Rural Healthcare Payment and Reimbursement – Resources
Selected recent or important resources focusing on Rural Healthcare Payment and Reimbursement.
Medicaid and Rural Health
Provides an overview of rural residents, including socioeconomic characteristics, insurance status, and health status. Explores the availability of healthcare providers in rural areas, with a focus on primary care providers and hospitals. Discusses the role of Medicaid in rural health, as well as Medicaid policies and services that are important for providing healthcare in rural communities.
Date: 04/2021
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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Provides an overview of rural residents, including socioeconomic characteristics, insurance status, and health status. Explores the availability of healthcare providers in rural areas, with a focus on primary care providers and hospitals. Discusses the role of Medicaid in rural health, as well as Medicaid policies and services that are important for providing healthcare in rural communities.
Date: 04/2021
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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State-Driven Initiatives to Support Moving to Value-Based Care in the Era of COVID-19
Describes four areas where state-driven strategies can facilitate and promote the adoption of value-based payment (VBP) models. Presents case examples throughout, including the Pennsylvania Rural Health Model. Discusses how additional federal actions could support transitions to VBP at the state level.
Author(s): Caroline Picher, Lauren Block, Mark Japinga, Hemi Tewarson
Date: 03/2021
Sponsoring organizations: Duke-Margolis Center for Health Policy, National Governors Association
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Describes four areas where state-driven strategies can facilitate and promote the adoption of value-based payment (VBP) models. Presents case examples throughout, including the Pennsylvania Rural Health Model. Discusses how additional federal actions could support transitions to VBP at the state level.
Author(s): Caroline Picher, Lauren Block, Mark Japinga, Hemi Tewarson
Date: 03/2021
Sponsoring organizations: Duke-Margolis Center for Health Policy, National Governors Association
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The Effect of Medicare Payment Standardization Methods on the Perceived Cost of Post-Acute Swing Bed Care in Critical Access Hospitals
Discusses the different payment systems the Centers for Medicare and Medicaid Services (CMS) uses to reimburse for post-acute care in Critical Access Hospitals (CAHs), prospective payment system (IPPS) hospitals, and skilled nursing facilities (SNFs). Describes how the payment standardization methods may influence post-acute care discharge patterns and access to care for rural residents. Examines the effects of these payment methods on the perceived cost of CAH swing bed care as it relates to the Medicare Spending per Beneficiary performance measure.
Author(s): Tyler Malone, Denise Kirk, Kristin Reiter
Date: 03/2021
Sponsoring organization: North Carolina Rural Health Research Program
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Discusses the different payment systems the Centers for Medicare and Medicaid Services (CMS) uses to reimburse for post-acute care in Critical Access Hospitals (CAHs), prospective payment system (IPPS) hospitals, and skilled nursing facilities (SNFs). Describes how the payment standardization methods may influence post-acute care discharge patterns and access to care for rural residents. Examines the effects of these payment methods on the perceived cost of CAH swing bed care as it relates to the Medicare Spending per Beneficiary performance measure.
Author(s): Tyler Malone, Denise Kirk, Kristin Reiter
Date: 03/2021
Sponsoring organization: North Carolina Rural Health Research Program
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How to Design Value‐based Care Models for Rural Participant Success: A Summit Findings Report
Summarizes a July 2020 virtual summit of rural participants in value‐based care (VBC) models and programs. Details six themes on VBC model design, implementation, and operation that can influence rural organization participation in VBC models. Provides recommendations for VBC model designers to improve rural healthcare provider participation and success in VBC models.
Author(s): Keith Mueller, Clint MacKinney, Jennifer Lundblad, Karla Weng
Date: 12/2020
Sponsoring organization: Rural Health Value
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Summarizes a July 2020 virtual summit of rural participants in value‐based care (VBC) models and programs. Details six themes on VBC model design, implementation, and operation that can influence rural organization participation in VBC models. Provides recommendations for VBC model designers to improve rural healthcare provider participation and success in VBC models.
Author(s): Keith Mueller, Clint MacKinney, Jennifer Lundblad, Karla Weng
Date: 12/2020
Sponsoring organization: Rural Health Value
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Rural Health Value: Policy Documents and Demonstrations
Summaries of selected rural health demonstration programs and rural aspects of payment policies.
Sponsoring organization: Rural Health Value
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Summaries of selected rural health demonstration programs and rural aspects of payment policies.
Sponsoring organization: Rural Health Value
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ACO Primary Care Flex Model
Provides information on the Centers for Medicare & Medicaid Services (CMS) Innovation Center's ACO Primary Care Flex Model, which will test how prospective payments and increased funding for primary care in accountable care organizations (ACOs) impact health outcomes, quality, and costs of care. Aims to increase the number of low-revenue ACOs participating in the Medicare Shared Savings Program (SSP), including ACOs serving rural and underserved populations.
Sponsoring organization: Centers for Medicare and Medicaid Services
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Provides information on the Centers for Medicare & Medicaid Services (CMS) Innovation Center's ACO Primary Care Flex Model, which will test how prospective payments and increased funding for primary care in accountable care organizations (ACOs) impact health outcomes, quality, and costs of care. Aims to increase the number of low-revenue ACOs participating in the Medicare Shared Savings Program (SSP), including ACOs serving rural and underserved populations.
Sponsoring organization: Centers for Medicare and Medicaid Services
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Achieving Healthcare Efficiency through Accountable Design (AHEAD) Model
Provides information on the Centers for Medicare & Medicaid Services (CMS) Innovation Center's Achieving Healthcare Efficiency through Accountable Design (AHEAD) Model, a voluntary state total cost of care model that will test state accountability for controlling overall growth in health expenditures while increasing investment in primary care and improving population health outcomes.
Sponsoring organization: Centers for Medicare and Medicaid Services
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Provides information on the Centers for Medicare & Medicaid Services (CMS) Innovation Center's Achieving Healthcare Efficiency through Accountable Design (AHEAD) Model, a voluntary state total cost of care model that will test state accountability for controlling overall growth in health expenditures while increasing investment in primary care and improving population health outcomes.
Sponsoring organization: Centers for Medicare and Medicaid Services
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State Medicaid Links
Provides links to state Medicaid agency websites, including pages for state contacts, eligibility, and enrollment information.
Sponsoring organization: Centers for Medicare and Medicaid Services
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Provides links to state Medicaid agency websites, including pages for state contacts, eligibility, and enrollment information.
Sponsoring organization: Centers for Medicare and Medicaid Services
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Medicare Shared Savings Program
Provides an overview of the Medicare Shared Savings Program. Offers links to program resources, including application information, program data, and program statutes and regulations.
Sponsoring organization: Centers for Medicare and Medicaid Services
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Provides an overview of the Medicare Shared Savings Program. Offers links to program resources, including application information, program data, and program statutes and regulations.
Sponsoring organization: Centers for Medicare and Medicaid Services
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ACO REACH Model
Provides information on the Centers for Medicare & Medicaid Services (CMS) Innovation Center's ACO REACH Model, which is intended to encourage healthcare coordination to improve care for people with Medicare.
Sponsoring organization: Centers for Medicare and Medicaid Services
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Provides information on the Centers for Medicare & Medicaid Services (CMS) Innovation Center's ACO REACH Model, which is intended to encourage healthcare coordination to improve care for people with Medicare.
Sponsoring organization: Centers for Medicare and Medicaid Services
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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: 10/13/2025