Rural Health
Resources by Topic: Reimbursement and payment models
Rural Hospital Bypass by Patients With Commercial Health Insurance
Results of a study examining rural hospital bypass rates among commercially insured patients, and hospital payments from patients who bypassed their nearest hospitals. Features statistics with breakdowns by clinical category and 4 levels of population density.
Author(s): Jessica Y. Chang, Caitlin E. Carroll
Citation: JAMA Network Open, 9(1), e2555017
Date: 01/2026
view details
Results of a study examining rural hospital bypass rates among commercially insured patients, and hospital payments from patients who bypassed their nearest hospitals. Features statistics with breakdowns by clinical category and 4 levels of population density.
Author(s): Jessica Y. Chang, Caitlin E. Carroll
Citation: JAMA Network Open, 9(1), e2555017
Date: 01/2026
view details
Small Practices Guide: Getting Started with Electronic Clinical Quality Measure (CQM) Reporting
Provides an overview of electronic clinical quality measures (eCQMs) under the Merit-based Incentive Payment System (MIPS). Describes how small practices can report eCQMs, whether participating as an individual clinician, group, subgroup, or Alternative Payment Model (APM) Entity.
Date: 01/2026
Sponsoring organization: Centers for Medicare and Medicaid Services
view details
Provides an overview of electronic clinical quality measures (eCQMs) under the Merit-based Incentive Payment System (MIPS). Describes how small practices can report eCQMs, whether participating as an individual clinician, group, subgroup, or Alternative Payment Model (APM) Entity.
Date: 01/2026
Sponsoring organization: Centers for Medicare and Medicaid Services
view details
Advancing Medicaid Primary Care Population-Based Payment Models: Four Lessons for States
Discusses the impact of Medicaid policy, the Rural Health Transformation Program, and reimbursement models on primary healthcare. Discusses population-based payment (PC PBP) and value-based payment (VBP) models, sharing examples from Colorado meant to enhance payments to rural and small primary care practices.
Author(s): Kelsey Brykman
Date: 01/2026
Sponsoring organization: Center for Health Care Strategies
view details
Discusses the impact of Medicaid policy, the Rural Health Transformation Program, and reimbursement models on primary healthcare. Discusses population-based payment (PC PBP) and value-based payment (VBP) models, sharing examples from Colorado meant to enhance payments to rural and small primary care practices.
Author(s): Kelsey Brykman
Date: 01/2026
Sponsoring organization: Center for Health Care Strategies
view details
Doula Services for Medicaid Beneficiaries in Virginia: Access, Utilization, and Policy Lessons
Discusses barriers and facilitators of access to doula care for Medicaid beneficiaries in Virginia after evaluation of a collection of both qualitative and quantitative data gathered between January 2022 and January 2025. Discusses geographic disparities including concerns for access in rural areas and policies to address access.
Author(s): Desirae Leaphart Mensah, Alison E. Cuellar
Citation: Health Affairs Scholar, 4(1)
Date: 01/2026
view details
Discusses barriers and facilitators of access to doula care for Medicaid beneficiaries in Virginia after evaluation of a collection of both qualitative and quantitative data gathered between January 2022 and January 2025. Discusses geographic disparities including concerns for access in rural areas and policies to address access.
Author(s): Desirae Leaphart Mensah, Alison E. Cuellar
Citation: Health Affairs Scholar, 4(1)
Date: 01/2026
view details
January 2026 MedPAC Meeting Transcript
Transcript from the Medicare Payment Advisory Commission's (MedPAC) January 2026 meeting. Covers payment adequacy and updates for physician and other health professional services, hospital inpatient and outpatient services, skilled nursing facility services, home health agency services, inpatient rehabilitation facility services, outpatient dialysis services, and hospice services. Discusses status reports on Medicare Part D, ambulatory surgical centers, and the Medicare Advantage program, as well as mandated reports on changes to the home health prospective payment system and dual-eligible special needs plans. Includes rural references and considerations throughout.
Date: 01/2026
Sponsoring organization: Medicare Payment Advisory Commission
view details
Transcript from the Medicare Payment Advisory Commission's (MedPAC) January 2026 meeting. Covers payment adequacy and updates for physician and other health professional services, hospital inpatient and outpatient services, skilled nursing facility services, home health agency services, inpatient rehabilitation facility services, outpatient dialysis services, and hospice services. Discusses status reports on Medicare Part D, ambulatory surgical centers, and the Medicare Advantage program, as well as mandated reports on changes to the home health prospective payment system and dual-eligible special needs plans. Includes rural references and considerations throughout.
Date: 01/2026
Sponsoring organization: Medicare Payment Advisory Commission
view details
Merit-based Incentive Payment System (MIPS) 2026 Small Practice Eligibility and Participation Frequently Asked Questions
Provides answers to frequently asked questions regarding small practice participation and eligibility for the Merit-based Incentive Payment System (MIPS) for the 2026 performance year. Covers individual and group eligibility, the low-volume threshold, changes to group composition during the performance year, and more.
Date: 01/2026
Sponsoring organization: Centers for Medicare and Medicaid Services
view details
Provides answers to frequently asked questions regarding small practice participation and eligibility for the Merit-based Incentive Payment System (MIPS) for the 2026 performance year. Covers individual and group eligibility, the low-volume threshold, changes to group composition during the performance year, and more.
Date: 01/2026
Sponsoring organization: Centers for Medicare and Medicaid Services
view details
Indian Health Service and Health Care Affordability Issues Among American Indian/ Alaska Native People by Rurality
Report explores healthcare affordability and Indian Health Services (IHS) utilization among American Indian and Alaska Native (AI/AN) in rural and urban communities. Highlights rates of patients receiving care at IHS, privately insured, and uninsured in rural and urban communities, among other measures.
Author(s): Ingrid Jacobson, Katie Rydberg, Alexis Swendener, et al.
Date: 01/2026
Sponsoring organization: University of Minnesota Rural Health Research Center
view details
Report explores healthcare affordability and Indian Health Services (IHS) utilization among American Indian and Alaska Native (AI/AN) in rural and urban communities. Highlights rates of patients receiving care at IHS, privately insured, and uninsured in rural and urban communities, among other measures.
Author(s): Ingrid Jacobson, Katie Rydberg, Alexis Swendener, et al.
Date: 01/2026
Sponsoring organization: University of Minnesota Rural Health Research Center
view details
Merit-Based Incentive Payment System (MIPS): 2026 Improvement Activities Performance Category Quick Start Guide
Provides an overview of Merit-based Incentive Payment System (MIPS) requirements, data collection, and data submission for the improvement activities performance category for the 2026 performance year. Includes information about special status scoring for small practices and clinicians located in a rural or Health Professional Shortage Area.
Date: 01/2026
Sponsoring organization: Centers for Medicare and Medicaid Services
view details
Provides an overview of Merit-based Incentive Payment System (MIPS) requirements, data collection, and data submission for the improvement activities performance category for the 2026 performance year. Includes information about special status scoring for small practices and clinicians located in a rural or Health Professional Shortage Area.
Date: 01/2026
Sponsoring organization: Centers for Medicare and Medicaid Services
view details
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: 01/2026
Sponsoring organizations: Mathematica, Rural Health Redesign Center
view details
Provides answers to frequently asked questions regarding the Rural Emergency Hospital (REH) designation. Covers general information, Conditions of Participation, and REH payment policies.
Date: 01/2026
Sponsoring organizations: Mathematica, Rural Health Redesign Center
view details
January 2026 Annual Rural Emergency Hospital (REH) Monthly Facility Payment Amount
Presents the monthly Rural Emergency Hospital (REH) monthly facility payment amount for Calendar Year 2026.
Date: 12/2025
Sponsoring organization: Centers for Medicare and Medicaid Services
view details
Presents the monthly Rural Emergency Hospital (REH) monthly facility payment amount for Calendar Year 2026.
Date: 12/2025
Sponsoring organization: Centers for Medicare and Medicaid Services
view details