Rural Health
Resources by Topic: Healthcare quality
Merit-Based Incentive Payment System (MIPS): 2025 Merit-Based Incentive Payment (MIPS) Value Pathways (MVPs) Implementation Guide
Provides an overview of the Merit-based Incentive Payment System (MIPS) Value Pathways (MVPs), a voluntary reporting option that can be used to meet MIPS reporting requirements for the 2025 performance year. Describes subgroup reporting, reporting requirements, scoring, performance feedback and public reporting, and how to register to report an MVP. Includes information on considerations and exceptions for small practices and clinicians in a rural or Health Professional Shortage Area.
Date: 12/2025
Sponsoring organization: Centers for Medicare and Medicaid Services
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Provides an overview of the Merit-based Incentive Payment System (MIPS) Value Pathways (MVPs), a voluntary reporting option that can be used to meet MIPS reporting requirements for the 2025 performance year. Describes subgroup reporting, reporting requirements, scoring, performance feedback and public reporting, and how to register to report an MVP. Includes information on considerations and exceptions for small practices and clinicians in a rural or Health Professional Shortage Area.
Date: 12/2025
Sponsoring organization: Centers for Medicare and Medicaid Services
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Calendar Year 2026 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center Final Rule (CMS-1834-FC)
Fact sheet providing an overview of the Centers for Medicare & Medicaid Services (CMS) final rule regarding updates and changes to the Medicare payments for hospital outpatient and Ambulatory Surgical Center (ASC) services for calendar year 2026. Summarizes provisions regarding changes to hospital price transparency; Intensive Outpatient Program (IOP) and partial hospital program rate setting; updates to the Hospital Outpatient Quality Reporting (OQR), Ambulatory Surgical Center Quality Reporting (ASCQR), and Rural Emergency Hospital Quality Reporting (REHQR) Programs; hospital quality start ratings; and more.
Date: 11/2025
Sponsoring organization: Centers for Medicare and 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 for hospital outpatient and Ambulatory Surgical Center (ASC) services for calendar year 2026. Summarizes provisions regarding changes to hospital price transparency; Intensive Outpatient Program (IOP) and partial hospital program rate setting; updates to the Hospital Outpatient Quality Reporting (OQR), Ambulatory Surgical Center Quality Reporting (ASCQR), and Rural Emergency Hospital Quality Reporting (REHQR) Programs; hospital quality start ratings; and more.
Date: 11/2025
Sponsoring organization: Centers for Medicare and Medicaid Services
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A New Rural Blueprint: Strategic Partnerships That Keep Care Local
Discusses the Wisconsin High Value Network (WHVN), a clinically integrated network (CIN) focused on value-based care arrangements, data sharing, and quality improvement initiatives. Describes WHVN's strategic partnerships, governance, specialty care network, and more.
Date: 11/2025
Sponsoring organization: American Hospital Association
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Discusses the Wisconsin High Value Network (WHVN), a clinically integrated network (CIN) focused on value-based care arrangements, data sharing, and quality improvement initiatives. Describes WHVN's strategic partnerships, governance, specialty care network, and more.
Date: 11/2025
Sponsoring organization: American Hospital Association
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Facilitators of Strong Quality and Financial Outcomes in Critical Access Hospitals
Examines leadership traits, management strategies, and other governance and collaboration-based supports for positive quality and financial outcomes in Critical Access Hospitals (CAHs), utilizing insights from interviews of leaders at 10 CAHs which met high financial and quality benchmarks. Provides interview excerpts and identifies themes.
Author(s): Robert Barclay, Zoe Pringle, Megan Lahr, et al.
Date: 11/2025
Sponsoring organization: Flex Monitoring Team
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Examines leadership traits, management strategies, and other governance and collaboration-based supports for positive quality and financial outcomes in Critical Access Hospitals (CAHs), utilizing insights from interviews of leaders at 10 CAHs which met high financial and quality benchmarks. Provides interview excerpts and identifies themes.
Author(s): Robert Barclay, Zoe Pringle, Megan Lahr, et al.
Date: 11/2025
Sponsoring organization: Flex Monitoring Team
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Operational Challenges and Adaptive Leadership in Emergency Departments in the United States of America: A Mixed-Methods Analysis
Analyzes perspectives from emergency department (ED) leadership regarding operational challenges such as overcrowding, staffing shortages, and diminishing quality of care and provider well-being. Utilizes survey and interview data from ED leaders to examine adaptive strategies, evidence-based protocols, cross-professional collaboration, and more, with a focus on rural contexts included.
Author(s): Emmanuel Animashaun, Ellen Barnie Peprah, Olaoluwa Olorunfemi, et al.
Citation: BMC Emergency Medicine, 25, 241
Date: 11/2025
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Analyzes perspectives from emergency department (ED) leadership regarding operational challenges such as overcrowding, staffing shortages, and diminishing quality of care and provider well-being. Utilizes survey and interview data from ED leaders to examine adaptive strategies, evidence-based protocols, cross-professional collaboration, and more, with a focus on rural contexts included.
Author(s): Emmanuel Animashaun, Ellen Barnie Peprah, Olaoluwa Olorunfemi, et al.
Citation: BMC Emergency Medicine, 25, 241
Date: 11/2025
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Characteristics of Critical Access Hospitals with High Financial and Quality Metric Performance
Examines Critical Access Hospital (CAH) financial and quality performance utilizing Medicare Beneficiary Quality Improvement Project (MBQIP) data. Provides characteristics of CAHs and their respective measures according to 5 financial and 5 quality benchmarks.
Author(s): Lauren Wallace, George H Pink, Kristie Thompson, et al.
Date: 11/2025
Sponsoring organization: Flex Monitoring Team
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Examines Critical Access Hospital (CAH) financial and quality performance utilizing Medicare Beneficiary Quality Improvement Project (MBQIP) data. Provides characteristics of CAHs and their respective measures according to 5 financial and 5 quality benchmarks.
Author(s): Lauren Wallace, George H Pink, Kristie Thompson, et al.
Date: 11/2025
Sponsoring organization: Flex Monitoring Team
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Small Practices Guide: Getting Started with Merit-based Incentive Payment System (MIPS) Clinical Quality Measure (CQM) Reporting
Provides an overview of Merit-based Incentive Payment System (MIPS) clinical quality measures (MIPS CQMs). Describes how small practices can report MIPS CQMs, whether participating as an individual clinician, group, subgroup, or Alternative Payment Model (APM) Entity.
Date: 11/2025
Sponsoring organization: Centers for Medicare and Medicaid Services
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Provides an overview of Merit-based Incentive Payment System (MIPS) clinical quality measures (MIPS CQMs). Describes how small practices can report MIPS CQMs, whether participating as an individual clinician, group, subgroup, or Alternative Payment Model (APM) Entity.
Date: 11/2025
Sponsoring organization: Centers for Medicare and Medicaid Services
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Medicare Payment Basics: Accountable Care Organizations Payment Systems
Provides an overview of Medicare's Accountable Care Organization (ACO) programs. Discusses the payment mechanics of ACOs, including the maximum shared savings and losses of Medicare Shared Savings Program ACOs by track and level.
Date: 11/2025
Sponsoring organization: Medicare Payment Advisory Commission
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Provides an overview of Medicare's Accountable Care Organization (ACO) programs. Discusses the payment mechanics of ACOs, including the maximum shared savings and losses of Medicare Shared Savings Program ACOs by track and level.
Date: 11/2025
Sponsoring organization: Medicare Payment Advisory Commission
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An Assessment of Nurse Practitioner Low-Value Care Use in Primary Care
Analyzes how patient demographics and geography are associated with the prevalence of nurse practitioner-delivered low-value lumbar x-ray, aURI antibiotic, and ECG services, utilizing 2021 Merative MarketScan Commercial and Medicare database data for Arizona, Nevada, and New Mexico. Includes metro versus nonmetro comparison data.
Author(s): Sara B. Nugent, Roberta P. Lavin, Jongwon Lee, Brady P. Horn, Barbara I. Holmes Damron
Citation: The American Journal of Managed Care, 31(1), 553-557
Date: 10/2025
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Analyzes how patient demographics and geography are associated with the prevalence of nurse practitioner-delivered low-value lumbar x-ray, aURI antibiotic, and ECG services, utilizing 2021 Merative MarketScan Commercial and Medicare database data for Arizona, Nevada, and New Mexico. Includes metro versus nonmetro comparison data.
Author(s): Sara B. Nugent, Roberta P. Lavin, Jongwon Lee, Brady P. Horn, Barbara I. Holmes Damron
Citation: The American Journal of Managed Care, 31(1), 553-557
Date: 10/2025
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Report to the Secretary of Health and Human Services: Reducing Barriers to Participation in Population-Based Total Cost of Care (PB-TCOC) Models and Supporting Primary and Specialty Care Transformation
Summarizes findings from the Physician-Focused Payment Model Technical Advisory Committee's (PTAC) review of information on reducing barriers to participation in alternative payment models (APMs). Discusses key issues relating to reducing barriers to participation in APMs and value-based care transformation, areas where additional research is needed, and potential next steps.
Date: 10/2025
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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Summarizes findings from the Physician-Focused Payment Model Technical Advisory Committee's (PTAC) review of information on reducing barriers to participation in alternative payment models (APMs). Discusses key issues relating to reducing barriers to participation in APMs and value-based care transformation, areas where additional research is needed, and potential next steps.
Date: 10/2025
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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