Skip to main content
Rural Health Information Hub

Rural Health
Resources by Topic: Reimbursement and payment models

Rural Federally Qualified Health Centers Financial and Operational Performance Analysis 2018-2021
Examines financial and operational characteristics of rural Federally Qualified Health Centers (FQHCs) from 2018-2021. Explores FQHC growth and expansion, patient and payer mix, revenue and growth mix, financial performance, quality of care, and more. Compares data on rural FQHCs to urban and national FQHC data. Requires name, email address, and organization information to download.
Date: 01/2023
Type: Document
Sponsoring organization: Capital Link
view details
Examining Rural Telehealth During the Public Health Emergency
Examines the use of telehealth visits for rural and urban fee-for-service Medicare enrollees between January 2018 and June 2021. Compares telehealth utilization before the COVID-19 pandemic (2018-2019) with telehealth utilization from January 2020 to June 2021. Describes the demographic, geographical, and technological characteristics of telehealth services that were associated with increased telehealth use. Explores the extent to which the increased implementation and utilization of telehealth during the PHE impacted the cost of patient care and provider utilization.
Date: 01/2023
Type: Document
Sponsoring organizations: Centers for Medicare and Medicaid Services, CMS Alliance to Modernize Healthcare
view details
Merit-Based Incentive Payment System (MIPS): 2022 Opt-in and Voluntary Reporting Election Process Guide
Discusses the eligibility of clinicians, groups, and Alternative Payment Model (APM) entities that exceed some low-volume threshold criteria to opt-in to the Merit-Based Incentive Payment System (MIPS) for the 2022 performance period. Compares opting in and voluntarily reporting MIPS data and provides an overview of the election process.
Date: 01/2023
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
view details
Virginia Community Services Boards Behavioral Health Services: 2022
Report on activities of Virginia's Community Services Boards (CSBs), the state's primary mechanism for providing publicly funded behavioral health services in local communities. Includes a section on CSBs' role in providing services to rural areas. Features statistics on numbers of substance use disorder and mental health consumers, with breakdowns by urban and rural CSBs.
Date: 12/2022
Type: Document
Sponsoring organization: Joint Legislative Audit and Review Commission
view details
Evaluation of the Rural Community Hospital Demonstration: Interim Report Two (Covering 2016-2018)
Provides an overview of the Rural Community Hospital Demonstration (RCHD). Describes the characteristics of RCHD participants as of fiscal year 2018, the Medicare payments received under the program, and the impact of the RCHD on hospital financial measures. Examines whether hospitals that continued to participate in the RCHD under the 21st Century Cures Act (CCA) extension experienced additional changes to their financial condition, as well as the impact of the program on hospitals that joined the demonstration for the first time under the CCA extension.
Additional links: Findings at a Glance
Date: 12/2022
Type: Document
Sponsoring organizations: American Institutes for Research, Centers for Medicare and Medicaid Services
view details
Public Law 117–328: Consolidated Appropriations Act, 2023
Text of the Consolidated Appropriations Act, 2023, Public Law 117-328 (December 29, 2022). Section 4113 extends certain COVID-19 telehealth flexibilities, including the ability of Rural Health Clinics and Federally Qualified Health Centers to serve as distant site providers, through December 31, 2024. Section 4137 authorizes the extension of a 1% add-on payment for home health services provided in high-utilization rural counties through 2023.
Date: 12/2022
Type: Document
Sponsoring organization: U.S. Congress
view details
December 2022 MedPAC Meeting Transcript
Transcript from the Medicare Payment Advisory Commission's (MedPAC) December 2020 meeting. Covers payment adequacy and updates for hospital inpatient and outpatient services and supporting Medicare safety-net hospitals, ambulatory surgical center services, outpatient dialysis services, physician and other health professional services, hospice services, skilled nursing facilities, home health services, and inpatient rehabilitation facility services. Includes rural references throughout.
Date: 12/2022
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
view details
Merit-Based Incentive Payment System (MIPS): 2023 Reporting MIPS Quality Measures through Medicare Part B Claims Quick Start Guide for Small Practices (Traditional MIPS)
Provides details on how small practices can report quality measures through Medicare Part B claims measures. Highlights changes to these measures in 2023, score redistribution policies for small practices, and information for clinicians at Critical Access Hospitals.
Date: 12/2022
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
view details
Merit-Based Incentive Payment System (MIPS): 2023 Improvement Activities Performance Category Quick Start Guide - Traditional MIPS
Provides an overview of Merit-based Incentive Payment System (MIPS) requirements, data collection, and data submission for the improvement activities performance category for the 2023 performance year. Includes information about special status scoring for small practices and clinicians located in a rural or Health Professional Shortage Area.
Date: 12/2022
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
view details
Merit-based Incentive Payment System (MIPS): 2023 What's New for Small Practices (15 or Fewer Clinicians)
Summarizes new elements of the Merit-based Incentive Payment System (MIPS) for small practices during the 2023 performance year, including an additional reporting option and participation option. Discusses changes to performance category requirements and flexibilities, as well as performance threshold and payment adjustments. Includes information on performance category redistribution policies for small practices.
Date: 12/2022
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
view details