Rural Health
Resources by Topic: Reimbursement and payment models
Evaluation of the ACO REACH Model: Evaluation Report 3
Presents key findings from an evaluation of the Accountable Care Organization (ACO) REACH Model's first performance year, as well as the two years of the preceding Global and Professional Direct Contracting (GPDC) Model. Examines model participants' implementation experiences and the model's impact on cost, utilization, and quality outcomes. Includes information on the participation of Federally Qualified Health Centers (FQHCs), Rural Health Clinics (RHCs), and Critical Access Hospitals (CAHs) in the model.
Additional links: Appendices, CMS Perspective Report, Executive Summary, Findings at a Glance
Date: 07/2026
Sponsoring organizations: Centers for Medicare & Medicaid Services, NORC at the University of Chicago
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Presents key findings from an evaluation of the Accountable Care Organization (ACO) REACH Model's first performance year, as well as the two years of the preceding Global and Professional Direct Contracting (GPDC) Model. Examines model participants' implementation experiences and the model's impact on cost, utilization, and quality outcomes. Includes information on the participation of Federally Qualified Health Centers (FQHCs), Rural Health Clinics (RHCs), and Critical Access Hospitals (CAHs) in the model.
Additional links: Appendices, CMS Perspective Report, Executive Summary, Findings at a Glance
Date: 07/2026
Sponsoring organizations: Centers for Medicare & Medicaid Services, NORC at the University of Chicago
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Rural Emergency Hospital (REH) Model Frequently Asked Questions
Provides answers to frequently asked questions regarding the Rural Emergency Hospital (REH) designation. Covers general information, Conditions of Participation, and REH payment policies.
Date: 07/2026
Sponsoring organizations: Mathematica, Rural Health Redesign Center
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Provides answers to frequently asked questions regarding the Rural Emergency Hospital (REH) designation. Covers general information, Conditions of Participation, and REH payment policies.
Date: 07/2026
Sponsoring organizations: Mathematica, Rural Health Redesign Center
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Transforming Rural Health: RHTP and Value-Based Payment
Webinar recording featuring Dr. Keith Mueller from Rural Health Value discussing Rural Health Transformation Program (RHTP) activities that link to value-based payment arrangements in rural communities.
Additional links: Audio Recording, Webinar Slides
Date: 06/2026
Sponsoring organization: Rural Health Information Hub
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Webinar recording featuring Dr. Keith Mueller from Rural Health Value discussing Rural Health Transformation Program (RHTP) activities that link to value-based payment arrangements in rural communities.
Additional links: Audio Recording, Webinar Slides
Date: 06/2026
Sponsoring organization: Rural Health Information Hub
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Rural Implications of Increased Medicare Beneficiary Enrollment in ACOs and MA Plans
Explores the relationship between Medicare Advantage (MA) enrollment and beneficiary attribution to Centers for Medicare & Medicaid Services (CMS) Medicare Shared Savings Program (MSSP) Accountable Care Organizations (ACOs). Describes the growth of ACO assignment and MA enrollment between 2013 and 2023 by county-level rurality. Compares the characteristics of micropolitan and noncore counties with high and low ACO and MA penetration in 2023. Discusses the implications of expanding MA and ACO enrollment in rural areas.
Author(s): Edmer Lazaro, Fred Ullrich, Dan M. Shane, Keith Mueller
Date: 06/2026
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Explores the relationship between Medicare Advantage (MA) enrollment and beneficiary attribution to Centers for Medicare & Medicaid Services (CMS) Medicare Shared Savings Program (MSSP) Accountable Care Organizations (ACOs). Describes the growth of ACO assignment and MA enrollment between 2013 and 2023 by county-level rurality. Compares the characteristics of micropolitan and noncore counties with high and low ACO and MA penetration in 2023. Discusses the implications of expanding MA and ACO enrollment in rural areas.
Author(s): Edmer Lazaro, Fred Ullrich, Dan M. Shane, Keith Mueller
Date: 06/2026
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Connection for a Cure: How Broadband Access Supports Telehealth Use
Describes broadband access, the impact it has on telehealth utilization, and the impact of telehealth on health outcomes. Highlights various state and federal policy measures addressing broadband and telehealth access, the Rural Health Transformation Program, reimbursement, cross-state licensure flexibility, teleprescribing, and emergency medical services.
Date: 06/2026
Sponsoring organization: National Conference of State Legislatures
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Describes broadband access, the impact it has on telehealth utilization, and the impact of telehealth on health outcomes. Highlights various state and federal policy measures addressing broadband and telehealth access, the Rural Health Transformation Program, reimbursement, cross-state licensure flexibility, teleprescribing, and emergency medical services.
Date: 06/2026
Sponsoring organization: National Conference of State Legislatures
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MedPAC Report to the Congress: Medicare and the Health Care Delivery System, June 2026
Evaluates Medicare payment issues and provides recommendations to the U.S. Congress. Covers payment incentives in Medicare, the complexity of Medicare enrollment decisions for beneficiaries, Medicare payment operations and their role in identifying improper payments, the estimated association between Medicare Advantage (MA) enrollment and hospitals' and post-acute care providers' finances, and access to hospice and certain complex palliative services for beneficiaries with end-stage renal disease or cancer. Includes a mandated report regarding the Medicare Ground Ambulance Data Collection System. Includes rural references throughout.
Additional links: Executive Summary
Date: 06/2026
Sponsoring organization: Medicare Payment Advisory Commission
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Evaluates Medicare payment issues and provides recommendations to the U.S. Congress. Covers payment incentives in Medicare, the complexity of Medicare enrollment decisions for beneficiaries, Medicare payment operations and their role in identifying improper payments, the estimated association between Medicare Advantage (MA) enrollment and hospitals' and post-acute care providers' finances, and access to hospice and certain complex palliative services for beneficiaries with end-stage renal disease or cancer. Includes a mandated report regarding the Medicare Ground Ambulance Data Collection System. Includes rural references throughout.
Additional links: Executive Summary
Date: 06/2026
Sponsoring organization: Medicare Payment Advisory Commission
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Factors Influencing Rural Hospitals to Participate and Remain in Accountable Care Organizations
Examines factors that impact rural hospital participation in Medicare and accountable care organization (ACO) models. Utilizes interview feedback from rural hospital executives regarding ACO participation and discusses themes such as financial incentives, value-based reimbursement, population health, healthcare quality, and more.
Author(s): Emily J. Lawton, Jenah McCarty, Thomas E. Vaughn, Fred Ullrich, Keith J. Mueller
Citation: Journal of Rural Health, 42(2), e70179
Date: 06/2026
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Examines factors that impact rural hospital participation in Medicare and accountable care organization (ACO) models. Utilizes interview feedback from rural hospital executives regarding ACO participation and discusses themes such as financial incentives, value-based reimbursement, population health, healthcare quality, and more.
Author(s): Emily J. Lawton, Jenah McCarty, Thomas E. Vaughn, Fred Ullrich, Keith J. Mueller
Citation: Journal of Rural Health, 42(2), e70179
Date: 06/2026
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Marriage and Family Therapist and Mental Health Counselor Workforces in Rural America Under New Medicare Reimbursement Policy
Describes how Medicare reimbursement expanded to cover marriage and family therapists (MFTs) and mental health counselors (MHCs) in January 2024. Examines the change in Medicare-enrolled MFTs and MHCs between the third quarter (Q3) of 2023 and fourth quarter (Q4) of 2024. Presents findings from semi-structured interviews with rural health system and mental health organization leaders regarding practice arrangements, the perceived impacts of MFT and MHC reimbursement, barriers to serving rural Medicare beneficiaries, and considerations for future policies.
Author(s): Janessa M. Graves, Natalia V. Oster, Lisa A. Garberson, Davis G. Patterson, C. Holly A. Andrilla
Date: 06/2026
Sponsoring organization: WWAMI Rural Health Research Center
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Describes how Medicare reimbursement expanded to cover marriage and family therapists (MFTs) and mental health counselors (MHCs) in January 2024. Examines the change in Medicare-enrolled MFTs and MHCs between the third quarter (Q3) of 2023 and fourth quarter (Q4) of 2024. Presents findings from semi-structured interviews with rural health system and mental health organization leaders regarding practice arrangements, the perceived impacts of MFT and MHC reimbursement, barriers to serving rural Medicare beneficiaries, and considerations for future policies.
Author(s): Janessa M. Graves, Natalia V. Oster, Lisa A. Garberson, Davis G. Patterson, C. Holly A. Andrilla
Date: 06/2026
Sponsoring organization: WWAMI Rural Health Research Center
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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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State-Level Impacts of Key Medicaid Provisions in the One Big Beautiful Bill Act
Explores the potential impacts of 12 healthcare provisions within the One Big Beautiful Bill Act (Public Law 119-21) on Medicaid and state budgets. Presents estimated impacts for each state provision-by-provision and overall. Includes analysis related to Medicaid determination, provider taxes, state-directed payments, work requirements, and the Rural Health Transformation Program.
Author(s): Preethi Rao, Lawrence Baker, Federico Girosi, et al.
Date: 06/2026
Sponsoring organization: RAND Corporation
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Explores the potential impacts of 12 healthcare provisions within the One Big Beautiful Bill Act (Public Law 119-21) on Medicaid and state budgets. Presents estimated impacts for each state provision-by-provision and overall. Includes analysis related to Medicaid determination, provider taxes, state-directed payments, work requirements, and the Rural Health Transformation Program.
Author(s): Preethi Rao, Lawrence Baker, Federico Girosi, et al.
Date: 06/2026
Sponsoring organization: RAND Corporation
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