Rural Health
Resources by Topic: Healthcare business and finance
Risk Adjustment in the Medicare Advantage Population Using Encounter Data
Examines the Centers for Medicare and Medicaid Services (CMS) Hierarchical Condition Category (HCC) risk model by comparing 2016-2022 Traditional Medicare (TM) claims and Medicare Advantage (MA) encounter data. Analyzes differences in the TM-based model and MA-based model and discusses risk-adjusted MA payment, MA payment policy, and enrollment incentives for various populations, including rural.
Author(s): Caroline S. Carlin, Roger Feldman, Jeah Jung
Citation: Health Services Research, 61(5), e70165
Date: 10/2026
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Examines the Centers for Medicare and Medicaid Services (CMS) Hierarchical Condition Category (HCC) risk model by comparing 2016-2022 Traditional Medicare (TM) claims and Medicare Advantage (MA) encounter data. Analyzes differences in the TM-based model and MA-based model and discusses risk-adjusted MA payment, MA payment policy, and enrollment incentives for various populations, including rural.
Author(s): Caroline S. Carlin, Roger Feldman, Jeah Jung
Citation: Health Services Research, 61(5), e70165
Date: 10/2026
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Telehealth FAQ
Provides information on Medicare telehealth regulations and payment policy for calendar year 2026. Includes information on audio-only services, behavioral health services, direct supervision, and more.
Date: 10/2026
Sponsoring organization: Centers for Medicare & Medicaid Services
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Provides information on Medicare telehealth regulations and payment policy for calendar year 2026. Includes information on audio-only services, behavioral health services, direct supervision, and more.
Date: 10/2026
Sponsoring organization: Centers for Medicare & Medicaid Services
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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: 10/2026
Sponsoring organization: Medicare Payment Advisory Commission
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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: 10/2026
Sponsoring organization: Medicare Payment Advisory Commission
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Medicare Payment Basics: Federally Qualified Health Center and Rural Health Clinic Payment Systems
Presents an overview of Medicare payments for Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs). Details how the all-inclusive rate (AIR) is calculated for RHCs and how the national statutory payment limit applies to provider-based RHCs enrolled in Medicare before December 31, 2020, and whether they part of a hospital with fewer than 50 beds. Includes information on special payment rules for certain services provided by FQHCs and RHCs.
Date: 10/2026
Sponsoring organization: Medicare Payment Advisory Commission
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Presents an overview of Medicare payments for Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs). Details how the all-inclusive rate (AIR) is calculated for RHCs and how the national statutory payment limit applies to provider-based RHCs enrolled in Medicare before December 31, 2020, and whether they part of a hospital with fewer than 50 beds. Includes information on special payment rules for certain services provided by FQHCs and RHCs.
Date: 10/2026
Sponsoring organization: Medicare Payment Advisory Commission
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Medicare Payment Basics: Outpatient Dialysis Services Payment System
Overview of Medicare payment methods for outpatient dialysis services of beneficiaries with end-stage renal disease (ESRD). Describes the base payment rate for freestanding and hospital-based facilities and identifies facility-level adjustments, including facilities located in rural areas.
Date: 10/2026
Sponsoring organization: Medicare Payment Advisory Commission
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Overview of Medicare payment methods for outpatient dialysis services of beneficiaries with end-stage renal disease (ESRD). Describes the base payment rate for freestanding and hospital-based facilities and identifies facility-level adjustments, including facilities located in rural areas.
Date: 10/2026
Sponsoring organization: Medicare Payment Advisory Commission
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Medicare Payment Basics: Inpatient Psychiatric Facilities Services Payment System
Overview of Medicare's payment system for inpatient psychiatric services provided in freestanding hospitals or specialized hospital-based units. Demonstrates how payments for these services are adjusted to reflect geographic differences in labor costs, and cost of care by facility and patient characteristics.
Date: 10/2026
Sponsoring organization: Medicare Payment Advisory Commission
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Overview of Medicare's payment system for inpatient psychiatric services provided in freestanding hospitals or specialized hospital-based units. Demonstrates how payments for these services are adjusted to reflect geographic differences in labor costs, and cost of care by facility and patient characteristics.
Date: 10/2026
Sponsoring organization: Medicare Payment Advisory Commission
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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: 10/2026
Sponsoring organization: Medicare Payment Advisory Commission
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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: 10/2026
Sponsoring organization: Medicare Payment Advisory Commission
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Medicare Payment Basics: Ambulance Services Payment System
Provides an overview of Medicare payments for ambulance services. Discusses rural add-on payment policies, geographic categories determining payment rates, super-rural ZIP codes, and ambulance fee schedules.
Date: 10/2026
Sponsoring organization: Medicare Payment Advisory Commission
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Provides an overview of Medicare payments for ambulance services. Discusses rural add-on payment policies, geographic categories determining payment rates, super-rural ZIP codes, and ambulance fee schedules.
Date: 10/2026
Sponsoring organization: Medicare Payment Advisory Commission
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Medicare Payment Basics: Durable Medical Equipment Payment System
Overview of Medicare payments for medical equipment used to treat beneficiaries at home. Defines durable medical equipment (DME), details the DME fee schedule, and discusses the competitive bidding program (CBP) for DME. Includes information a revised methodology for awarding contracts in the next round of competitive establishing payment rates in 2028.
Date: 10/2026
Sponsoring organization: Medicare Payment Advisory Commission
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Overview of Medicare payments for medical equipment used to treat beneficiaries at home. Defines durable medical equipment (DME), details the DME fee schedule, and discusses the competitive bidding program (CBP) for DME. Includes information a revised methodology for awarding contracts in the next round of competitive establishing payment rates in 2028.
Date: 10/2026
Sponsoring organization: Medicare Payment Advisory Commission
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Medicare Payment Basics: Home Health Care Services Payment System
Overview of Medicare payments for home healthcare services. Includes information on rate-setting and payments for quality reporting and performance. Describes the Patient-Driven Groupings Model (PDGM) and the home health resource groups (HHRGs) based on clinical and functional status.
Date: 10/2026
Sponsoring organization: Medicare Payment Advisory Commission
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Overview of Medicare payments for home healthcare services. Includes information on rate-setting and payments for quality reporting and performance. Describes the Patient-Driven Groupings Model (PDGM) and the home health resource groups (HHRGs) based on clinical and functional status.
Date: 10/2026
Sponsoring organization: Medicare Payment Advisory Commission
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