Rural Health
Resources by Topic: Reimbursement and payment models
Calendar Year (CY) 2026 Medicare Physician Fee Schedule Final Rule (CMS-1832-F)
Fact sheet providing an overview of the Centers for Medicare & Medicaid Services (CMS) final rule regarding updates and changes to the Medicare payments under the Physician Fee Schedule (PFS) and other Medicare Part B issues for calendar year 2026. Summarizes provisions related to telehealth services; improving care for chronic illness and behavioral health needs; Rural Health Clinic (RHC) and Federally Qualified Health Center (FQHC) care coordination services, services requiring direct supervision, and telecommunication services; and more.
Date: 10/2025
Sponsoring organization: Centers for Medicare and Medicaid Services
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Fact sheet providing an overview of the Centers for Medicare & Medicaid Services (CMS) final rule regarding updates and changes to the Medicare payments under the Physician Fee Schedule (PFS) and other Medicare Part B issues for calendar year 2026. Summarizes provisions related to telehealth services; improving care for chronic illness and behavioral health needs; Rural Health Clinic (RHC) and Federally Qualified Health Center (FQHC) care coordination services, services requiring direct supervision, and telecommunication services; and more.
Date: 10/2025
Sponsoring organization: Centers for Medicare and Medicaid Services
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State Telehealth Laws and Reimbursement Policies Report, Fall 2025
Provides an overview of state telehealth policies as of early September 2025. Covers Medicaid reimbursement, private payer laws, and professional requirements.
Additional links: Executive Summary, Infographic, State Summary Chart
Date: 10/2025
Sponsoring organization: Center for Connected Health Policy: The National Telehealth Policy Resource Center
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Provides an overview of state telehealth policies as of early September 2025. Covers Medicaid reimbursement, private payer laws, and professional requirements.
Additional links: Executive Summary, Infographic, State Summary Chart
Date: 10/2025
Sponsoring organization: Center for Connected Health Policy: The National Telehealth Policy Resource Center
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Rural Transformation Program State Legislative Resources
Provides an overview of the Rural Health Transformation Program, including how states approached seeking public input for the application. Describes how states have successfully implemented policies related to the allowable uses of Rural Health Transformation Program funds.
Date: 10/2025
Sponsoring organization: National Conference of State Legislatures
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Provides an overview of the Rural Health Transformation Program, including how states approached seeking public input for the application. Describes how states have successfully implemented policies related to the allowable uses of Rural Health Transformation Program funds.
Date: 10/2025
Sponsoring organization: National Conference of State Legislatures
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Merit-Based Incentive Payment System (MIPS): 2024 Performance Year/2026 MIPS Payment Year - Payment Adjustment User Guide
Provides information on Merit-Based Incentive Payment System (MIPS) payment adjustments for calendar year 2026. Describes how 2024 MIPS scores relate to 2026 payment adjustments and how payment adjustments are applied. Offers answers to frequently asked questions.
Date: 10/2025
Sponsoring organization: Centers for Medicare and Medicaid Services
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Provides information on Merit-Based Incentive Payment System (MIPS) payment adjustments for calendar year 2026. Describes how 2024 MIPS scores relate to 2026 payment adjustments and how payment adjustments are applied. Offers answers to frequently asked questions.
Date: 10/2025
Sponsoring organization: Centers for Medicare and Medicaid Services
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Investing in Primary Care: The Nurse Practitioner Will See You Now
Describes opportunities to support advancement of preparation and growth for nurse practitioners (NPs) to meet the population's primary care needs. Explores the importance of NPs in rural and underserved communities, and Health Professional Shortage Areas.
Author(s): Jessica McCann, Margaret Flinter
Date: 10/2025
Sponsoring organization: Milbank Memorial Fund
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Describes opportunities to support advancement of preparation and growth for nurse practitioners (NPs) to meet the population's primary care needs. Explores the importance of NPs in rural and underserved communities, and Health Professional Shortage Areas.
Author(s): Jessica McCann, Margaret Flinter
Date: 10/2025
Sponsoring organization: Milbank Memorial Fund
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Transforming Rural Health Care Through Medicaid Innovation: Tip Sheet Series
Informational tip sheets discussing the use of Medicaid innovations to assist states in creating their Rural Health Transformation (RHT) Program applications. Covers issues such as behavioral health, school-based services, integrated care access, community health workers, community paramedicine, specialty care, and healthcare technology. Provides examples, strategies, Medicaid policy information, and resources.
Additional links: Improving Access to Integrated Care for Dually Eligible Individuals in Rural Areas, Leveraging Community Health Workers to Address Rural Health Care Needs, Leveraging Community Paramedicine to Address Rural Health Needs, Leveraging Peers and Lay Counselors to Address Behavioral Health Care Workforce Shortages in Rural Areas, Using Project ECHO to Deliver Specialty Care in Rural Areas, Using School-Based Services to Improve Access to Preventive Health Care for Children in Rural Areas, Using Tech-Enabled Solutions to Improve Care Quality and Access in Rural Areas
Author(s): Molly Knowles, Nancy Archibald, Karla Silverman, Lauren Scannelli Jacobs
Date: 10/2025
Sponsoring organization: Center for Health Care Strategies
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Informational tip sheets discussing the use of Medicaid innovations to assist states in creating their Rural Health Transformation (RHT) Program applications. Covers issues such as behavioral health, school-based services, integrated care access, community health workers, community paramedicine, specialty care, and healthcare technology. Provides examples, strategies, Medicaid policy information, and resources.
Additional links: Improving Access to Integrated Care for Dually Eligible Individuals in Rural Areas, Leveraging Community Health Workers to Address Rural Health Care Needs, Leveraging Community Paramedicine to Address Rural Health Needs, Leveraging Peers and Lay Counselors to Address Behavioral Health Care Workforce Shortages in Rural Areas, Using Project ECHO to Deliver Specialty Care in Rural Areas, Using School-Based Services to Improve Access to Preventive Health Care for Children in Rural Areas, Using Tech-Enabled Solutions to Improve Care Quality and Access in Rural Areas
Author(s): Molly Knowles, Nancy Archibald, Karla Silverman, Lauren Scannelli Jacobs
Date: 10/2025
Sponsoring organization: Center for Health Care Strategies
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Rural Emergency Hospital (REH) Model Frequently Asked Questions
Provides answers to frequently asked questions regarding the Rural Emergency Hospital (REH) designation. Covers general information, Conditions of Participation, and REH payment policies.
Date: 10/2025
Sponsoring organizations: Mathematica, Rural Health Redesign Center
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Provides answers to frequently asked questions regarding the Rural Emergency Hospital (REH) designation. Covers general information, Conditions of Participation, and REH payment policies.
Date: 10/2025
Sponsoring organizations: Mathematica, Rural Health Redesign Center
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Unfairness Toward Rural Beneficiaries in Medicare's Hierarchical Conditions Categories Score
Evaluates the Centers for Medicare & Medicaid Services (CMS) Hierarchical Condition Category (HCC) to determine its usefulness in accurately predicting risk for rural and urban patients. Assesses rural and urban risk by mortality rates and compares findings with HCC's measure of spending to identify risk. Discusses implications of findings related to reimbursement rates, healthcare access, social determinants of health, and Medicare Advantage enrollment. Offers potential solutions to address study findings.
Author(s): Ravi B. Parikh, Kristin A. Linn, Junning Liang, et al
Citation: Health Affairs Scholar, 3(9)
Date: 09/2025
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Evaluates the Centers for Medicare & Medicaid Services (CMS) Hierarchical Condition Category (HCC) to determine its usefulness in accurately predicting risk for rural and urban patients. Assesses rural and urban risk by mortality rates and compares findings with HCC's measure of spending to identify risk. Discusses implications of findings related to reimbursement rates, healthcare access, social determinants of health, and Medicare Advantage enrollment. Offers potential solutions to address study findings.
Author(s): Ravi B. Parikh, Kristin A. Linn, Junning Liang, et al
Citation: Health Affairs Scholar, 3(9)
Date: 09/2025
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Supporting Rural Health Facilities
Discusses strategies pursued by states to strengthen the financial stability of rural hospitals and expand access to primary care, behavioral healthcare, and emergency care. Describes state policies related to technical assistance, financial stabilization grants, payment models, Rural Health Clinics (RHCs), health centers, Certified Community Behavioral Health Clinics (CCBHCs), and free-standing emergency departments.
Date: 09/2025
Sponsoring organization: National Conference of State Legislatures
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Discusses strategies pursued by states to strengthen the financial stability of rural hospitals and expand access to primary care, behavioral healthcare, and emergency care. Describes state policies related to technical assistance, financial stabilization grants, payment models, Rural Health Clinics (RHCs), health centers, Certified Community Behavioral Health Clinics (CCBHCs), and free-standing emergency departments.
Date: 09/2025
Sponsoring organization: National Conference of State Legislatures
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Evaluation of the Rural Community Hospital Demonstration: CCA Extension Final Report (Covering 2016-2021)
Provides an overview of the Rural Community Hospital Demonstration (RCHD), focusing on the 26 hospitals that participated during the extension period authorized by the 21st Century Cures Act (2016-2021). Describes the characteristics of active RCHD participants before they joined the demonstration, the Medicare payments received under the program, and the impact of the RCHD on hospital financial measures.
Additional links: Appendices, At-A-Glance, Executive Summary
Date: 09/2025
Sponsoring organizations: American Institutes for Research, Centers for Medicare and Medicaid Services
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Provides an overview of the Rural Community Hospital Demonstration (RCHD), focusing on the 26 hospitals that participated during the extension period authorized by the 21st Century Cures Act (2016-2021). Describes the characteristics of active RCHD participants before they joined the demonstration, the Medicare payments received under the program, and the impact of the RCHD on hospital financial measures.
Additional links: Appendices, At-A-Glance, Executive Summary
Date: 09/2025
Sponsoring organizations: American Institutes for Research, Centers for Medicare and Medicaid Services
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