Rural Health
Resources by Topic: Emergency medical services
Inadequate EMS in Rural Wisconsin: Strategies to Improve Reliability
Examines emergency medical services (EMS) in rural Wisconsin and provides a comparative analysis of EMS across rural counties and in other states. Focuses on policy interventions, recruitment and retention, training barriers, EMS infrastructure, financial constraints, and more. Includes data from an EMS reliability survey and interview feedback from EMS professionals.
Additional links: Brief
Author(s): Francis Amedoadzi, Anthony Carreno, Sammy Rothman, Lisa Severini, Gatiosso Traore
Date: 05/2025
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Examines emergency medical services (EMS) in rural Wisconsin and provides a comparative analysis of EMS across rural counties and in other states. Focuses on policy interventions, recruitment and retention, training barriers, EMS infrastructure, financial constraints, and more. Includes data from an EMS reliability survey and interview feedback from EMS professionals.
Additional links: Brief
Author(s): Francis Amedoadzi, Anthony Carreno, Sammy Rothman, Lisa Severini, Gatiosso Traore
Date: 05/2025
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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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Impact of Hospital Closure on Rural Communities: A Qualitative Study
Examines the impact of rural hospital closure on access to care, and identifies ways that rural communities adapt to hospital closures. Utilizes interview excerpts from 25 informants examining themes related to pre-closure conditions, impacts on communities and health systems, and actions by communities, states, health systems, and emergency medical services.
Author(s): Redwan Bin Abdul Baten, Mina Shrestha, Fred Ullrich, Whitney Zahnd, Keith J. Mueller
Date: 05/2025
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Examines the impact of rural hospital closure on access to care, and identifies ways that rural communities adapt to hospital closures. Utilizes interview excerpts from 25 informants examining themes related to pre-closure conditions, impacts on communities and health systems, and actions by communities, states, health systems, and emergency medical services.
Author(s): Redwan Bin Abdul Baten, Mina Shrestha, Fred Ullrich, Whitney Zahnd, Keith J. Mueller
Date: 05/2025
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Rural Emergency Medical Services Perspectives on Improving Acute Stroke Care: A Qualitative Study
Examines barriers and facilitators to timely and high-quality acute stroke care in rural communities via interviews with 12 rural EMS professionals in North Carolina. Discusses topics including comprehensive stroke assessment, destination decision protocols, communication between EMS and hospital staff, transport distances, limited staffing, and more.
Author(s): Emma N. Johnson, Mahesh V. Pinapaka, Mary E. Grewe, et al.
Citation: Prehospital Emergency Care, 29(8), 1123–1131
Date: 04/2025
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Examines barriers and facilitators to timely and high-quality acute stroke care in rural communities via interviews with 12 rural EMS professionals in North Carolina. Discusses topics including comprehensive stroke assessment, destination decision protocols, communication between EMS and hospital staff, transport distances, limited staffing, and more.
Author(s): Emma N. Johnson, Mahesh V. Pinapaka, Mary E. Grewe, et al.
Citation: Prehospital Emergency Care, 29(8), 1123–1131
Date: 04/2025
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Sustaining Rural Hospital Access: Adjustments to Medicare Rural Hospital Designations
Describes the history of Medicare rural hospital designations. Discusses how traditional Medicare, Medicare Advantage, and Medicaid impact hospital finances. Outlines policy recommendations to the Secretary of Health and Human Services (HHS) and Congress regarding rural hospitals designations, payment adjustments, Medicare Advantage, and rural ambulance and emergency services.
Author(s): Emma Sheffert, Maya Sandalow
Date: 04/2025
Sponsoring organization: Bipartisan Policy Center
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Describes the history of Medicare rural hospital designations. Discusses how traditional Medicare, Medicare Advantage, and Medicaid impact hospital finances. Outlines policy recommendations to the Secretary of Health and Human Services (HHS) and Congress regarding rural hospitals designations, payment adjustments, Medicare Advantage, and rural ambulance and emergency services.
Author(s): Emma Sheffert, Maya Sandalow
Date: 04/2025
Sponsoring organization: Bipartisan Policy Center
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Rurality and Area Deprivation and Outcomes After Out-of-Hospital Cardiac Arrest
Results of a study exploring the association between neighborhood rurality or economic deprivation with regional variation in outcomes after out-of-hospital cardiac arrest (OHCA). Features patient demographics and statistics with breakdowns by rural, suburban, and urban areas.
Author(s): Lakota Cheek, Robert H. Schmicker, Remle Crowe, et al.
Citation: JAMA Network Open, 8(4), e253435
Date: 04/2025
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Results of a study exploring the association between neighborhood rurality or economic deprivation with regional variation in outcomes after out-of-hospital cardiac arrest (OHCA). Features patient demographics and statistics with breakdowns by rural, suburban, and urban areas.
Author(s): Lakota Cheek, Robert H. Schmicker, Remle Crowe, et al.
Citation: JAMA Network Open, 8(4), e253435
Date: 04/2025
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The Impacts of New York's Balance Billing Regulation on Ground Ambulance Pricing
Examines the impact of surprise out-of-network (OON) billing regulations on New York emergency ground ambulances. Analyzes 2012-2019 commercial claims data and discusses the impacts of billing regulations on costs of care, with considerations related to transports from rural, super-rural, and urban locations.
Author(s): Wendy Y. Xu, Christopher Garmon, Sheldon M. Retchin, Yiting Li
Citation: Health Services Research, 60(2)
Date: 04/2025
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Examines the impact of surprise out-of-network (OON) billing regulations on New York emergency ground ambulances. Analyzes 2012-2019 commercial claims data and discusses the impacts of billing regulations on costs of care, with considerations related to transports from rural, super-rural, and urban locations.
Author(s): Wendy Y. Xu, Christopher Garmon, Sheldon M. Retchin, Yiting Li
Citation: Health Services Research, 60(2)
Date: 04/2025
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Epidemiology of 911 Calls for Opioid Overdose in Nogales, Arizona
Presents a study reviewing the 911 calls pertaining to opioid overdose in the Nogales, AZ area. Details the prehospital care received in the rural, borderland community and evaluates EMS's adherence to naloxone distribution protocol.
Author(s): Melody Glenn, Darien Stratton, Keith Primeau, Amber Rice
Citation: Western Journal of Emergency Medicine: Integrating Emergency Care with Population Health, 26(3)
Date: 03/2025
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Presents a study reviewing the 911 calls pertaining to opioid overdose in the Nogales, AZ area. Details the prehospital care received in the rural, borderland community and evaluates EMS's adherence to naloxone distribution protocol.
Author(s): Melody Glenn, Darien Stratton, Keith Primeau, Amber Rice
Citation: Western Journal of Emergency Medicine: Integrating Emergency Care with Population Health, 26(3)
Date: 03/2025
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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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Nebraska: Roadmap to Strong Rural Health Care
Provides information on sustaining rural hospitals and clinics, growing the rural healthcare workforce in Nebraska, improving access to long-term care, improving rural well-being, and preserving emergency medical services, among other topics related to rural healthcare in Nebraska.
Date: 02/2025
Sponsoring organizations: Nebraska Hospital Association, Nebraska Rural Health Association
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Provides information on sustaining rural hospitals and clinics, growing the rural healthcare workforce in Nebraska, improving access to long-term care, improving rural well-being, and preserving emergency medical services, among other topics related to rural healthcare in Nebraska.
Date: 02/2025
Sponsoring organizations: Nebraska Hospital Association, Nebraska Rural Health Association
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