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Rural Health
Resources by Topic: Health reform

ACA and Medicaid Expansion Associated with Increased Insurance Coverage for Rural Americans with Disabilities
Fact sheet exploring ways in which Affordable Care Act (ACA) policy changes and Medicaid expansion affected people with disabilities, especially those in rural areas. Features statistics including changes in insurance coverage for urban and rural people with and without disabilities from 2006-2017, and differences in coverage in Medicaid expansion or non-expansion states, with breakdowns by urban or rural locations.
Author(s): Research and Training Center on Disability in Rural Communities
Date: 09/2019
Type: Document
Sponsoring organization: University of Montana: Rural Institute for Inclusive Communities
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Effects of the Patient Protection and Affordable Care Act on Coverage and Access to Care in Metropolitan vs. Non-Metropolitan Areas through 2016
Examines the combined effects of the Patient Protection and Affordable Care Act (PPACA) insurance provisions versus the effect of the Medicaid expansions, using recent national data to show possible differences between metropolitan and nonmetropolitan areas. Features statistics including changes in each of the years between 2013 and 2016, with breakdowns by metropolitan and nonmetropolitan areas.
Author(s): George L. Wehby, Wei Lyu, Dan M. Shane
Date: 08/2019
Type: Document
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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When Will the U.S. Territories Exhaust Federal Medicaid Funding?
Issue brief exploring the projected effects on healthcare expense funding in American Samoa, the Northern Mariana Islands, Guam, Puerto Rico, and the U.S. Virgin Islands if all sources of federal funding are allowed to expire in 2019. Features statistics for Medicaid funding and spending in the territories for fiscal year 2018, and sources of federal Medicaid funding and periods during which the funding is available.
Date: 07/2019
Type: Document
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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Insurer Participation in Rural Health Insurance Marketplaces: Are Some Markets Intrinsically More Competitive Than Others?
Policy position brief reporting on analyses of insurer participation data in the Federal Employees Health Benefits Program, Medicare Advantage, and Health Insurance Marketplaces (HIMs). Assesses to what extent participation in HIMs may be associated with prior levels of local market competition. Includes statistics on prior market competition in low-population-density counties in 2014 and 2017, and county characteristics associated with low insurer participation, with comparisons between metro and nonmetro counties.
Author(s): Abigail R. Barker, Timothy D. McBride, Keith J. Mueller
Date: 06/2019
Type: Document
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Cost-Sharing as a Barrier to Accessing Care at FQHCs and RHCs for Rural Medicare Beneficiaries
Results of a national study investigating cost barriers, using data acquired after enactment of the Affordable Care Act and viewed from perspectives other than ambulatory care sensitive hospitalizations. Features statistics including descriptive data of Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs) from the study sample, with breakdowns by rural and urban location.
Author(s): Alex R. Schulte, George H. Pink, Mark Holmes, Denise Kirk
Date: 06/2019
Type: Document
Sponsoring organization: North Carolina Rural Health Research Program
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Toward a High Performing Rural Health Care System: Key Issues and Recommendations from Rural Health Care System Innovators
Summarizes key themes and recommendations from a meeting of rural health leaders regarding innovations in rural healthcare financing and service delivery to inform state and national policy discussions. Offers recommendations, examples, and discussion on these 3 areas: financing rural health system innovation, creating an infrastructure to support rural health innovation, and promoting governance models that support innovation.
Author(s): Keith J. Mueller, Charlie Alfero, Andrew F. Coburn, et al.
Date: 05/2019
Type: Document
Sponsoring organization: Rural Policy Research Institute Rural Health Panel
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Independent Evaluation of Comprehensive Primary Care Plus (CPC+): First Annual Report
Provides an overview of first-year findings for CPC+, including who participated, the supports practices received, how practices implemented CPC+, and the impacts on cost, service use, and outcomes for Medicare beneficiaries. Features statistics with breakdowns by rural, suburban, or urban location.
Additional links: Appendices to the Supplemental Volume, Findings at a Glance, Supplemental Volume
Author(s): Deborah Peikes, Grace Anglin, Mary Harrington, et al.
Date: 04/2019
Type: Document
Sponsoring organization: Mathematica Policy Research
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Strengthening Medicaid Long-term Services and Supports in an Evolving Policy Environment: A Toolkit for States
Shares strategies states can use to reform their long-term services and supports (LTSS) framework, focusing on improving LTSS in two key areas: rebalancing LTSS to increase the proportion of LTSS provided in community-based settings and integrating LTSS with physical and behavioral health services through managed care. Uses case studies to provide examples of each strategy, and discusses rural considerations throughout.
Additional links: Brief for Legislators, Summary of Reforms
Author(s): Stephanie Anthony, Arielle Traub, Sarah Lewis, et al.
Date: 03/2019
Type: Document
Sponsoring organization: Center for Health Care Strategies
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Where Are They Now: Indian Programs on the GAO High Risk List
Features a Senate Committee on Indian Affairs oversight hearing discussing three high risk programs serving American Indians and Alaska Natives. Features testimony from representatives of the Government Accountability Office, the Bureau of Indian Education, the Bureau of Indian Affairs, and the Indian Health Service.
Date: 03/2019
Type: Video/Multimedia
Sponsoring organization: Senate Committee on Indian Affairs
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HHS and HRSA Rural Summit
Summary of a January 28, 2019 discussion among rural healthcare stakeholders concerning challenges rural communities face in providing and accessing healthcare. Also explores opportunities for the Department of Health and Human Services Administration and the Health Resources and Services Administration to address these issues through program and policy development. Topics include access to care, workforce challenges, rural health system transformation, telehealth, and response to the opioid crisis.
Date: 01/2019
Type: Document
Sponsoring organization: Health Resources and Services Administration
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