Rural Health
Resources by Topic: Accountable Care Organizations
Rural-Based Accountable Care Organizations Agreement Renewal
Policy brief describing characteristics of Accountable Care Organizations participating in the Medicare Shared Savings Program (MSSP). Compares trends in exits and entries into MSSP between rural and urban areas from 2013-2022.
Author(s): Edmer Lazaro, Dan M. Shane, Fred Ullrich, Keith Mueller
Date: 02/2026
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
view details
Policy brief describing characteristics of Accountable Care Organizations participating in the Medicare Shared Savings Program (MSSP). Compares trends in exits and entries into MSSP between rural and urban areas from 2013-2022.
Author(s): Edmer Lazaro, Dan M. Shane, Fred Ullrich, Keith Mueller
Date: 02/2026
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
view details
Metropolitan and Nonmetropolitan Medicare Shared Savings Program Assigned Beneficiaries Among Original Medicare Enrollees
Describes trends of Medicare beneficiaries assigned to Medicare Shared Savings Program (SSP) Accountable Care Organizations (ACOs). Presents data on metropolitan and nonmetropolitan SSP ACO assignment and Medicare Advantage enrollment between 2018 and 2024, as well as the percentage of original Medicare beneficiaries assigned to an ACO in 2024 by metropolitan status and state.
Author(s): Fred Ullrich, Keith Mueller
Date: 02/2026
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
view details
Describes trends of Medicare beneficiaries assigned to Medicare Shared Savings Program (SSP) Accountable Care Organizations (ACOs). Presents data on metropolitan and nonmetropolitan SSP ACO assignment and Medicare Advantage enrollment between 2018 and 2024, as well as the percentage of original Medicare beneficiaries assigned to an ACO in 2024 by metropolitan status and state.
Author(s): Fred Ullrich, Keith Mueller
Date: 02/2026
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
view details
A Comparison of Independent and System-Affiliated Rural Hospitals
Compares independent and system-affiliated rural hospitals by organizational characteristics, financial performance, and county characteristics. Presents Medicare Cost Report data from 2023-2024 on the number and percentage of independent and system-affiliated rural hospitals by state, ownership characteristics, Medicare payment classification, use of swing beds, financial distress, and more.
Author(s): Aditya R. Pillutla, Sruthi Malavika Srinivasan, Kristie Thompson, George Pink, Tyler Malone
Date: 02/2026
Sponsoring organization: North Carolina Rural Health Research Program
view details
Compares independent and system-affiliated rural hospitals by organizational characteristics, financial performance, and county characteristics. Presents Medicare Cost Report data from 2023-2024 on the number and percentage of independent and system-affiliated rural hospitals by state, ownership characteristics, Medicare payment classification, use of swing beds, financial distress, and more.
Author(s): Aditya R. Pillutla, Sruthi Malavika Srinivasan, Kristie Thompson, George Pink, Tyler Malone
Date: 02/2026
Sponsoring organization: North Carolina Rural Health Research Program
view details
Shared Savings Program Fast Facts
Provides summary statistics on the Medicare Shared Savings Program as of January 1, 2026. Offers data on the number of Accountable Care Organizations (ACOs), assigned beneficiaries, total earned shared savings, and quality scores each year since 2012; the number and percent of ACOs in each track; and more. Includes information on ACO participants, including the number of Rural Health Clinics (RHCs) and Critical Access Hospitals (CAHs) participating in the program.
Date: 02/2026
Sponsoring organization: Centers for Medicare and Medicaid Services
view details
Provides summary statistics on the Medicare Shared Savings Program as of January 1, 2026. Offers data on the number of Accountable Care Organizations (ACOs), assigned beneficiaries, total earned shared savings, and quality scores each year since 2012; the number and percent of ACOs in each track; and more. Includes information on ACO participants, including the number of Rural Health Clinics (RHCs) and Critical Access Hospitals (CAHs) participating in the program.
Date: 02/2026
Sponsoring organization: Centers for Medicare and Medicaid Services
view details
Rural–Urban Disparities in Diabetes Quality of Care with Accountable Care Organization Participation
Examines the relationship among diabetes quality of care, accountable care organization (ACO) participation, and rural versus urban health disparities. Utilizes 2011-2018 Wisconsin Collaborative for Healthcare Quality all-patient all-payer data to analyze diabetes care management across ACO versus non-ACO participation and rural versus urban location.
Author(s): Mariétou H. Ouayogodé, Xiyuan Hu
Citation: Journal of Rural Health, 42(1), e70121
Date: 02/2026
view details
Examines the relationship among diabetes quality of care, accountable care organization (ACO) participation, and rural versus urban health disparities. Utilizes 2011-2018 Wisconsin Collaborative for Healthcare Quality all-patient all-payer data to analyze diabetes care management across ACO versus non-ACO participation and rural versus urban location.
Author(s): Mariétou H. Ouayogodé, Xiyuan Hu
Citation: Journal of Rural Health, 42(1), e70121
Date: 02/2026
view details
RHCs and CAHs Participating in the Medicare Shared Savings Program (MSSP): Characteristics of the Providers and Communities
Describes the characteristics of Rural Health Clinics (RHCs) and Critical Access Hospitals (CAHs) currently participating in the Medicare Shared Savings Program (MSSP) in 2023. Compares CAH and RHC characteristics by MSSP participation, ownership status, and free-standing versus provider-based RHC status.
Author(s): Edmer Lazaro, Dan Shane, Fred Ullrich, Keith Mueller
Date: 11/2025
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
view details
Describes the characteristics of Rural Health Clinics (RHCs) and Critical Access Hospitals (CAHs) currently participating in the Medicare Shared Savings Program (MSSP) in 2023. Compares CAH and RHC characteristics by MSSP participation, ownership status, and free-standing versus provider-based RHC status.
Author(s): Edmer Lazaro, Dan Shane, Fred Ullrich, Keith Mueller
Date: 11/2025
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
view details
MedPAC Payment Basics
Series of briefs providing an of Medicare payment systems. Covers payments systems including Accountable Care Organizations (ACO), Critical Access Hospitals (CAH), Federally Qualified Health Centers and Rural Health Clinics, hospital acute inpatient services, and more.
Date: 11/2025
Sponsoring organization: Medicare Payment Advisory Commission
view details
Series of briefs providing an of Medicare payment systems. Covers payments systems including Accountable Care Organizations (ACO), Critical Access Hospitals (CAH), Federally Qualified Health Centers and Rural Health Clinics, hospital acute inpatient services, and more.
Date: 11/2025
Sponsoring organization: Medicare Payment Advisory Commission
view details
Medicare Payment Basics: Accountable Care Organizations Payment Systems
Provides an overview of Medicare's Accountable Care Organization (ACO) programs. Discusses the payment mechanics of ACOs, including the maximum shared savings and losses of Medicare Shared Savings Program ACOs by track and level.
Date: 11/2025
Sponsoring organization: Medicare Payment Advisory Commission
view details
Provides an overview of Medicare's Accountable Care Organization (ACO) programs. Discusses the payment mechanics of ACOs, including the maximum shared savings and losses of Medicare Shared Savings Program ACOs by track and level.
Date: 11/2025
Sponsoring organization: Medicare Payment Advisory Commission
view details
MedPAC Data Book: Health Care Spending and the Medicare Program, 2025
Provides an overview of Medicare spending and highlights data on Medicare beneficiary demographics, dual-eligible beneficiaries, quality of care provided through the Medicare program, and other payer liability. Examines settings of care, including rural-specific provider sites, as they relate to spending, access to care, and profit margins. Compares rural and urban beneficiaries and providers throughout. Chart 6-2 addresses rural hospital closures and Rural Emergency Hospital conversions.
Date: 07/2025
Sponsoring organization: Medicare Payment Advisory Commission
view details
Provides an overview of Medicare spending and highlights data on Medicare beneficiary demographics, dual-eligible beneficiaries, quality of care provided through the Medicare program, and other payer liability. Examines settings of care, including rural-specific provider sites, as they relate to spending, access to care, and profit margins. Compares rural and urban beneficiaries and providers throughout. Chart 6-2 addresses rural hospital closures and Rural Emergency Hospital conversions.
Date: 07/2025
Sponsoring organization: Medicare Payment Advisory Commission
view details
Beneficiary and Clinician Perspectives on Medicare and Other Issues: Findings from 2025 Focus Groups in St. Louis, Missouri, and 2021–2025 Rural Focus Groups
Summarizes findings from 8 focus groups of Medicare beneficiaries, Medicare and Medicaid (dual eligible) beneficiaries, and clinicians conducted between April and May 2025, including one virtual focus group of rural Medicare beneficiaries. Compiles findings from 13 focus groups of rural Medicare beneficiaries between 2021 and 2025. Highlights themes that emerged across the focus groups covering Medicare coverage options, access to care, telehealth, organization of care, and prescription drugs.
Date: 06/2025
Sponsoring organizations: Medicare Payment Advisory Commission, NORC at the University of Chicago
view details
Summarizes findings from 8 focus groups of Medicare beneficiaries, Medicare and Medicaid (dual eligible) beneficiaries, and clinicians conducted between April and May 2025, including one virtual focus group of rural Medicare beneficiaries. Compiles findings from 13 focus groups of rural Medicare beneficiaries between 2021 and 2025. Highlights themes that emerged across the focus groups covering Medicare coverage options, access to care, telehealth, organization of care, and prescription drugs.
Date: 06/2025
Sponsoring organizations: Medicare Payment Advisory Commission, NORC at the University of Chicago
view details