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Rural Health Information Hub

Rural Health
Resources by Topic: Service delivery models

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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Profile in Innovation: Rural Hospital Participation in Missouri HealthNet's Transformation of Rural Community Health (ToRCH) Program
Provides an overview of ToRCH, a Missouri Medicaid program designed to improve health outcomes and overall well-being in rural Missouri communities by addressing both medical and health-related social needs through a comprehensive, integrated care model. Discusses how hospitals, primary care teams, and community-based organizations implemented the model and funding strategy for the program.
Date: 04/2025
Sponsoring organization: Rural Health Value
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Evolving Remote Monitoring: An Evidence-Based Approach to Coverage and Payment
Reports on trends in utilization of remote patient monitoring (RPM) and discusses policy and payment approaches for effectively and efficiently utilizing RPM, particularly via Medicare and Medicaid. Includes data and discussion of rural barriers to RPM access.
Date: 04/2025
Sponsoring organization: Peterson Center on Healthcare
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CMS Bundled Payments for Care Improvement Advanced Model: Sixth Annual Evaluation Report
Sixth annual report of the Bundled Payments for Care Improvement Advanced (BPCI Advanced) Model, which tests whether linking payments for a clinical episode of care can reduce Medicare expenditures while maintaining or improving the quality of care. Examines the impact of BPCI Advanced on episode payments, utilization, and quality of care, as well as estimates of Medicare program savings in Model Year 5. Also explores the impact of the model on accountable care relationships, strengthening primary care, and care for patients eligible for both Medicare and Medicaid. Includes data on the percentage of BPCI Advanced episodes with and without ACO attribution by patient characteristics, including rural residents.
Additional links: Appendices, Executive Summary, Findings at a Glance, Transformation Spotlight
Author(s): The Lewin Group, Abt Associates, GDIT, Telligen
Date: 04/2025
Sponsoring organization: Centers for Medicare and Medicaid Services
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Advancing Value-Based Payment Policies Relevant to Rural Areas – Continued Challenges and New Opportunities
Discusses lessons from the recent public health emergency, rising health care costs, improved quality measurement, and innovative technologies on the transition from volume-based payment to value-based payment. Outlines potential policy opportunities for the Centers for Medicare & Medicaid Services (CMS) Innovation Center model design and CMS program inclusion to expand rural-appropriate opportunities to participate in the transition to value-based care. Builds on the 2020 publication How to Design Value‐based Care Models for Rural Participant Success: A Summit Findings Report.
Date: 04/2025
Sponsoring organization: Rural Health Value
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Missouri Rural Health Clinic Provider Manual
Provider manual identifying the conditions of participation providing services in Missouri state-funded healthcare programs, including MO HealthNet, Missouri's Medicaid program. Addresses enrollment, eligibility, claim filing, and billing requirements for Rural Health Clinics (RHCs) in Missouri. Includes information on covered telehealth services.
Date: 04/2025
Sponsoring organization: Missouri Department of Social Services
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FH Healthcare Indicators and FH Medical Price Index 2025: An Annual View of Place of Service Trends and Medical Pricing
White paper exploring changes in healthcare utilization, demographic and geographic factors, diagnoses, costs, and procedures. Features statistics including usage of retail clinics and telehealth from 2018-2023; and urgent care, ambulatory surgery centers, and emergency rooms from 2014-2024. Includes comparisons of utilization of each service type by urban and rural location.
Date: 03/2025
Sponsoring organization: FAIR Health
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Comparative Effectiveness of Buprenorphine Adherence with Telemedicine Versus In-Person for Rural and Urban Patients
Compares adherence to buprenorphine for opioid use disorder in telemedicine versus in-person healthcare in rural and urban populations. Utilizes 2017–2022 data from 511 adults and compares 3,302 in-person and 519 telemedicine visits, with breakdowns according to patient characteristics, adherence, gaps in treatment, and rural versus urban location. Discusses changing legislative requirements related to buprenorphine treatment and the potential impact on rural populations.
Author(s): Thomas J. Reese, Nana Addo Padi-Adjirackor, Kevin N. Griffith, et al.
Citation: Journal of the American Pharmacists Association, 65(2), 102318
Date: 03/2025
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Millions in US Live in Places Where Doctors Don't Practice and Telehealth Doesn't Reach
Discusses U.S. regions that experience healthcare workforce shortages and lack access to telehealth. Includes interactive county-level map showing behavioral healthcare deserts, primary care deserts, broadband deserts, dead zones, life expectancy, household income, and percentage of rural residents. Provides comparisons of chronic disease for those with and without digital access and showcases county-level dead zones in Alabama.
Author(s): Sarah Jane Tribble, Holly K. Hacker Data, Lydia Zuraw
Date: 03/2025
Sponsoring organization: KFF
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Enhancing Access to Nephrology Care: Telenephrology Dashboard Optimization via Human-Centered Design
Examines how the development of the Telenephrology Dashboard for veterans served by the Iowa City Veterans Affairs Health Care System (ICVAHCS) provides improved access to nephrology care and kidney specialists. Describes the methodology used to create and evaluate the dashboard as well as how telehealth tools can serve veterans in predominately rural areas.
Author(s): Melissa Swee, Bharat Kumar, M. Lee Sanders, et al.
Citation: BMC Nephrology, 26, 164
Date: 03/2025
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