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Rural Health
Resources by Topic: Reimbursement and payment models

Support for Small, Underserved, and Rural Practices
Section of the Quality Payment Program (QPP) website, enabling practices with 15 or fewer clinicians to receive free, customized technical assistance, including help choosing and reporting on quality measures, guidance with forming partnerships, and support optimizing health information technology.
Type: Website
Sponsoring organization: Centers for Medicare and Medicaid Services
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Hospital Spotlights
Features small rural hospitals from across the country, highlighting how they successfully implemented best practices to improve performance and adopted transition strategies to prepare for population health.
Type: Website
Sponsoring organization: National Rural Health Resource Center
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Medicare Learning Network: Health Professional Shortage Area Physician Bonus Program
Provides an overview of the Health Professional Shortage Area (HPSA) Physician Bonus Program and explains how bonus payments are calculated and paid. Includes information related to Critical Access Hospitals (CAHs) as well as primary care and mental health HPSAs.
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Medicare Advantage Capitation Rates and Medicare Advantage and Part D Payment Policies and Final Call Letter
Announces the final calendar year Medicare Advantage (MA) capitation rates, and provides detailed information for MA organizations and prescription drug plan sponsors regarding MA and Part D payment policies.
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Rural Hospital Toolkit for Transitioning to Value-based Systems
Toolkit developed to help rural hospitals improve their financial, operational, and quality performance. Shares best practices and strategies to help rural providers transition to value-based payment and population health. A PDF version released in September 2015 is also available.
Type: Website
Sponsoring organization: National Rural Health Resource Center
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AHA Case Studies
A collection of case studies demonstrating community-level innovations and new models of care, payment, and healthcare delivery. Includes rural examples and those focused on serving vulnerable communities.
Type: Website
Sponsoring organization: American Hospital Association
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Chronic Care Management (CCM) Services for Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs)
Provides instructions for Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs) on how to submit claims for chronic care management services according to the RHC All-Inclusive Rate and the FQHC Prospective Payment System, effective January 1, 2016.
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Calendar Year (CY) 2015 Rural Health Clinic (RHC) and Federally Qualified Health Centers (FQHC) Updates: Payment Rate Increases for RHCs and FQHCs Billing Under the All-Inclusive Rate System (AIR), and Urban and Rural Designations for FQHCs Billing Under
Provides updates for RHCs and FQHCs that are submitting claims to Medicare Administrative Contractors (MACs) for services to Medicare beneficiaries.
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Rural Community Hospital Demonstration
An overview of a CMS demonstration project which provides cost-based reimbursement for small rural hospitals too large to be Critical Access Hospitals. Examines the community benefits and financial impact for participating hospitals.
Type: Website
Sponsoring organization: Centers for Medicare and Medicaid Services
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Rural Health Value: Innovations & Demonstrations
Profiles of rural health delivery and finance innovations and summaries of selected rural health demonstration programs.
Type: Website
Sponsoring organization: Rural Health Value
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