Rural Health
Resources by Topic: Reimbursement and payment models
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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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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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: 09/2026
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: 09/2026
Sponsoring organization: National Conference of State Legislatures
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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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Numerous Overlapping Programs Add Complexity, Unpredictability to Rural Hospital Finances
Analyzes payments between 1997 and 2024 to 2,942 rural hospitals participating in at least one Medicare-specific payment program, including the Sole Community Hospital, Medicare-Dependent Hospital, Critical Access Hospital, or Low-Volume Hospital programs. Discusses the impact of the programs and policy changes throughout the study period on hospital finances.
Author(s): Carolyn San Soucie, Michael E. Chernew, Benjamin D. Sommers
Citation: Health Affairs Scholar, 4(9)
Date: 09/2026
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Analyzes payments between 1997 and 2024 to 2,942 rural hospitals participating in at least one Medicare-specific payment program, including the Sole Community Hospital, Medicare-Dependent Hospital, Critical Access Hospital, or Low-Volume Hospital programs. Discusses the impact of the programs and policy changes throughout the study period on hospital finances.
Author(s): Carolyn San Soucie, Michael E. Chernew, Benjamin D. Sommers
Citation: Health Affairs Scholar, 4(9)
Date: 09/2026
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RHC Cost Reporting Fall 2026
Recording of a September 14, 2026, webinar providing an overview of Rural Health Clinic (RHC) cost reporting. Covers key cost report drivers, including allowable costs, RHC visits and provider productivity, Medicare vaccine reimbursement, and Medicare bad debt. Discusses RHC benchmarking and more. Part of the Rural Health Clinic Technical Assistance Series.
Additional links: Presentation Slides
Date: 09/2026
Sponsoring organization: National Association of Rural Health Clinics
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Recording of a September 14, 2026, webinar providing an overview of Rural Health Clinic (RHC) cost reporting. Covers key cost report drivers, including allowable costs, RHC visits and provider productivity, Medicare vaccine reimbursement, and Medicare bad debt. Discusses RHC benchmarking and more. Part of the Rural Health Clinic Technical Assistance Series.
Additional links: Presentation Slides
Date: 09/2026
Sponsoring organization: National Association of Rural Health Clinics
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September 2026 MedPAC Meeting Transcript
Transcript from the Medicare Payment Advisory Commission's (MedPAC) September 2026 meeting. Covers the context for Medicare payment policy, issues relating to Medicare Part D and potential policy directions, MedPAC's work plan regarding ambulatory surgical centers, the use of post-acute care services by beneficiaries in fee-for-service Medicare and Medicare Advantage, and Medicare Advantage risk adjustment at the plan level.
Date: 09/2026
Sponsoring organization: Medicare Payment Advisory Commission
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Transcript from the Medicare Payment Advisory Commission's (MedPAC) September 2026 meeting. Covers the context for Medicare payment policy, issues relating to Medicare Part D and potential policy directions, MedPAC's work plan regarding ambulatory surgical centers, the use of post-acute care services by beneficiaries in fee-for-service Medicare and Medicare Advantage, and Medicare Advantage risk adjustment at the plan level.
Date: 09/2026
Sponsoring organization: Medicare Payment Advisory Commission
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Medicare Advantage: Plan Options and Enrollment Trends in Arkansas
Explains how Medicare Advantage plans affect healthcare delivery, Medicare enrollment, and payment practices in Arkansas. Includes discussion of reimbursement challenges in rural hospitals.
Author(s): Jennifer Wessel, Chris Ray
Date: 09/2026
Sponsoring organization: Arkansas Center for Health Improvement
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Explains how Medicare Advantage plans affect healthcare delivery, Medicare enrollment, and payment practices in Arkansas. Includes discussion of reimbursement challenges in rural hospitals.
Author(s): Jennifer Wessel, Chris Ray
Date: 09/2026
Sponsoring organization: Arkansas Center for Health Improvement
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Rural Health Transformation Toolkit
Provides information and resources for state policymakers regarding rural health and the Rural Health Transformation Program. Links to resources describing how states have approached the RHTP application, policies on maternal health and oral health in rural communities, and more.
Date: 09/2026
Sponsoring organization: National Conference of State Legislatures
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Provides information and resources for state policymakers regarding rural health and the Rural Health Transformation Program. Links to resources describing how states have approached the RHTP application, policies on maternal health and oral health in rural communities, and more.
Date: 09/2026
Sponsoring organization: National Conference of State Legislatures
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North Carolina RHT Program Annual Report - Year 1
Reports on the first year of the Rural Health Transformation Program (RHTP) in North Carolina. Details the state policy actions, uses of funds, recipients of funds, and progress reports for each initiative funded by RHTP.
Date: 08/2026
Sponsoring organization: North Carolina Department of Health and Human Services
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Reports on the first year of the Rural Health Transformation Program (RHTP) in North Carolina. Details the state policy actions, uses of funds, recipients of funds, and progress reports for each initiative funded by RHTP.
Date: 08/2026
Sponsoring organization: North Carolina Department of Health and Human Services
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