Rural health care providers should be integrated into Medicare’s public reporting and value-based payment programs, recommends a recent report from the National Quality Forum. The report, developed with the input of NQF’s Rural Health Committee, recommends that participation be phased in over two to four years, and that methodological issues related to low case volumes be addressed prior to mandating participation. The report also recommends the development of rural-relevant measures, and that all rural providers should report on a core set of measures, with the flexibility to choose additional measures “to better reflect their unique characteristics.” In addition, the report recommends that any pay-for-performance programs include only incentive payments, not penalties. The authors also urge CMS to form a new Measure Applications Partnership rural health workgroup to give rural providers an opportunity to weigh in on measure selection.