Rural Health
Resources by Topic: Service delivery models
Evaluation of the Primary Care First Model: Third Annual Report
Provides an overview of the Primary Care First (PCF) model, which aims to enhance primary care and move primary care practitioners toward value-based payment. Describes the PCF model implementation experiences for Cohort 1 and Cohort 2 practices through 2023. Explores the characteristics of practices and payers that continued to participate in the PCF model compared to those who left. Examines the role that the PCF Model's incentives and supports played in the strategies and practices adopted to improve care delivery and how the trajectory of these strategies and activities practices have transformed over time. Estimates the impact of the PCF Model on Medicare fee-for-service (FFS) expenditures and service use, including acute hospitalizations. Estimates the impacts of the model on a set of seven leading indicators to provide an early assessment of whether care delivery changes are resulting in meaningful early outcome changes.
Additional links: Executive Summary, Findings at a Glance
Date: 05/2025
Sponsoring organizations: Centers for Medicare and Medicaid Services, Mathematica
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Provides an overview of the Primary Care First (PCF) model, which aims to enhance primary care and move primary care practitioners toward value-based payment. Describes the PCF model implementation experiences for Cohort 1 and Cohort 2 practices through 2023. Explores the characteristics of practices and payers that continued to participate in the PCF model compared to those who left. Examines the role that the PCF Model's incentives and supports played in the strategies and practices adopted to improve care delivery and how the trajectory of these strategies and activities practices have transformed over time. Estimates the impact of the PCF Model on Medicare fee-for-service (FFS) expenditures and service use, including acute hospitalizations. Estimates the impacts of the model on a set of seven leading indicators to provide an early assessment of whether care delivery changes are resulting in meaningful early outcome changes.
Additional links: Executive Summary, Findings at a Glance
Date: 05/2025
Sponsoring organizations: Centers for Medicare and Medicaid Services, Mathematica
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2024 National CAH Quality Inventory & Assessment National Report
Presents a high-level summary of key data points from the September-November 2024 National Critical Access Hospital (CAH) Quality Inventory and Assessment. Includes data on CAH system affiliation; median average daily census and emergency department volume; median swing bed admissions and swing bed length of stay; hospital inpatient, behavioral health and specialty care, and outpatient and other service lines; and CAH quality payment model participation.
Date: 05/2025
Sponsoring organization: Flex Monitoring Team
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Presents a high-level summary of key data points from the September-November 2024 National Critical Access Hospital (CAH) Quality Inventory and Assessment. Includes data on CAH system affiliation; median average daily census and emergency department volume; median swing bed admissions and swing bed length of stay; hospital inpatient, behavioral health and specialty care, and outpatient and other service lines; and CAH quality payment model participation.
Date: 05/2025
Sponsoring organization: Flex Monitoring Team
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CMS Bundled Payments for Care Improvement Advanced Model: Sixth Annual Evaluation Report
Sixth annual report of the Bundled Payments for Care Improvement Advanced (BPCI Advanced) Model, which tests whether linking payments for a clinical episode of care can reduce Medicare expenditures while maintaining or improving the quality of care. Examines the impact of BPCI Advanced on episode payments, utilization, and quality of care, as well as estimates of Medicare program savings in Model Year 5. Also explores the impact of the model on accountable care relationships, strengthening primary care, and care for patients eligible for both Medicare and Medicaid. Includes data on the percentage of BPCI Advanced episodes with and without ACO attribution by patient characteristics, including rural residents.
Additional links: Appendices, Executive Summary, Findings at a Glance, Transformation Spotlight
Author(s): The Lewin Group, Abt Associates, GDIT, Telligen
Date: 04/2025
Sponsoring organization: Centers for Medicare and Medicaid Services
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Sixth annual report of the Bundled Payments for Care Improvement Advanced (BPCI Advanced) Model, which tests whether linking payments for a clinical episode of care can reduce Medicare expenditures while maintaining or improving the quality of care. Examines the impact of BPCI Advanced on episode payments, utilization, and quality of care, as well as estimates of Medicare program savings in Model Year 5. Also explores the impact of the model on accountable care relationships, strengthening primary care, and care for patients eligible for both Medicare and Medicaid. Includes data on the percentage of BPCI Advanced episodes with and without ACO attribution by patient characteristics, including rural residents.
Additional links: Appendices, Executive Summary, Findings at a Glance, Transformation Spotlight
Author(s): The Lewin Group, Abt Associates, GDIT, Telligen
Date: 04/2025
Sponsoring organization: Centers for Medicare and Medicaid Services
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Advancing Value-Based Payment Policies Relevant to Rural Areas – Continued Challenges and New Opportunities
Discusses lessons from the recent public health emergency, rising health care costs, improved quality measurement, and innovative technologies on the transition from volume-based payment to value-based payment. Outlines potential policy opportunities for the Centers for Medicare & Medicaid Services (CMS) Innovation Center model design and CMS program inclusion to expand rural-appropriate opportunities to participate in the transition to value-based care. Builds on the 2020 publication How to Design Value‐based Care Models for Rural Participant Success: A Summit Findings Report.
Date: 04/2025
Sponsoring organization: Rural Health Value
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Discusses lessons from the recent public health emergency, rising health care costs, improved quality measurement, and innovative technologies on the transition from volume-based payment to value-based payment. Outlines potential policy opportunities for the Centers for Medicare & Medicaid Services (CMS) Innovation Center model design and CMS program inclusion to expand rural-appropriate opportunities to participate in the transition to value-based care. Builds on the 2020 publication How to Design Value‐based Care Models for Rural Participant Success: A Summit Findings Report.
Date: 04/2025
Sponsoring organization: Rural Health Value
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Social Workers Bridge Critical Care Gaps and Improve Health Outcomes for Rural Veterans
Discusses the role of social workers in primary care teams for rural veterans. Explores the impacts of incorporating social workers into primary care on hospitalizations, emergency department visits, and closing gaps in rural service delivery.
Author(s): James Rudolph
Date: 03/2025
Sponsoring organization: VA Health Systems Research, Office of Research & Development
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Discusses the role of social workers in primary care teams for rural veterans. Explores the impacts of incorporating social workers into primary care on hospitalizations, emergency department visits, and closing gaps in rural service delivery.
Author(s): James Rudolph
Date: 03/2025
Sponsoring organization: VA Health Systems Research, Office of Research & Development
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Medicare Telehealth Trends Report
Describes the trends of telehealth utilization among Medicare beneficiaries between January 1, 2020, and September 30, 2024. Presents data on the percentage of Medicare beneficiaries that used a telehealth service by calendar quarter and by Medicaid eligibility, type of Medicare eligibility, demographic characteristics, and rural/urban residence.
Date: 02/2025
Sponsoring organization: Centers for Medicare and Medicaid Services
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Describes the trends of telehealth utilization among Medicare beneficiaries between January 1, 2020, and September 30, 2024. Presents data on the percentage of Medicare beneficiaries that used a telehealth service by calendar quarter and by Medicaid eligibility, type of Medicare eligibility, demographic characteristics, and rural/urban residence.
Date: 02/2025
Sponsoring organization: Centers for Medicare and Medicaid Services
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Enhancing Rural Access to Medications for Opioid Use Disorder: Policy Brief and Recommendations to the Secretary
Provides an overview of issues related to opioid use disorder (OUD) in rural areas. Discusses access to medication for opioid use disorder (MOUD), MOUD workforce, telehealth to support access to MOUD, and Medicaid 1115 demonstrations that address OUD. Offers policy recommendations related to regulatory barriers, reimbursement flexibility, workforce, and service site expansion to increase access to MOUD in rural areas.
Date: 01/2025
Sponsoring organization: National Advisory Committee on Rural Health and Human Services
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Provides an overview of issues related to opioid use disorder (OUD) in rural areas. Discusses access to medication for opioid use disorder (MOUD), MOUD workforce, telehealth to support access to MOUD, and Medicaid 1115 demonstrations that address OUD. Offers policy recommendations related to regulatory barriers, reimbursement flexibility, workforce, and service site expansion to increase access to MOUD in rural areas.
Date: 01/2025
Sponsoring organization: National Advisory Committee on Rural Health and Human Services
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Assessing the Needs of Rural Families Affected by the Opioid Crisis: Issue Brief and Recommendations to the Secretary
Explores the considerations for addressing social determinants of health that influence opioid use disorder (OUD) and the role of community efforts in prevention, treatment, and recovery in rural areas, with a focus on prevention efforts in Las Vegas, New Mexico. Discusses youth and family prevention and well-being; stigma; adverse childhood experience; school-based health centers and youth and family resource centers; access to stable housing, food, and other social supports; the importance of trusted community resources for support; and workforce. Offers recommendations related to reducing stigma and promoting the enhanced utilization of the Community Services Block Grant (CSBG) to help rural communities address OUD and substance use disorders.
Date: 01/2025
Sponsoring organization: National Advisory Committee on Rural Health and Human Services
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Explores the considerations for addressing social determinants of health that influence opioid use disorder (OUD) and the role of community efforts in prevention, treatment, and recovery in rural areas, with a focus on prevention efforts in Las Vegas, New Mexico. Discusses youth and family prevention and well-being; stigma; adverse childhood experience; school-based health centers and youth and family resource centers; access to stable housing, food, and other social supports; the importance of trusted community resources for support; and workforce. Offers recommendations related to reducing stigma and promoting the enhanced utilization of the Community Services Block Grant (CSBG) to help rural communities address OUD and substance use disorders.
Date: 01/2025
Sponsoring organization: National Advisory Committee on Rural Health and Human Services
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An Examination of the Implementation and Effectiveness of the Telehealth Broadband Pilot Program in the United States
Provides a brief overview of the Telehealth Broadband Pilot (TBP) Program, which aimed to address gaps in broadband service that limited access to telehealth services in rural and underserved communities in Alaska, Michigan, Texas, and West Virginia. Describes the development and implementation of pods that measured broadband data in the communities over time. Summarizes discussions with TBP Program staff regarding the implementation and effectiveness of the program. Includes factors for consideration in the development of future programs to measure broadband in rural communities.
Date: 01/2025
Sponsoring organizations: Rural Telehealth Evaluation Center, University of Arkansas for Medical Sciences Regional Campuses
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Provides a brief overview of the Telehealth Broadband Pilot (TBP) Program, which aimed to address gaps in broadband service that limited access to telehealth services in rural and underserved communities in Alaska, Michigan, Texas, and West Virginia. Describes the development and implementation of pods that measured broadband data in the communities over time. Summarizes discussions with TBP Program staff regarding the implementation and effectiveness of the program. Includes factors for consideration in the development of future programs to measure broadband in rural communities.
Date: 01/2025
Sponsoring organizations: Rural Telehealth Evaluation Center, University of Arkansas for Medical Sciences Regional Campuses
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A Perinatal Psychiatry Access Program to Address Rural and Medically Underserved Populations Using Telemedicine
Examines the Moms IMPACTT (Improving Access to Perinatal Mental Health and Substance Use Disorder Care Through Telehealth and Tele-mentoring) program in South Carolina, which aims to address perinatal mental health and substance use issues through healthcare partnerships and telemedicine. Provides details and impact of the program, including outreach and engagement with rural and underserved communities.
Author(s): Courtney King, Marie Hayes, Lizmarie Maldonado, et al.
Citation: BMC Women's Health, 25, 30
Date: 01/2025
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Examines the Moms IMPACTT (Improving Access to Perinatal Mental Health and Substance Use Disorder Care Through Telehealth and Tele-mentoring) program in South Carolina, which aims to address perinatal mental health and substance use issues through healthcare partnerships and telemedicine. Provides details and impact of the program, including outreach and engagement with rural and underserved communities.
Author(s): Courtney King, Marie Hayes, Lizmarie Maldonado, et al.
Citation: BMC Women's Health, 25, 30
Date: 01/2025
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