Rural Healthcare Payment and Reimbursement – Resources
Selected recent or important resources focusing on Rural Healthcare Payment and Reimbursement.
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
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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
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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 & Medicaid Services
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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 & Medicaid Services
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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
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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
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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-TCOC 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
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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.
Date: 01/2026
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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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
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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
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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
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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
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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 & Medicaid Services
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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 & Medicaid Services
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Reimbursement and Policy Considerations of Point-of-Care Ultrasound (POCUS) in Rural Family Medicine
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.
Author(s): Kylie Long, Geoffrey Bocobo, Andrew Goldsmith
Citation: The Journal of the American Board of Family Medicine, 38(6), 967-973
Date: 11/2025
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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.
Author(s): Kylie Long, Geoffrey Bocobo, Andrew Goldsmith
Citation: The Journal of the American Board of Family Medicine, 38(6), 967-973
Date: 11/2025
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What to Ask (About) a Hospital
Describes payment and financial considerations for hospitals as it relates to the hospital's organizational structure, type of care provided, location, patient population, training programs, and alternative payment models. Discusses rural considerations throughout with a close analysis in Section 6: How a Hospital's Location Matters.
Author(s): Christine H. Monahan, Kennah Watts, Julia Burleson, Rachel Swindle, Ariel Winter
Date: 11/2025
Sponsoring organizations: Blood Cancer United, Georgetown University's Center on Health Insurance Reforms (CHIR)
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Describes payment and financial considerations for hospitals as it relates to the hospital's organizational structure, type of care provided, location, patient population, training programs, and alternative payment models. Discusses rural considerations throughout with a close analysis in Section 6: How a Hospital's Location Matters.
Author(s): Christine H. Monahan, Kennah Watts, Julia Burleson, Rachel Swindle, Ariel Winter
Date: 11/2025
Sponsoring organizations: Blood Cancer United, Georgetown University's Center on Health Insurance Reforms (CHIR)
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RHCs and CAHs Participating in the Medicare Shared Savings Program (MSSP): Characteristics of the Providers and Communities
Describes the characteristics of Rural Health Clinics (RHCs) and Critical Access Hospitals (CAHs) currently participating in the Medicare Shared Savings Program (MSSP) in 2023. Compares CAH and RHC characteristics by MSSP participation, ownership status, and free-standing versus provider-based RHC status.
Author(s): Edmer Lazaro, Dan Shane, Fred Ullrich, Keith Mueller
Date: 11/2025
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Describes the characteristics of Rural Health Clinics (RHCs) and Critical Access Hospitals (CAHs) currently participating in the Medicare Shared Savings Program (MSSP) in 2023. Compares CAH and RHC characteristics by MSSP participation, ownership status, and free-standing versus provider-based RHC status.
Author(s): Edmer Lazaro, Dan Shane, Fred Ullrich, Keith Mueller
Date: 11/2025
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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