At a roundtable, the administration touted a $50 billion fund that will make large investments in rural health. That funding would accomplish more if not on the heels of an estimated $137 billion reduction in federal Medicaid spending in rural areas.
www.kff.org/medicaid/how...
New: With first year awards from the rural health transformation fund out, our analysis shows wide variation in the amount per rural resident across states.
www.kff.org/state-health...
The Rural Fund grants are a grab bag from telehealth to mobile health to parks and trails for recreation.
Our analysis based on rural population:
KFF map showing that first-year awards per rural resident vary widely across states, ranging from less than $100 in ten states to more than $500 in eight states according to KFF analysis.
NEW: The initial awards to states under the new federal Rural Health Transformation Program show relatively modest variation in total awards across states but wide variation in how much states will receive per rural resident.
Our analysis: https://on.kff.org/3YW7Hv0
KFF graphic featuring a quote from Zachary Levinson, KFF Project Director, Project on Hospital Costs. It says, “The Administration’s change to reimbursement for drug administration services represents a step forward in implementing site neutral payment reforms but is modest compared to some of the more sweeping options raised by MedPAC and others.”
⚡ KFF’s Zachary Levinson writes about the site-neutral payment reform included in the CMS’s 2026 final outpatient prospective payment system rule under traditional Medicare. #QuickTake https://on.kff.org/4odNESQ
CMS will decide which states to fund by the end of the year, and how to allocate the first year of funding across states. It is not yet clear how states will distribute funds across rural hospitals, other providers, and other state initiatives (9/9)
The analysis could not factor in the $12.5 billion that will be distributed based on CMS’s discretionary scoring of state policy, state initiatives, and other factors (8/9).
TX, CA, NM, MT, and AK are estimated to receive the largest amounts from the $37.5 billion. Most of the extra dollars they're estimated to receive are due to their large land area, one of several factors used to allocate funds based on state need (7/9).
Additionally, of the $12.5 billion based on measures of need, only 20% is directly based on total rural population (6/9).
This in part reflects the fact that estimated state awards vary much less than differences in rural populations, principally due to the equal distribution of the first $25 billion across all states with approved applications (5/9).
Estimated awards from the $37.5B are partially, but not closely, tied to rural population. E.g., TX has the most rural residents in the nation (4.3M) but is estimated to only receive about twice as much as RI, which has the fewest (about 25,000) (4/9)
Estimated awards from the $37.5B range from $550 million in Rhode Island to just over $1 billion in Texas over five years if all states are approved for funding (3/9).
The analysis examines $37.5B of the $50B fund: $25B to be distributed equally across states with approved applications (as required by law) and an additional $12.5B to be distributed based on measures of state need (as specified primarily by CMS) (2/9).
The July 2025 reconciliation law created a $50B rural health fund to help offset the impact of the law on rural areas. Our brief suggests that state awards from most of the fund could vary only modestly despite large differences in rural health needs 👇(1/9): www.kff.org/state-health...
CMS's recent announcement includes many new details about the distribution of the rural health fund across states, but questions remain about which states will receive funding and how well awards will align with state need. More in our recent brief: www.kff.org/other-health...
States will receive more from the $50 billion rural health fund if they adopt certain Make America Health Again (MAHA) policies. This and more from a new KFF brief examining CMS's recent funding announcement:
www.kff.org/other-health...
New KFF brief examines CMS's recent rural health fund announcement. While the $50B fund could help rural areas in a number of ways, it's unclear the extent to which it will benefit rural hospitals and offset their losses under the reconciliation law. More from the brief: www.kff.org/other-health...
With today's announcement, it still remains to be seen how much of the $50 billion rural health fund will go to hospitals. According to CMS, payments to providers for care "cannot exceed 15% of the total" though other uses, like capital investments, could also benefit hospitals.
CMS just released its 2026 proposed rule for hospital outpatient payments. Among its proposals: lowering reimbursement for drug administration services at hospitals to the physician reimbursement rate.
Check out our brief to learn more about site neutral policies. www.kff.org/medicare/iss...
As well as the implications of the reconciliation bill for spending and coverage, including in rural areas (7/7):
www.kff.org/medicaid/iss...
www.kff.org/affordable-c...
www.kff.org/policy-watch...
Recent work from KFF provides a deeper dive on rural hospitals, Medicaid and hospitals, and the implications of the reconciliation bill (6/7):
www.kff.org/health-costs...
www.kff.org/medicaid/iss...
www.kff.org/medicaid/iss...
While the fund could help prop up rural hospitals, it doesn't address concerns about the millions of individuals who could lose Medicaid or ACA Marketplace coverage in rural and other areas, many of whom would also be at risk of losing SNAP benefits (5/7)
www.kff.org/medicaid/iss...
Urban hospitals that serve a large share of Medicaid patients have been left out of the conversation and without support from the fund, though many are already in the red. These hospitals could also have a hard time absorbing any losses under the bill (4/7)
The relief for hospitals and other providers would also be temporary, while major Medicaid and ACA cuts would be permanent (3/7).
It's unclear:
* How much of this fund would be used for hospitals,
* Which hospitals would be targeted, and
* Whether the fund would be enough to offset any losses for hospitals and other providers under the bill. (2/7).
One of the biggest flashpoints for the "One Big Beautiful Bill Act" has been its impact on roughly 1800 rural hospitals, which is why Senate Republicans are proposing a new $15 billion rural health fund. However, there are still questions and concerns about the bill 👇 (1/7)
A new @KFF analysis finds that Medicaid covers at least one in five hospital inpatient days in nearly every state as Congress considers potential cuts to the program. The data illustrate the importance of Medicaid to hospitals. www.kff.org/medicaid/iss...
New: New: Many rural hospitals are struggling. But, less so in states that have expanded Medicaid under the ACA.
www.kff.org/health-costs...
Federal cuts to #Medicaid could have implications for hospitals - check out new brief: www.kff.org/medicaid/iss...
Medicaid covers about one-fifth of all hospital spending. There's a hospital in pretty much every Congressional district, and it's often one of the biggest employers.
www.kff.org/medicaid/iss...
