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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Catalog of Value-Based Initiatives for Rural Providers
Summarizes rural-relevant, value-based programs currently or recently implemented by the U.S. Department of Health and Human Services (HHS), including the Centers for Medicare & Medicaid Services (CMS) and the CMS Innovation Center. Designed to help rural healthcare leaders identify HHS value-based programs that are suitable for rural participation. Contains descriptions of each demonstration and provides direct links to the corresponding agency web page.
Date: 05/2025
Sponsoring organization: Rural Health Value
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Summarizes rural-relevant, value-based programs currently or recently implemented by the U.S. Department of Health and Human Services (HHS), including the Centers for Medicare & Medicaid Services (CMS) and the CMS Innovation Center. Designed to help rural healthcare leaders identify HHS value-based programs that are suitable for rural participation. Contains descriptions of each demonstration and provides direct links to the corresponding agency web page.
Date: 05/2025
Sponsoring organization: Rural Health Value
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Medicare Shared Savings Program: Rule Changes and Implications for Rural Health Care Organizations
Summarizes changes to the Centers for Medicare & Medicaid Services (CMS) Medicare Shared Savings Program (SSP) that take effect in January 2023 for current participants, and in January 2024 for organizations applying for a January 1, 2024 start. Discusses the potential impact of these changes on rural health and participation considerations.
Date: 05/2025
Sponsoring organization: Rural Health Value
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Summarizes changes to the Centers for Medicare & Medicaid Services (CMS) Medicare Shared Savings Program (SSP) that take effect in January 2023 for current participants, and in January 2024 for organizations applying for a January 1, 2024 start. Discusses the potential impact of these changes on rural health and participation considerations.
Date: 05/2025
Sponsoring organization: Rural Health Value
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Medicare Telehealth Trends Report
Describes the trends of telehealth utilization among Medicare beneficiaries between January 1, 2020, and December 31, 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: 05/2025
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 December 31, 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: 05/2025
Sponsoring organization: Centers for Medicare and Medicaid Services
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Profile in Innovation: Rural Hospital Participation in Missouri HealthNet's Transformation of Rural Community Health (ToRCH) Program
Provides an overview of ToRCH, a Missouri Medicaid program designed to improve health outcomes and overall well-being in rural Missouri communities by addressing both medical and health-related social needs through a comprehensive, integrated care model. Discusses how hospitals, primary care teams, and community-based organizations implemented the model and funding strategy for the program.
Date: 04/2025
Sponsoring organization: Rural Health Value
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Provides an overview of ToRCH, a Missouri Medicaid program designed to improve health outcomes and overall well-being in rural Missouri communities by addressing both medical and health-related social needs through a comprehensive, integrated care model. Discusses how hospitals, primary care teams, and community-based organizations implemented the model and funding strategy for the program.
Date: 04/2025
Sponsoring organization: Rural Health Value
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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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FH Healthcare Indicators and FH Medical Price Index 2025: An Annual View of Place of Service Trends and Medical Pricing
White paper exploring changes in healthcare utilization, demographic and geographic factors, diagnoses, costs, and procedures. Features statistics including usage of retail clinics and telehealth from 2018-2023; and urgent care, ambulatory surgery centers, and emergency rooms from 2014-2024. Includes comparisons of utilization of each service type by urban and rural location.
Date: 03/2025
Sponsoring organization: FAIR Health
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White paper exploring changes in healthcare utilization, demographic and geographic factors, diagnoses, costs, and procedures. Features statistics including usage of retail clinics and telehealth from 2018-2023; and urgent care, ambulatory surgery centers, and emergency rooms from 2014-2024. Includes comparisons of utilization of each service type by urban and rural location.
Date: 03/2025
Sponsoring organization: FAIR Health
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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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