Rural Health
Resources by Topic: Reimbursement and payment models
Survival Versus Scale: The Effects of Critical Access Hospital Designation
Explores whether designation-based hospital subsidies, specifically the Critical Access Hospital (CAH) program, preserve meaningful access to care. Describes the effects of CAH designation on hospital finances, capacity, and organizational outcomes between 1995-2010. Discusses the implications of hospital preservation and reduced operational scale on access to care and patient health.
Author(s): Ian M. McCarthy, Katie Leinenbach
Date: 10/2026
Sponsoring organization: National Bureau of Economic Research
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Explores whether designation-based hospital subsidies, specifically the Critical Access Hospital (CAH) program, preserve meaningful access to care. Describes the effects of CAH designation on hospital finances, capacity, and organizational outcomes between 1995-2010. Discusses the implications of hospital preservation and reduced operational scale on access to care and patient health.
Author(s): Ian M. McCarthy, Katie Leinenbach
Date: 10/2026
Sponsoring organization: National Bureau of Economic Research
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Rural and Urban Health Center Patients and Financing
Reports on rural and urban community health centers' revenue sources, patient demographics, and patient health insurance coverage using 2025 Uniform Data System (UDS) data. Includes an interactive map showing shares of child and adult rural health center patients covered by Medicaid by state.
Author(s): Akash Pillai, Jennifer Tolbert
Date: 10/2026
Sponsoring organization: KFF
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Reports on rural and urban community health centers' revenue sources, patient demographics, and patient health insurance coverage using 2025 Uniform Data System (UDS) data. Includes an interactive map showing shares of child and adult rural health center patients covered by Medicaid by state.
Author(s): Akash Pillai, Jennifer Tolbert
Date: 10/2026
Sponsoring organization: KFF
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Historical State Actions Aligned with Approved RHTP Uses
Describes state legislation enacted to address rural health topics that coincide with priorities of the Rural Health Transformation Program, including chronic disease management, the healthcare workforce, emergency medical services, health technology, behavioral health, and healthcare payment.
Date: 10/2026
Sponsoring organization: National Conference of State Legislatures
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Describes state legislation enacted to address rural health topics that coincide with priorities of the Rural Health Transformation Program, including chronic disease management, the healthcare workforce, emergency medical services, health technology, behavioral health, and healthcare payment.
Date: 10/2026
Sponsoring organization: National Conference of State Legislatures
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Risk Adjustment in the Medicare Advantage Population Using Encounter Data
Examines the Centers for Medicare and Medicaid Services (CMS) Hierarchical Condition Category (HCC) risk model by comparing 2016-2022 Traditional Medicare (TM) claims and Medicare Advantage (MA) encounter data. Analyzes differences in the TM-based model and MA-based model and discusses risk-adjusted MA payment, MA payment policy, and enrollment incentives for various populations, including rural.
Author(s): Caroline S. Carlin, Roger Feldman, Jeah Jung
Citation: Health Services Research, 61(5), e70165
Date: 10/2026
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Examines the Centers for Medicare and Medicaid Services (CMS) Hierarchical Condition Category (HCC) risk model by comparing 2016-2022 Traditional Medicare (TM) claims and Medicare Advantage (MA) encounter data. Analyzes differences in the TM-based model and MA-based model and discusses risk-adjusted MA payment, MA payment policy, and enrollment incentives for various populations, including rural.
Author(s): Caroline S. Carlin, Roger Feldman, Jeah Jung
Citation: Health Services Research, 61(5), e70165
Date: 10/2026
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Telehealth FAQ
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: 10/2026
Sponsoring organization: Centers for Medicare & 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: 10/2026
Sponsoring organization: Centers for Medicare & Medicaid Services
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September 2026 MACPAC Meeting Transcript
Transcript from the Medicaid and CHIP Payment and Access Commission's (MACPAC) September 2026 meeting. Covers community engagement requirements in Medicaid, state directed payments and healthcare-related taxes, a comparison of an updated inpatient hospital payment index across states, utilization management for medications for opioid use disorder (MOUD) in Medicaid, and Medicaid coverage of assistive technology for adults, among other things. Includes rural references throughout.
Additional links: Medicaid Coverage of Assistive Technology for Adults: Data Analysis and Stakeholder Interviews
Date: 09/2026
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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Transcript from the Medicaid and CHIP Payment and Access Commission's (MACPAC) September 2026 meeting. Covers community engagement requirements in Medicaid, state directed payments and healthcare-related taxes, a comparison of an updated inpatient hospital payment index across states, utilization management for medications for opioid use disorder (MOUD) in Medicaid, and Medicaid coverage of assistive technology for adults, among other things. Includes rural references throughout.
Additional links: Medicaid Coverage of Assistive Technology for Adults: Data Analysis and Stakeholder Interviews
Date: 09/2026
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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2025 Merit-based Incentive Payment System (MIPS) Performance Feedback FAQs for Small Practices
Provides answers to frequently asked questions about the 2025 Merit-based Incentive Payment System (MIPS) performance feedback for small practices. Includes information on how to access and navigate performance feedback, as well as performance category reweighting and redistribution.
Date: 09/2026
Sponsoring organization: Centers for Medicare & Medicaid Services
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Provides answers to frequently asked questions about the 2025 Merit-based Incentive Payment System (MIPS) performance feedback for small practices. Includes information on how to access and navigate performance feedback, as well as performance category reweighting and redistribution.
Date: 09/2026
Sponsoring organization: Centers for Medicare & Medicaid Services
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Telehealth and Federally Qualified Health Centers
Provides an overview of state policies relating to Medicaid fee-for-service coverage and reimbursement of telehealth services at Federally Qualified Health Centers (FQHCs) as of May 2026. Includes state-by-state information on FQHC eligibility for reimbursement for being originating and distant sites, store-and-forward services, audio-only services, remote patient monitoring, and more.
Date: 09/2026
Sponsoring organization: National Association of Community Health Centers
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Provides an overview of state policies relating to Medicaid fee-for-service coverage and reimbursement of telehealth services at Federally Qualified Health Centers (FQHCs) as of May 2026. Includes state-by-state information on FQHC eligibility for reimbursement for being originating and distant sites, store-and-forward services, audio-only services, remote patient monitoring, and more.
Date: 09/2026
Sponsoring organization: National Association of Community Health Centers
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What Will It Take to Sustain Maternal Care in Rural Communities? These Strategies Are Helping Keep Care Close to Home
Discusses challenges facing rural maternal healthcare, such as workforce shortages, low birth volumes, and reimbursement. Provides strategies to help improve sustainability, focusing on leadership, diversifying the workforce, strengthening regional and community partnerships, extending community care, addressing behavioral health and social needs, and supporting financial sustainability.
Author(s): Julia J. Resnick, Aisha Syeda
Date: 09/2026
Sponsoring organization: Commonwealth Fund
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Discusses challenges facing rural maternal healthcare, such as workforce shortages, low birth volumes, and reimbursement. Provides strategies to help improve sustainability, focusing on leadership, diversifying the workforce, strengthening regional and community partnerships, extending community care, addressing behavioral health and social needs, and supporting financial sustainability.
Author(s): Julia J. Resnick, Aisha Syeda
Date: 09/2026
Sponsoring organization: Commonwealth Fund
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Digital Health Readiness and Medicare Primary Care Spending: Nationwide County-Level Observational Analysis
Analyzes associations between county-level digitalization and Medicare primary care spending for Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs) in 2,993 counties between 2017 and 2023 using the Digital Health Index. Discusses the differences when comparing within a county over time and between counties, as well as the impact on healthcare access and socioeconomic factors.
Author(s): Zhaoqiang Zhou, John Geracitano, Baiming Zou, Saif Khairat
Citation: Journal of Medical Internet Research, 28
Date: 09/2026
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Analyzes associations between county-level digitalization and Medicare primary care spending for Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs) in 2,993 counties between 2017 and 2023 using the Digital Health Index. Discusses the differences when comparing within a county over time and between counties, as well as the impact on healthcare access and socioeconomic factors.
Author(s): Zhaoqiang Zhou, John Geracitano, Baiming Zou, Saif Khairat
Citation: Journal of Medical Internet Research, 28
Date: 09/2026
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