Rural Health
Resources by Topic: Reimbursement and payment models
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
view details
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
view details
Risk Adjustment in the Medicare Advantage Population Using Encounter Data
Examines the Centers for Medicare & 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
view details
Examines the Centers for Medicare & 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
view details
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
view details
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
view details
MedPAC Payment Basics
Series of briefs providing an of Medicare payment systems. Covers payments systems including Accountable Care Organizations (ACO), Critical Access Hospitals (CAH), Federally Qualified Health Centers and Rural Health Clinics, hospital acute inpatient services, and more.
Date: 10/2026
Sponsoring organization: Medicare Payment Advisory Commission
view details
Series of briefs providing an of Medicare payment systems. Covers payments systems including Accountable Care Organizations (ACO), Critical Access Hospitals (CAH), Federally Qualified Health Centers and Rural Health Clinics, hospital acute inpatient services, and more.
Date: 10/2026
Sponsoring organization: Medicare Payment Advisory Commission
view details
Medicare Payment Basics: Federally Qualified Health Center and Rural Health Clinic Payment Systems
Presents an overview of Medicare payments for Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs). Details how the all-inclusive rate (AIR) is calculated for RHCs and how the national statutory payment limit applies to provider-based RHCs enrolled in Medicare before December 31, 2020, and whether they part of a hospital with fewer than 50 beds. Includes information on special payment rules for certain services provided by FQHCs and RHCs.
Date: 10/2026
Sponsoring organization: Medicare Payment Advisory Commission
view details
Presents an overview of Medicare payments for Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs). Details how the all-inclusive rate (AIR) is calculated for RHCs and how the national statutory payment limit applies to provider-based RHCs enrolled in Medicare before December 31, 2020, and whether they part of a hospital with fewer than 50 beds. Includes information on special payment rules for certain services provided by FQHCs and RHCs.
Date: 10/2026
Sponsoring organization: Medicare Payment Advisory Commission
view details
Medicare Payment Basics: Outpatient Dialysis Services Payment System
Overview of Medicare payment methods for outpatient dialysis services of beneficiaries with end-stage renal disease (ESRD). Describes the base payment rate for freestanding and hospital-based facilities and identifies facility-level adjustments, including facilities located in rural areas.
Date: 10/2026
Sponsoring organization: Medicare Payment Advisory Commission
view details
Overview of Medicare payment methods for outpatient dialysis services of beneficiaries with end-stage renal disease (ESRD). Describes the base payment rate for freestanding and hospital-based facilities and identifies facility-level adjustments, including facilities located in rural areas.
Date: 10/2026
Sponsoring organization: Medicare Payment Advisory Commission
view details
Medicare Payment Basics: Critical Access Hospitals Payment System
Presents an overview of Medicare eligibility and payments for Critical Access Hospitals (CAHs).
Date: 10/2026
Sponsoring organization: Medicare Payment Advisory Commission
view details
Presents an overview of Medicare eligibility and payments for Critical Access Hospitals (CAHs).
Date: 10/2026
Sponsoring organization: Medicare Payment Advisory Commission
view details
Medicare Payment Basics: Outpatient Hospital Services Payment System
Outlines Medicare's payments for outpatient hospital services, including considerations for rural sole community hospitals.
Date: 10/2026
Sponsoring organization: Medicare Payment Advisory Commission
view details
Outlines Medicare's payments for outpatient hospital services, including considerations for rural sole community hospitals.
Date: 10/2026
Sponsoring organization: Medicare Payment Advisory Commission
view details
Medicare Payment Basics: Part D Payment System
Overview of the Medicare Part D prescription drug benefit, including subsidy amounts, payments to plans, how enrollee premiums are calculated, and benefit and payment updates.
Date: 10/2026
Sponsoring organization: Medicare Payment Advisory Commission
view details
Overview of the Medicare Part D prescription drug benefit, including subsidy amounts, payments to plans, how enrollee premiums are calculated, and benefit and payment updates.
Date: 10/2026
Sponsoring organization: Medicare Payment Advisory Commission
view details
Medicare Payment Basics: Medicare Advantage Program Payment System
Overview of Medicare payments to Medicare Advantage (MA) local and regional plans discussing the methods for determining Medicare payments to both plans.
Date: 10/2026
Sponsoring organization: Medicare Payment Advisory Commission
view details
Overview of Medicare payments to Medicare Advantage (MA) local and regional plans discussing the methods for determining Medicare payments to both plans.
Date: 10/2026
Sponsoring organization: Medicare Payment Advisory Commission
view details