Rural Health
Resources by Topic: Specialty care
End-Stage Renal Disease Treatment Choices (ETC) Model: Third Annual Evaluation Report, Calendar Years 2021-2023
Evaluation of the End-Stage Renal Disease Treatment Choices (ETC) Model, incorporating analyses of home dialysis use, waitlisting for a kidney transplant, living donor and deceased donor transplantation, utilization of services, Medicare payments, and quality of care. Features results from interviews and surveys involving model participants and beneficiaries, and examines impacts of the first three years of the ETC Model, 2021-2023. Explores if the impacts of the ETC Model differed by patient subgroup, including rural residence.
Additional links: Appendices, Executive Summary, Findings at a Glance
Date: 08/2025
Sponsoring organizations: Centers for Medicare and Medicaid Services, The Lewin Group
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Evaluation of the End-Stage Renal Disease Treatment Choices (ETC) Model, incorporating analyses of home dialysis use, waitlisting for a kidney transplant, living donor and deceased donor transplantation, utilization of services, Medicare payments, and quality of care. Features results from interviews and surveys involving model participants and beneficiaries, and examines impacts of the first three years of the ETC Model, 2021-2023. Explores if the impacts of the ETC Model differed by patient subgroup, including rural residence.
Additional links: Appendices, Executive Summary, Findings at a Glance
Date: 08/2025
Sponsoring organizations: Centers for Medicare and Medicaid Services, The Lewin Group
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Supply, Distribution, and Access to Cardiologists, Oncologists, and Pulmonologists in the Rural and Urban U.S.
Describes the changes in the supply and demand of four specialists - cardiologists, neurologists, oncologists, and pulmonologists - between 2012 and 2022. Compares data on the ratio of these specialists per 100,000 population across urban, large rural, and small/isolated rural areas. Explores the socioeconomic characteristics of rural counties with and without one of these specialists in 2022. Summarizes perspectives of rural health system leaders on how specialty care is accessed by and delivered to rural patients.
Author(s): Signe Burchim, David Evans, Nathan Maris, et al.
Date: 08/2025
Sponsoring organization: WWAMI Rural Health Research Center
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Describes the changes in the supply and demand of four specialists - cardiologists, neurologists, oncologists, and pulmonologists - between 2012 and 2022. Compares data on the ratio of these specialists per 100,000 population across urban, large rural, and small/isolated rural areas. Explores the socioeconomic characteristics of rural counties with and without one of these specialists in 2022. Summarizes perspectives of rural health system leaders on how specialty care is accessed by and delivered to rural patients.
Author(s): Signe Burchim, David Evans, Nathan Maris, et al.
Date: 08/2025
Sponsoring organization: WWAMI Rural Health Research Center
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MedPAC Data Book: Health Care Spending and the Medicare Program, 2025
Provides an overview of Medicare spending and highlights data on Medicare beneficiary demographics, dual-eligible beneficiaries, quality of care provided through the Medicare program, and other payer liability. Examines settings of care, including rural-specific provider sites, as they relate to spending, access to care, and profit margins. Compares rural and urban beneficiaries and providers throughout. Chart 6-2 addresses rural hospital closures and Rural Emergency Hospital conversions.
Date: 07/2025
Sponsoring organization: Medicare Payment Advisory Commission
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Provides an overview of Medicare spending and highlights data on Medicare beneficiary demographics, dual-eligible beneficiaries, quality of care provided through the Medicare program, and other payer liability. Examines settings of care, including rural-specific provider sites, as they relate to spending, access to care, and profit margins. Compares rural and urban beneficiaries and providers throughout. Chart 6-2 addresses rural hospital closures and Rural Emergency Hospital conversions.
Date: 07/2025
Sponsoring organization: Medicare Payment Advisory Commission
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Empowering Patients to Participate in Clinical Trials
Discusses the importance of clinical trials as well as the barriers that impact participant enrollment and retention. Provides strategies and policy suggestions to improve participation in clinical trials for various populations, including those in rural and remote areas.
Author(s): Allison Kolbe, Agata Bodie
Date: 07/2025
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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Discusses the importance of clinical trials as well as the barriers that impact participant enrollment and retention. Provides strategies and policy suggestions to improve participation in clinical trials for various populations, including those in rural and remote areas.
Author(s): Allison Kolbe, Agata Bodie
Date: 07/2025
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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Beneficiary and Clinician Perspectives on Medicare and Other Issues: Findings from 2025 Focus Groups in St. Louis, Missouri, and 2021–2025 Rural Focus Groups
Summarizes findings from 8 focus groups of Medicare beneficiaries, Medicare and Medicaid (dual eligible) beneficiaries, and clinicians conducted between April and May 2025, including one virtual focus group of rural Medicare beneficiaries. Compiles findings from 13 focus groups of rural Medicare beneficiaries between 2021 and 2025. Highlights themes that emerged across the focus groups covering Medicare coverage options, access to care, telehealth, organization of care, and prescription drugs.
Date: 06/2025
Sponsoring organizations: Medicare Payment Advisory Commission, NORC at the University of Chicago
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Summarizes findings from 8 focus groups of Medicare beneficiaries, Medicare and Medicaid (dual eligible) beneficiaries, and clinicians conducted between April and May 2025, including one virtual focus group of rural Medicare beneficiaries. Compiles findings from 13 focus groups of rural Medicare beneficiaries between 2021 and 2025. Highlights themes that emerged across the focus groups covering Medicare coverage options, access to care, telehealth, organization of care, and prescription drugs.
Date: 06/2025
Sponsoring organizations: Medicare Payment Advisory Commission, NORC at the University of Chicago
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Environmental Scan on Reducing Barriers to Participation in Population-Based Total Cost of Care (PB-TCOC) Models and Supporting Primary and Specialty Care Transformation
Presents results of an environmental scan on reducing barriers to participation in population-based total cost of care (PB-TCOC) models and supporting primary and specialty care transformation. Discusses identifying pathways for maximizing participation of different kinds of organizations in PB-TCOC models; an assessment of and approaches to reducing organization-level barriers; approaches to support primary and specialty care transformation; an assessment of factors that influence the ability of PB-TCOC models to be competitive; and a summary of relevant features in previously submitted Physician-Focused Payment Model Technical Advisory Committee (PTAC) proposals. Includes rural references throughout.
Date: 05/2025
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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Presents results of an environmental scan on reducing barriers to participation in population-based total cost of care (PB-TCOC) models and supporting primary and specialty care transformation. Discusses identifying pathways for maximizing participation of different kinds of organizations in PB-TCOC models; an assessment of and approaches to reducing organization-level barriers; approaches to support primary and specialty care transformation; an assessment of factors that influence the ability of PB-TCOC models to be competitive; and a summary of relevant features in previously submitted Physician-Focused Payment Model Technical Advisory Committee (PTAC) proposals. Includes rural references throughout.
Date: 05/2025
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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Rural Health Disparities and Differences in Definitions of Rurality
Examines health disparities and differences in healthcare characteristics between rural and nonrural counties using data from the 2023 County Health Rankings and 2021-2022 Area Health Resources Files. Compares community health and healthcare characteristics by two county-level urban-rural classification systems: Rural-Urban Continuum Codes (RUCC) and Core Based Statistical Areas (CBSAs). Explores the degree to which four county-level classification systems - RUCC, CBSA, the National Center for Health Statistics (NCHS) Urban-Rural Classification Scheme for Counties, and Urban Influence Codes (UIC) - agree regarding which counties are designated as rural.
Date: 02/2025
Sponsoring organizations: HHS Office of the Assistant Secretary for Planning and Evaluation, NORC at the University of Chicago
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Examines health disparities and differences in healthcare characteristics between rural and nonrural counties using data from the 2023 County Health Rankings and 2021-2022 Area Health Resources Files. Compares community health and healthcare characteristics by two county-level urban-rural classification systems: Rural-Urban Continuum Codes (RUCC) and Core Based Statistical Areas (CBSAs). Explores the degree to which four county-level classification systems - RUCC, CBSA, the National Center for Health Statistics (NCHS) Urban-Rural Classification Scheme for Counties, and Urban Influence Codes (UIC) - agree regarding which counties are designated as rural.
Date: 02/2025
Sponsoring organizations: HHS Office of the Assistant Secretary for Planning and Evaluation, NORC at the University of Chicago
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A Perinatal Psychiatry Access Program to Address Rural and Medically Underserved Populations Using Telemedicine
Examines the Moms IMPACTT (Improving Access to Perinatal Mental Health and Substance Use Disorder Care Through Telehealth and Tele-mentoring) program in South Carolina, which aims to address perinatal mental health and substance use issues through healthcare partnerships and telemedicine. Provides details and impact of the program, including outreach and engagement with rural and underserved communities.
Author(s): Courtney King, Marie Hayes, Lizmarie Maldonado, et al.
Citation: BMC Women's Health, 25, 30
Date: 01/2025
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Examines the Moms IMPACTT (Improving Access to Perinatal Mental Health and Substance Use Disorder Care Through Telehealth and Tele-mentoring) program in South Carolina, which aims to address perinatal mental health and substance use issues through healthcare partnerships and telemedicine. Provides details and impact of the program, including outreach and engagement with rural and underserved communities.
Author(s): Courtney King, Marie Hayes, Lizmarie Maldonado, et al.
Citation: BMC Women's Health, 25, 30
Date: 01/2025
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Understanding the Impact and Costs Associated with Medical Device Shortages During the COVID-19 Pandemic on Providers, Health Systems, Patients, and Manufacturers
Analyzes the U.S. medical device shortage during the COVID-19 pandemic and provides a related literature review, key stakeholder interviews, and data synthesis. Includes information on type of medical device shortages, strategies to manage shortages, and more, with a focus on shortages in nursing homes and rural hospitals.
Author(s): Linda Thai, Trinidad Beleche, Oluwarantimi Adetunji
Date: 01/2025
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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Analyzes the U.S. medical device shortage during the COVID-19 pandemic and provides a related literature review, key stakeholder interviews, and data synthesis. Includes information on type of medical device shortages, strategies to manage shortages, and more, with a focus on shortages in nursing homes and rural hospitals.
Author(s): Linda Thai, Trinidad Beleche, Oluwarantimi Adetunji
Date: 01/2025
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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Behavioral Health Diagnosis, Service Utilization, and Spending Among Older Adult Medicare Beneficiaries: A Chartbook
Examines the prevalence of behavioral health (BH) conditions among older adults. Utilizes 2017-2019 Medicare claims and administrative data to examine BH diagnoses, BH service utilization, cost of services, and more. Includes data breakdowns according to diagnosis, substance use, rates of diagnoses and service utilization, service type, rurality, and additional demographic factors.
Date: 01/2025
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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Examines the prevalence of behavioral health (BH) conditions among older adults. Utilizes 2017-2019 Medicare claims and administrative data to examine BH diagnoses, BH service utilization, cost of services, and more. Includes data breakdowns according to diagnosis, substance use, rates of diagnoses and service utilization, service type, rurality, and additional demographic factors.
Date: 01/2025
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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