Rural Health
Resources by Topic: Access
Characteristics and Trends of Critical Access Hospitals That Own or Operate Ambulance Services
Explores trends in the number of Critical Access Hospital (CAH)-based ambulance services between 2017 and 2022. Analyzes Medicare Cost Report data to compare the characteristics of of CAHs that own and operate ambulance services to CAHs that do not. Presents findings from interviews with eight CAH-based ambulance services regarding the challenges of operating these services, including workforce recruitment and retention issues, the role of partnerships and community involvement, and lessons learned.
Author(s): John Gale, Karen Pearson, Rebecca Stearns, Zachariah Croll
Date: 05/2025
Sponsoring organization: Flex Monitoring Team
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Explores trends in the number of Critical Access Hospital (CAH)-based ambulance services between 2017 and 2022. Analyzes Medicare Cost Report data to compare the characteristics of of CAHs that own and operate ambulance services to CAHs that do not. Presents findings from interviews with eight CAH-based ambulance services regarding the challenges of operating these services, including workforce recruitment and retention issues, the role of partnerships and community involvement, and lessons learned.
Author(s): John Gale, Karen Pearson, Rebecca Stearns, Zachariah Croll
Date: 05/2025
Sponsoring organization: Flex Monitoring Team
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Rural Access to Certified Community Behavioral Health Clinics (CCBHCs)
Examines access to, and services offered by, Certified Community Behavioral Health Clinics (CCBHCs) in rural and urban communities. Also compares services at CCBHCs with those offered at other mental health clinics. Features state-level maps showing CCBHC counts by state, and statistics on services counts in CCBHCs and other mental health facilities, with breakdowns by urban and rural areas.
Author(s): Aaron P. Smith, Jeffrey Talbert
Date: 05/2025
Sponsoring organization: Rural and Underserved Health Research Center
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Examines access to, and services offered by, Certified Community Behavioral Health Clinics (CCBHCs) in rural and urban communities. Also compares services at CCBHCs with those offered at other mental health clinics. Features state-level maps showing CCBHC counts by state, and statistics on services counts in CCBHCs and other mental health facilities, with breakdowns by urban and rural areas.
Author(s): Aaron P. Smith, Jeffrey Talbert
Date: 05/2025
Sponsoring organization: Rural and Underserved Health Research Center
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Federal and State Reimbursement for Youth Behavioral Health Services
Report details Medicaid and Children's Health Insurance Program (CHIP) coverage of behavioral health services for rural people under 21 years of age. Breaks down reimbursement eligibility for behavioral health providers in all 50 states and discusses barriers to access in rural areas.
Date: 04/2025
Sponsoring organization: WWAMI Rural Health Research Center
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Report details Medicaid and Children's Health Insurance Program (CHIP) coverage of behavioral health services for rural people under 21 years of age. Breaks down reimbursement eligibility for behavioral health providers in all 50 states and discusses barriers to access in rural areas.
Date: 04/2025
Sponsoring organization: WWAMI Rural Health Research Center
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April 2025 MedPAC Meeting Transcript
Transcript from the Medicare Payment Advisory Commission's (MedPAC) April 2025 meeting. Covers physician fee schedule updates and improving the accuracy of relative payment rates; structural differences between the stand-alone prescription drug plan (PDP) and Medicare Advantage–Prescription Drug plan (MA–PD) markets; the utilization and delivery of Medicare Advantage supplemental benefits; the effect of Medicare Advantage on rural hospitals; paying for software technologies in Medicare; access to hospice and certain services under the hospice benefit for beneficiaries with end-stage renal disease and beneficiaries with cancer; and regulations, star ratings, and fee-for-service Medicare policies aimed at improving nursing home quality.
Additional links: Exploring the Effect of Medicare Advantage on Rural Hospitals
Date: 04/2025
Sponsoring organization: Medicare Payment Advisory Commission
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Transcript from the Medicare Payment Advisory Commission's (MedPAC) April 2025 meeting. Covers physician fee schedule updates and improving the accuracy of relative payment rates; structural differences between the stand-alone prescription drug plan (PDP) and Medicare Advantage–Prescription Drug plan (MA–PD) markets; the utilization and delivery of Medicare Advantage supplemental benefits; the effect of Medicare Advantage on rural hospitals; paying for software technologies in Medicare; access to hospice and certain services under the hospice benefit for beneficiaries with end-stage renal disease and beneficiaries with cancer; and regulations, star ratings, and fee-for-service Medicare policies aimed at improving nursing home quality.
Additional links: Exploring the Effect of Medicare Advantage on Rural Hospitals
Date: 04/2025
Sponsoring organization: Medicare Payment Advisory Commission
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County Characteristics Associated With Receipt of Food Boxes Through the Farmers to Families Food Box Program
Reports on county-level food box distribution through the USDA Farmers to Families Food Box Program between May 2020 and May 2021. Provides data on program funding and characteristics of food distributed by program round. Examines associations between likelihood of receiving food boxes and county-level rurality, access to food, and other demographic factors.
Additional links: Report Summary
Author(s): Keenan Marchesi, Saied Toossi, Katy Georg
Date: 04/2025
Sponsoring organization: USDA Economic Research Service
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Reports on county-level food box distribution through the USDA Farmers to Families Food Box Program between May 2020 and May 2021. Provides data on program funding and characteristics of food distributed by program round. Examines associations between likelihood of receiving food boxes and county-level rurality, access to food, and other demographic factors.
Additional links: Report Summary
Author(s): Keenan Marchesi, Saied Toossi, Katy Georg
Date: 04/2025
Sponsoring organization: USDA Economic Research Service
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The Rural and Urban Supply of Clinicians With a DEA Waiver to Prescribe Buprenorphine in 2022 Prior to the Elimination of the Waiver Requirement
Report explores the differences in rates of clinicians with DEA waivers to prescribe buprenorphine in 2022 in rural versus urban counties. Highlights the rural gaps in access to buprenorphine to treat opioid use disorder prior to the elimination of the DEA waiver requirement in 2023. Provides rural, urban, and regional comparisons.
Date: 04/2025
Sponsoring organization: WWAMI Rural Health Research Center
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Report explores the differences in rates of clinicians with DEA waivers to prescribe buprenorphine in 2022 in rural versus urban counties. Highlights the rural gaps in access to buprenorphine to treat opioid use disorder prior to the elimination of the DEA waiver requirement in 2023. Provides rural, urban, and regional comparisons.
Date: 04/2025
Sponsoring organization: WWAMI Rural Health Research Center
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MedPAC Report to the Congress: Medicare Payment Policy: Skilled Nursing Facility Services: Chapter 6
Discusses payment adequacy for skilled nursing facility (SNF) services. Features statistics on SNF care provided by rural hospitals and Critical Access Hospitals (CAHs) via swing beds and Medicare margins for urban, rural, and frontier freestanding SNFs in 2023.
Date: 03/2025
Sponsoring organization: Medicare Payment Advisory Commission
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Discusses payment adequacy for skilled nursing facility (SNF) services. Features statistics on SNF care provided by rural hospitals and Critical Access Hospitals (CAHs) via swing beds and Medicare margins for urban, rural, and frontier freestanding SNFs in 2023.
Date: 03/2025
Sponsoring organization: Medicare Payment Advisory Commission
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MedPAC Report to the Congress: Medicare Payment Policy, 2025
Annual review of Medicare payment policies, with recommendations to Congress. Includes discussion on Medicare payment policies directly affecting rural providers and beneficiaries. Addresses payment adequacy for Medicare fee-for-service payment systems, Medicare Advantage (MA), and Medicare Part D.
Date: 03/2025
Sponsoring organization: Medicare Payment Advisory Commission
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Annual review of Medicare payment policies, with recommendations to Congress. Includes discussion on Medicare payment policies directly affecting rural providers and beneficiaries. Addresses payment adequacy for Medicare fee-for-service payment systems, Medicare Advantage (MA), and Medicare Part D.
Date: 03/2025
Sponsoring organization: Medicare Payment Advisory Commission
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Report to Congress on Medicaid and CHIP, March 2025
Reports on three aspects of Medicaid of interest to Congress: 1) improving the usability and transparency of the managed care external quality review process, 2) improvements on timely access to home- and community-based services (HCBS), and 3) ways to streamline Medicaid Section 1915 authorities for home-and community-based services and reduce the administrative burden.
Date: 03/2025
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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Reports on three aspects of Medicaid of interest to Congress: 1) improving the usability and transparency of the managed care external quality review process, 2) improvements on timely access to home- and community-based services (HCBS), and 3) ways to streamline Medicaid Section 1915 authorities for home-and community-based services and reduce the administrative burden.
Date: 03/2025
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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Rural Health Disparities and Differences in Definitions of Rurality
Examines health disparities and differences in healthcare characteristics between rural and nonrural counties using data from the 2023 County Health Rankings and 2021-2022 Area Health Resources Files. Compares community health and healthcare characteristics by two county-level urban-rural classification systems: Rural-Urban Continuum Codes (RUCC) and Core Based Statistical Areas (CBSAs). Explores the degree to which four county-level classification systems - RUCC, CBSA, the National Center for Health Statistics (NCHS) Urban-Rural Classification Scheme for Counties, and Urban Influence Codes (UIC) - agree regarding which counties are designated as rural.
Date: 02/2025
Sponsoring organizations: HHS Office of the Assistant Secretary for Planning and Evaluation, NORC at the University of Chicago
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Examines health disparities and differences in healthcare characteristics between rural and nonrural counties using data from the 2023 County Health Rankings and 2021-2022 Area Health Resources Files. Compares community health and healthcare characteristics by two county-level urban-rural classification systems: Rural-Urban Continuum Codes (RUCC) and Core Based Statistical Areas (CBSAs). Explores the degree to which four county-level classification systems - RUCC, CBSA, the National Center for Health Statistics (NCHS) Urban-Rural Classification Scheme for Counties, and Urban Influence Codes (UIC) - agree regarding which counties are designated as rural.
Date: 02/2025
Sponsoring organizations: HHS Office of the Assistant Secretary for Planning and Evaluation, NORC at the University of Chicago
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