Rural Health
Resources by Topic: Reimbursement and payment models
Study of the Feasibility and Desirability of Establishing a Delinquent Billing Reimbursement Grant System for Ambulance Service Providers - Survey Results & Overview
Presents a the results of a study on the feasibility of implementing a grant-funded reimbursement system for ambulance service providers in North Dakota. Explores the financial stability of North Dakota's EMS providers under the fee-for-service model and highlights gaps and shortfalls in reimbursement. Discusses the effect of these reimbursement issues in both rural and urban areas.
Date: 02/2026
Sponsoring organizations: North Dakota Department of Health and Human Services, North Dakota EMS Association, North Dakota Legislative Council
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Presents a the results of a study on the feasibility of implementing a grant-funded reimbursement system for ambulance service providers in North Dakota. Explores the financial stability of North Dakota's EMS providers under the fee-for-service model and highlights gaps and shortfalls in reimbursement. Discusses the effect of these reimbursement issues in both rural and urban areas.
Date: 02/2026
Sponsoring organizations: North Dakota Department of Health and Human Services, North Dakota EMS Association, North Dakota Legislative Council
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State-Level Impacts of Key Medicaid Provisions in the One Big Beautiful Bill Act
Explores the potential impacts of 12 healthcare provisions within the One Big Beautiful Bill Act (Public Law 119-21) on Medicaid and state budgets. Presents estimated impacts for each state provision-by-provision and overall. Includes analysis related to Medicaid determination, provider taxes, state-directed payments, work requirements, and the Rural Health Transformation Program.
Author(s): Preethi Rao, Lawrence Baker, Federico Girosi, et al.
Date: 02/2026
Sponsoring organization: RAND Corporation
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Explores the potential impacts of 12 healthcare provisions within the One Big Beautiful Bill Act (Public Law 119-21) on Medicaid and state budgets. Presents estimated impacts for each state provision-by-provision and overall. Includes analysis related to Medicaid determination, provider taxes, state-directed payments, work requirements, and the Rural Health Transformation Program.
Author(s): Preethi Rao, Lawrence Baker, Federico Girosi, et al.
Date: 02/2026
Sponsoring organization: RAND Corporation
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Catalog of Value-Based Initiatives for Rural Providers
Summarizes rural-relevant, value-based programs currently or recently implemented by the U.S. Department of Health and Human Services (HHS), including the Centers for Medicare & Medicaid Services (CMS) and the CMS Innovation Center. Designed to help rural healthcare leaders identify HHS value-based programs that are suitable for rural participation. Contains descriptions of each demonstration and provides direct links to the corresponding agency web page.
Date: 02/2026
Sponsoring organization: Rural Health Value
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Summarizes rural-relevant, value-based programs currently or recently implemented by the U.S. Department of Health and Human Services (HHS), including the Centers for Medicare & Medicaid Services (CMS) and the CMS Innovation Center. Designed to help rural healthcare leaders identify HHS value-based programs that are suitable for rural participation. Contains descriptions of each demonstration and provides direct links to the corresponding agency web page.
Date: 02/2026
Sponsoring organization: Rural Health Value
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Evaluation of the Making Care Primary Model
Provides an overview of the Centers for Medicare & Medicaid Services (CMS) Innovation Center's Making Care Primary (MCP) Model. Explores model participation, participants' early implementation experiences, and the model's chances for meeting model expansion criteria related to cost and quality.
Additional links: Findings at a Glance
Date: 02/2026
Sponsoring organization: Centers for Medicare and Medicaid Services
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Provides an overview of the Centers for Medicare & Medicaid Services (CMS) Innovation Center's Making Care Primary (MCP) Model. Explores model participation, participants' early implementation experiences, and the model's chances for meeting model expansion criteria related to cost and quality.
Additional links: Findings at a Glance
Date: 02/2026
Sponsoring organization: Centers for Medicare and Medicaid Services
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State Strategies to Improve Health Care Market Oversight
Presents a summary of a December 2025 roundtable with policymakers and regulators from 12 states regarding emerging challenges and policy strategies related to healthcare consolidation, workforce pressures, rising costs, and healthcare market oversight. Identifies broad themes, key challenges, examples of state strategies, and links to key resources.
Author(s): Erin C. Fuse Brown
Date: 02/2026
Sponsoring organization: Peterson-Milbank Program for Sustainable Health Care Costs.
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Presents a summary of a December 2025 roundtable with policymakers and regulators from 12 states regarding emerging challenges and policy strategies related to healthcare consolidation, workforce pressures, rising costs, and healthcare market oversight. Identifies broad themes, key challenges, examples of state strategies, and links to key resources.
Author(s): Erin C. Fuse Brown
Date: 02/2026
Sponsoring organization: Peterson-Milbank Program for Sustainable Health Care Costs.
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Strengthening California's Primary Care Team Workforce: Data and Recommendations for Action
Reports on the state of California's primary care workforce and provides policy recommendations. Provides data and discussion on topics including workforce-related barriers to care, approaches to payment and reimbursement, workforce training, and support for service delivery models. Discusses rural and underserved areas throughout.
Additional links: Executive Summary, Summary of Policy Recommendations, Technical Appendix
Author(s): Diane Rittenhouse, Katie Coleman, Janet Coffman, et al.
Date: 02/2026
Sponsoring organization: California Health Care Foundation
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Reports on the state of California's primary care workforce and provides policy recommendations. Provides data and discussion on topics including workforce-related barriers to care, approaches to payment and reimbursement, workforce training, and support for service delivery models. Discusses rural and underserved areas throughout.
Additional links: Executive Summary, Summary of Policy Recommendations, Technical Appendix
Author(s): Diane Rittenhouse, Katie Coleman, Janet Coffman, et al.
Date: 02/2026
Sponsoring organization: California Health Care Foundation
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A Comparison of Independent and System-Affiliated Rural Hospitals
Compares independent and system-affiliated rural hospitals by organizational characteristics, financial performance, and county characteristics. Presents Medicare Cost Report data from 2023-2024 on the number and percentage of independent and system-affiliated rural hospitals by state, ownership characteristics, Medicare payment classification, use of swing beds, financial distress, and more.
Author(s): Aditya R. Pillutla, Sruthi Malavika Srinivasan, Kristie Thompson, George Pink, Tyler Malone
Date: 02/2026
Sponsoring organization: North Carolina Rural Health Research Program
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Compares independent and system-affiliated rural hospitals by organizational characteristics, financial performance, and county characteristics. Presents Medicare Cost Report data from 2023-2024 on the number and percentage of independent and system-affiliated rural hospitals by state, ownership characteristics, Medicare payment classification, use of swing beds, financial distress, and more.
Author(s): Aditya R. Pillutla, Sruthi Malavika Srinivasan, Kristie Thompson, George Pink, Tyler Malone
Date: 02/2026
Sponsoring organization: North Carolina Rural Health Research Program
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Improving the Value Proposition of Critical Access Hospitals – Lessons from Federal and State Initiatives
Report details how federal and state initiatives can support Critical Access Hospitals (CAHs) transition to value-based payment models. Provides examples of initiatives that offer models for use by State Flex Programs (SFPs) for supporting CAHs' transformation to value-based care.
Author(s): John Gale, Rebecca Stearns, Bridget Harr
Date: 02/2026
Sponsoring organization: Flex Monitoring Team
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Report details how federal and state initiatives can support Critical Access Hospitals (CAHs) transition to value-based payment models. Provides examples of initiatives that offer models for use by State Flex Programs (SFPs) for supporting CAHs' transformation to value-based care.
Author(s): John Gale, Rebecca Stearns, Bridget Harr
Date: 02/2026
Sponsoring organization: Flex Monitoring Team
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2026 Stability of the Rural Health Safety Net: State and National Data Tables
Provides links to national and state data tables showing the financial impact of federal policies such as sequestration and bad debt reimbursement on rural hospital revenues, jobs, and gross domestic product. Presented at the February 2026 National Rural Health Association Policy Institute.
Date: 02/2026
Sponsoring organization: Chartis Center for Rural Health
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Provides links to national and state data tables showing the financial impact of federal policies such as sequestration and bad debt reimbursement on rural hospital revenues, jobs, and gross domestic product. Presented at the February 2026 National Rural Health Association Policy Institute.
Date: 02/2026
Sponsoring organization: Chartis Center for Rural Health
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Chartis Center for Rural Health Research & Resources for the 2026 National Rural Health Association's Rural Health Policy Institute Conference
Offers research and analysis of the stability of the rural healthcare safety net. Includes 2026 Rural State of the State, and presentation slides on this report from the 2026 National Rural Health Association Policy Institute. Provides links to national and state data tables showing the financial impact of federal policies on rural hospitals.
Date: 02/2026
Sponsoring organization: Chartis Center for Rural Health
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Offers research and analysis of the stability of the rural healthcare safety net. Includes 2026 Rural State of the State, and presentation slides on this report from the 2026 National Rural Health Association Policy Institute. Provides links to national and state data tables showing the financial impact of federal policies on rural hospitals.
Date: 02/2026
Sponsoring organization: Chartis Center for Rural Health
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