Rural Health
Resources by Topic: Medicare
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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Demographic Characteristics of Medicaid Beneficiaries Enrolled in the Program of All-Inclusive Care for the Elderly
Describes the demographic characteristics and long-term nursing facility use of Program of All-Inclusive Care for the Elderly (PACE) enrollees in 2023, including rural residence. Compares data by PACE enrollees who are full-benefit dually eligible beneficiaries and those who are Medicaid-only enrollees.
Date: 07/2026
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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Describes the demographic characteristics and long-term nursing facility use of Program of All-Inclusive Care for the Elderly (PACE) enrollees in 2023, including rural residence. Compares data by PACE enrollees who are full-benefit dually eligible beneficiaries and those who are Medicaid-only enrollees.
Date: 07/2026
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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Early Evidence of Geographic Variation in Medicare Participation among Newly Eligible Mental Health Providers Following the 2024 Coverage Expansion
Explores the effect that Medicare's expansion of coverage to marriage and family therapists (MFTs) and mental health counselors (MHCs) has had on the rural mental health workforce. Highlights the rate of participation among rural MFTs and MHCs in Medicare from 2022 to 2024 and compares rates to metro counties.
Author(s): Janessa M. Graves, Natalia V. Oster, Lisa A. Garberson, et al.
Citation: Journal of Rural Health, 42(3), e70180
Date: 07/2026
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Explores the effect that Medicare's expansion of coverage to marriage and family therapists (MFTs) and mental health counselors (MHCs) has had on the rural mental health workforce. Highlights the rate of participation among rural MFTs and MHCs in Medicare from 2022 to 2024 and compares rates to metro counties.
Author(s): Janessa M. Graves, Natalia V. Oster, Lisa A. Garberson, et al.
Citation: Journal of Rural Health, 42(3), e70180
Date: 07/2026
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Rural Implications of Increased Medicare Beneficiary Enrollment in ACOs and MA Plans
Explores the relationship between Medicare Advantage (MA) enrollment and beneficiary attribution to Centers for Medicare & Medicaid Services (CMS) Medicare Shared Savings Program (MSSP) Accountable Care Organizations (ACOs). Describes the growth of ACO assignment and MA enrollment between 2013 and 2023 by county-level rurality. Compares the characteristics of micropolitan and noncore counties with high and low ACO and MA penetration in 2023. Discusses the implications of expanding MA and ACO enrollment in rural areas.
Author(s): Edmer Lazaro, Fred Ullrich, Dan M. Shane, Keith Mueller
Date: 06/2026
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Explores the relationship between Medicare Advantage (MA) enrollment and beneficiary attribution to Centers for Medicare & Medicaid Services (CMS) Medicare Shared Savings Program (MSSP) Accountable Care Organizations (ACOs). Describes the growth of ACO assignment and MA enrollment between 2013 and 2023 by county-level rurality. Compares the characteristics of micropolitan and noncore counties with high and low ACO and MA penetration in 2023. Discusses the implications of expanding MA and ACO enrollment in rural areas.
Author(s): Edmer Lazaro, Fred Ullrich, Dan M. Shane, Keith Mueller
Date: 06/2026
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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MedPAC Report to the Congress: Medicare and the Health Care Delivery System, June 2026
Evaluates Medicare payment issues and provides recommendations to the U.S. Congress. Covers payment incentives in Medicare, the complexity of Medicare enrollment decisions for beneficiaries, Medicare payment operations and their role in identifying improper payments, the estimated association between Medicare Advantage (MA) enrollment and hospitals' and post-acute care providers' finances, and access to hospice and certain complex palliative services for beneficiaries with end-stage renal disease or cancer. Includes a mandated report regarding the Medicare Ground Ambulance Data Collection System. Includes rural references throughout.
Additional links: Executive Summary
Date: 06/2026
Sponsoring organization: Medicare Payment Advisory Commission
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Evaluates Medicare payment issues and provides recommendations to the U.S. Congress. Covers payment incentives in Medicare, the complexity of Medicare enrollment decisions for beneficiaries, Medicare payment operations and their role in identifying improper payments, the estimated association between Medicare Advantage (MA) enrollment and hospitals' and post-acute care providers' finances, and access to hospice and certain complex palliative services for beneficiaries with end-stage renal disease or cancer. Includes a mandated report regarding the Medicare Ground Ambulance Data Collection System. Includes rural references throughout.
Additional links: Executive Summary
Date: 06/2026
Sponsoring organization: Medicare Payment Advisory Commission
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Factors Influencing Rural Hospitals to Participate and Remain in Accountable Care Organizations
Examines factors that impact rural hospital participation in Medicare and accountable care organization (ACO) models. Utilizes interview feedback from rural hospital executives regarding ACO participation and discusses themes such as financial incentives, value-based reimbursement, population health, healthcare quality, and more.
Author(s): Emily J. Lawton, Jenah McCarty, Thomas E. Vaughn, Fred Ullrich, Keith J. Mueller
Citation: Journal of Rural Health, 42(2), e70179
Date: 06/2026
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Examines factors that impact rural hospital participation in Medicare and accountable care organization (ACO) models. Utilizes interview feedback from rural hospital executives regarding ACO participation and discusses themes such as financial incentives, value-based reimbursement, population health, healthcare quality, and more.
Author(s): Emily J. Lawton, Jenah McCarty, Thomas E. Vaughn, Fred Ullrich, Keith J. Mueller
Citation: Journal of Rural Health, 42(2), e70179
Date: 06/2026
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2026 Annual Report of the Boards of Trustees of the Federal Hospital Insurance and Federal Supplementary Medical Insurance Trust Funds
Report detailing the current state of the Medicare Hospital Insurance (HI) and Supplemental Medical Insurance (SMI) Trust Funds. Discusses Medicare expenditures as a percentage of Gross Domestic Product (GDP) and makes short and long-range sustainability projections based on variable economic, demographic, and healthcare trends. Also explains the actuarial methods used to calculate the estimates. Includes information on Medicare payment policy updates since the 2025 report.
Additional links: Tables and Figures
Date: 06/2026
Sponsoring organization: Board of Trustees, Federal Hospital Insurance and Federal Supplementary Medical Insurance Trust Funds
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Report detailing the current state of the Medicare Hospital Insurance (HI) and Supplemental Medical Insurance (SMI) Trust Funds. Discusses Medicare expenditures as a percentage of Gross Domestic Product (GDP) and makes short and long-range sustainability projections based on variable economic, demographic, and healthcare trends. Also explains the actuarial methods used to calculate the estimates. Includes information on Medicare payment policy updates since the 2025 report.
Additional links: Tables and Figures
Date: 06/2026
Sponsoring organization: Board of Trustees, Federal Hospital Insurance and Federal Supplementary Medical Insurance Trust Funds
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Marriage and Family Therapist and Mental Health Counselor Workforces in Rural America Under New Medicare Reimbursement Policy
Describes how Medicare reimbursement expanded to cover marriage and family therapists (MFTs) and mental health counselors (MHCs) in January 2024. Examines the change in Medicare-enrolled MFTs and MHCs between the third quarter (Q3) of 2023 and fourth quarter (Q4) of 2024. Presents findings from semi-structured interviews with rural health system and mental health organization leaders regarding practice arrangements, the perceived impacts of MFT and MHC reimbursement, barriers to serving rural Medicare beneficiaries, and considerations for future policies.
Author(s): Janessa M. Graves, Natalia V. Oster, Lisa A. Garberson, Davis G. Patterson, C. Holly A. Andrilla
Date: 06/2026
Sponsoring organization: WWAMI Rural Health Research Center
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Describes how Medicare reimbursement expanded to cover marriage and family therapists (MFTs) and mental health counselors (MHCs) in January 2024. Examines the change in Medicare-enrolled MFTs and MHCs between the third quarter (Q3) of 2023 and fourth quarter (Q4) of 2024. Presents findings from semi-structured interviews with rural health system and mental health organization leaders regarding practice arrangements, the perceived impacts of MFT and MHC reimbursement, barriers to serving rural Medicare beneficiaries, and considerations for future policies.
Author(s): Janessa M. Graves, Natalia V. Oster, Lisa A. Garberson, Davis G. Patterson, C. Holly A. Andrilla
Date: 06/2026
Sponsoring organization: WWAMI Rural Health Research Center
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Medicare Hospice: Action Needed to Pay More Efficiently for Routine Home Care
Describes the frequency and characteristics of routine home care visits in 2024 for Medicare beneficiaries enrolled in hospice since 2022 who died or were discharged alive in 2024. Compares estimated per-visit Medicare payment rates for routine home care across hospices with the highest and lowest number of visits per week and to home health per-visit rates. Includes information on the average number of visits per week by rural and urban hospice providers. Offers recommendations to the U.S. Department of Health and Human Services regarding revisions to the hospice payment system.
Additional links: Full Report
Date: 06/2026
Sponsoring organization: Government Accountability Office
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Describes the frequency and characteristics of routine home care visits in 2024 for Medicare beneficiaries enrolled in hospice since 2022 who died or were discharged alive in 2024. Compares estimated per-visit Medicare payment rates for routine home care across hospices with the highest and lowest number of visits per week and to home health per-visit rates. Includes information on the average number of visits per week by rural and urban hospice providers. Offers recommendations to the U.S. Department of Health and Human Services regarding revisions to the hospice payment system.
Additional links: Full Report
Date: 06/2026
Sponsoring organization: Government Accountability Office
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MBQIP Quality Measures National Annual Report - 2024
Summarizes quality measure reporting rates and performance among Critical Access Hospitals (CAHs) in 2024. Presents data on the five Medicare Beneficiary Quality Improvement Project (MBQIP) domains: global measures, patient safety, patient engagement, care coordination, and emergency department.
Date: 06/2026
Sponsoring organization: Flex Monitoring Team
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Summarizes quality measure reporting rates and performance among Critical Access Hospitals (CAHs) in 2024. Presents data on the five Medicare Beneficiary Quality Improvement Project (MBQIP) domains: global measures, patient safety, patient engagement, care coordination, and emergency department.
Date: 06/2026
Sponsoring organization: Flex Monitoring Team
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