Rural Health
Resources by Topic: Reimbursement and payment models
Update to the Payment for Historically Excepted Tribal Federally Qualified Health Centers (FQHCs) for Calendar Year (CY) 2026
Provides an overview of updates to the historically excepted Tribal Federally Qualified Health Center (FQHC) Prospective Payment System (PPS) rate for calendar year 2026.
Date: 02/2026
Sponsoring organization: Centers for Medicare and Medicaid Services
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Provides an overview of updates to the historically excepted Tribal Federally Qualified Health Center (FQHC) Prospective Payment System (PPS) rate for calendar year 2026.
Date: 02/2026
Sponsoring organization: Centers for Medicare and Medicaid Services
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Shared Savings Program Fast Facts
Provides summary statistics on the Medicare Shared Savings Program as of January 1, 2026. Offers data on the number of Accountable Care Organizations (ACOs), assigned beneficiaries, total earned shared savings, and quality scores each year since 2012; the number and percent of ACOs in each track; and more. Includes information on ACO participants, including the number of Rural Health Clinics (RHCs) and Critical Access Hospitals (CAHs) participating in the program.
Date: 02/2026
Sponsoring organization: Centers for Medicare and Medicaid Services
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Provides summary statistics on the Medicare Shared Savings Program as of January 1, 2026. Offers data on the number of Accountable Care Organizations (ACOs), assigned beneficiaries, total earned shared savings, and quality scores each year since 2012; the number and percent of ACOs in each track; and more. Includes information on ACO participants, including the number of Rural Health Clinics (RHCs) and Critical Access Hospitals (CAHs) participating in the program.
Date: 02/2026
Sponsoring organization: Centers for Medicare and Medicaid Services
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Telehealth FAQ Calendar Year 2026
Provides information on Medicare telehealth regulations and payment policy for calendar year 2026. Includes information on audio-only services, behavioral health services, direct supervision, and more.
Date: 02/2026
Sponsoring organization: Centers for Medicare and Medicaid Services
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Provides information on Medicare telehealth regulations and payment policy for calendar year 2026. Includes information on audio-only services, behavioral health services, direct supervision, and more.
Date: 02/2026
Sponsoring organization: Centers for Medicare and Medicaid Services
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Glossary of Value-Based Care Terms
Presents definitions of key terms related to value-based care and payment. Includes terminology regarding healthcare value, payment and incentive structures, care delivery, data and technology, and more.
Date: 01/2026
Sponsoring organization: Rural Health Value
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Presents definitions of key terms related to value-based care and payment. Includes terminology regarding healthcare value, payment and incentive structures, care delivery, data and technology, and more.
Date: 01/2026
Sponsoring organization: Rural Health Value
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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
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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
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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
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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
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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
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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
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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
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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
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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
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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
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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
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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
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