Rural Healthcare Payment and Reimbursement – Resources
Selected recent or important resources focusing on Rural Healthcare Payment and Reimbursement.
Calendar Year (CY) 2027 Medicare Physician Fee Schedule Final Rule (CMS-1848-F) — Medicare Shared Savings Program
Fact sheet providing an overview of the Centers for Medicare & Medicaid Services (CMS) final rule regarding updates and changes to the Medicare Shared Savings Program for calendar year 2027. Covers modifications to the Shared Savings Program financial methodology, quality measurement and reporting, advance investment payments to encourage rural participation in Accountable Care Organizations, and more.
Date: 11/2026
Sponsoring organization: Centers for Medicare & Medicaid Services
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Fact sheet providing an overview of the Centers for Medicare & Medicaid Services (CMS) final rule regarding updates and changes to the Medicare Shared Savings Program for calendar year 2027. Covers modifications to the Shared Savings Program financial methodology, quality measurement and reporting, advance investment payments to encourage rural participation in Accountable Care Organizations, and more.
Date: 11/2026
Sponsoring organization: Centers for Medicare & Medicaid Services
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Calendar Year (CY) 2027 Medicare Physician Fee Schedule Final Rule
Fact sheet providing an overview of the Centers for Medicare & Medicaid Services (CMS) final rule regarding updates and changes to the Medicare payments under the Physician Fee Schedule (PFS) and other Medicare Part B issues for calendar year 2027. Summarizes provisions related to remote monitoring, improving care for chronic illness and behavioral health needs, Rural Health Clinic (RHC) Diabetes Self-Management Training (DSMT) and Medical Nutrition Therapy (MNT) services, RHC and Federally Qualified Health Center (FQHC) mental health and telecommunication visits, the Medicare Prescription Drug Inflation Rebate Program, and more.
Date: 11/2026
Sponsoring organization: Centers for Medicare & Medicaid Services
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Fact sheet providing an overview of the Centers for Medicare & Medicaid Services (CMS) final rule regarding updates and changes to the Medicare payments under the Physician Fee Schedule (PFS) and other Medicare Part B issues for calendar year 2027. Summarizes provisions related to remote monitoring, improving care for chronic illness and behavioral health needs, Rural Health Clinic (RHC) Diabetes Self-Management Training (DSMT) and Medical Nutrition Therapy (MNT) services, RHC and Federally Qualified Health Center (FQHC) mental health and telecommunication visits, the Medicare Prescription Drug Inflation Rebate Program, and more.
Date: 11/2026
Sponsoring organization: Centers for Medicare & Medicaid Services
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Aligning Payment Strategy with Community Need: A Framework for Rural Healthcare Leaders
Describes a framework for rural health providers to build partnerships with payers. Discusses what payers need, knowing the true cost of access, defining services needed for each community, and using data and transformation planning as contracting tools.
Date: 10/2026
Sponsoring organization: Rural Health Redesign Center
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Describes a framework for rural health providers to build partnerships with payers. Discusses what payers need, knowing the true cost of access, defining services needed for each community, and using data and transformation planning as contracting tools.
Date: 10/2026
Sponsoring organization: Rural Health Redesign Center
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Merit-Based Incentive Payment System (MIPS): 2025 Performance Year/2027 MIPS Payment Year - Payment Adjustment User Guide
Provides information on Merit-Based Incentive Payment System (MIPS) payment adjustments for calendar year 2027. Describes how 2025 MIPS scores relate to 2027 payment adjustments and how payment adjustments are applied. Offers answers to frequently asked questions.
Date: 10/2026
Sponsoring organization: Centers for Medicare & Medicaid Services
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Provides information on Merit-Based Incentive Payment System (MIPS) payment adjustments for calendar year 2027. Describes how 2025 MIPS scores relate to 2027 payment adjustments and how payment adjustments are applied. Offers answers to frequently asked questions.
Date: 10/2026
Sponsoring organization: Centers for Medicare & Medicaid Services
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MedPAC Payment Basics
Series of briefs providing an of Medicare payment systems. Covers payments systems including Accountable Care Organizations (ACO), Critical Access Hospitals (CAH), Federally Qualified Health Centers and Rural Health Clinics, hospital acute inpatient services, and more.
Date: 10/2026
Sponsoring organization: Medicare Payment Advisory Commission
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Series of briefs providing an of Medicare payment systems. Covers payments systems including Accountable Care Organizations (ACO), Critical Access Hospitals (CAH), Federally Qualified Health Centers and Rural Health Clinics, hospital acute inpatient services, and more.
Date: 10/2026
Sponsoring organization: Medicare Payment Advisory Commission
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Numerous Overlapping Programs Add Complexity, Unpredictability to Rural Hospital Finances
Analyzes payments between 1997 and 2024 to 2,942 rural hospitals participating in at least one Medicare-specific payment program, including the Sole Community Hospital, Medicare-Dependent Hospital, Critical Access Hospital, or Low-Volume Hospital programs. Discusses the impact of the programs and policy changes throughout the study period on hospital finances.
Author(s): Carolyn San Soucie, Michael E. Chernew, Benjamin D. Sommers
Citation: Health Affairs Scholar, 4(9)
Date: 09/2026
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Analyzes payments between 1997 and 2024 to 2,942 rural hospitals participating in at least one Medicare-specific payment program, including the Sole Community Hospital, Medicare-Dependent Hospital, Critical Access Hospital, or Low-Volume Hospital programs. Discusses the impact of the programs and policy changes throughout the study period on hospital finances.
Author(s): Carolyn San Soucie, Michael E. Chernew, Benjamin D. Sommers
Citation: Health Affairs Scholar, 4(9)
Date: 09/2026
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Rural Health Value Virtual Summit: Rural Healthcare Information Technology
Summarizes an April 2026 summit of rural value-based care thought leaders regarding the implementation of health information technology (HIT) to support value-based care. Identifies five themes that emerged from discussion and recommendations for healthcare leaders who want to invest in technology to support value-based care and value-based payment.
Date: 09/2026
Sponsoring organization: Rural Health Value
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Summarizes an April 2026 summit of rural value-based care thought leaders regarding the implementation of health information technology (HIT) to support value-based care. Identifies five themes that emerged from discussion and recommendations for healthcare leaders who want to invest in technology to support value-based care and value-based payment.
Date: 09/2026
Sponsoring organization: Rural Health Value
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Health Care Access, Preventive Care, and Affordability Among Rural Adults With Cardiometabolic Conditions: Medicare Advantage Versus Traditional Medicare
Examines the differences in healthcare experiences for rural adults with cardiometabolic conditions who are enrolled in Medicare Advantage (MA) versus traditional Medicare. Utilizes 2021-2022 Medicare Current Beneficiary Survey data from 4,274 rural beneficiaries and analyzes MA versus traditional Medicare coverage related to issues such as healthcare access, preventive care, and affordability.
Author(s): Nicholas Chiu, Andrew Oseran, Archana P. Tale, Rishi K. Wadhera
Citation: Journal of the American Heart Association, 15, 15
Date: 07/2026
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Examines the differences in healthcare experiences for rural adults with cardiometabolic conditions who are enrolled in Medicare Advantage (MA) versus traditional Medicare. Utilizes 2021-2022 Medicare Current Beneficiary Survey data from 4,274 rural beneficiaries and analyzes MA versus traditional Medicare coverage related to issues such as healthcare access, preventive care, and affordability.
Author(s): Nicholas Chiu, Andrew Oseran, Archana P. Tale, Rishi K. Wadhera
Citation: Journal of the American Heart Association, 15, 15
Date: 07/2026
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MedPAC Data Book: Health Care Spending and the Medicare Program, 2026
Provides an overview of Medicare spending and highlights data on Medicare beneficiary demographics, dual-eligible beneficiaries, quality of care provided through the Medicare program, and other payer liability. Examines settings of care, including rural-specific provider sites, as they relate to spending, access to care, and Medicare and operating margins. Compares rural and urban beneficiaries and providers throughout. Chart 6-2 addresses rural hospital closures and Rural Emergency Hospital conversions.
Date: 07/2026
Sponsoring organization: Medicare Payment Advisory Commission
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Provides an overview of Medicare spending and highlights data on Medicare beneficiary demographics, dual-eligible beneficiaries, quality of care provided through the Medicare program, and other payer liability. Examines settings of care, including rural-specific provider sites, as they relate to spending, access to care, and Medicare and operating margins. Compares rural and urban beneficiaries and providers throughout. Chart 6-2 addresses rural hospital closures and Rural Emergency Hospital conversions.
Date: 07/2026
Sponsoring organization: Medicare Payment Advisory Commission
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Evaluation of the ACO REACH Model: Evaluation Report 3
Presents key findings from an evaluation of the Accountable Care Organization (ACO) REACH Model's first performance year, as well as the two years of the preceding Global and Professional Direct Contracting (GPDC) Model. Examines model participants' implementation experiences and the model's impact on cost, utilization, and quality outcomes. Includes information on the participation of Federally Qualified Health Centers (FQHCs), Rural Health Clinics (RHCs), and Critical Access Hospitals (CAHs) in the model.
Additional links: Appendices, CMS Perspective Report, Executive Summary, Findings at a Glance
Date: 07/2026
Sponsoring organizations: Centers for Medicare & Medicaid Services, NORC at the University of Chicago
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Presents key findings from an evaluation of the Accountable Care Organization (ACO) REACH Model's first performance year, as well as the two years of the preceding Global and Professional Direct Contracting (GPDC) Model. Examines model participants' implementation experiences and the model's impact on cost, utilization, and quality outcomes. Includes information on the participation of Federally Qualified Health Centers (FQHCs), Rural Health Clinics (RHCs), and Critical Access Hospitals (CAHs) in the model.
Additional links: Appendices, CMS Perspective Report, Executive Summary, Findings at a Glance
Date: 07/2026
Sponsoring organizations: Centers for Medicare & Medicaid Services, NORC at the University of Chicago
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