Rural Healthcare Payment and Reimbursement resources via the Rural Health Information Hub

Event: LEAD for Rural: Is It a Good Fit for You?

Thu, 16 Apr 2026 16:59:15 -0500

-- National Rural Health Association

News: CMS: Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals (IPPS) and the Long-Term Care Hospital Prospective Payment System and Policy Changes and Fiscal Year (FY) 2027 Rates; Requirements for Quality Programs; and Other Policy Changes; Correction

Wed, 15 Apr 2026 08:51:27 -0500

Notice from the Centers for Medicare & Medicaid Services (CMS) making technical corrections to the April 14, 2026, proposed rule. Comments on the proposed rule are due by June 9, 2026.

Event: LTSS Webinar: Traditional Healing as Medicine - New Mexico's Medicaid Coverage of Traditional Health Care Practices

Wed, 15 Apr 2026 08:16:48 -0500

-- Centers for Medicare & Medicaid Services

Resource: April 2026 MedPAC Meeting Transcript

Tue, 14 Apr 2026 10:52:11 -0500

Transcript from the Medicare Payment Advisory Commission's (MedPAC) April 2026 meeting. Covers Medicare payment incentives, regional benchmarks and benchmark-plan availability in the Part D prescription drug plan (PDP) market, preferred networks and pharmacy access in Medicare Part D, the estimated association between Medicare Advantage enrollment and hospitals' and post-acute care providers' finances, information sources that beneficiaries use to make Medicare enrollment decisions, and institutional special-needs plans. Includes a mandated report on the assessment of the Medicare ground ambulance data collection system. Includes rural references and considerations throughout. -- Medicare Payment Advisory Commission

News: CMS: Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals (IPPS) and the Long-Term Care Hospital Prospective Payment System and Policy Changes and Fiscal Year (FY) 2027 Rates; Requirements for Quality Programs; and Other Policy Changes

Tue, 14 Apr 2026 08:45:34 -0500

Notice of a proposed rule from the Centers for Medicare & Medicaid Services (CMS) regarding changes to the hospital inpatient prospective payment system (IPPS) for operating and capital-related costs of acute care hospitals for fiscal year 2027. Contains details of proposed changes related to Medicare graduate medical education (GME) for teaching hospitals; payment policies and the annual payment rates for the Medicare prospective payment system (PPS) for inpatient hospital services provided by long-term care hospitals; and certain quality programs, among other things. Comments are due by April 10, 2026.

Resource: Merit-based Incentive Payment System (MIPS): Traditional MIPS Scoring Guide for the 2026 Performance Year

Thu, 09 Apr 2026 09:26:03 -0500

Provides details on how scores are calculated for the Merit-based Incentive Payment System (MIPS), one of two tracks under the Medicare Quality Payment Program. Explains the four performance categories that affect Medicare Physician Fee Schedule payments: quality, cost, improvement activities, and promoting interoperability. Includes information for small practices. -- Centers for Medicare & Medicaid Services

News: CMS: Medicare Program; Contract Year 2027 and Certain Contract Year 2026 Policy and Technical Changes to the Medicare Advantage Program, Medicare Prescription Drug Benefit Program, and Medicare Cost Plan Program

Thu, 02 Apr 2026 16:05:30 -0500

Notice of final rule from the Centers for Medicare & Medicaid Services (CMS) revising the Medicare Advantage (Part C), Medicare Prescription Drug Benefit (Part D), Medicare cost plan regulations. Among other things, this rule finalizes revisions related to Star Ratings, marketing and communications, drug coverage, enrollment processes, special needs plans, and other programmatic areas for contract year 2027. These regulations are effective June 1, 2026, and are applicable to coverage beginning January 1, 2027.

Funding opportunity: LEAD (Long-Term Enhanced ACO Design) Model

Tue, 31 Mar 2026 16:10:01 -0500

A reimbursement model for healthcare providers and Accountable Care Organizations (ACOs). LEAD builds upon the CMS Innovation Center's earlier accountable care work and uses improved benchmarking to appeal to a broader mix of healthcare providers, including those with specialized patient populations and those new to ACOs such as smaller, independent or rural-based practices. -- Centers for Medicare & Medicaid Services

Resource: CMS Innovation Center: Obligations and Model Testing Progress

Fri, 27 Mar 2026 11:12:06 -0500

Discusses the Centers for Medicare & Medicaid Innovation Center's (Innovation Center) financial obligations from 2011 through 2024 and how it used the funds to develop and test new healthcare payment and service delivery models. Describes the outcomes of model testing, highlighting four models that CMS certified for expansion. Explores the extent to which the Innovation Center uses selected performance management practices to regularly assess its efforts. -- Government Accountability Office

News: Blackburn, Kustoff Introduce Rural Health Agenda to Ease Financial Strain for Rural Hospitals, Expand Access to Urgent Care, and Strengthen Recruiting

Fri, 27 Mar 2026 09:52:31 -0500

Highlights the Rural Health Agenda, a bipartisan and bicameral group of proposed legislation aiming to support rural hospitals through increased Medicare reimbursement, introduce new funding to promote innovation in rural emergency healthcare, and incentivize rural communities for healthcare workers through extended loan repayment programs.

Event: Medicaid and CHIP Payment and Access Commission (MACPAC) Public Meeting

Wed, 25 Mar 2026 10:35:20 -0500

-- Medicaid and CHIP Payment and Access Commission

Event: Medicaid and CHIP Payment and Access Commission (MACPAC) Public Meeting

Wed, 25 Mar 2026 10:33:02 -0500

-- Medicaid and CHIP Payment and Access Commission

Event: Medicaid and CHIP Payment and Access Commission (MACPAC) Public Meeting

Wed, 25 Mar 2026 10:31:08 -0500

-- Medicaid and CHIP Payment and Access Commission

Event: Medicaid and CHIP Payment and Access Commission (MACPAC) Public Meeting

Wed, 18 Mar 2026 08:54:14 -0500

-- Medicaid and CHIP Payment and Access Commission

Resource: MedPAC Report to the Congress: Medicare Payment Policy, 2026

Thu, 12 Mar 2026 13:11:00 -0500

Annual review of Medicare payment policies, with recommendations to Congress. Includes discussion on Medicare payment policies directly affecting rural providers and beneficiaries. Addresses payment adequacy for Medicare fee-for-service payment systems, Medicare Advantage (MA), and Medicare Part D. Includes mandated reports on the impact of regulatory changes to the home health prospective payment system and dual-eligible special needs plans. -- Medicare Payment Advisory Commission

Resource: Reimbursement and Policy Considerations of Point-of-Care Ultrasound (POCUS) in Rural Family Medicine

Mon, 09 Mar 2026 09:08:28 -0500

Examines the current Point-of-Care Ultrasound (POCUS) reimbursement landscape, challenges, and opportunities for improvement in rural primary care and emergency departments. Includes a section on financial differences between providing POCUS in Critical Access Hospitals and in Rural Health Clinics.

Resource: March 2026 MedPAC Meeting Transcript

Wed, 04 Mar 2026 09:45:22 -0600

Transcript from the Medicare Payment Advisory Commission's (MedPAC) March 2026 meeting. Covers research and proposals related to the Medicare ground ambulance data collection system, access to hospice and certain complex palliative services for beneficiaries with end-stage renal disease and beneficiaries with cancer, provider participation in Medicare Advantage (MA) networks, MA encounter data in risk adjustment, the complexity of Medicare enrollment decisions for beneficiaries, and Medicare Part B premium payment basics. Includes rural references and considerations throughout. -- Medicare Payment Advisory Commission

Resource: Rural Health Value Virtual Summit: Designing Rural Value-Based Care for the Future

Mon, 02 Mar 2026 13:25:25 -0600

Summarizes a June 2025 summit of rural value-based care (VBC) thought leaders regarding the current state and future opportunities of rural VBC and payment. Describes summit participants' experiences related to the adoption of VBC initiatives. Identifies strategies to accelerate rural healthcare provider participation and success in VBC and value-based payment. -- Rural Health Value

Resource: Catalog of Value-Based Initiatives for Rural Providers

Tue, 24 Feb 2026 09:27:24 -0600

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. -- Rural Health Value

Resource: Encouraging Rural Participation in Population-Based Total Cost of Care (PB-TCOC) Models

Fri, 20 Feb 2026 13:38:27 -0600

Examines the financial constraints rural providers have in pivoting to value-based care and alternative payment models (APMs), including population-based total cost of care (PB-TCOC) models. Provides recommendations and supportive policies to increase rural participation in PB-TCOC models and discusses issues such as financial risk, use of benchmarks to meet spending goals, performance measurements, information technology and telehealth, and more. -- HHS Office of the Assistant Secretary for Planning and Evaluation

Resource: Metropolitan and Nonmetropolitan Medicare Shared Savings Program Assigned Beneficiaries Among Original Medicare Enrollees

Thu, 19 Feb 2026 11:18:34 -0600

Describes trends of Medicare beneficiaries assigned to Medicare Shared Savings Program (SSP) Accountable Care Organizations (ACOs). Presents data on metropolitan and nonmetropolitan SSP ACO assignment and Medicare Advantage enrollment between 2018 and 2024, as well as the percentage of original Medicare beneficiaries assigned to an ACO in 2024 by metropolitan status and state. -- RUPRI Center for Rural Health Policy Analysis

Resource: Improving the Value Proposition of Critical Access Hospitals – Lessons from Federal and State Initiatives

Thu, 12 Feb 2026 13:23:39 -0600

Report details how federal and state initiatives can support Critical Access Hospitals (CAHs) transition to value-based payment models. Provides examples of initiatives that offer models for use by State Flex Programs (SFPs) for supporting CAHs' transformation to value-based care. -- Flex Monitoring Team

Resource: Glossary of Value-Based Care Terms

Fri, 06 Feb 2026 09:10:00 -0600

Presents definitions of key terms related to value-based care and payment. Includes terminology regarding healthcare value, payment and incentive structures, care delivery, data and technology, and more. -- Rural Health Value

Resource: Shared Savings Program Fast Facts

Thu, 05 Feb 2026 08:46:09 -0600

Provides summary statistics on the Medicare Shared Savings Program as of January 1, 2026. Offers data on the number of Accountable Care Organizations (ACOs), assigned beneficiaries, total earned shared savings, and quality scores each year since 2012; the number and percent of ACOs in each track; and more. Includes information on ACO participants, including the number of Rural Health Clinics (RHCs) and Critical Access Hospitals (CAHs) participating in the program. -- Centers for Medicare & Medicaid Services

Resource: Provider-Level Variation in the Delivery of Primary Care Telehealth for the Rural Medicare Advantage Population

Wed, 04 Feb 2026 13:32:51 -0600

Results of a study comparing use of telehealth primary care between rural and nonrural Medicare Advantage (MA) beneficiaries by providers' level of telehealth delivery. Based on data from claims for MA beneficiaries enrolled in Humana Inc. plans from January 2021 to June 2024.

Event: Physician-Focused Payment Model Technical Advisory Committee (PTAC) Meeting

Mon, 02 Feb 2026 13:22:55 -0600

-- HHS Office of the Assistant Secretary for Planning and Evaluation

Event: Physician-Focused Payment Model Technical Advisory Committee (PTAC) Meeting

Mon, 02 Feb 2026 13:21:43 -0600

-- HHS Office of the Assistant Secretary for Planning and Evaluation

Event: Physician-Focused Payment Model Technical Advisory Committee (PTAC) Meeting

Mon, 02 Feb 2026 13:20:20 -0600

-- HHS Office of the Assistant Secretary for Planning and Evaluation

Resource: January 2026 MedPAC Meeting Transcript

Wed, 21 Jan 2026 09:52:35 -0600

Transcript from the Medicare Payment Advisory Commission's (MedPAC) January 2026 meeting. Covers payment adequacy and updates for physician and other health professional services, hospital inpatient and outpatient services, skilled nursing facility services, home health agency services, inpatient rehabilitation facility services, outpatient dialysis services, and hospice services. Discusses status reports on Medicare Part D, ambulatory surgical centers, and the Medicare Advantage program, as well as mandated reports on changes to the home health prospective payment system and dual-eligible special needs plans. Includes rural references and considerations throughout. -- Medicare Payment Advisory Commission

Event: Meeting of the Medicare Payment Advisory Commission (MedPAC)

Mon, 12 Jan 2026 11:00:24 -0600

-- Medicare Payment Advisory Commission