Rural Emergency Medical Services (EMS) and Trauma – Resources
Selected recent or important resources focusing on Rural Emergency Medical Services (EMS) and Trauma.
Rural EMS Regionalization - Opportunities and Policy Considerations
Explores models of emergency medical services (EMS) at the state level. Includes a case study exploring successes in Minnesota and offers policy recommendations to overcome common rural EMS challenges.
Author(s): Eli Steenhoek, Lauren Lavin, Keith Mueller
Date: 08/2025
Sponsoring organization: Rural Policy Research Institute Rural Health Panel
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Explores models of emergency medical services (EMS) at the state level. Includes a case study exploring successes in Minnesota and offers policy recommendations to overcome common rural EMS challenges.
Author(s): Eli Steenhoek, Lauren Lavin, Keith Mueller
Date: 08/2025
Sponsoring organization: Rural Policy Research Institute Rural Health Panel
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Quantitative Effects of Mechanical Cardiopulmonary Resuscitation Devices in Rural American Emergency Medical Services: A Retrospective Cohort Study
Examines the effect of mechanical cardiopulmonary resuscitation on out-of-hospital cardiac arrest incidents in rural areas and the usefulness of new technologies on rural emergency medical services (EMS). Utilizes 2017–2019 National Emergency Medical Services Information System data to analyze 585 rural cardiac arrests and the impact of mechanical cardiopulmonary resuscitation on EMS care quality.
Author(s): Peter H. King, Esmaeil Bahalkeh
Citation: International Journal of Emergency Medicine, 18, 151
Date: 08/2025
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Examines the effect of mechanical cardiopulmonary resuscitation on out-of-hospital cardiac arrest incidents in rural areas and the usefulness of new technologies on rural emergency medical services (EMS). Utilizes 2017–2019 National Emergency Medical Services Information System data to analyze 585 rural cardiac arrests and the impact of mechanical cardiopulmonary resuscitation on EMS care quality.
Author(s): Peter H. King, Esmaeil Bahalkeh
Citation: International Journal of Emergency Medicine, 18, 151
Date: 08/2025
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How Should Rural EMS Funding Streams Be Improved?
Discusses the need and mechanisms for funding rural EMS systems more robustly. Offers suggestions for finding funding and discusses the decline in volunteerism.
Author(s): James Small
Citation: AMA Journal of Ethics, 27(7), E518-524
Date: 07/2025
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Discusses the need and mechanisms for funding rural EMS systems more robustly. Offers suggestions for finding funding and discusses the decline in volunteerism.
Author(s): James Small
Citation: AMA Journal of Ethics, 27(7), E518-524
Date: 07/2025
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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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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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Strategies for Sustaining Emergency Care in the United States
Assesses the value of emergency care in the United States, evaluates challenges to sustaining emergency care, measures trends in emergency care payment, and identifies alternate funding strategies for emergency care. Features a case study of a hospital-based emergency department closure in a rural community, and mentions rural throughout.
Author(s): Mahshid Abir, Brian Briscombe, Carl T. Berdahl, et al.
Date: 04/2025
Sponsoring organization: RAND Corporation
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Assesses the value of emergency care in the United States, evaluates challenges to sustaining emergency care, measures trends in emergency care payment, and identifies alternate funding strategies for emergency care. Features a case study of a hospital-based emergency department closure in a rural community, and mentions rural throughout.
Author(s): Mahshid Abir, Brian Briscombe, Carl T. Berdahl, et al.
Date: 04/2025
Sponsoring organization: RAND Corporation
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AHRQ Summit to Address Emergency Department Boarding: Technical Report
Report from an October 2024 Agency for Healthcare Research and Quality (AHRQ) summit to discuss emergency department boarding. Examines some of emergency physicians' biggest concerns and highlights possible solutions to address boarding head-on, including enhancing measurement and standards, re-aligning hospital incentives, and increasing support to empower emergency physicians to do their jobs effectively. Includes sections on rural patients and rural areas.
Author(s): Robin M. Weinick, Sean Bruna, Rachael M. Boicourt, Sean S. Michael, Laura L. Sessums
Date: 01/2025
Sponsoring organization: Agency for Healthcare Research and Quality
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Report from an October 2024 Agency for Healthcare Research and Quality (AHRQ) summit to discuss emergency department boarding. Examines some of emergency physicians' biggest concerns and highlights possible solutions to address boarding head-on, including enhancing measurement and standards, re-aligning hospital incentives, and increasing support to empower emergency physicians to do their jobs effectively. Includes sections on rural patients and rural areas.
Author(s): Robin M. Weinick, Sean Bruna, Rachael M. Boicourt, Sean S. Michael, Laura L. Sessums
Date: 01/2025
Sponsoring organization: Agency for Healthcare Research and Quality
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Examining Differences in Rural and Urban Medicare FFS Beneficiaries' Emergency Department Use Before and During COVID-19
Results of a study describing changes from 2018-2022 in emergency department use among rural and urban Medicare Fee-for-Service (FFS) beneficiaries. Features statistics including patient demographics, primary diagnoses, and admission sources, with breakdowns by urban and rural areas.
Author(s): Alana Knudson, Craig D. Holden, Marilyn Klug, Tricia Stauffer, Shena Popat
Date: 01/2025
Sponsoring organization: ETSU/NORC Rural Health Research Center
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Results of a study describing changes from 2018-2022 in emergency department use among rural and urban Medicare Fee-for-Service (FFS) beneficiaries. Features statistics including patient demographics, primary diagnoses, and admission sources, with breakdowns by urban and rural areas.
Author(s): Alana Knudson, Craig D. Holden, Marilyn Klug, Tricia Stauffer, Shena Popat
Date: 01/2025
Sponsoring organization: ETSU/NORC Rural Health Research Center
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Emergency Triage, Treat, and Transport (ET3) Model: Final Evaluation Report
Presents quantitative and qualitative results from the evaluation of the Emergency Triage, Treat, and Transport (ET3) Model, a voluntary model that allowed ambulance care teams to use alternate models of emergency healthcare to improve quality and lower care costs. Describes the characteristics of ET3 participants, the extent to which ET3 interventions successfully prevented emergency department (ED) visits, and how average Medicare Parts A and B spending for patients that received ET3 interventions compared to patients who had low acuity ED visits. Discusses challenges and barriers to delivering ET3 interventions. Includes rural references throughout.
Additional links: Findings at a Glance, Technical Appendix
Date: 01/2025
Sponsoring organization: Centers for Medicare and Medicaid Services
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Presents quantitative and qualitative results from the evaluation of the Emergency Triage, Treat, and Transport (ET3) Model, a voluntary model that allowed ambulance care teams to use alternate models of emergency healthcare to improve quality and lower care costs. Describes the characteristics of ET3 participants, the extent to which ET3 interventions successfully prevented emergency department (ED) visits, and how average Medicare Parts A and B spending for patients that received ET3 interventions compared to patients who had low acuity ED visits. Discusses challenges and barriers to delivering ET3 interventions. Includes rural references throughout.
Additional links: Findings at a Glance, Technical Appendix
Date: 01/2025
Sponsoring organization: Centers for Medicare and Medicaid Services
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Medicare Ground Ambulance Data Collection System (GADCS) Report: Year 1 and Year 2 Cohort Analysis
Provides data from the first two cohorts of ground ambulance organizations selected to participate in the Ground Ambulance Data Collection System. Includes response rates, information on data cleaning and validation, statistics summarizing responses, and analyses exploring relationships between costs per service and organizational characteristics. Features statistics with breakdowns by urban, rural, and super rural areas.
Additional links: Codebook
Author(s): Andrew W. Mulcahy, Sara E. Heins, Petra W. Rasmussen, et al.
Date: 12/2024
Sponsoring organizations: Centers for Medicare and Medicaid Services, RAND Corporation
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Provides data from the first two cohorts of ground ambulance organizations selected to participate in the Ground Ambulance Data Collection System. Includes response rates, information on data cleaning and validation, statistics summarizing responses, and analyses exploring relationships between costs per service and organizational characteristics. Features statistics with breakdowns by urban, rural, and super rural areas.
Additional links: Codebook
Author(s): Andrew W. Mulcahy, Sara E. Heins, Petra W. Rasmussen, et al.
Date: 12/2024
Sponsoring organizations: Centers for Medicare and Medicaid Services, RAND Corporation
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Additional resources are available related to this guide. See the full list of resources by topic for:
- Emergency department and urgent care services
- Emergency medical services
- Emergency medical technicians and paramedics
Last Updated: 9/11/2025