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Rural Health Information Hub

Rural Health
Resources by Topic: Reimbursement and payment models

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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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. Discusses behavioral health, school-based services, and integrated care access. Provides examples, strategies, Medicaid policy information, and resources.
Additional links: Improving Access to Integrated Care for Dually Eligible Individuals in Rural Areas, Leveraging Peers and Lay Counselors to Address Behavioral Health Care Workforce Shortages in Rural Areas, Using School-Based Services to Improve Access to Preventive Health Care for Children 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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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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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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MedPAC Comment on CMS's Proposed Rule on CY 2026 Revisions to Payment Policies Under the Physician Fee Schedule and Other Changes to Part B for Payment Policies
Comment on a July 16, 2025, Federal Register proposed rule revising the physician fee schedule to improve payment systems for physicians and other Medicare Part B revisions. Includes a discussion of a proposal to allow Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs) to provide and bill for medical visits via telehealth and be paid at Physician Fee Schedule (PFS)-equivalent rates through December 2026.
Date: 09/2025
Sponsoring organization: Medicare Payment Advisory Commission
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September 2025 MedPAC Meeting Transcript
Transcript from the Medicare Payment Advisory Commission's (MedPAC) September 2024 meeting. Covers Medicare payment operations and improving payment accuracy, a discussion with the Comptroller General of the United States regarding the Government Accountability Office's work related to improper payments in the Medicare program and opportunities to improve program sustainability, Medicare's overall financial situation, access to hospice and services under the Medicare hospice benefit for beneficiaries with end-stage renal disease or cancer, and the relationship between changes in Medicare Advantage enrollment and hospital finances.
Date: 09/2025
Sponsoring organization: Medicare Payment Advisory Commission
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Comparing Utilization of Home Health Care Between Traditional Medicare and Medicare Advantage Beneficiaries by Rural-Urban Status
Policy report describing differences in utilization of home health care between beneficiaries enrolled in Traditional Medicare (TM) and Medicare Advantage (MA), and by rural or urban status. Examines differences in use of home health overall, provision of specific services, including physical and occupational therapy, and receipt of care from home health agencies by enrollment in TM and MA. Features statistics with breakdowns by urban, large rural, small rural, and isolated rural areas.
Date: 09/2025
Sponsoring organization: WWAMI Rural Health Research Center
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Comparison of Care in Hospital Outpatient Departments and Independent Physician Offices: Updated Findings for 2019-2024
Examines differences in Medicare payments for services at an independent physician's office (IPO) or a hospital outpatient department (HOPD). Utilizes 2019-2024 data to analyze characteristics of Medicare patients seen in HOPDs and IPOs, including rural versus urban location.
Date: 09/2025
Sponsoring organization: American Hospital Association
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Implementing High-Quality Primary Care: A Policy Menu for States
Presents policy strategies utilized by states to strengthen primary care across five priority areas. Strategies cover primary care reimbursement; addressing individual, community, and market-level barriers to care; expanding and supporting the primary care workforce; and supporting practice transformation. Includes rural references throughout.
Date: 09/2025
Sponsoring organizations: Milbank Memorial Fund, National Academy for State Health Policy
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Expiring Health Provisions of the 119th Congress
Outlines the healthcare-related funding and governmental authorities that will expire during the 119th Congress, calendars year 2025-2026, if not extended through congressional action. Highlights similar provisions that expired during the 118th Congress (2023-2024). Includes rural references throughout.
Date: 09/2025
Sponsoring organization: Congressional Research Service
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