Dec 21, 2018 -- Pre-publication notice from the Centers for Medicare and Medicaid Services (CMS) regarding final rules for the Medicare Shared Savings Program participation options to encourage Accountable Care Organizations (ACOs) to transition to two-sided models. Discusses issues specific to rural throughout, addresses the impact on small rural hospitals starting on PDF page 857, and offers some options for Critical Access Hospitals (CAHs) and hospitals with swing bed agreements. The rule takes effect 45 days after the publication of this notice in the Federal Register, which is scheduled for December 31, 2018. Read more.