addition to hospital outpatient departments and freestanding ambulatory surgery centers in Pennsylvania.

The County-Level Utilization Reports are updated every quarter and show the overall total number of inpatient hospitalizations and ambulatory/outpatient cases for Pennsylvania residents. These results are displayed by patient age, sex, and payer. The newly released County-Level Utilization Reports reflect data from Q2 of 2025.

PHC4 invites all stakeholders to review these reports, available now at phc4.org. These timely reports are updated every quarter and show the number of cases for each county, with breakouts by patient age, sex, and payer. Recognizing this data is key in supporting research, business, and health care communities, PHC4 welcomes inquiries from interested parties regarding standard and custom data purchases to visit Purchase Customized Data – PHC4 or connect at specialrequests@phc4.org.

PHC4 is an independent council formed under Pennsylvania statute (Act 89 of 1986, as amended by Act 15 of 2020) in order to address rapidly growing health care costs. PHC4 continues to produce comparative information about the most efficient and effective health care to individual consumers and group purchasers of health services. In addition, PHC4 produces information used to identify opportunities to contain costs and improve the quality of care delivered. For more information, visit phc4.org or access the reports here.

The Flex Monitoring Team (FMT) is excited to release the National Report for the 2025 National Critical Access Hospital (CAH) Quality Inventory and Assessment (“Assessment”)!

The Assessment provides a wealth of information on quality improvement processes from CAHs in a standardized manner, in order to enhance support to CAHs in quality improvement activities. This report provides a high-level summary of national data from the Assessment, fielded in Fall 2025. Over 1,270 CAHs (92%) completed the Assessment and provided data on a variety of characteristics, including service lines, patient volume, and CAH quality infrastructure.

The Center for Rural Pennsylvania has recently released, Analysis of Pennsylvania Crime Trends: An Updated Rural/Urban Comparison, a new research report examining crime trends across Pennsylvania’s rural and urban counties from 2013 through 2023. The study was authored by Brandon Vick, Ph.D.; Robert Orth, Ph.D.; Emily Schumacher of Indiana University of Pennsylvania; and Angel Alcantara of the Pennsylvania Commission on Crime and Delinquency.

The report found that overall crime declined statewide during the study period, while also identifying several areas where rural crime trends differ from urban patterns. Among the findings, rural counties experienced higher violent offense rates than urban counties (excluding Philadelphia County) in recent years, along with higher rates of DUI and drug offenses. The report also highlights variation across Pennsylvania’s rural regions and points to the value of county-level data in shaping local and statewide responses.

“This research gives policymakers and local leaders a clearer picture of how crime trends are changing across rural Pennsylvania,” said Zachary L. Adams, Executive Director of the Center for Rural Pennsylvania. “While overall crime has declined, the report also shows that some types of crime continue to affect rural communities differently than urban ones. These findings can help inform discussions about public safety, resource needs, and how best to support communities across the Commonwealth.”

The study updates prior Center research and expands the analysis to include additional offense categories, county-level variation, and comparisons across seven rural regions of Pennsylvania. It also outlines policy considerations related to DUI and drug offenses, protection from abuse cases, and the use of statewide data to support planning and decision-making.

The executive summary and full report are available on the Center’s website at www.rural.pa.gov.

The Pennsylvania Health Care Cost Containment Council’s (PHC4) article, Hospital Closures, as part of PHC4’s Current Events series, details the closing of two Pennsylvania hospitals, serving as a case study to support a better understanding of the dynamics of hospital closures in the Commonwealth.

From 2018 to the time of this article, 10 general acute care (GAC) hospitals licensed by the PA Department of Health have closed, 1 GAC hospital has converted to a psychiatric hospital, 17 have merged with another licensed GAC hospital, and 10 GAC hospitals have opened in the Commonwealth of Pennsylvania. This article focuses on the closures of Brandywine Hospital (Brandywine) and Jennersville Hospital (Jennersville), both of which were operated by Tower Health at the time of closing. Jennersville closed to patients on December 31, 2021, followed by Brandywine on January 31, 2022. Both located in Chester County; the two hospitals were less than 20 miles apart from each other at the time of closure.

PHC4 is an independent council formed under Pennsylvania statute (Act 89 of 1986, as amended by Act 15 of 2020) in order to address rapidly growing health care costs. PHC4 continues to produce comparative information about the most efficient and effective health care to individual consumers and group purchasers of health services. In addition, PHC4 produces information used to identify opportunities to contain costs and improve the quality of care delivered.  

For more information, visit phc4.org or access the article here.

The Pennsylvania Health Care Cost Containment Council (PHC4) announced the release of new data detailing ownership of hospitals and ambulatory surgery centers (ASCs) across Pennsylvania, along with updated access to care information on facility locations and services for hospitals, ASCs, and nursing homes. The data is now available for purchase and supports updates to PHC4’s online resources.

The interactive resource, MAPPED: Facility Ownership (formerly MAPPED 1), initially published in 2023, provides a comprehensive view of hospital and ASC locations alongside ownership information. The tool features an interactive map and bar graph showing the number of hospitals and ASCs owned by each health system. Users can filter results, search for and highlight specific facilities or owners, and explore detailed ownership categories through dynamic visualizations.

MAPPED: Access to Care (formerly MAPPED 2), first published in 2025, highlights areas where health care services may be limited for patients in Pennsylvania counties. This resource includes data on hospitals, ASCs, and nursing homes, promoting transparency into the types of care available at each location. Users can filter by county, facility name, or selected data points, and customize the visualization search and dropdown features.

Both MAPPED resources were designed to help patients, policymakers, researchers, and health care providers in better understanding Pennsylvania’s health care landscape. By offering user-friendly access to reliable data, these resources help to identify gaps in care and improve awareness of available services across the Commonwealth.

“These types of online tools support legislators, health care providers, and researchers to explore health care deserts in PA, while also helping patients and caregivers find care in their communities,” said Barry D. Buckingham, PHC4’s Executive Director. “Navigating the ever-changing landscape of care is a key challenge for stakeholders and these MAPPED resources provide the ease, information, and access needed to stay informed.”

PHC4 is an independent council formed under Pennsylvania statute (Act 89 of 1986, as amended by Act 15 of 2020) in order to address rapidly growing health care costs. PHC4 continues to produce comparative information about the most efficient and effective health care to individual consumers and group purchasers of health services. In addition, PHC4 produces information used to identify opportunities to contain costs and improve the quality of care delivered.

For more information, visit phc4.org or interact with each of these online resources at:

• MAPPED: Facility Ownership — Hospitals & Ambulatory Surgery Centers
• MAPPED: Access to Care — Hospitals, Ambulatory Surgery Centers, & Nursing Homes

The Flex Monitoring Team (FMT) has released a new brief, Strategies for Critical Access Hospital Financial and Operational Performance Improvement: A Systematic Review.

This brief synthesizes evidence from the literature to highlight practical, hospital-level approaches that can help strengthen rural hospitals and preserve access to care.