Rural Health
Resources by Topic: Policy
Evaluation of the Primary Care First Model: Third Annual Report
Provides an overview of the Primary Care First (PCF) model, which aims to enhance primary care and move primary care practitioners toward value-based payment. Describes the PCF model implementation experiences for Cohort 1 and Cohort 2 practices through 2023. Explores the characteristics of practices and payers that continued to participate in the PCF model compared to those who left. Examines the role that the PCF Model's incentives and supports played in the strategies and practices adopted to improve care delivery and how the trajectory of these strategies and activities practices have transformed over time. Estimates the impact of the PCF Model on Medicare fee-for-service (FFS) expenditures and service use, including acute hospitalizations. Estimates the impacts of the model on a set of seven leading indicators to provide an early assessment of whether care delivery changes are resulting in meaningful early outcome changes.
Additional links: Executive Summary, Findings at a Glance
Date: 05/2025
Sponsoring organizations: Centers for Medicare & Medicaid Services, Mathematica
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Provides an overview of the Primary Care First (PCF) model, which aims to enhance primary care and move primary care practitioners toward value-based payment. Describes the PCF model implementation experiences for Cohort 1 and Cohort 2 practices through 2023. Explores the characteristics of practices and payers that continued to participate in the PCF model compared to those who left. Examines the role that the PCF Model's incentives and supports played in the strategies and practices adopted to improve care delivery and how the trajectory of these strategies and activities practices have transformed over time. Estimates the impact of the PCF Model on Medicare fee-for-service (FFS) expenditures and service use, including acute hospitalizations. Estimates the impacts of the model on a set of seven leading indicators to provide an early assessment of whether care delivery changes are resulting in meaningful early outcome changes.
Additional links: Executive Summary, Findings at a Glance
Date: 05/2025
Sponsoring organizations: Centers for Medicare & Medicaid Services, Mathematica
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Merit-based Incentive Payment System (MIPS): 2025 MIPS Promoting Interoperability Performance Category Hardship Exception Application Guide
Provides guidance on how clinicians can apply for a MIPS hardship exception. Highlights guidance for having your MIPS Promoting Interoperability performance category reweighted to 0% in cases of insufficient internet connectivity, decertified electronic health record technology, or other circumstances out of the clinicians' control.
Date: 05/2025
Sponsoring organization: Centers for Medicare & Medicaid Services
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Provides guidance on how clinicians can apply for a MIPS hardship exception. Highlights guidance for having your MIPS Promoting Interoperability performance category reweighted to 0% in cases of insufficient internet connectivity, decertified electronic health record technology, or other circumstances out of the clinicians' control.
Date: 05/2025
Sponsoring organization: Centers for Medicare & Medicaid Services
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Rural and Urban Differences in Suicide in the United States, 2018-2021
Highlights the rates of suicide across the U.S. from 2018-2021 in rural and urban areas. Discusses some of the geographic and demographic characteristics that correlate with higher rates of suicide. Breaks down data by year, demographics, Census and HHS regions, and rural versus urban location. Makes policy recommendations based on the report's findings.
Author(s): Qian Huang, Nicole Galler, Michael Meit, Amy Wahlquist
Date: 05/2025
Sponsoring organization: ETSU/NORC Rural Health Research Center
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Highlights the rates of suicide across the U.S. from 2018-2021 in rural and urban areas. Discusses some of the geographic and demographic characteristics that correlate with higher rates of suicide. Breaks down data by year, demographics, Census and HHS regions, and rural versus urban location. Makes policy recommendations based on the report's findings.
Author(s): Qian Huang, Nicole Galler, Michael Meit, Amy Wahlquist
Date: 05/2025
Sponsoring organization: ETSU/NORC Rural Health Research Center
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Medicare Shared Savings Program: Rule Changes and Implications for Rural Health Care Organizations
Summarizes changes to the Centers for Medicare & Medicaid Services (CMS) Medicare Shared Savings Program (SSP) that take effect in January 2023 for current participants, and in January 2024 for organizations applying for a January 1, 2024 start. Discusses the potential impact of these changes on rural health and participation considerations.
Date: 05/2025
Sponsoring organization: Rural Health Value
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Summarizes changes to the Centers for Medicare & Medicaid Services (CMS) Medicare Shared Savings Program (SSP) that take effect in January 2023 for current participants, and in January 2024 for organizations applying for a January 1, 2024 start. Discusses the potential impact of these changes on rural health and participation considerations.
Date: 05/2025
Sponsoring organization: Rural Health Value
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Critical Access Hospital Electronic Clinical Quality Measure (eCQM) Resource List
Resource list for electronic clinical quality measures (eCQMs), reflecting new materials and updates from the Centers for Medicare & Medicaid Services for 2025 reporting.
Date: 05/2025
Sponsoring organization: Rural Quality Improvement Technical Assistance (RQITA) Resource Center
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Resource list for electronic clinical quality measures (eCQMs), reflecting new materials and updates from the Centers for Medicare & Medicaid Services for 2025 reporting.
Date: 05/2025
Sponsoring organization: Rural Quality Improvement Technical Assistance (RQITA) Resource Center
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Medicare Rural Hospital Flexibility Program Structure for FY 2024 – FY 2028
Outlines the purpose and allowable activities within each of the five Medicare Rural Hospital Flexibility (Flex) Program program areas, as well as suggested outcome measures for each program area.
Date: 04/2025
Sponsoring organization: National Rural Health Resource Center
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Outlines the purpose and allowable activities within each of the five Medicare Rural Hospital Flexibility (Flex) Program program areas, as well as suggested outcome measures for each program area.
Date: 04/2025
Sponsoring organization: National Rural Health Resource Center
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Strategies for Sustaining Emergency Care in the United States
Assesses the value of emergency care in the United States, evaluates challenges to sustaining emergency care, measures trends in emergency care payment, and identifies alternate funding strategies for emergency care. Features a case study of a hospital-based emergency department closure in a rural community, and mentions rural throughout.
Author(s): Mahshid Abir, Brian Briscombe, Carl T. Berdahl, et al.
Date: 04/2025
Sponsoring organization: RAND Corporation
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Assesses the value of emergency care in the United States, evaluates challenges to sustaining emergency care, measures trends in emergency care payment, and identifies alternate funding strategies for emergency care. Features a case study of a hospital-based emergency department closure in a rural community, and mentions rural throughout.
Author(s): Mahshid Abir, Brian Briscombe, Carl T. Berdahl, et al.
Date: 04/2025
Sponsoring organization: RAND Corporation
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The Future of Rural Health: Report on a Special Convening Held November 19-20, 2024
Summarizes discussions held during a November 2024 summit of rural health services delivery and finance experts that aimed to identify the needs of the rural health communities, build on existing strengths, and develop a cohesive approach to improving the health of rural residents. Describes the themes and policy options that emerged throughout the summit. Covers financing rural health services, payment policies, workforce considerations, the use of technology and data, and more.
Date: 04/2025
Sponsoring organizations: National Rural Health Association, Rural Policy Research Institute, The Leona M. and Harry B. Helmsley Charitable Trust, West Health Institute
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Summarizes discussions held during a November 2024 summit of rural health services delivery and finance experts that aimed to identify the needs of the rural health communities, build on existing strengths, and develop a cohesive approach to improving the health of rural residents. Describes the themes and policy options that emerged throughout the summit. Covers financing rural health services, payment policies, workforce considerations, the use of technology and data, and more.
Date: 04/2025
Sponsoring organizations: National Rural Health Association, Rural Policy Research Institute, The Leona M. and Harry B. Helmsley Charitable Trust, West Health Institute
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10 Things to Know About Rural Hospitals
Presents information and data on rural hospitals and rural hospital finances. Compares insurance coverage of discharges and births, margins, and the impact of Medicaid expansion by hospitals' rural and urban location. Includes information on rural hospital closures and Medicare special payment designations for rural hospitals. Discusses the potential impacts of recent federal spending proposals on rural hospitals.
Author(s): Scott Hulver, Zachary Levinson, Jamie Godwin, Tricia Neuman
Date: 04/2025
Sponsoring organization: KFF
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Presents information and data on rural hospitals and rural hospital finances. Compares insurance coverage of discharges and births, margins, and the impact of Medicaid expansion by hospitals' rural and urban location. Includes information on rural hospital closures and Medicare special payment designations for rural hospitals. Discusses the potential impacts of recent federal spending proposals on rural hospitals.
Author(s): Scott Hulver, Zachary Levinson, Jamie Godwin, Tricia Neuman
Date: 04/2025
Sponsoring organization: KFF
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Sustaining Rural Hospital Access: Adjustments to Medicare Rural Hospital Designations
Describes the history of Medicare rural hospital designations. Discusses how traditional Medicare, Medicare Advantage, and Medicaid impact hospital finances. Outlines policy recommendations to the Secretary of Health and Human Services (HHS) and Congress regarding rural hospitals designations, payment adjustments, Medicare Advantage, and rural ambulance and emergency services.
Author(s): Emma Sheffert, Maya Sandalow
Date: 04/2025
Sponsoring organization: Bipartisan Policy Center
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Describes the history of Medicare rural hospital designations. Discusses how traditional Medicare, Medicare Advantage, and Medicaid impact hospital finances. Outlines policy recommendations to the Secretary of Health and Human Services (HHS) and Congress regarding rural hospitals designations, payment adjustments, Medicare Advantage, and rural ambulance and emergency services.
Author(s): Emma Sheffert, Maya Sandalow
Date: 04/2025
Sponsoring organization: Bipartisan Policy Center
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