Rural Health
Resources by Topic: Reimbursement and payment models
Medicare Hospice: Action Needed to Pay More Efficiently for Routine Home Care
Describes the frequency and characteristics of routine home care visits in 2024 for Medicare beneficiaries enrolled in hospice since 2022 who died or were discharged alive in 2024. Compares estimated per-visit Medicare payment rates for routine home care across hospices with the highest and lowest number of visits per week and to home health per-visit rates. Includes information on the average number of visits per week by rural and urban hospice providers. Offers recommendations to the U.S. Department of Health and Human Services regarding revisions to the hospice payment system.
Additional links: Full Report
Date: 06/2026
Sponsoring organization: Government Accountability Office
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Describes the frequency and characteristics of routine home care visits in 2024 for Medicare beneficiaries enrolled in hospice since 2022 who died or were discharged alive in 2024. Compares estimated per-visit Medicare payment rates for routine home care across hospices with the highest and lowest number of visits per week and to home health per-visit rates. Includes information on the average number of visits per week by rural and urban hospice providers. Offers recommendations to the U.S. Department of Health and Human Services regarding revisions to the hospice payment system.
Additional links: Full Report
Date: 06/2026
Sponsoring organization: Government Accountability Office
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2024 QPP Participation and Performance Results: At-a-Glance
Provides an overview of the results of the Quality Payment Program (QPP) for the 2024 performance year. Highlights the percentages of small and rural providers receiving negative, neutral, and positive payment adjustments for 2026.
Date: 05/2026
Sponsoring organization: Centers for Medicare & Medicaid Services
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Provides an overview of the results of the Quality Payment Program (QPP) for the 2024 performance year. Highlights the percentages of small and rural providers receiving negative, neutral, and positive payment adjustments for 2026.
Date: 05/2026
Sponsoring organization: Centers for Medicare & Medicaid Services
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How Do Changes in Medicare Reimbursement for Mental Health Services Impact Access for Rural Older Adults?
Examines how policies allowing marriage and family therapists (MFTs) and mental health counselors (MHCs) to independently bill Medicare have impacted mental healthcare access among Medicare beneficiaries living in rural areas. Utilizes interview data from 14 leaders representing rural health systems and mental health organizations regarding their perceptions on mental healthcare access, Medicare reimbursement policy, and the inclusion of MFTs and MHCs as mental health providers for Medicare recipients.
Author(s): Natalia V. Oster, C. Holly A. Andrilla, Davis G. Patterson, Signe Burchim, Janessa M. Graves
Citation: Journal of Rural Health, 42(2), e70162
Date: 05/2026
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Examines how policies allowing marriage and family therapists (MFTs) and mental health counselors (MHCs) to independently bill Medicare have impacted mental healthcare access among Medicare beneficiaries living in rural areas. Utilizes interview data from 14 leaders representing rural health systems and mental health organizations regarding their perceptions on mental healthcare access, Medicare reimbursement policy, and the inclusion of MFTs and MHCs as mental health providers for Medicare recipients.
Author(s): Natalia V. Oster, C. Holly A. Andrilla, Davis G. Patterson, Signe Burchim, Janessa M. Graves
Citation: Journal of Rural Health, 42(2), e70162
Date: 05/2026
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2026 Merit-Based Incentive Payment System Automatic Extreme and Uncontrollable Circumstances Policy
Addresses the automatic Merit-Based Incentive Payment System (MIPS) extreme and uncontrollable circumstances (EUC) policy as it applies to individual MIPS eligible clinicians for 2026. Table 2 features information on reweighting for clinicians in a small practice.
Date: 05/2026
Sponsoring organization: Centers for Medicare & Medicaid Services
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Addresses the automatic Merit-Based Incentive Payment System (MIPS) extreme and uncontrollable circumstances (EUC) policy as it applies to individual MIPS eligible clinicians for 2026. Table 2 features information on reweighting for clinicians in a small practice.
Date: 05/2026
Sponsoring organization: Centers for Medicare & Medicaid Services
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Access to and Provision of Child and Youth Behavioral Health Services in the Rural and Urban U.S.
Compiles findings from 9 reports on youth behavioral health in the rural U.S. Describes prevalence of behavioral health conditions, the youth behavioral health workforce, behavioral health licensure and reimbursement policy, and provision of youth behavioral health services. Features statistics with breakdowns by 7 levels of population density.
Author(s): Janessa M. Graves, Lisa A. Garberson, Sara C. Woolcock, C. Holly A. Andrilla
Date: 05/2026
Sponsoring organization: WWAMI Rural Health Research Center
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Compiles findings from 9 reports on youth behavioral health in the rural U.S. Describes prevalence of behavioral health conditions, the youth behavioral health workforce, behavioral health licensure and reimbursement policy, and provision of youth behavioral health services. Features statistics with breakdowns by 7 levels of population density.
Author(s): Janessa M. Graves, Lisa A. Garberson, Sara C. Woolcock, C. Holly A. Andrilla
Date: 05/2026
Sponsoring organization: WWAMI Rural Health Research Center
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Trends in Medicare Advantage Quality for Nonmetropolitan Enrollees, 2019-2023
Examines quality of care in Medicare Advantage (MA) plans by geography, region, and plan type. Analyzes average ratings of 2019-2023 MA plans on a 1-5 star rating scale according to metro, micro, or noncore rural location. Provides additional data on MA enrollments by rural concentration of contracts as well as star ratings by benchmark quartile and quality bonus capping.
Author(s): Abigail Barker, Eliot Jost, Timothy McBride, Keith J. Mueller
Date: 05/2026
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Examines quality of care in Medicare Advantage (MA) plans by geography, region, and plan type. Analyzes average ratings of 2019-2023 MA plans on a 1-5 star rating scale according to metro, micro, or noncore rural location. Provides additional data on MA enrollments by rural concentration of contracts as well as star ratings by benchmark quartile and quality bonus capping.
Author(s): Abigail Barker, Eliot Jost, Timothy McBride, Keith J. Mueller
Date: 05/2026
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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MedPAC Comment on CMS's Proposed Rule on Inpatient Rehabilitation Facility for FY 2027
Comments on an April 6, 2026, Federal Register proposed rule addressing updates to the prospective payment system for inpatient rehabilitation facilities (IRFs) for fiscal year 2026. Includes comments on the potential creation of an IRF-specific wage index and refinements to the IRF payment system, such as changes to IRF patient clinical classification. Includes rural considerations throughout.
Date: 04/2026
Sponsoring organization: Medicare Payment Advisory Commission
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Comments on an April 6, 2026, Federal Register proposed rule addressing updates to the prospective payment system for inpatient rehabilitation facilities (IRFs) for fiscal year 2026. Includes comments on the potential creation of an IRF-specific wage index and refinements to the IRF payment system, such as changes to IRF patient clinical classification. Includes rural considerations throughout.
Date: 04/2026
Sponsoring organization: Medicare Payment Advisory Commission
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National Association of Rural Health Clinics 2026 Policy Survey Report
Summarizes results of a 2026 national survey of Rural Health Clinics (RHCs). Presents data on the average payer mix, telehealth use and management trends, Medicare Advantage (MA) contracts and reimbursement rates compared to traditional Medicare rates, value-based care participation, challenges, and more.
Date: 04/2026
Sponsoring organization: National Association of Rural Health Clinics
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Summarizes results of a 2026 national survey of Rural Health Clinics (RHCs). Presents data on the average payer mix, telehealth use and management trends, Medicare Advantage (MA) contracts and reimbursement rates compared to traditional Medicare rates, value-based care participation, challenges, and more.
Date: 04/2026
Sponsoring organization: National Association of Rural Health Clinics
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Medicare Payment for Rural or Geographically Isolated Hospitals, 2026
Displays data on Medicare payment adjustments for Sole Community Hospitals, Medicare-Dependent Hospitals, Low-Volume Hospitals, and Critical Access Hospitals. Includes information on the number of qualifying hospitals by state and eligibility criteria.
Date: 04/2026
Sponsoring organization: Congressional Research Service
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Displays data on Medicare payment adjustments for Sole Community Hospitals, Medicare-Dependent Hospitals, Low-Volume Hospitals, and Critical Access Hospitals. Includes information on the number of qualifying hospitals by state and eligibility criteria.
Date: 04/2026
Sponsoring organization: Congressional Research Service
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A Closer Look at Rural Nursing Homes
Compares characteristics of nursing homes in rural and urban areas including patient population data, distribution, and ownership. Also discusses payer mix, healthcare quality, and staffing levels. Highlights changes between 2015 and 2025 for some data.
Author(s): Priya Chidambaram, Alice Burns, Robin Rudowitz
Date: 04/2026
Sponsoring organization: KFF
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Compares characteristics of nursing homes in rural and urban areas including patient population data, distribution, and ownership. Also discusses payer mix, healthcare quality, and staffing levels. Highlights changes between 2015 and 2025 for some data.
Author(s): Priya Chidambaram, Alice Burns, Robin Rudowitz
Date: 04/2026
Sponsoring organization: KFF
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