Rural Health
Resources by Topic: Reimbursement and payment models
Boosting Oral Health Care in Rural Communities
Provides a brief overview of the state of oral healthcare in rural areas. Highlights state and federal actions taken to improve access to oral healthcare and support and expand the dental health workforce.
Date: 04/2026
Sponsoring organization: National Conference of State Legislatures
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Provides a brief overview of the state of oral healthcare in rural areas. Highlights state and federal actions taken to improve access to oral healthcare and support and expand the dental health workforce.
Date: 04/2026
Sponsoring organization: National Conference of State Legislatures
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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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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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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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Payer Mix Shifts and Profitability at Critical Access Hospitals, 2011 to 2023
Analyzes 1,384 Critical Access Hospitals between 2011 and 2023 to determine the impact of changes in commercial, Medicare, Medicaid, and uncompensated care on their finances. Discusses reimbursement policy based on study findings.
Author(s): Yusheng Jia, Yue Li, Xueya Cai, Samuel J. Enumah
Citation: Health Affairs Scholar, 4(4)
Date: 04/2026
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Analyzes 1,384 Critical Access Hospitals between 2011 and 2023 to determine the impact of changes in commercial, Medicare, Medicaid, and uncompensated care on their finances. Discusses reimbursement policy based on study findings.
Author(s): Yusheng Jia, Yue Li, Xueya Cai, Samuel J. Enumah
Citation: Health Affairs Scholar, 4(4)
Date: 04/2026
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Medicare Wage Index Trends in Rural and Urban Hospitals Before and During the Low Wage Index Policy, 2018–2022
Provides an overview of the wage index and its role in hospital reimbursement and financial stability. Describes the pattern of wage index values for rural and urban prospective payment system (PPS) hospitals from 2018 to 2022. Explores the impact of the low-wage index policy (LWIP), which was implemented in fiscal year 2020, and the potential implications of its discontinuation in fiscal year 2025.
Author(s): Saleema Karim, George Pink, Kristie Thompson, Mark Holmes
Date: 04/2026
Sponsoring organization: North Carolina Rural Health Research Program
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Provides an overview of the wage index and its role in hospital reimbursement and financial stability. Describes the pattern of wage index values for rural and urban prospective payment system (PPS) hospitals from 2018 to 2022. Explores the impact of the low-wage index policy (LWIP), which was implemented in fiscal year 2020, and the potential implications of its discontinuation in fiscal year 2025.
Author(s): Saleema Karim, George Pink, Kristie Thompson, Mark Holmes
Date: 04/2026
Sponsoring organization: North Carolina Rural Health Research Program
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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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Average Salary Expense in Rural and Urban Hospitals Before and During the Low Wage Index Policy, 2018–2022
Examines and compares wage patterns of Critical Access Hospitals (CAHs), Rural Prospective Payment System (PPS) hospitals, and Urban PPS hospitals as related to the Low Wage Index Policy (LWIP) in effect from 2020-2022. Utilizes hospital data from the Centers for Medicare & Medicaid Services (CMS) Healthcare Cost Report Information System (HCRIS) between 2018 and 2022 and analyzes median salaries. Discusses the impact of Medicare payments and LWIP on hospitals.
Author(s): Saleema Karim, George Pink, Kristie Thompson, Mark Holmes
Date: 04/2026
Sponsoring organization: North Carolina Rural Health Research Program
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Examines and compares wage patterns of Critical Access Hospitals (CAHs), Rural Prospective Payment System (PPS) hospitals, and Urban PPS hospitals as related to the Low Wage Index Policy (LWIP) in effect from 2020-2022. Utilizes hospital data from the Centers for Medicare & Medicaid Services (CMS) Healthcare Cost Report Information System (HCRIS) between 2018 and 2022 and analyzes median salaries. Discusses the impact of Medicare payments and LWIP on hospitals.
Author(s): Saleema Karim, George Pink, Kristie Thompson, Mark Holmes
Date: 04/2026
Sponsoring organization: North Carolina Rural Health Research Program
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Value-based Payment Strategies Used by Medicaid Managed Care Organizations
Presents findings from a review of 36 state Medicaid program websites that detail value-based payment (VBP) strategies deployed by state-contracted Managed Care Organizations (MCO). Describes how Medicaid MCOs approach VBP strategies and implications for rural healthcare providers and organizations.
Additional links: Appendix: State Medicaid Programs with VBP Elements
Date: 04/2026
Sponsoring organization: Rural Health Value
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Presents findings from a review of 36 state Medicaid program websites that detail value-based payment (VBP) strategies deployed by state-contracted Managed Care Organizations (MCO). Describes how Medicaid MCOs approach VBP strategies and implications for rural healthcare providers and organizations.
Additional links: Appendix: State Medicaid Programs with VBP Elements
Date: 04/2026
Sponsoring organization: Rural Health Value
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Transforming Rural Health: Value-Based Payment
Presentation slides that discuss state examples related to the Rural Health Transformation Program (RHTP) and value-based payment (VBP) initiatives, with a focus on healthcare delivery systems, use of technology, and the healthcare workforce.
Author(s): Keith J. Mueller
Date: 04/2026
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Presentation slides that discuss state examples related to the Rural Health Transformation Program (RHTP) and value-based payment (VBP) initiatives, with a focus on healthcare delivery systems, use of technology, and the healthcare workforce.
Author(s): Keith J. Mueller
Date: 04/2026
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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