Rural Health Clinics

Document Type

Policy Brief

Publication Date



RHC, rural health clinics, MRHRC, quality reporting, Merit-Based Incentive Payment System, health system reform


Rural Health Clinics (RHCs) are an important source of primary care in underserved rural communities with more than 4,200 RHCs providing primary care services to rural Medicare and Medicaid beneficiaries in 44 states. In light of the growing emphasis on quality reporting, it is important to understand factors influencing RHC readiness to participate in quality reporting including the Merit-Based Incentive Payment System (MIPS), Medicaid, and commercial payer quality reporting programs. The exclusion of RHCs from CMS’s quality reporting programs and value-based initiatives may potentially create a perception among consumers and policymakers that RHCs are unable to meet the requirements of these initiatives and are providing lesser quality care than larger, urban-based clinicians. To inform this brief, we conducted an extensive review of the MACRA legislation and regulations, literature on RHC quality reporting and CMS RHC billing manuals, advisory and consulting reports, and monitored listservs relevant to the topic. Additionally, we conducted key informant interviews with national and state organizations associated with RHCs. This brief outlines several challenges faced by RHCs to engage in quality reporting initiatives and highlights the opportunities to support their participation in these initiatives.


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This study was supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number CA#U1CRH03716, Rural Health Research Center Cooperative Agreement to the Maine Rural Health Research Center. This study was 100 percent funded from governmental sources. This information or content and conclusions are those of the authors and should not be construed as the official position or policy of, nor should any endorsement be inferred by, HRSA, HHS or the U.S. Government.

Funding Organization

Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS)

Grant Number




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