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Rural Health Information Hub

Rural Health
Resources by Topic: Reimbursement and payment models

Organizational Factors Associated with Using Telehealth Services: Perspectives from Leaders of Rural Health Clinics and Federally Qualified Health Centers
Research and policy brief examining organizational factors influencing telehealth use in Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs). Summarizes interviews with RHC and FQHC key informants to discuss perceptions of telehealth, implementation challenges, operational challenges, and opportunities for innovation. Provides suggestions for policy and reimbursement approaches to improve telehealth provision and access.
Author(s): Constance van Eeghen, John A. Gale, Erika Ziller, Yvonne Jonk
Date: 06/2025
Sponsoring organization: Rural Telehealth Research Center
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Preventing Medical Debt among Rural Residents: Example Programs from Hospitals in Minnesota and Montana
Highlights the ways some rural hospitals are working to reduce medical debt for their patients. Presents a number of strategies from hospitals in Minnesota and Montana that aim to reduce patient medical debts through financial assistance programs and cost-cutting measures. Features case-studies reviewing the structure of each hospital's debt reduction efforts.
Author(s): Katie Rydberg, Sushma Shankar, Mariana Tuttle, Carrie Henning-Smith
Date: 06/2025
Sponsoring organization: University of Minnesota Rural Health Research Center
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Quality Payment Program (QPP) 2023: Participation and Payment Results At-a-Glance
Provides an overview of the results of the Quality Payment Program (QPP) for the 2023 performance year. Highlights the percentages of small and rural providers receiving negative, neutral, and positive payment adjustments for 2025.
Date: 06/2025
Sponsoring organization: Centers for Medicare and Medicaid Services
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Merit-Based Incentive Payment System (MIPS): 2025 Reporting Options Comparison Resource
Provides an overview of the similarities and differences among the three Merit-Based Incentive Payment System (MIPS) reporting options: Traditional MIPS, MIPS Value Pathways (MVP), and Alternative Payment Model (APM) Performance Pathway (APP). Designed to help providers understand which reporting options may be best for their practice. Includes information on reporting flexibilities and scoring for small and rural practices.
Additional links: 2025 Merit-Based Incentive Payment System (MIPS) At-A-Glance Reporting Options for Small Practices
Date: 05/2025
Sponsoring organization: Centers for Medicare and Medicaid Services
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CMS Innovation Center Strategic Direction
Describes the vision and strategic objectives for the Center for Medicare and Medicaid Innovation (CMS Innovation Center). Strategic objectives include promoting evidence-based prevention, empowering people to achieve their health goals, and driving choice and competition.
Additional links: Frequently Asked Questions, White Paper: The CMS Innovation Center's Strategy to Make America Healthy Again
Date: 05/2025
Sponsoring organization: Centers for Medicare and Medicaid Services
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Rural Healthcare Provider Transition Project (RHPTP) Webinar: Quality Improvement (QI) Alignment Across the Hospital and Clinics is Key to Value-Based Payment (VBP) Success
A recorded webinar that discusses strategies to align quality improvement (QI) projects with value-based payment (VBP) across organizational settings. Discusses clinical quality measures and sustainability of QI. Transcript available below description.
Additional links: Slides
Author(s): Lisa Olson, Candy Hanson
Date: 05/2025
Sponsoring organizations: National Rural Health Resource Center, Stratis Health
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Evaluation of the Primary Care First Model: Third Annual Report
Provides an overview of the Primary Care First (PCF) model, which aims to enhance primary care and move primary care practitioners toward value-based payment. Describes the PCF model implementation experiences for Cohort 1 and Cohort 2 practices through 2023. Explores the characteristics of practices and payers that continued to participate in the PCF model compared to those who left. Examines the role that the PCF Model's incentives and supports played in the strategies and practices adopted to improve care delivery and how the trajectory of these strategies and activities practices have transformed over time. Estimates the impact of the PCF Model on Medicare fee-for-service (FFS) expenditures and service use, including acute hospitalizations. Estimates the impacts of the model on a set of seven leading indicators to provide an early assessment of whether care delivery changes are resulting in meaningful early outcome changes.
Additional links: Executive Summary, Findings at a Glance
Date: 05/2025
Sponsoring organizations: Centers for Medicare and Medicaid Services, Mathematica
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Merit-Based Incentive Payment System (MIPS): 2025 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 2025 performance year. Includes information about special status scoring for small practices and clinicians located in a rural or Health Professional Shortage Area.
Date: 05/2025
Sponsoring organization: Centers for Medicare and Medicaid Services
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Medicare Shared Savings Program: Rule Changes and Implications for Rural Health Care Organizations
Summarizes changes to the Centers for Medicare & Medicaid Services (CMS) Medicare Shared Savings Program (SSP) that take effect in January 2023 for current participants, and in January 2024 for organizations applying for a January 1, 2024 start. Discusses the potential impact of these changes on rural health and participation considerations.
Date: 05/2025
Sponsoring organization: Rural Health Value
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Ways and Means Republican Members Share Commitment to Value-Based Health Care and Outline Priorities For Medicare Innovation Hub
An April 2025 letter from the U.S. House Committee on Ways and Means majority members regarding the Centers for Medicare & Medicaid Services (CMS) Innovation Center (CMMI). Offers considerations for new and existing models related to promoting value, improving care in rural and underserved communities, and incorporating public input.
Date: 04/2025
Sponsoring organization: House Ways and Means Committee
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