Understanding and Facilitating Rural Health Transformation

Programs & Demonstrations

The Rural Health Value Team has summarized select innovative rural health care demonstrations and programs that might serve as inspiration for new health care delivery and financing models.

Featured Resource
Medicare Shared Savings Program: Rule Changes and Implications for Rural Health Care Organizations
A summary of the changes made to the Medicare Shared Savings Program taking effect January 2023 and 2024. This Rural Health Value analysis outlines how the changes would reduce barriers to participation for potential or reentering ACOs that operate in rural contexts.

Advancing Value-Based Payment Policies Relevant to Rural Areas - Continued Challenges and New Opportunies - This paper suggests potential Innovation Center and CMS policy opportunities to ensure that all Traditional, fee-for-service Medicare beneficiaries will be in a care relationship with accountability for quality and total cost of care by 2030, and to ensure the inclusion of rural health care providers in CMS models, programs, and quality improvement initiatives. (2023)

Catalog of Value-Based Initiatives for Rural Providers - Find federal Health and Human Services (HHS) value-based programs that might be appropriate for rural participation. (2024)

CHART Model - Through the new Community Health Access and Rural Transformation (CHART) Model, CMS aims to continue addressing disparities by providing a way for rural communities to transform their health care delivery systems by leveraging innovative financial arrangements as well as operational and regulatory flexibilities. The Rural Health Value team has been hosting "Let's Talk About CHART" virtual discussions to help rural communities and stakeholders identify opportunities, questions, and potential next steps regarding the CHART Community Track application. (2020)

How to Design Value-Based Care Models for Rural Participant Success: A Summit Findings Report - Based on the input from a two-day virtual summit of rural participants in value-based care models and programs, this report summarizes themes and actionable recommendations that can be used by those designing and supporting value-based care models to improve the viability, relevance, and likelihood of rural health care organization participation and success. (2020)

The Future of Rural Value-Based Health Care and Surge Capacity - Healthcare service demands consequent to the COVID-19 pandemic have challenged preconceived rural value-based priorities such as inpatient-care reduction and just-in-time inventories. This Rural Health Value commentary outlines questions for consideration about the future of rural value-based care and payment as rural healthcare organizations struggle with conflicting demands for surge-ready healthcare infrastructure and value-oriented business processes. (2020)

The Rural Emergency Hospital and Value-Based Care - REH is a new hospital designation to be effective January 1, 2023. An REH will be a rural hospital providing outpatient services (including emergency and observation services), but not providing inpatient care services. REHs may have a role in value-based care by ensuring access to health care, or as a component of a regional health system participating in value-based care models. This brief outlines issues for consideration by stakeholders for input into proposed rules. (2021)

State Innovation Model Testing Awards - Learn about activities and early accomplishments of eleven states with rural focus areas that were awarded State Innovation Model (SIM) funds from the Center for Medicare & Medicaid Innovation (CMMI). (2022)

Technical Assistance for Hospitals Applying to the Pennsylvania Rural Health Model - A CMMI-Sponsored Rural Hospital Global Budget Model - This brief summarizes Rural Health Value’s process to facilitate hospital development of a transition plan for those considering developing or participating in a global budget or other transformation models for rural hospitals. (2019)

What Are Rural Health Leaders Asking about Value-Based Care and Payment? - This brief summarizes the health care value issues most frequently cited, and given the highest priority, by 26 rural health care leaders. (2018)