Rural Health
Resources by Topic: Service delivery models
Strategies for Critical Access Hospital Financial and Operational Performance Improvement: A Systematic Review
Summarizes findings from a systematic review of peer-reviewed and grey literature published since 2000 regarding financial and operational performance improvement interventions implemented by Critical Access Hospitals (CAHs) and rural hospitals in the United States and in other developed countries. Identifies key intervention areas, including service line optimization, revenue and cost management, and technology adoption, among others. Describes how State Flex Programs and hospital administrators can use these findings to inform decision-making and resource allocation.
Author(s): Angelina Budko, Laura Bozovich McFadyen, Carrie Baldwin-SoRelle, et al.
Date: 04/2026
Sponsoring organization: Flex Monitoring Team
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Summarizes findings from a systematic review of peer-reviewed and grey literature published since 2000 regarding financial and operational performance improvement interventions implemented by Critical Access Hospitals (CAHs) and rural hospitals in the United States and in other developed countries. Identifies key intervention areas, including service line optimization, revenue and cost management, and technology adoption, among others. Describes how State Flex Programs and hospital administrators can use these findings to inform decision-making and resource allocation.
Author(s): Angelina Budko, Laura Bozovich McFadyen, Carrie Baldwin-SoRelle, et al.
Date: 04/2026
Sponsoring organization: Flex Monitoring Team
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Reported Receipt of Mental Health Services by Adolescents Aged 12 to 17 in the Rural and Urban U.S., 2021
Describes the mental health services received by adolescents in rural and urban counties nationwide in 2021. Presents data on the percentage of adolescents that received mental health services by rurality. Includes data on rural and urban adolescents' receipt of inpatient and outpatient mental health services across Census regions; services provided in specialty mental health settings; and services provided by a therapist or counselor, in a general medical setting, or via telehealth.
Author(s): Janessa M. Graves, Gina A. Keppel, Lisa A. Garberson, C. Holly A. Andrilla
Date: 04/2026
Sponsoring organization: WWAMI Rural Health Research Center
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Describes the mental health services received by adolescents in rural and urban counties nationwide in 2021. Presents data on the percentage of adolescents that received mental health services by rurality. Includes data on rural and urban adolescents' receipt of inpatient and outpatient mental health services across Census regions; services provided in specialty mental health settings; and services provided by a therapist or counselor, in a general medical setting, or via telehealth.
Author(s): Janessa M. Graves, Gina A. Keppel, Lisa A. Garberson, C. Holly A. Andrilla
Date: 04/2026
Sponsoring organization: WWAMI Rural Health Research Center
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A Chartbook on the Characteristics and Needs of Frontier Critical Access Hospitals
Summarizes findings from a 2025 national survey of executives from 117 Critical Access Hospitals (CAHs) in frontier counties. Includes data on the distribution and characteristics of frontier CAHs. Identifies themes related to financial and operational challenges, service availability, and access to care in frontier settings.
Author(s): John A. Gale, Rebecca Stearns, Zachariah Croll, Jayne Foley
Date: 04/2026
Sponsoring organization: Flex Monitoring Team
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Summarizes findings from a 2025 national survey of executives from 117 Critical Access Hospitals (CAHs) in frontier counties. Includes data on the distribution and characteristics of frontier CAHs. Identifies themes related to financial and operational challenges, service availability, and access to care in frontier settings.
Author(s): John A. Gale, Rebecca Stearns, Zachariah Croll, Jayne Foley
Date: 04/2026
Sponsoring organization: Flex Monitoring Team
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Racial and Ethnic Disparities in Access to Acute Stroke Capabilities in California: Association with Rurality and Telestroke Access
Examines disparities in presentation to emergency departments (EDs) with or without acute stroke capability among patients with acute stroke by race and ethnicity, and variations in these associations by patient rurality and ED telestroke status, using 2021 NEDI-California and NEDI-USA survey data.
Author(s): Kori S. Zachrison, Renee Y. Hsia, Krislyn M. Boggs, et al.
Citation: Journal of Stroke & Cerebrovascular Diseases, 35(4), 108607
Date: 04/2026
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Examines disparities in presentation to emergency departments (EDs) with or without acute stroke capability among patients with acute stroke by race and ethnicity, and variations in these associations by patient rurality and ED telestroke status, using 2021 NEDI-California and NEDI-USA survey data.
Author(s): Kori S. Zachrison, Renee Y. Hsia, Krislyn M. Boggs, et al.
Citation: Journal of Stroke & Cerebrovascular Diseases, 35(4), 108607
Date: 04/2026
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Telehealth Resource Center Skills Matrix
Outlines the technical assistance and subject matter expertise of the 14 federally funded Telehealth Resource Centers in specific telehealth topics, clinical specialties, and areas of telehealth implementation.
Date: 04/2026
Sponsoring organization: National Consortium of Telehealth Resource Centers
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Outlines the technical assistance and subject matter expertise of the 14 federally funded Telehealth Resource Centers in specific telehealth topics, clinical specialties, and areas of telehealth implementation.
Date: 04/2026
Sponsoring organization: National Consortium of Telehealth Resource Centers
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Home Visiting Partnerships Serving Native Families: An Extension of the Multi-Site Implementation Study of Tribal Home Visiting (MUSE)
Discusses the Multi-Site Study of State-Tribal Collaboration (MUSE-STC) that examines collaboration between State Maternal, Infant, and Early Childhood Home Visiting (MIECHV) program awardees and organizations within tribal communities that provide home visiting services. Analyzes facilitators and barriers of collaborative partnerships and how they impact tribal home visiting services, including those in rural areas.
Author(s): Melina Salvador, William Voinot-Baron, Erin Geary, Nancy Whitesell, Kate Lyon
Date: 03/2026
Sponsoring organization: Administration for Children and Families
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Discusses the Multi-Site Study of State-Tribal Collaboration (MUSE-STC) that examines collaboration between State Maternal, Infant, and Early Childhood Home Visiting (MIECHV) program awardees and organizations within tribal communities that provide home visiting services. Analyzes facilitators and barriers of collaborative partnerships and how they impact tribal home visiting services, including those in rural areas.
Author(s): Melina Salvador, William Voinot-Baron, Erin Geary, Nancy Whitesell, Kate Lyon
Date: 03/2026
Sponsoring organization: Administration for Children and Families
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Telehealth Uptake and Rural-Urban and Racial/Ethnic Disparities in Postpartum Care Access Among Medicaid Beneficiaries in South Carolina, 2018–2022
Compares how postpartum care attendance and timeliness varied by race and ethnicity, rural or urban dwelling, and exposure to the COVID-19 pandemic, and how these associations varied by level of telehealth uptake, using 2019-2022 South Carolina Medicaid claims and enrollment data.
Author(s): Anirban Chatterjee, Xuzhuo Zhao, Jihong Liu, et al.
Citation: Medical Care, 64(5), 298-309
Date: 03/2026
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Compares how postpartum care attendance and timeliness varied by race and ethnicity, rural or urban dwelling, and exposure to the COVID-19 pandemic, and how these associations varied by level of telehealth uptake, using 2019-2022 South Carolina Medicaid claims and enrollment data.
Author(s): Anirban Chatterjee, Xuzhuo Zhao, Jihong Liu, et al.
Citation: Medical Care, 64(5), 298-309
Date: 03/2026
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Strengthening the Rural Health Workforce
Discusses legislation passed by state legislatures to address rural healthcare workforce challenges. Describes policies related to measuring the health workforce, encouraging rural practice, enhancing access to specialty care, and retaining rural healthcare professionals.
Author(s): Kelsie George
Date: 03/2026
Sponsoring organization: National Conference of State Legislatures
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Discusses legislation passed by state legislatures to address rural healthcare workforce challenges. Describes policies related to measuring the health workforce, encouraging rural practice, enhancing access to specialty care, and retaining rural healthcare professionals.
Author(s): Kelsie George
Date: 03/2026
Sponsoring organization: National Conference of State Legislatures
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Increasing Access to Oral Health Care in Rural Communities
Describes strategies states are implementing to meet the oral health needs of their rural communities. Covers initiatives related to telehealth, expanding the dental workforce, medical-dental integration, as well as initiatives proposed as part of state Rural Health Transformation Program applications.
Author(s): Megan D'Alessandro, Katie Greene
Date: 03/2026
Sponsoring organization: National Academy for State Health Policy
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Describes strategies states are implementing to meet the oral health needs of their rural communities. Covers initiatives related to telehealth, expanding the dental workforce, medical-dental integration, as well as initiatives proposed as part of state Rural Health Transformation Program applications.
Author(s): Megan D'Alessandro, Katie Greene
Date: 03/2026
Sponsoring organization: National Academy for State Health Policy
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Expanding Access to Low-Barrier Opioid Use Disorder Treatment in Non-Traditional Settings: Washington's Opioid Treatment Network
Presents a study exploring use of opioid treatment networks to provide low-barrier access to medications to treat opioid use disorder (MOUD) in Washington State. Compares rates of buprenorohine utilization of individuals within and outside of the network and by rural-urban residence.
Author(s): Shay M. Daily, Sharon Reif, Elizabeth Speaker, et al.
Citation: Journal of Rural Health, 42(2), e70139
Date: 03/2026
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Presents a study exploring use of opioid treatment networks to provide low-barrier access to medications to treat opioid use disorder (MOUD) in Washington State. Compares rates of buprenorohine utilization of individuals within and outside of the network and by rural-urban residence.
Author(s): Shay M. Daily, Sharon Reif, Elizabeth Speaker, et al.
Citation: Journal of Rural Health, 42(2), e70139
Date: 03/2026
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