Rural Health
Resources by Topic: Reimbursement and payment models
2026 Merit-Based Incentive Payment System Automatic Extreme and Uncontrollable Circumstances Policy
Addresses the automatic Merit-Based Incentive Payment System (MIPS) extreme and uncontrollable circumstances (EUC) policy as it applies to individual MIPS eligible clinicians for 2026. Table 2 features information on reweighting for clinicians in a small practice.
Date: 05/2026
Sponsoring organization: Centers for Medicare & Medicaid Services
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Addresses the automatic Merit-Based Incentive Payment System (MIPS) extreme and uncontrollable circumstances (EUC) policy as it applies to individual MIPS eligible clinicians for 2026. Table 2 features information on reweighting for clinicians in a small practice.
Date: 05/2026
Sponsoring organization: Centers for Medicare & Medicaid Services
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Access to and Provision of Child and Youth Behavioral Health Services in the Rural and Urban U.S.
Compiles findings from 9 reports on youth behavioral health in the rural U.S. Describes prevalence of behavioral health conditions, the youth behavioral health workforce, behavioral health licensure and reimbursement policy, and provision of youth behavioral health services. Features statistics with breakdowns by 7 levels of population density.
Author(s): Janessa M. Graves, Lisa A. Garberson, Sara C. Woolcock, C. Holly A. Andrilla
Date: 05/2026
Sponsoring organization: WWAMI Rural Health Research Center
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Compiles findings from 9 reports on youth behavioral health in the rural U.S. Describes prevalence of behavioral health conditions, the youth behavioral health workforce, behavioral health licensure and reimbursement policy, and provision of youth behavioral health services. Features statistics with breakdowns by 7 levels of population density.
Author(s): Janessa M. Graves, Lisa A. Garberson, Sara C. Woolcock, C. Holly A. Andrilla
Date: 05/2026
Sponsoring organization: WWAMI Rural Health Research Center
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Trends in Medicare Advantage Quality for Nonmetropolitan Enrollees, 2019-2023
Examines quality of care in Medicare Advantage (MA) plans by geography, region, and plan type. Analyzes average ratings of 2019-2023 MA plans on a 1-5 star rating scale according to metro, micro, or noncore rural location. Provides additional data on MA enrollments by rural concentration of contracts as well as star ratings by benchmark quartile and quality bonus capping.
Author(s): Abigail Barker, Eliot Jost, Timothy McBride, Keith J. Mueller
Date: 05/2026
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Examines quality of care in Medicare Advantage (MA) plans by geography, region, and plan type. Analyzes average ratings of 2019-2023 MA plans on a 1-5 star rating scale according to metro, micro, or noncore rural location. Provides additional data on MA enrollments by rural concentration of contracts as well as star ratings by benchmark quartile and quality bonus capping.
Author(s): Abigail Barker, Eliot Jost, Timothy McBride, Keith J. Mueller
Date: 05/2026
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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MedPAC Comment on CMS's Proposed Rule on Inpatient Rehabilitation Facility for FY 2027
Comments on an April 6, 2026, Federal Register proposed rule addressing updates to the prospective payment system for inpatient rehabilitation facilities (IRFs) for fiscal year 2026. Includes comments on the potential creation of an IRF-specific wage index and refinements to the IRF payment system, such as changes to IRF patient clinical classification. Includes rural considerations throughout.
Date: 04/2026
Sponsoring organization: Medicare Payment Advisory Commission
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Comments on an April 6, 2026, Federal Register proposed rule addressing updates to the prospective payment system for inpatient rehabilitation facilities (IRFs) for fiscal year 2026. Includes comments on the potential creation of an IRF-specific wage index and refinements to the IRF payment system, such as changes to IRF patient clinical classification. Includes rural considerations throughout.
Date: 04/2026
Sponsoring organization: Medicare Payment Advisory Commission
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National Association of Rural Health Clinics 2026 Policy Survey Report
Summarizes results of a 2026 national survey of Rural Health Clinics (RHCs). Presents data on the average payer mix, telehealth use and management trends, Medicare Advantage (MA) contracts and reimbursement rates compared to traditional Medicare rates, value-based care participation, challenges, and more.
Date: 04/2026
Sponsoring organization: National Association of Rural Health Clinics
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Summarizes results of a 2026 national survey of Rural Health Clinics (RHCs). Presents data on the average payer mix, telehealth use and management trends, Medicare Advantage (MA) contracts and reimbursement rates compared to traditional Medicare rates, value-based care participation, challenges, and more.
Date: 04/2026
Sponsoring organization: National Association of Rural Health Clinics
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Medicare Payment for Rural or Geographically Isolated Hospitals, 2026
Displays data on Medicare payment adjustments for Sole Community Hospitals, Medicare-Dependent Hospitals, Low-Volume Hospitals, and Critical Access Hospitals. Includes information on the number of qualifying hospitals by state and eligibility criteria.
Date: 04/2026
Sponsoring organization: Congressional Research Service
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Displays data on Medicare payment adjustments for Sole Community Hospitals, Medicare-Dependent Hospitals, Low-Volume Hospitals, and Critical Access Hospitals. Includes information on the number of qualifying hospitals by state and eligibility criteria.
Date: 04/2026
Sponsoring organization: Congressional Research Service
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Medicare Wage Index Trends in Rural and Urban Hospitals Before and During the Low Wage Index Policy, 2018–2022
Provides an overview of the wage index and its role in hospital reimbursement and financial stability. Describes the pattern of wage index values for rural and urban prospective payment system (PPS) hospitals from 2018 to 2022. Explores the impact of the low-wage index policy (LWIP), which was implemented in fiscal year 2020, and the potential implications of its discontinuation in fiscal year 2025.
Author(s): Saleema Karim, George Pink, Kristie Thompson, Mark Holmes
Date: 04/2026
Sponsoring organization: North Carolina Rural Health Research Program
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Provides an overview of the wage index and its role in hospital reimbursement and financial stability. Describes the pattern of wage index values for rural and urban prospective payment system (PPS) hospitals from 2018 to 2022. Explores the impact of the low-wage index policy (LWIP), which was implemented in fiscal year 2020, and the potential implications of its discontinuation in fiscal year 2025.
Author(s): Saleema Karim, George Pink, Kristie Thompson, Mark Holmes
Date: 04/2026
Sponsoring organization: North Carolina Rural Health Research Program
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A Closer Look at Rural Nursing Homes
Compares characteristics of nursing homes in rural and urban areas including patient population data, distribution, and ownership. Also discusses payer mix, healthcare quality, and staffing levels. Highlights changes between 2015 and 2025 for some data.
Author(s): Priya Chidambaram, Alice Burns, Robin Rudowitz
Date: 04/2026
Sponsoring organization: KFF
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Compares characteristics of nursing homes in rural and urban areas including patient population data, distribution, and ownership. Also discusses payer mix, healthcare quality, and staffing levels. Highlights changes between 2015 and 2025 for some data.
Author(s): Priya Chidambaram, Alice Burns, Robin Rudowitz
Date: 04/2026
Sponsoring organization: KFF
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Payer Mix Shifts and Profitability at Critical Access Hospitals, 2011 to 2023
Analyzes 1,384 Critical Access Hospitals between 2011 and 2023 to determine the impact of changes in commercial, Medicare, Medicaid, and uncompensated care on their finances. Discusses reimbursement policy based on study findings.
Author(s): Yusheng Jia, Yue Li, Xueya Cai, Samuel J. Enumah
Citation: Health Affairs Scholar, 4(4)
Date: 04/2026
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Analyzes 1,384 Critical Access Hospitals between 2011 and 2023 to determine the impact of changes in commercial, Medicare, Medicaid, and uncompensated care on their finances. Discusses reimbursement policy based on study findings.
Author(s): Yusheng Jia, Yue Li, Xueya Cai, Samuel J. Enumah
Citation: Health Affairs Scholar, 4(4)
Date: 04/2026
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Average Salary Expense in Rural and Urban Hospitals Before and During the Low Wage Index Policy, 2018–2022
Examines and compares wage patterns of Critical Access Hospitals (CAHs), Rural Prospective Payment System (PPS) hospitals, and Urban PPS hospitals as related to the Low Wage Index Policy (LWIP) in effect from 2020-2022. Utilizes hospital data from the Centers for Medicare & Medicaid Services (CMS) Healthcare Cost Report Information System (HCRIS) between 2018 and 2022 and analyzes median salaries. Discusses the impact of Medicare payments and LWIP on hospitals.
Author(s): Saleema Karim, George Pink, Kristie Thompson, Mark Holmes
Date: 04/2026
Sponsoring organization: North Carolina Rural Health Research Program
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Examines and compares wage patterns of Critical Access Hospitals (CAHs), Rural Prospective Payment System (PPS) hospitals, and Urban PPS hospitals as related to the Low Wage Index Policy (LWIP) in effect from 2020-2022. Utilizes hospital data from the Centers for Medicare & Medicaid Services (CMS) Healthcare Cost Report Information System (HCRIS) between 2018 and 2022 and analyzes median salaries. Discusses the impact of Medicare payments and LWIP on hospitals.
Author(s): Saleema Karim, George Pink, Kristie Thompson, Mark Holmes
Date: 04/2026
Sponsoring organization: North Carolina Rural Health Research Program
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