Rural Health
Resources by Topic: Emergency medical services
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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March 2025 MedPAC Meeting Transcript
Transcript from the Medicare Payment Advisory Commission's (MedPAC) March 2025 meeting. Covers research and proposals related to reforming physician fee schedule updates and improving the accuracy of relative payment rates, reducing beneficiary cost-sharing for outpatient services at Critical Access Hospitals, Medicare insurance agents, Medigap, payment for ground ambulance services, home healthcare use among Medicare Advantage enrollees, and institutional special needs plans. Includes rural references and considerations throughout.
Additional links: Mandated Report: Payment for Ground Ambulance Services, Reducing Beneficiary Cost-Sharing for Outpatient Services at Critical Access Hospitals
Date: 03/2025
Sponsoring organization: Medicare Payment Advisory Commission
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Transcript from the Medicare Payment Advisory Commission's (MedPAC) March 2025 meeting. Covers research and proposals related to reforming physician fee schedule updates and improving the accuracy of relative payment rates, reducing beneficiary cost-sharing for outpatient services at Critical Access Hospitals, Medicare insurance agents, Medigap, payment for ground ambulance services, home healthcare use among Medicare Advantage enrollees, and institutional special needs plans. Includes rural references and considerations throughout.
Additional links: Mandated Report: Payment for Ground Ambulance Services, Reducing Beneficiary Cost-Sharing for Outpatient Services at Critical Access Hospitals
Date: 03/2025
Sponsoring organization: Medicare Payment Advisory Commission
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Community Opioid Overdose Reversal Medications (OORMs) Planning Toolkit
Provides planning and strategy resources for organizations and communities to expand access to naloxone and other opioid overdose reversal medications (OORMs). Includes templates, implementation strategies and program examples, and more. Discusses rural considerations and programs throughout, including the Rural EMS Training Program and Rural Communities Opioid Response Program (RCORP).
Date: 01/2025
Sponsoring organization: Substance Abuse and Mental Health Services Administration
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Provides planning and strategy resources for organizations and communities to expand access to naloxone and other opioid overdose reversal medications (OORMs). Includes templates, implementation strategies and program examples, and more. Discusses rural considerations and programs throughout, including the Rural EMS Training Program and Rural Communities Opioid Response Program (RCORP).
Date: 01/2025
Sponsoring organization: Substance Abuse and Mental Health Services Administration
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Emergency Triage, Treat, and Transport (ET3) Model: Final Evaluation Report
Presents quantitative and qualitative results from the evaluation of the Emergency Triage, Treat, and Transport (ET3) Model, a voluntary model that allowed ambulance care teams to use alternate models of emergency healthcare to improve quality and lower care costs. Describes the characteristics of ET3 participants, the extent to which ET3 interventions successfully prevented emergency department (ED) visits, and how average Medicare Parts A and B spending for patients that received ET3 interventions compared to patients who had low acuity ED visits. Discusses challenges and barriers to delivering ET3 interventions. Includes rural references throughout.
Additional links: Findings at a Glance, Technical Appendix
Date: 01/2025
Sponsoring organization: Centers for Medicare and Medicaid Services
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Presents quantitative and qualitative results from the evaluation of the Emergency Triage, Treat, and Transport (ET3) Model, a voluntary model that allowed ambulance care teams to use alternate models of emergency healthcare to improve quality and lower care costs. Describes the characteristics of ET3 participants, the extent to which ET3 interventions successfully prevented emergency department (ED) visits, and how average Medicare Parts A and B spending for patients that received ET3 interventions compared to patients who had low acuity ED visits. Discusses challenges and barriers to delivering ET3 interventions. Includes rural references throughout.
Additional links: Findings at a Glance, Technical Appendix
Date: 01/2025
Sponsoring organization: Centers for Medicare and Medicaid Services
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Medicare Ground Ambulance Data Collection System (GADCS) Report: Year 1 and Year 2 Cohort Analysis
Provides data from the first two cohorts of ground ambulance organizations selected to participate in the Ground Ambulance Data Collection System. Includes response rates, information on data cleaning and validation, statistics summarizing responses, and analyses exploring relationships between costs per service and organizational characteristics. Features statistics with breakdowns by urban, rural, and super rural areas.
Author(s): Andrew W. Mulcahy, Sara E. Heins, Petra W. Rasmussen, et al.
Date: 12/2024
Sponsoring organizations: Centers for Medicare and Medicaid Services, RAND Corporation
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Provides data from the first two cohorts of ground ambulance organizations selected to participate in the Ground Ambulance Data Collection System. Includes response rates, information on data cleaning and validation, statistics summarizing responses, and analyses exploring relationships between costs per service and organizational characteristics. Features statistics with breakdowns by urban, rural, and super rural areas.
Author(s): Andrew W. Mulcahy, Sara E. Heins, Petra W. Rasmussen, et al.
Date: 12/2024
Sponsoring organizations: Centers for Medicare and Medicaid Services, RAND Corporation
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Identifying Best Practices for Improving the Evaluation and Management of Stroke in Rural Lower-Resourced Settings: A Scientific Statement From the American Heart Association
Discusses the value of quality improvement and expanded stroke service availability in underserved rural and remote settings. Identifies disparities in stroke care access and patient outcomes, and provides strategies related to policy, investment, training, and inter-organizational cooperation which address challenges in prehospital, inpatient, and postacute care, thrombolysis and ED care, patient transfers, and thrombectomy.
Author(s): Kori S. Zachrison, Kaiz S. Asif, Sherita Chapman, et al.
Citation: Stroke
Date: 12/2024
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Discusses the value of quality improvement and expanded stroke service availability in underserved rural and remote settings. Identifies disparities in stroke care access and patient outcomes, and provides strategies related to policy, investment, training, and inter-organizational cooperation which address challenges in prehospital, inpatient, and postacute care, thrombolysis and ED care, patient transfers, and thrombectomy.
Author(s): Kori S. Zachrison, Kaiz S. Asif, Sherita Chapman, et al.
Citation: Stroke
Date: 12/2024
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National Rural Health Day: Highlighting Challenges Facing Rural Communities
A blog post that provides an overview of rural health challenges in Indiana and nationwide, such as workforce challenges, hospital closures, lack of access to emergency services, and more. Includes rural versus urban and county-level data points as well as references to additional resources.
Author(s): Zachary Ammerman
Date: 11/2024
Sponsoring organization: Bowen Center for Health Workforce Research and Policy
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A blog post that provides an overview of rural health challenges in Indiana and nationwide, such as workforce challenges, hospital closures, lack of access to emergency services, and more. Includes rural versus urban and county-level data points as well as references to additional resources.
Author(s): Zachary Ammerman
Date: 11/2024
Sponsoring organization: Bowen Center for Health Workforce Research and Policy
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USDA Rural Development Rural Health: What We Do
Presents an overview of USDA Rural Development funding for rural health in fiscal year 2024. Covers telehealth and broadband, rural facilities, economic development, housing, infrastructure, mental health and substance use, and emergency medical services.
Date: 11/2024
Sponsoring organization: USDA Rural Development
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Presents an overview of USDA Rural Development funding for rural health in fiscal year 2024. Covers telehealth and broadband, rural facilities, economic development, housing, infrastructure, mental health and substance use, and emergency medical services.
Date: 11/2024
Sponsoring organization: USDA Rural Development
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Indiana EMS 2025 Report
Reports on emergency medical services (EMS) in Indiana based on meetings throughout 2023 and 2024 with EMS stakeholders. Focuses on funding and sustainability, operations, education, training, and workforce. Includes discussion on EMS access in rural areas.
Date: 11/2024
Sponsoring organization: Indiana Department of Homeland Security
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Reports on emergency medical services (EMS) in Indiana based on meetings throughout 2023 and 2024 with EMS stakeholders. Focuses on funding and sustainability, operations, education, training, and workforce. Includes discussion on EMS access in rural areas.
Date: 11/2024
Sponsoring organization: Indiana Department of Homeland Security
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Calendar Year (CY) 2025 Medicare Physician Fee Schedule Final Rule
Fact sheet providing an overview of the Centers for Medicare & Medicaid Services (CMS) final rule regarding updates and changes to the Medicare payments under the Physician Fee Schedule (PFS) and other Medicare Part B issues for calendar year 2025. Summarizes provisions related to telehealth services; advanced primary care management services; behavioral health services; opioid treatment programs; dental and oral health services; Rural Health Clinic (RHC) and Federally Qualified Health Center (FQHC) care coordination services, telecommunication services, intensive outpatient program (IOP) services, and payment for vaccine costs; and more.
Date: 11/2024
Sponsoring organization: Centers for Medicare and Medicaid Services
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Fact sheet providing an overview of the Centers for Medicare & Medicaid Services (CMS) final rule regarding updates and changes to the Medicare payments under the Physician Fee Schedule (PFS) and other Medicare Part B issues for calendar year 2025. Summarizes provisions related to telehealth services; advanced primary care management services; behavioral health services; opioid treatment programs; dental and oral health services; Rural Health Clinic (RHC) and Federally Qualified Health Center (FQHC) care coordination services, telecommunication services, intensive outpatient program (IOP) services, and payment for vaccine costs; and more.
Date: 11/2024
Sponsoring organization: Centers for Medicare and Medicaid Services
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