Rural Healthcare Payment and Reimbursement – Resources
Selected recent or important resources focusing on Rural Healthcare Payment and Reimbursement.
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: 02/2026
Sponsoring organization: Rural Health Value
view details
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: 02/2026
Sponsoring organization: Rural Health Value
view details
Metropolitan and Nonmetropolitan Medicare Shared Savings Program Assigned Beneficiaries Among Original Medicare Enrollees
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.
Author(s): Fred Ullrich, Keith Mueller
Date: 02/2026
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
view details
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.
Author(s): Fred Ullrich, Keith Mueller
Date: 02/2026
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
view details
Improving the Value Proposition of Critical Access Hospitals – Lessons from Federal and State Initiatives
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.
Author(s): John Gale, Rebecca Stearns, Bridget Harr
Date: 02/2026
Sponsoring organization: Flex Monitoring Team
view details
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.
Author(s): John Gale, Rebecca Stearns, Bridget Harr
Date: 02/2026
Sponsoring organization: Flex Monitoring Team
view details
Shared Savings Program Fast Facts
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.
Date: 02/2026
Sponsoring organization: Centers for Medicare and Medicaid Services
view details
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.
Date: 02/2026
Sponsoring organization: Centers for Medicare and Medicaid Services
view details
Provider-Level Variation in the Delivery of Primary Care Telehealth for the Rural Medicare Advantage Population
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.
Author(s): Debra Bozzi, Amanda Sutherland, Melanie Canterberry, Emily Boudreau, Gosia Sylwestrzak
Citation: The Journal of Rural Health, 42(1), e70127
Date: 02/2026
view details
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.
Author(s): Debra Bozzi, Amanda Sutherland, Melanie Canterberry, Emily Boudreau, Gosia Sylwestrzak
Citation: The Journal of Rural Health, 42(1), e70127
Date: 02/2026
view details
Encouraging Rural Participation in Population-Based Total Cost of Care (PB-TCOC) Models
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-TOC models and discusses issues such as financial risk, use of benchmarks to meet spending goals, performance measurements, information technology and telehealth, and more.
Date: 01/2026
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
view details
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-TOC models and discusses issues such as financial risk, use of benchmarks to meet spending goals, performance measurements, information technology and telehealth, and more.
Date: 01/2026
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
view details
Glossary of Value-Based Care Terms
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.
Date: 01/2026
Sponsoring organization: Rural Health Value
view details
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.
Date: 01/2026
Sponsoring organization: Rural Health Value
view details
January 2026 MedPAC Meeting Transcript
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.
Date: 01/2026
Sponsoring organization: Medicare Payment Advisory Commission
view details
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.
Date: 01/2026
Sponsoring organization: Medicare Payment Advisory Commission
view details
Merit-based Incentive Payment System (MIPS): 2026 MIPS Quick Start Guide for Small Practices
Provides an overview of the Merit-based Incentive Payment System (MIPS). Outlines 6 steps for small practices regarding participation in the 2026 performance year. Includes information on performance category redistribution policies for small practices.
Date: 12/2025
Sponsoring organization: Centers for Medicare and Medicaid Services
view details
Provides an overview of the Merit-based Incentive Payment System (MIPS). Outlines 6 steps for small practices regarding participation in the 2026 performance year. Includes information on performance category redistribution policies for small practices.
Date: 12/2025
Sponsoring organization: Centers for Medicare and Medicaid Services
view details
Merit-Based Incentive Payment System (MIPS): Traditional MIPS Scoring Guide for the 2025 Performance Year
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.
Date: 12/2025
Sponsoring organization: Centers for Medicare and Medicaid Services
view details
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.
Date: 12/2025
Sponsoring organization: Centers for Medicare and Medicaid Services
view details
Additional resources are available related to this guide. See the full list of resources by topic for:
- Accountable Care Organizations
- Care coordination
- Health insurance
- Healthcare business and finance
- Medicaid
- Medicare
- Policy
- Reimbursement and payment models
- Service delivery models
Last Updated: 2/24/2026