Rural Health
Resources by Topic: Scope of practice
State Midwifery Full Practice Authority Policies and Midwife-Attended Births among Rural and Urban U.S. Residents
Analyzes how the implementation of state policies providing full practice authority to midwives was associated with the percentage of midwife-attended births in rural and urban areas between 2007 and 2023, using CDC WONDER data. Compares rates of midwife-attended births among states with and without full practice authority and those that passed policies during the study period.
Author(s): Clara E. Busse, Emily C. Sheffield, Caitlin Carroll, et al.
Citation: Women's Health Issues, 36(5), 436-443
Date: 07/2026
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Analyzes how the implementation of state policies providing full practice authority to midwives was associated with the percentage of midwife-attended births in rural and urban areas between 2007 and 2023, using CDC WONDER data. Compares rates of midwife-attended births among states with and without full practice authority and those that passed policies during the study period.
Author(s): Clara E. Busse, Emily C. Sheffield, Caitlin Carroll, et al.
Citation: Women's Health Issues, 36(5), 436-443
Date: 07/2026
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How Primary Care Medics Can Bring Needed Health Care to Rural Americans
Describes Penn State College of Medicine's Primary Care Medic Project, a certificate-based pathway under development that will train local individuals to deliver primary and preventive care under the supervision of licensed clinicians. Discusses how primary care medics will fill gaps between community-based outreach and licensed primary care providers. Compares the scope of practice of primary care medics with those of community health workers, paramedics, and registered nurses, among others.
Author(s): Mark B. Stephens, Robin W. Weinick
Date: 07/2026
Sponsoring organization: Commonwealth Fund
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Describes Penn State College of Medicine's Primary Care Medic Project, a certificate-based pathway under development that will train local individuals to deliver primary and preventive care under the supervision of licensed clinicians. Discusses how primary care medics will fill gaps between community-based outreach and licensed primary care providers. Compares the scope of practice of primary care medics with those of community health workers, paramedics, and registered nurses, among others.
Author(s): Mark B. Stephens, Robin W. Weinick
Date: 07/2026
Sponsoring organization: Commonwealth Fund
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Governors' Policy Actions in Rural Health Workforce
Describes policy actions taken by governors to advance healthcare career pathways, education and training, and recruitment and retention, as well as policies related to licensure and scope of practice. Includes examples from state Rural Health Transformation Program project narratives.
Date: 05/2026
Sponsoring organization: National Governors Association
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Describes policy actions taken by governors to advance healthcare career pathways, education and training, and recruitment and retention, as well as policies related to licensure and scope of practice. Includes examples from state Rural Health Transformation Program project narratives.
Date: 05/2026
Sponsoring organization: National Governors Association
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Unapologetically Built Backwards: ONU HealthWise, Pharmacist-Driven Healthcare Access in Rural Ohio
Features a university pharmacy department in rural Ohio that prepares pharmacy students for rural practice while also providing mobile services in nearby rural counties. Describes how the program has expanded to offer interprofessional education experiences and serve a larger region.
Author(s): Kay Miller Temple
Citation: Rural Monitor
Date: 03/2026
Sponsoring organization: Rural Health Information Hub
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Features a university pharmacy department in rural Ohio that prepares pharmacy students for rural practice while also providing mobile services in nearby rural counties. Describes how the program has expanded to offer interprofessional education experiences and serve a larger region.
Author(s): Kay Miller Temple
Citation: Rural Monitor
Date: 03/2026
Sponsoring organization: Rural Health Information Hub
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The Impact of Nurse Practitioner Full Practice Authority on Pediatric Care Experiences: A National Secondary Data Analysis
Examines the impact of full practice authority (FPA) for pediatric nurse practitioners (NPs) on pediatric primary healthcare access. Utilizes 2010–2019 Medical Expenditure Panel Survey data to analyze policy changes related to FPA implementation according to patient access, experiences, and rurality.
Author(s): Joyce J. Fitzpatrick, Maxwell Mehlman, Alicia Plemmons, et al.
Citation: Journal of Pediatric Health Care, 40(2), 251-257
Date: 03/2026
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Examines the impact of full practice authority (FPA) for pediatric nurse practitioners (NPs) on pediatric primary healthcare access. Utilizes 2010–2019 Medical Expenditure Panel Survey data to analyze policy changes related to FPA implementation according to patient access, experiences, and rurality.
Author(s): Joyce J. Fitzpatrick, Maxwell Mehlman, Alicia Plemmons, et al.
Citation: Journal of Pediatric Health Care, 40(2), 251-257
Date: 03/2026
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Rural-Serving Primary Care Practitioners' and Cardiologists' Care Adaptations for Cardiovascular Services: A Qualitative Analysis
Examines the cardiovascular services provided by rural-serving primary care practitioners and cardiologists. Utilizes interview feedback from 20 healthcare professionals and discusses rural cardiovascular services as related to interprofessional collaboration, expanded scope of practice, altered care, care adaptations, and more.
Author(s): Susan G. Miller, Signe Burchim, Kristin Beima-Sofie, et al.
Citation: Journal of Rural Health, 42(1), e70129
Date: 02/2026
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Examines the cardiovascular services provided by rural-serving primary care practitioners and cardiologists. Utilizes interview feedback from 20 healthcare professionals and discusses rural cardiovascular services as related to interprofessional collaboration, expanded scope of practice, altered care, care adaptations, and more.
Author(s): Susan G. Miller, Signe Burchim, Kristin Beima-Sofie, et al.
Citation: Journal of Rural Health, 42(1), e70129
Date: 02/2026
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Rural Health System Administrator Perspectives on Pharmacists' Role in Collaborative Drug Therapy Management
Examines the impact of pharmacist-led collaborative drug therapy modification (CDTM) on access to patient care in rural Georgia. Utilizes interview feedback from 7 primary healthcare system administrators regarding CDTM benefits and barriers, such as patient access to care, interprofessional collaboration among healthcare professionals, pharmacist knowledge and scope of practice, financial impacts, and more.
Author(s): Suzanne Whitten, Sharmon P. Osae, Russ Palmer, et al.
Citation: Journal of the American Pharmacists Association, 66(1), 102929
Date: 01/2026
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Examines the impact of pharmacist-led collaborative drug therapy modification (CDTM) on access to patient care in rural Georgia. Utilizes interview feedback from 7 primary healthcare system administrators regarding CDTM benefits and barriers, such as patient access to care, interprofessional collaboration among healthcare professionals, pharmacist knowledge and scope of practice, financial impacts, and more.
Author(s): Suzanne Whitten, Sharmon P. Osae, Russ Palmer, et al.
Citation: Journal of the American Pharmacists Association, 66(1), 102929
Date: 01/2026
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Towards Consistency for Behavioral Health Paraprofessionals - Part 1: Where We Stand — A National Landscape of BHP Formalization
Examines how states regulate, educate, and reimburse behavioral health and substance use paraprofessionals. Identifies variations in credentials, training requirements, scope of practice, and financing. Includes a set of state profiles examining how selected states have approached development and regulation of behavioral health paraprofessionals. Mentions rural throughout.
Author(s): Hannah L. Maxey, Mykayla Moore
Date: 2026
Sponsoring organizations: Bowen Center for Health Workforce Research and Policy, Indiana University School of Medicine
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Examines how states regulate, educate, and reimburse behavioral health and substance use paraprofessionals. Identifies variations in credentials, training requirements, scope of practice, and financing. Includes a set of state profiles examining how selected states have approached development and regulation of behavioral health paraprofessionals. Mentions rural throughout.
Author(s): Hannah L. Maxey, Mykayla Moore
Date: 2026
Sponsoring organizations: Bowen Center for Health Workforce Research and Policy, Indiana University School of Medicine
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Impact of Scope of Practice Laws for Certified Registered Nurse Anesthetists on the Utilization of Anesthesia Services
Examines scope of practice laws (SOPLs) for certified registered nurse anesthetists (CRNAs) and the impact of the COVID-19 pandemic on SOPLs. Utilizes 2018-2022 national administrative claims data to examine anesthesia providers by rurality, utilization rate of anesthesia procedures, and utilization of anesthesia procedures by SOPL changes and county underserved status, defined by density of available anesthesia providers. Discusses the impact of SOPLs on access to anesthesia services.
Author(s): Projesh P. Ghosh, Wafa W. Tarazi, Nwanneamaka Ume, et al.
Citation: Health Services Research, 61(1), e70052
Date: 10/2025
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Examines scope of practice laws (SOPLs) for certified registered nurse anesthetists (CRNAs) and the impact of the COVID-19 pandemic on SOPLs. Utilizes 2018-2022 national administrative claims data to examine anesthesia providers by rurality, utilization rate of anesthesia procedures, and utilization of anesthesia procedures by SOPL changes and county underserved status, defined by density of available anesthesia providers. Discusses the impact of SOPLs on access to anesthesia services.
Author(s): Projesh P. Ghosh, Wafa W. Tarazi, Nwanneamaka Ume, et al.
Citation: Health Services Research, 61(1), e70052
Date: 10/2025
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Investing in Primary Care: The Nurse Practitioner Will See You Now
Describes opportunities to support advancement of preparation and growth for nurse practitioners (NPs) to meet the population's primary care needs. Explores the importance of NPs in rural and underserved communities, and Health Professional Shortage Areas.
Author(s): Jessica McCann, Margaret Flinter
Date: 10/2025
Sponsoring organization: Milbank Memorial Fund
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Describes opportunities to support advancement of preparation and growth for nurse practitioners (NPs) to meet the population's primary care needs. Explores the importance of NPs in rural and underserved communities, and Health Professional Shortage Areas.
Author(s): Jessica McCann, Margaret Flinter
Date: 10/2025
Sponsoring organization: Milbank Memorial Fund
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