Scott Hulver
@scotthulver.bsky.social
Health policy analyst @KFF.org focusing on hospital access, affordability, and costs. Paw-rent 🐶, nature lover, board game enthusiast. They/them
Yesterday was the last day for states to apply for the $50B Rural Health Transformation Fund.
Final awards will be released in January; we've estimated how most of the fund could be distributed across states (if all states are approved, etc.) www.kff.org/state-health...
Final awards will be released in January; we've estimated how most of the fund could be distributed across states (if all states are approved, etc.) www.kff.org/state-health...
State Awards From Most of the Rural Health Funds Could Vary Only Modestly Despite Large Differences in Rural Needs | KFF
This brief provides estimates of how $37.5 billion of the $50 billion rural health fund could be distributed across states if all states are approved for funding. Awards from the $37.5 billion could r...
www.kff.org
November 6, 2025 at 6:16 PM
Yesterday was the last day for states to apply for the $50B Rural Health Transformation Fund.
Final awards will be released in January; we've estimated how most of the fund could be distributed across states (if all states are approved, etc.) www.kff.org/state-health...
Final awards will be released in January; we've estimated how most of the fund could be distributed across states (if all states are approved, etc.) www.kff.org/state-health...
It's also unclear how much will go to rural areas. The policies and some other factors that states are scored on don't appear to have a rural focus, and some of the permitted uses are not limited to rural areas.
www.kff.org/other-health...
www.kff.org/other-health...
September 29, 2025 at 9:28 PM
It's also unclear how much will go to rural areas. The policies and some other factors that states are scored on don't appear to have a rural focus, and some of the permitted uses are not limited to rural areas.
www.kff.org/other-health...
www.kff.org/other-health...
𝐍𝐞𝐰 𝐛𝐫𝐢𝐞𝐟 looking at CMS's funding announcement on the rural health fund.
One tidbit: CMS has exercise a large amount of discretion designing its allocation plan; 20 of the 23 allocation factors (allocation $25B) were not referenced in the reconciliation law.
www.kff.org/other-health...
One tidbit: CMS has exercise a large amount of discretion designing its allocation plan; 20 of the 23 allocation factors (allocation $25B) were not referenced in the reconciliation law.
www.kff.org/other-health...
Key Takeaways from CMS's Rural Health Funding Announcement | KFF
This brief describes five key takeaways from CMS's Notice of Funding Opportunity for the $50 billion Rural Health Transformation Program. It includes information about how CMS intends to review state ...
www.kff.org
September 25, 2025 at 6:18 PM
𝐍𝐞𝐰 𝐛𝐫𝐢𝐞𝐟 looking at CMS's funding announcement on the rural health fund.
One tidbit: CMS has exercise a large amount of discretion designing its allocation plan; 20 of the 23 allocation factors (allocation $25B) were not referenced in the reconciliation law.
www.kff.org/other-health...
One tidbit: CMS has exercise a large amount of discretion designing its allocation plan; 20 of the 23 allocation factors (allocation $25B) were not referenced in the reconciliation law.
www.kff.org/other-health...
Reposted by Scott Hulver
New analysis by @kff.org finds that immigrants make up 3X the share of physicians and surgeons in rural America than their share of the rural population/total workforce (14% vs. 5%). They also play outsized roles in agriculture, construction, and service occupations.
www.kff.org/racial-equit...
www.kff.org/racial-equit...
What Role Do Immigrants Play in the Rural Workforce? | KFF
This data note examines the role that immigrants play in the rural workforce, particularly in industries disproportionately filled by immigrants, including health care, agriculture, construction, and ...
www.kff.org
August 4, 2025 at 4:19 PM
New analysis by @kff.org finds that immigrants make up 3X the share of physicians and surgeons in rural America than their share of the rural population/total workforce (14% vs. 5%). They also play outsized roles in agriculture, construction, and service occupations.
www.kff.org/racial-equit...
www.kff.org/racial-equit...
Reposted by Scott Hulver
The temporary $50 billion rural health fund in the Republican tax and spending bill gets distributed from 2026 to 2030. But, 63% of the Medicaid cuts hit after 2030.
www.kff.org/medicaid/iss...
www.kff.org/medicaid/iss...
A Closer Look at the $50 Billion Rural Health Fund in the New Reconciliation Law | KFF
The new reconciliation law includes a $50 billion rural health fund. This brief describes the rural health fund, explains what the law says about the allocation of funds, and highlights outstanding qu...
www.kff.org
July 16, 2025 at 7:10 PM
The temporary $50 billion rural health fund in the Republican tax and spending bill gets distributed from 2026 to 2030. But, 63% of the Medicaid cuts hit after 2030.
www.kff.org/medicaid/iss...
www.kff.org/medicaid/iss...
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...
Check out our brief to learn more about site neutral policies. www.kff.org/medicare/iss...
Five Things to Know About Medicare Site-Neutral Payment Reforms | KFF
This brief examines key facts around proposals to align Medicare payments for outpatient services across care settings, otherwise known as “site-neutral payment reforms.”
www.kff.org
July 15, 2025 at 9:18 PM
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...
Check out our brief to learn more about site neutral policies. www.kff.org/medicare/iss...
Along with Medicaid/ACA cuts, the BBB will trigger mandatory Medicare cuts - about $45B in 2026
If cuts are proportional across providers, hospitals could see ~$17B lower Medicare payments in 2026 (larger than Medicare DSH + UCC payments)
Historically Congress has stopped triggered cuts before EOY
If cuts are proportional across providers, hospitals could see ~$17B lower Medicare payments in 2026 (larger than Medicare DSH + UCC payments)
Historically Congress has stopped triggered cuts before EOY
House Reconciliation Bill Could Trigger $500 Billion in Mandatory Medicare Cuts
If enacted into law in its current form, and Congress takes no further action, [the House reconciliation bill's] increase in the deficit would trigger mandatory cuts, also known as sequestration, unde...
www.kff.org
July 3, 2025 at 7:29 PM
Along with Medicaid/ACA cuts, the BBB will trigger mandatory Medicare cuts - about $45B in 2026
If cuts are proportional across providers, hospitals could see ~$17B lower Medicare payments in 2026 (larger than Medicare DSH + UCC payments)
Historically Congress has stopped triggered cuts before EOY
If cuts are proportional across providers, hospitals could see ~$17B lower Medicare payments in 2026 (larger than Medicare DSH + UCC payments)
Historically Congress has stopped triggered cuts before EOY
Reposted by Scott Hulver
The Senate added $50B for rural hospitals. While cutting $155B in rural Medicaid spending.
NEW RURAL BRIEF @kff.org : Senate reconciliation bill would cut federal Medicaid funding in rural areas by $155B—$36B more than the House bill. www.kff.org/policy-watch...
How Might Federal Medicaid Cuts in the Senate-Passed Reconciliation Bill Affect Rural Areas? | KFF
Under the Senate-passed reconciliation bill, federal Medicaid spending in rural areas is estimated to decline by $155 billion, more than in the House-passed bill, and far more than the $50 billion app...
www.kff.org
July 2, 2025 at 1:11 PM
The Senate added $50B for rural hospitals. While cutting $155B in rural Medicaid spending.
The Senate's proposed limits on state-directed payments are estimated to lower federal spending by almost $150B over 10 years according to CBO's new estimates, which would likely reduce payments to hospitals and nursing facilities in most states.
www.kff.org/medicaid/iss...
www.kff.org/medicaid/iss...
Reconciliation Language Could Lead To Cuts in Medicaid State-Directed Payments to Hospitals and Nursing Facilities | KFF
The Senate Finance Committee’s reconciliation language would reduce existing state-directed payments to hospitals and nursing facilities over time until they are at or slightly above Medicare rates. ...
www.kff.org
June 29, 2025 at 4:55 PM
The Senate's proposed limits on state-directed payments are estimated to lower federal spending by almost $150B over 10 years according to CBO's new estimates, which would likely reduce payments to hospitals and nursing facilities in most states.
www.kff.org/medicaid/iss...
www.kff.org/medicaid/iss...
About 2/3 of rural hospital closures occurred in states that did not expand Medicaid between 2014 and 2024.
Unclear if the Senate's $25B rural fund would cover losses from Medicaid/ACA cuts but it's only for 5 years and rural hospitals have historically struggled to adapt to financial challenges.
Unclear if the Senate's $25B rural fund would cover losses from Medicaid/ACA cuts but it's only for 5 years and rural hospitals have historically struggled to adapt to financial challenges.
10 Things to Know About Rural Hospitals | KFF
This brief explores data about rural hospitals’ financial health and stability at a time when Congress is considering potential federal budget cuts. It examines the prevalence of rural hospitals, thei...
www.kff.org
June 29, 2025 at 2:38 PM
About 2/3 of rural hospital closures occurred in states that did not expand Medicaid between 2014 and 2024.
Unclear if the Senate's $25B rural fund would cover losses from Medicaid/ACA cuts but it's only for 5 years and rural hospitals have historically struggled to adapt to financial challenges.
Unclear if the Senate's $25B rural fund would cover losses from Medicaid/ACA cuts but it's only for 5 years and rural hospitals have historically struggled to adapt to financial challenges.
The Senate's new reconciliation language would increase some Medicare payments to hospitals in Alaska and Hawaii. Recently, hospitals in Alaska had some of the highest operating margins, in aggregate. Margins in Hawaii were also above the national average.
www.kff.org/health-costs...
www.kff.org/health-costs...
June 28, 2025 at 5:41 PM
The Senate's new reconciliation language would increase some Medicare payments to hospitals in Alaska and Hawaii. Recently, hospitals in Alaska had some of the highest operating margins, in aggregate. Margins in Hawaii were also above the national average.
www.kff.org/health-costs...
www.kff.org/health-costs...
Reposted by Scott Hulver
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)
June 27, 2025 at 6:50 PM
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)
Reposted by Scott Hulver
Senate Finance language could lead to cuts in #Medicaid state-directed payments for hospitals and nursing facilities in at least 29 states. See new @kff.org analysis: www.kff.org/medicaid/iss...
Reconciliation Language Could Lead To Cuts in Medicaid State-Directed Payments to Hospitals and Nursing Facilities | KFF
The Senate Finance Committee’s reconciliation language would reduce existing state-directed payments to hospitals and nursing facilities over time until they are at or slightly above Medicare rates. ...
www.kff.org
June 27, 2025 at 5:55 PM
Senate Finance language could lead to cuts in #Medicaid state-directed payments for hospitals and nursing facilities in at least 29 states. See new @kff.org analysis: www.kff.org/medicaid/iss...