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Healthcare Access in Rural Communities Resources

Selected recent or important resources focusing on Healthcare Access in Rural Communities.

Stepping into the Breach: How States and Insurers Worked Together to Prevent Bare Counties for 2018
Examines six states - Iowa, Nevada, Ohio, Oklahoma, Tennessee, and Washington - that faced the prospect of having counties with no participating insurers ahead of the 2018 plan year open enrollment period. Shares insights from interviews with insurers and state regulators, focusing on how administrative and/or legislative actions and media coverage affected insurers' decisions to remain in the Marketplace. Includes a discussion on the challenges associated with risk assessment and rate setting in low-population, rural counties.
Author(s): Kevin Lucia, Jack Hoadley, Sabrina Corlette, Dania Palanker, Olivia Hoppe
Date: 11/2017
Type: Document
Sponsoring organization: Urban Institute
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2017 National Healthcare Quality and Disparities Report: Chartbook on Rural Health Care
Summarizes trends in healthcare quality and disparities for rural populations. Includes quality measures for access to healthcare, patient safety, person- and family-centered care, care coordination, affordability, healthy living, and effective treatment.
Author(s): Barbara Barton, Irim Azam
Date: 10/2017
Type: Document
Sponsoring organization: Agency for Healthcare Research and Quality
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Health Insurance Coverage in the United States: 2016
Provides statistics on health insurance coverage in 2016 and also focuses on changes between 2015 and 2016, as well as changes between 2013 and 2016. Tables 5 and A-4 list statistics for metropolitan and non-metropolitan areas. Based on data from the Current Population Survey Annual Social and Economic Supplement and the American Community Survey.
Author(s): Jessica C. Barnett, Edward R. Berchick
Date: 09/2017
Type: Document
Sponsoring organization: U.S. Census Bureau
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Rural/Urban Analysis on Individual Insurance Market Topics
Presents data on enrollment rates in the Federally-Facilitated Marketplace (FFM) in rural and urban areas by income. Compares the average number of off-market issuers and on-market issuers in both rural and urban counties.
Author(s): Abigail R. Barker, Timothy D. McBride, Kelsey A. Huntzberry, Keith J. Mueller
Date: 08/2017
Type: Document
Sponsoring organization: Rural Policy Research Institute
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Regulating Network Adequacy for Rural Populations: Perspectives of Five States
Policy brief describing a study to explore how California, Kentucky, Montana, Texas, and Wisconsin define insurance network adequacy and how much consideration is given to rural issues in regulating their networks. Features statistics including these states' rural population, rural percent of total population, rural area in square miles, number of marketplace networks, and percent that are narrow networks.
Author(s): Michelle Casey, Carrie Henning-Smith, Jean Abraham, Ira Moscovice
Date: 08/2017
Type: Document
Sponsoring organization: University of Minnesota Rural Health Research Center
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2016 National Healthcare Quality and Disparities Report
Provides a comprehensive summary and data analysis of the quality of and access to healthcare received in the U.S. and discusses the disparities encountered by different racial and ethnic groups, and by geographic locations.
Additional links: Introduction and Methods
Date: 07/2017
Type: Document
Sponsoring organization: Agency for Healthcare Research and Quality
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The Justice Gap: Measuring the Unmet Civil Legal Needs of Low-income Americans
Reports on civil legal needs experienced by low-income Americans who do not seek professional legal help and the paths they take when facing civil legal problems. Includes information on legal needs related to healthcare access and other issues that impact health, such as housing. Provides details for specific groups, including rural residents, seniors, veterans, people with disabilities, parents of children under 18, and domestic violence survivors.
Additional links: Appendix B2 Tables, Appendix B3 Tables, Full Report, Special Focus: Rural Residents
Date: 06/2017
Type: Document
Sponsoring organization: Legal Services Corporation
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After Hospital Closure: Pursuing High Performance Rural Health Systems without Inpatient Care
Describes ways for rural communities to develop optimal healthcare delivery systems after a local hospital closure. Features 3 case studies from Arizona, Michigan, and Illinois. Includes tables showing options currently available under federal and state laws, and policies under consideration.
Author(s): Keith J. Mueller, Charlie Alfero, Andrew F. Coburn, et al.
Date: 06/2017
Type: Document
Sponsoring organization: Rural Policy Research Institute Rural Health Panel
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Access to Mental Health Services for Children in Rural Areas
Policy brief identifying strategies to help rural children with mental, behavioral, or development disorders (MBDDs) access behavioral health services. Discusses the potential of telehealth, integration of behavioral health and primary care, and school-based health centers to address this need.
Date: 05/2017
Type: Document
Sponsoring organization: Centers for Disease Control and Prevention
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The Role of Public Versus Private Health Insurance in Ensuring Health Care Access & Affordability for Low-Income Rural Children
Reports on the rural-urban differences in healthcare access for children with public health insurance versus private insurance, and how families perceive affordability of healthcare when enrolled in Medicaid, the Children’s Health Insurance Program (CHIP), and private insurance plans.
Author(s): Erika C. Ziller, Jennifer D. Lenardson, Amanda R. Burgess
Date: 05/2017
Type: Document
Sponsoring organization: Maine Rural Health Research Center
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Rural Health Literacy Rural Health Chat
Summary of an April 2017 Twitter chat focused on rural health literacy issues. Documents a conversation among rural health literacy experts addressing a range of topics, including health literacy issues specific to rural areas, what healthcare providers and community organizations can do, and resources available to address rural health literacy.
Date: 04/2017
Type: Document
Sponsoring organization: Rural Health Information Hub
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The Role of Medicaid in Rural America
Uses data from the 2013-2015 American Community Survey to examine the role of Medicaid in rural areas, and discuss how potential expansions or cuts could affect rural healthcare. Highlights the importance of Medicaid for many rural residents who are often faced with limited access to insurance and providers, longer travel times, and greater health needs when compared to their urban counterparts. Includes several charts and graphs to illustrate important statistics and demographic comparisons.
Author(s): Julia Foutz, Samantha Artiga, Rachel Garfield
Date: 04/2017
Type: Document
Sponsoring organization: Kaiser Family Foundation
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Closure of Hospital Obstetric Services Disproportionately Affects Less-Populated Rural Counties
Policy brief describing a study examining obstetric unit and hospital closures in rural areas of the United States, 2004-2014. Features statistics with breakdowns by all rural counties, micropolitan, and noncore areas.
Author(s): Peiyin Hung, Katy Kozhimannil, Carrie Henning-Smith, Michelle Casey
Date: 04/2017
Type: Document
Sponsoring organization: University of Minnesota Rural Health Research Center
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Strengthening the Safety Net: Community Health Centers on the Front Lines of American Health Care
Highlights community health centers as an integral part of the American healthcare delivery system. Explains how health centers area able to improve access to care, deliver value, serve communities, and respond to emerging challenges. Also provides stories about health centers that currently serve rural communities, and presents policy priorities that will help health centers succeed in the future.
Date: 03/2017
Type: Document
Sponsoring organization: National Association of Community Health Centers
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Uninsured Rates Decrease for Most Counties From 2014 to 2015
Two maps comparing county-level uninsured rates in 2014 and 2015.
Date: 03/2017
Type: Map/Mapping System
Sponsoring organization: U.S. Census Bureau
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Small Area Health Insurance Estimates: 2015
Reports on health insurance coverage in the United States in 2015 and changes between 2014 and 2015. Includes maps showing county-level uninsured rates.
Additional links: SAHIE Highlights Brief Maps, 2015
Author(s): Lauren Bowers, Carolyn Gann, Stefan Elser
Date: 03/2017
Type: Document
Sponsoring organization: U.S. Census Bureau
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Obstetric Care Quality and Access for Rural U.S. Women
Webinar recording presenting information gathered from recent studies of obstetric care in rural hospitals, including quality, workforce, and predictors of non-local childbirth. Overarching themes include the discussion of access to obstetric care for women in rural communities and whether rural hospitals can provide it. Presented by Katy Kozhimannil, University of Minnesota School of Public Health/Director of Research at the U of M Rural Health Research Center. Approximately 60 minutes.
Additional links: Presentation Slides, Transcript
Author(s): Katy Kozhimannil
Date: 01/2017
Type: Video/Multimedia
Sponsoring organizations: Rural Health Research Gateway, University of Minnesota Rural Health Research Center
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Chartbook: Trends in Rural Children’s Health and Access to Care
Findings brief discussing changing status of rural and urban children from 2003-2012, with a focus on their demographics, financial access to care, reported use of care, and health status. Features statistics including poverty rate, insurance coverage, and race or ethnicity, with breakdowns by urban, large rural, and small rural location.
Additional links: Fact Sheet
Author(s): Janice C. Probst, Karen M. Jones
Date: 01/2017
Type: Document
Sponsoring organization: South Carolina Rural Health Research Center
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More Than 95 Percent of U.S. Children Had Health Insurance in 2015
Reports on the percent of children with any type of health insurance in 2015 by state and region for rural, suburban, and urban areas. Includes changes in health insurance coverage since 2014 and since 2008.
Author(s): Michael J. Staley
Date: 2017
Type: Document
Sponsoring organization: Carsey School of Public Policy
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Access to Services Diminishes in Rural America as Populations Age
With data derived from the Bureau of Labor Statistics and the American Community Survey this brief investigates the effect of a changing median age and population size in metropolitan and nonmetropolitan counties of the U.S. Population decline and population aging in nonmetropolitan counties is described as negatively impacting the local economies resulting in fewer health and education services available locally.
Author(s): Brian C. Thiede, David L. Brown, Scott R. Sanders, Nina Glasgow, László J. Kulcsár
Date: 12/2016
Type: Document
Sponsoring organization: Applied Population Laboratory
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Findings from the National Agricultural Workers Survey (NAWS) 2013-2014: A Demographic and Employment Profile of United States Farmworkers
Reports on demographic and employment characteristics of hired agricultural workers in the United States. Includes data on health insurance and healthcare access, as well as information on social determinants of health such as income, education level, language skills, and housing. Based on data collected from face-to-face interviews with 4,235 crop farmworkers conducted between October 1, 2012 and September 30, 2014.
Author(s): Trish Hernandez, Susan Gabbard, Daniel Carroll
Date: 12/2016
Type: Document
Sponsoring organization: U.S. Department of Labor
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Task Force on Ensuring Access in Vulnerable Communities
Report from a task force created by the American Hospital Association (AHA) charged with identifying access related challenges facing vulnerable communities, and examining ways in which hospitals can ensure access is maintained. Includes sections identifying characteristics of vulnerable communities, essential healthcare services to be maintained, emerging strategies, barriers to implementation, policy and advocacy issues, and more. Also includes multiple case examples where the emerging strategies and best practices have been used in vulnerable communities across the country.
Additional links: Executive Summary, Rural Chart Pack, Video
Date: 11/2016
Type: Document
Sponsoring organization: American Hospital Association
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Freestanding Emergency Departments: An Alternative Model for Rural Communities
Describes the freestanding emergency department (FSED) model as an option for rural communities that can no longer support inpatient services. Looks at both hospital-based and independent FSEDs, examines financial viability of the model, and features rural FSEDs in Illinois and Arizona.
Author(s): Jenn Lukens
Location: Rural Monitor
Date: 11/2016
Type: Document
Sponsoring organization: Rural Health Information Hub
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Unfinished Business: More than 20 Million Children in U.S. Still Lack Sufficient Access to Essential Health Care
Report based on analyses of national data sets concerning uninsured children, insured children who miss primary care visits due to various barriers, and insured children who lack access to essential subspecialties. Describes problems that underserved rural children face in obtaining adequate healthcare.
Date: 11/2016
Type: Document
Sponsoring organization: Children's Health Fund
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Health Insurance CO-OPs: Product Availability and Premiums in Rural Counties
Describes the role of CO-OPs, their regional distribution, and national prevalence in rural and urban counties, and compares the number of products available in counties with and without CO-OP plans in 2014 and 2015.
Author(s): Erika C. Ziller, Zachariah Croll, Andrew F. Coburn
Date: 10/2016
Type: Document
Sponsoring organization: Maine Rural Health Research Center
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NACRHHS Policy Briefs on Emergency Care Models and Rural Opioid Misuse Implications
September 2016 webinar discussion of two policy briefs sent to the Secretary of the U.S. Department of Health and Human Services (HHS) regarding alternative provision for emergency care due to rural hospital closures and the impact of opioid misuse in rural communities. Presented by members of the National Advisory Committee on Rural Health and Human Services including Former Governor Ronnie Musgrove, Committee Chair; Kelly Evans, Chief Executive Officer for Beartooth Billings Clinic, Red Lodge, MT; and Paul Moore, Executive Secretary. 60 minutes.
Additional links: Transcript
Date: 09/2016
Type: Video/Multimedia
Sponsoring organization: Rural Health Information Hub
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Intersection of Living in a Rural Versus Urban Area and Race/Ethnicity in Explaining Access to Health Care in the United States
Examines healthcare access for Hispanic, African American, and white rural and urban residents. Reports on access to a usual source of health care, health care needs met, cholesterol screening, cervical screening, and dental visits.
Author(s): Julia T. Caldwell, Chandra L. Ford, Steven P. Wallace, May C. Wang, Lois M. Takahashi
Location: American Journal of Public Health, 106(8), 1463-9
Date: 08/2016
Type: Document
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Geographic Variation in Health Insurance Marketplaces: Rural and Urban Trends in Enrollment, Firm Participation, Premiums, and Cost Sharing in 2016
A webinar discussing how geographic location influences the implementation and success of health insurance marketplaces as a result of the Affordable Care Act (ACA). Specific focus on the impact in rural areas. Includes data and statistics about Cost of Living Adjustments (COLAs), premium rates, firms participating, and Medicaid expansion.
Additional links: Presentation Slides, Transcript
Author(s): Timothy D. McBride, Abigail R. Barker, Leah Kemper, Keith Mueller
Date: 08/2016
Type: Video/Multimedia
Sponsoring organization: Rural Health Research Gateway
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Alternative Models to Preserving Access to Emergency Care
Explores proposals to maintain timely access to emergency and other basic healthcare services in rural communities that may not be able to support a full-service hospital. Identifies models of care and various ideologies for the Secretary and the Department of Health and Human Services to consider when evaluating policy options for an alternative model of care in rural communities.
Date: 07/2016
Type: Document
Sponsoring organization: National Advisory Committee on Rural Health and Human Services
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Breaking the Barriers to Specialty Care: Practical Ideas to Improve Health Equity and Reduce Cost
A collection of briefs focused on how to improve access to specialty care for rural and low-income patients. Discusses telehealth, developing primary care capacity to provide appropriate specialty care, and coordinated specialist networks as approaches to improve specialty care access. Free, but registration required to download.
Date: 06/2016
Type: Document
Sponsoring organizations: Bristol-Myers Squibb Foundation, FSG
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Impact of the Affordable Care Act Coverage Expansion on Rural and Urban Populations
A brief discussing the advances supported by the provisions of the Affordable Care Act (ACA) in health insurance coverage, premium tax credits, and healthcare access for rural and urban populations with a special focus on rural individuals.
Author(s): Kelsey Avery, Kenneth Finegold, Xiao Xiao
Date: 06/2016
Type: Document
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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2015 National Healthcare Quality and Disparities Report: Chartbook on Access to Health Care
Summarizes and illustrates trends across measures of access to healthcare using data from the National Healthcare Quality and Disparities Report. Includes a chart displaying the distribution of trauma center utilization by geographic location.
Date: 05/2016
Type: Document
Sponsoring organization: Agency for Healthcare Research and Quality
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LGBTQ Healthcare: Building Inclusive Rural Practices
Discusses the challenges rural LGBTQ individuals face in accessing quality care and what rural healthcare providers can do to improve the healthcare experience for this patient population.
Author(s): Zachary Toliver
Location: Rural Monitor
Date: 05/2016
Type: Document
Sponsoring organization: Rural Health Information Hub
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15 Million Kids in Health Care Deserts: Can Telehealth Make a Difference?
Highlights the problems with access to healthcare for children of vulnerable populations living in rural and poverty stricken areas, and discusses how telehealth can be implemented to overcome these barriers. Describes several case studies including a rural school-based telehealth program as a method for improving access to healthcare services to children.
Author(s): Dale Alverson, Julie Hall-Barrow, Denise M. Dion, et al.
Date: 04/2016
Type: Document
Sponsoring organization: Children's Health Fund
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Improving Efficiency and Preserving Access to Emergency Care in Rural Areas
Provides an overview of the current policies and strategies in place to ensure access to emergency department services in rural areas and the challenges they face today. Guides a discussion to alternative strategies that support outpatient-only services, such as a stand alone emergency department and a clinic that offers ambulatory services. Slides from MedPAC public meeting held on April 12, 2016.
Author(s): Jeff Stensland, Zach Gaumer
Date: 04/2016
Type: Presentation Slides
Sponsoring organization: Medicare Payment Advisory Commission
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How Could Nurse Practitioners and Physician Assistants Be Deployed to Provide Rural Primary Care?
Examines various methods in which nurse practitioners (NPs) and physician assistants (PAs) could meet the increased need for primary care services in rural areas as a result of the expanded access to health insurance due to the implementation of the Affordable Care Act (ACA).
Author(s): E.H. Larson, C.H.A. Andrilla, C. Coulthard, J. Spetz
Date: 03/2016
Type: Document
Sponsoring organization: WWAMI Rural Health Research Center
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Explaining the Link Between Access-to-care Factors and Health Care Resource Utilization among Individuals with COPD
Estimates with national data the relationship between access to healthcare and healthcare utilization that includes primary care physicians, hospitals, Rural Health Centers (RHCs), and Federally Qualified Health Centers (FQHCs) for patients with chronic obstructive pulmonary disease (COPD).
Author(s): Minchul Kim, Jinma Ren, William Tillis, et al.
Location: International Journal of Chronic Obstructive Pulmonary Disease, 11, 357-67
Date: 02/2016
Type: Document
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QuickStats: Percentage of Children and Adolescents Aged ≤17 Years Whose Usual Place of Sick Care is a Clinic or Health Center, by Race/Ethnicity and Metropolitan Status of Residence - National Health Interview Survey, United States, 2014
Chart showing the percentage of children who typically go to a clinic or health center when sick, as opposed to a doctor's office or the emergency room. Identifies children by race/ethnicity and metro/non-metro status. Analysis did not include children without a usual place of sick care.
Location: MMWR (Morbidity and Mortality Weekly Report), 65(4), 99
Date: 02/2016
Type: Chart/Graph
Sponsoring organization: Centers for Disease Control and Prevention
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QuickStats: Percentage of Youths Aged 10–17 Years Who Did Not Receive a Well-Child Checkup in the Past 12 Months, by Metropolitan Status of Residence - National Health Interview Survey, United States, 2008-2014
Chart showing the percent of children who did not receive a well-child check-up in the past year, comparing rates for those living in metropolitan and non-metropolitan areas.
Location: MMWR (Morbidity and Mortality Weekly Report), 64(52),1410
Date: 01/2016
Type: Chart/Graph
Sponsoring organization: Centers for Disease Control and Prevention
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Community Characteristics Associated with Where Urgent Care Centers Are Located: A Cross-sectional Analysis
Study examining the qualities and characteristics of a community with a non-hospital-based urgent care center, regardless of location. Table 1 lists a comparison of communities with and without non-hospital-based urgent care centers.
Author(s): Sidney T. Le, Renee Y. Hsia
Location: BMJ Open, 6(4)
Date: 2016
Type: Document
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After a Parent Left Employment, One in Five Children Lost Private Insurance
Examines children’s loss of private health insurance after parental job loss. Includes data on rural compared to urban privately insured children. Reports that, after parental job loss, rural and urban children were similarly impacted related to health insurance coverage.
Author(s): Kristin Smith
Date: 2016
Type: Document
Sponsoring organization: Carsey School of Public Policy
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Rural Adults Delay, Forego, and Strategize to Afford Their Pre-ACA Health Care
Provides an in-depth discussion regarding rural and urban adults under the age of 65 and their perceptions of the affordability of health insurance coverage and health services prior to the passage of the Affordable Care Act (ACA).
Author(s): Erika C. Ziller, Jennifer D. Lenardson, Andrew F. Coburn,
Date: 11/2015
Type: Document
Sponsoring organization: Maine Rural Health Research Center
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QuickStats: Percentage of Adults Aged 18-64 Years Who Did Not Get or Delayed Medical Care in the Past Year Because of Cost, by Type of Locality - National Health Interview Survey, 2012-2014
Chart showing the percentage of adults living in metropolitan compared to non-metropolitan areas who delayed seeking or obtaining medical care because of worry about cost.
Location: MMWR (Morbidity and Mortality Weekly Report), 64(44),1259
Date: 11/2015
Type: Chart/Graph
Sponsoring organization: Centers for Disease Control and Prevention
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Rural Enrollment in Health Insurance Marketplaces, by State
Compares rural and urban rates of enrollment in Health Insurance Marketplaces by state. Provides figures in relation to potential market participants.
Author(s): Abigail R. Barker, Timothy D. McBride, Leah M. Kemper, Keith J. Mueller
Date: 10/2015
Type: Document
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Challenges of Rural Cancer Care in the United States
Highlights the impact of rurality affecting the care of rural cancer patients and healthcare providers treating cancer patients. Topics discussed include the availability of cancer specialists, limited transportation services, lower socioeconomic status, health insurance coverage, less access to clinic trials, and the shortage of palliative and end-of-life staff and services.
Author(s): Mary Charlton, Jennifer Schlichting, Catherine Chioreso, et al.
Location: Oncology Journal, Practice & Policy, 29(9), 633-640
Date: 09/2015
Type: Document
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The ACA's Impact on Rural Areas
Webinar slides showing the impact of the Affordable Care Act (ACA) on uninsured rates across the country. Highlights differences in enrollment and market characteristics between urban and rural areas by analyzing change in enrollment rates, payer mix, and number of insurance plans offered.
Author(s): Tim McBride
Date: 09/2015
Type: Presentation Slides
Sponsoring organization: Rural Policy Research Institute
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Free Clinics in the Rural Safety Net, 2014
Examines availability and location of free clinics across the United States. Highlights challenges faced by free clinics, including challenges associated with the implementation of the Affordable Care Act (ACA).
Additional links: Key Facts
Author(s): Amy Martin, Grishma Bhavsar, Lauren Workman, Janice Probst
Date: 09/2015
Type: Document
Sponsoring organization: South Carolina Rural Health Research Center
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Not Near Enough: Racial and Ethnic Disparities in Access to Nearby Behavioral Health Care and Primary Care
Analyzes the association of integrated behavioral health and primary care services with communities in rural areas and communities with higher percentages of African Americans and Hispanics for a better understanding of the disparities in access to integrated care.
Author(s): Lynn M. VanderWielen, Emma C. Gilchrist, Molly A. Nowels, et al.
Location: Journal of Health Care for the Poor and Underserved, 26(3) 1032–1047
Date: 08/2015
Type: Document
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Rural Ambulatory Access for Semi-Urgent Care and the Relationship of Distance to an Emergency Department
Examines how distance to emergency departments (ED) and urgent care (UC) facilities impact semi-urgent ambulatory appointments, and assesses the effect of insurance and ability to pay cash on a patient’s achievement in scheduling appointments in rural and suburban areas of the Eastern U.S.
Author(s): Ashley Parks, Andy Hoegh, Damon Kuehl
Location: Western Journal of Emergency Medicine, 16(4), 594-599
Date: 07/2015
Type: Document
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Dentist Supply, Dental Care Utilization, and Oral Health Among Rural and Urban U.S. Residents
Investigates the differences between rural and urban adults regarding their utilization of dental care services. Discusses the influence of dentist supply and oral health outcomes in rural and urban areas.
Author(s): Mark P. Doescher, Gina A. Keppel
Date: 06/2015
Type: Document
Sponsoring organization: WWAMI Rural Health Research Center
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The Persistent Health Care Gap for Children Living in Poverty: Will the Health Technology Revolution Level the Playing Field?
Discusses the need for and the challenges to expanding healthcare technology for medically underserved children living in poverty stricken areas and in rural areas. Highlights the potential to improve access to healthcare and health outcomes through the use of electronic health records, telehealth, mobile medical clinics and diagnostic tools, and mobile communication devices. Offers recommendations for accelerating the use of technology in rural and underserved areas.
Date: 04/2015
Type: Document
Sponsoring organization: Children's Health Fund
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The Value Proposition of Retail Clinics
Describes the role that retail clinics can play in improving healthcare access in underserved communities, including rural areas. Discusses the potential of telehealth use at retail clinics. Offers recommendations for optimizing the value of retail clinics to meet individual and community health needs.
Author(s): Deborah Bachrach, Jonah Frohlich, Allison Garcimonde, Keith Nevitt
Date: 04/2015
Type: Document
Sponsoring organization: Robert Wood Johnson Foundation
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Acceptance of New Patients With Public and Private Insurance by Office-based Physicians: United States, 2013
Provides data on office-based physicians accepting new patients with Medicaid, Medicare, and private insurance. See Figure 2 for comparison of metropolitan to non-metropolitan acceptance rates by patient payment source. Also includes state-level data.
Author(s): Esther Hing, Sandra L. Decker, Eric Jamoom
Date: 03/2015
Type: Document
Sponsoring organization: National Center for Health Statistics
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Rural Substance Use Treatment Centers in the United States: An Assessment of Treatment Quality by Location
Investigates the differences in treatment quality in rural and urban substance abuse treatment centers to determine if these differences are a result of structural characteristics and rurality.
Author(s): Mary Bond Edmond, Lydia Aletraris, Paul M. Roman
Location: American Journal of Drug and Alcohol Abuse, 41(5), 449-457
Date: 2015
Type: Document
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Rural Healthy People 2020: A Companion Document to Healthy People 2020, Volume 1
Provides a rural focus for the Healthy People 2020 priorities. Includes overviews of the top 10 rural health priority areas identified by rural stakeholders. (Volume 2 discusses priorities 11-20.) Topics addressed include: health insurance, primary care, emergency services, nutrition and weight status, diabetes, mental health, substance abuse, heart disease and stroke, physical activity, older adults, maternal and child health, and tobacco use. Each overview includes reviews of the relevant literature and models that rural communities can use to address the issues. Document is available for free download, after providing brief information about intended use.
Author(s): Jane N. Bolin, Gail Bellamy, Alva O. Ferdinand, Bita Kash, Janet W. Helduser
Date: 2015
Type: Document
Sponsoring organization: Southwest Rural Health Research Center
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The Obstetric Care Workforce in Critical Access Hospitals (CAHs) and Rural Non-CAHs
Examines current obstetric practice models in critical access hospitals and other rural hospitals to understand obstetric care services and obstetric workforce issues. Types of clinicians providing obstetric care in a sample of rural hospitals are reported including obstetricians, family physicians, certified nurse midwives and general surgeons.
Author(s): Katy Kozhimannil, Michelle Casey, Peiyin Hung, Shailendra Prasad, Ira Moscovice
Date: 11/2014
Type: Document
Sponsoring organization: University of Minnesota Rural Health Research Center
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The 2014 Update of the Rural-Urban Chartbook
Updates information presented in Health, United States, 2001: With Urban and Rural Health Chartbook. Highlights current trends and disparities across different levels of metro and nonmetropolitan counties including population characteristics; health-related behaviors and risk factors; mortality rates; healthcare access and use; and other health measures such as teen birth rates, tooth loss, and activity limitations due to chronic disease. Individual data tables are available in an Excel file.
Author(s): Michael Meit, Alana Knudson, Tess Gilbert, et al.
Date: 10/2014
Type: Document
Sponsoring organization: Rural Health Reform Policy Research Center
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Health Insurance Among Young Adults Rebounds Post Recession: More Become Dependents on a Parent's Plan After ACA Extends Coverage to Adult Children
Reports on rates of health insurance coverage among young adults in the U.S. Nationally, rates were similar in rural and urban areas.
Author(s): Michael J. Staley, Jessica A. Carson
Date: 10/2014
Type: Document
Sponsoring organization: Carsey School of Public Policy
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Geographic Variation in Plan Uptake in the Federally Facilitated Marketplace
Combines data on health insurance plan selection in the Federally Facilitated Marketplaces with estimates of people likely to qualify for the Marketplace in order to calculate the percent of eligible people who chose a health insurance plan. Includes a heat map that illustrates which U.S. regions had the highest and lowest plan selection rates.
Author(s): Mark Holmes, Pam Silberman, Kristie Thompson, Victoria Freeman, Randy K. Randolph
Date: 10/2014
Type: Document
Sponsoring organization: North Carolina Rural Health Research Program
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Geographic Variation in Premiums in Health Insurance Marketplaces
Analyzes the 2014 premiums of the health insurance plans provided through the exchanges created by the Affordable Care Act. Results found the insurance ratings for areas with smaller populations had higher premiums.
Author(s): Abigail R. Barker, Timothy D. McBride, Leah M. Kemper, Keith Mueller
Date: 09/2014
Type: Document
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Rural Implications of the Blueprints for State-Based Health Insurance Marketplaces
Presents different states’ approaches to the health insurance marketplaces including service areas and rating areas, network adequacy requirements, rural consumer outreach, rural representation on the Marketplace governing board, certification and oversight of Qualified Health Plans, and design of the Small Business Health Options Program.
Author(s): Andy Potter, Matt Nattinger, Keith J. Mueller
Date: 09/2014
Type: Document
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Access to Rural Health Care – A Literature Review and New Synthesis
Reviews relevant literature to help clarify the meaning of access in the context of rural healthcare. Focuses on four dimensions of access including people, place, provider, and payment, and notes that changes in one dimension affects the others. Recommends that policymakers address all dimensions of access throughout the policymaking process to ensure best outcomes.
Author(s): A. Clinton MacKinney, Andrew Coburn, Jennifer Lundblad, et al.
Date: 08/2014
Type: Document
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Improving Access to Comprehensive Healthcare for Veterans
Summarizes findings from recent VA research related to healthcare access. Includes studies on telemental health services for rural Veterans with PTSD (post-traumatic stress disorder), barriers for rural veterans at risk of suicide, and home-based primary care services for rural American Indian veterans who receive care from both VA and the Indian Health Service.
Date: 08/2014
Type: Document
Sponsoring organization: VA Health Services Research & Development Service
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Geographical and Seasonal Barriers to Mammography Services and Breast Cancer Stage at Diagnosis
Discusses the geographical and seasonal barriers affecting rural women in receiving routine mammography screening and early detection for breast cancer.
Author(s): Adedayo Onitilo, Hong Liang, Rachel Stankowski, et al.
Location: Rural and Remote Health, 14, 2738
Date: 07/2014
Type: Document
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Expanding the Dental Team: Increasing Access to Care in Public Settings
Looks at three examples of midlevel dental providers working to expand care to underserved populations. Highlights three practices in Minnesota, California, and Alaska, the latter deploying dental health aide therapists to distant rural locations.
Date: 06/2014
Type: Document
Sponsoring organization: Pew Charitable Trusts
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The Affordable Care Act and Insurance Coverage in Rural Areas
Examines differences in urban and rural populations and health insurance coverage patterns and assesses how ACA coverage reforms will affect rural and metropolitan areas in different ways.
Author(s): Vann Newkirk, Anthony Damico
Date: 05/2014
Type: Document
Sponsoring organization: Kaiser Family Foundation
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A Guide to Understanding the Variation in Premiums in Rural Health Insurance Marketplaces
Discusses several factors to consider when comparing health insurance plans in the health insurance exchange marketplace created by the Affordable Care Act across geographic areas.
Author(s): Abigail Barker, Timothy McBride, Leah Kemper, Keith Mueller
Date: 05/2014
Type: Document
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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High Deductible Health Insurance Plans in Rural Areas
Reports that rural residents with private insurance are more likely to have a high deductible health insurance plan (HDHP) than are urban residents, especially when they live in remote, rural areas. Among those covered by an HDHP, rural residents are more likely to have low incomes and more limited educational attainment than urban residents. This suggests that it will be important to monitor HDHP enrollment and plan affordability among plans available through the Health Insurance Marketplaces.
Author(s): Jennifer D. Lenardson, Erika C. Ziller, Andrew F. Coburn
Date: 05/2014
Type: Document
Sponsoring organization: Maine Rural Health Research Center
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Affordable Care Act Plans and Premiums in Rural America
Discusses insurance premium pricing for rural populations following the implementation of the Affordable Care Act. Offers recommendations to maximize the number of rural Americans who receive accessible, affordable health insurance.
Date: 04/2014
Type: Document
Sponsoring organization: National Advisory Committee on Rural Health and Human Services
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Health Coverage and Care in the South: A Chartbook
Provides key data on the demographic and economic characteristics of the Southern population as well as their health status, health insurance coverage, and access to care. Provides data on citizenship status, age, urban-rural composition, and income of residents in the South as well as the number of Rural Health Clinics and Federally Qualified Health Centers in the South.
Author(s): Jessica Stephens, Alexandra Gates, Vann Newkirk, Laura Snyder
Date: 04/2014
Type: Document
Sponsoring organization: Kaiser Family Foundation
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The Patient Protection and Affordable Care Act of 2010: Impacts on Rural People, Places, and Providers: A Second Look
Addresses the impact of the Patient Protection and Affordable Care Act on rural communities including the issues of health insurance coverage, Medicare and Medicaid payment, quality and delivery system reform, public health, healthcare workforce, and long-term care.
Author(s): Andrew F. Coburn, Jennifer P. Lundblad, A. Clinton MacKinney, et al.
Date: 04/2014
Type: Document
Sponsoring organization: Rural Policy Research Institute Rural Health Panel
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Health Insurance Coverage of Low-Income Rural Children Increases and Is More Continuous Following CHIP Implementation
Reports that prior to the passage of the Children’s Health Insurance Program (CHIP), about one in four low-income rural and urban children (family income below 200% of the federal poverty level) were uninsured in a given month. Using data from the Medical Expenditure Panel Survey, this study found that in the years following CHIP’s implementation health insurance coverage and continuity increased among low-income children, particularly for those living in rural areas. By CHIP’s maturity, coverage for rural children improved so much that their uninsured rate dropped below that of urban children (14% compared to 20%, respectively).
Author(s): Erika C. Ziller
Date: 03/2014
Type: Document
Sponsoring organization: Maine Rural Health Research Center
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Access Is the Answer: Community Health Centers, Primary Care & the Future of American Health Care
Discusses health insurance coverage through the Affordable Care Act as only part of a healthier America. Access to healthcare by ensuring a regular, reliable source of quality preventive and primary healthcare is another separate part of the healthcare equation. Includes information on healthcare inadequacy in rural areas.
Date: 03/2014
Type: Document
Sponsoring organization: National Association of Community Health Centers
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Health Disparities in Rural Women
Discusses the health disparities that exist for rural women in all categories of women's health, including obstetric and gynecologic outcomes and access to care.
Date: 02/2014
Type: Document
Sponsoring organization: American Congress of Obstetricians and Gynecologists
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Access to Chemotherapy Services by Availability of Local and Visiting Oncologists
Identifies the significant factors associated with choice of provider, cancer treatment and the travel time affecting access for rural residents in Iowa.
Author(s): Marcia M. Ward, Fred Ullrich, Kevin Matthews, et al.
Location: Journal of Oncology Practice, 10(1), 26-31
Date: 01/2014
Type: Document
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Evaluation of the Medicare Frontier Extended Stay Clinic Demonstration: Report to Congress
Reports on the results of a Medicare Frontier Extended Stay Clinic (FESC) demonstration project that used an enhanced clinic model in frontier areas to address the needs of seriously ill or injured patients who could not be transferred to a hospital or needed monitoring and observation for a limited period of time. Includes an overview of the demonstration and key findings from the project.
Date: 2014
Type: Document
Sponsoring organization: U.S. Department of Health and Human Services
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Uninsured Population in Nonmetropolitan Counties
Printable map that shows percent of population without health insurance nationwide by county. Data source: U.S. Census Bureau, 2014 Small Area Health Insurance Estimates (SAHIE) program.
Date: 2014
Type: Map/Mapping System
Sponsoring organization: Rural Health Information Hub
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Improving Rural Health: State Policy Options
Discusses strategies that states have used to improve healthcare in rural communities. Covers workforce pipeline initiatives, long-term care services, behavioral health, emergency medical services, wellness and prevention, rural health clinics, school-based health centers, telehealth, recruitment and retention of healthcare professionals, loan repayment programs, and community health workers.
Author(s): Kristine Goodwin, Laura Tobler
Date: 11/2013
Type: Document
Sponsoring organization: National Conference of State Legislatures
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CDC Health Disparities and Inequalities Report - United States, 2013
Addresses the differences in mortality and disease risk related to behaviors, access to health care, and social determinants of health in both rural and urban settings.
Location: MMWR (Morbidity and Mortality Weekly Report), 62(3)
Date: 11/2013
Type: Document
Sponsoring organization: Centers for Disease Control and Prevention
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Health Coverage and Care for American Indians and Alaska Natives
Issue brief describing the current health coverage and care for American Indians and Alaska Natives and potential implications of the Affordable Care Act (ACA) coverage expansions.
Additional links: Appendices, Executive Summary
Author(s): Samantha Artiga, Rachel Arguello, Philethea Duckett
Date: 10/2013
Type: Document
Sponsoring organization: Kaiser Family Foundation
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Removing Barriers to Care: Community Health Centers in Rural Areas
Discusses access to care in rural areas and reports that about half (48%) of community health centers in the United States are located in rural and frontier areas. Includes information on rural community health center patients and services.
Date: 10/2013
Type: Document
Sponsoring organization: National Association of Community Health Centers
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Characteristics of the Frontier Extended Stay Clinic: A New Facility Model
A descriptive study of the characteristics of Frontier Extended Stay Clinic (FESC) facilities and an analysis of patient utilization and outcomes.
Author(s): Rosyland Frazier, Sanna Doucette
Location: International Journal of Circumpolar Health, 72
Date: 08/2013
Type: Document
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Causes and Consequences of Rural Pharmacy Closures: A Multi-Case Study
Policy brief identifies factors that contributed to the closing of six rural pharmacies in different states and describes how the affected communities adapted to losing locally based services.
Author(s): Kelli Todd, Katie Westfall, Bill Doucette, Fred Ullrich, Keith Mueller
Date: 08/2013
Type: Document
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Increasing Access to Behavioral Health Care Through Technology
Presents insights on establishing a telebehavioral health program shared at a meeting convened by the U.S. Department of Health and Human Services (HHS) and the Health Resources and Services Administration’s (HRSA) Office of Special Health Affairs with participants from HRSA-funded health centers in urban and rural areas.
Date: 02/2013
Type: Document
Sponsoring organization: Health Resources and Services Administration
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A Population-Based Cross-Sectional Study of Health Service Deficits among U.S. Adults with Depressive Symptoms
Examines the prevalence of health service deficits in rural versus non-rural adults with depressive symptoms. Factors contributing to health service deficits include: no health insurance, no health provider, deferred medical care due to cost and no routine medical exam in the past year. Table 4 lists demographics of adults with current depressive symptoms by rural versus urban.
Author(s): Krista L. Huot, May Nawal Lutfiyya, Michael F. Akers, et al.
Location: BMC Health Services Research, 13, 160
Date: 2013
Type: Document
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Health Care Access and Use Among the Rural Uninsured
Examines access to care and service use among non-elderly, uninsured rural and urban residents compared to each other and to their insured counterparts.
Author(s): Erika C. Ziller, Jennifer D. Lenardson, Andrew F. Coburn
Date: 11/2011
Type: Document
Sponsoring organization: Maine Rural Health Research Center
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Health Decision-making Among Rural Women: Physician Access and Prescription Adherence
Presents findings from a study that explored physician access and prescription adherence among rural, low-income women. Suggests interventions and further research in order to improve access to care and improve the overall health and wellbeing of rural women.
Author(s): Erik Carlton, Leigh Ann Simmons
Location: Rural and Remote Health, 11, 1599
Date: 03/2011
Type: Document
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Impact of Employment Transitions on Health Insurance Coverage of Rural Residents
Explores the impact of changes in employment status on insurance coverage for rural and urban workers.
Additional links: Policy Brief: Many Urban and Rural Workers Lose Health Insurance During Job Transitions
Author(s): Nathaniel J. Anderson, Erika C. Ziller, Melanie M. Race, Andrew F. Coburn
Date: 10/2010
Type: Document
Sponsoring organization: Muskie School of Public Service Institute for Health Policy
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Availability, Characteristics, and Role of Detoxification Services in Rural Areas
Reports on rural detoxification (detox) providers, including their characteristics, access issues, and geographic distribution. Based on data from a national inventory of facilities providing substance abuse treatment services.
Additional links: Policy Brief: Few and Far Away: Detoxification Services in Rural Areas
Author(s): Jennifer D. Lenardson, Melanie M. Race, John A. Gale
Date: 12/2009
Type: Document
Sponsoring organization: Maine Rural Health Research Center
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Health Status and Health Care Access of Farm and Rural Populations
Discusses healthcare access and health status in rural areas, where the population is older, has lower education and income levels, and is more likely to be living in medically underserved areas. Also discusses health risks faced by farm families due to the work environment.
Additional links: Report Summary
Author(s): Carol Adaire Jones, Timothy S. Parker, Mary Ahearn, Ashok K. Mishra, Jayachandran N. Variyam
Date: 08/2009
Type: Document
Sponsoring organization: USDA Economic Research Service
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HUD's Homeless Assistance Programs: Rural Continuums of Care
Provides an overview of the challenges faced by the rural homeless population, including healthcare access barriers. Includes strategies for providers to help them meet the needs of homeless families and individuals who live in rural areas.
Date: 06/2009
Type: Document
Sponsoring organization: U.S. Department of Housing and Urban Development
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Private Health Insurance in Rural Areas: Challenges and Reform Options
Reports that rural residents are less likely than their urban counterparts to have private health insurance coverage.
Author(s): Erika Ziller, Andrew Coburn
Date: 04/2009
Type: Document
Sponsoring organization: Maine Rural Health Research Center
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The Crisis in Rural Dentistry
Lists issues related to oral health care in rural America. Discusses the need for intensified recruitment efforts to increase dental access and improve oral health in rural areas. Proposes potential solutions that may increase the rural oral health care workforce.
Author(s): Mark P. Doescher, Gina A. Keppel, Susan M. Skillman, Roger A. Rosenblatt
Date: 04/2009
Type: Document
Sponsoring organization: WWAMI Rural Health Research Center
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Health Disparities: A Rural-Urban Chartbook
Presents data on health disparities experienced by people living in rural America. Includes national and state-level data on health status, health behaviors, healthcare access, preventive care, and diabetes care.
Additional links: Executive Summary, Fact Sheet, December 2008
Author(s): Kevin J. Bennett, Bankole Olatosi, Janice C. Probst
Date: 06/2008
Type: Document
Sponsoring organization: South Carolina Rural Health Research Center
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Why Are Fewer Hospitals in the Delivery Business
Examines the declining availability of hospital-based obstetric services in rural areas from the mid-1980s to the early 2000s. It examines potential causes for this trend and explores the effects of medical malpractice reforms.
Author(s): Lan Zhao
Date: 04/2007
Type: Document
Sponsoring organization: NORC Walsh Center for Rural Health Analysis
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SHADAC: State Profiles
Provides national, state-level, and county-level statistics on health insurance coverage, access to care, care affordability, and service utilization for all fifty states.
Type: Website
Sponsoring organization: State Health Access Data Assistance Center
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Rural Transportation Toolkit
Resources and best practices to help communities develop transportation programs for rural residents to access healthcare and meet other health-related needs. Identifies program models and examples, and discusses implementation, evaluation, sustainability, and dissemination of program results.
Type: Website
Sponsoring organization: Rural Health Information Hub
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Small Area Health Insurance Estimates (SAHIE): Interactive Data and Mapping
Interactive map providing access to health insurance coverage data by county, with option to focus results by age, gender, race/ethnicity, and income.
Type: Map/Mapping System
Sponsoring organization: U.S. Census Bureau
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Rural Hospital Closures: January 2010 – Present
Interactive map displaying the location of rural hospital closures across the U.S. from January 2010 to present. Also provides a sortable, printable list containing important facility information about each closed hospital.
Type: Website
Sponsoring organization: North Carolina Rural Health Research Program
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PubMed Search: Rural Healthcare Access
Searches PubMed's collection of journal article citations on healthcare access and rural health.
Type: Literature Search
Sponsoring organization: National Library of Medicine
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Mobile Health Map
Provides a map of mobile health clinics across the country, which visually demonstrates the extensive network of communities served by mobile clinics. Offers mobile healthcare providers an online tool for calculating an ROI (return on investment) ratio for their mobile health services.
Type: Map/Mapping System
Sponsoring organization: Mobile Healthcare Association
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FastStats: Health of American Indian or Alaska Native Population
Contains health-related statistics for the American Indian or Alaska Native population. Statistics include: population, live births, health status, health risk factors, access to health care, mortality rates, and more.
Type: Website
Sponsoring organization: National Center for Health Statistics
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HealthCare.gov
A consumer website that provides one-stop information related to health insurance coverage, how to get covered, and requirements related to health insurance. A Spanish language version, CuidadoDeSalud.gov, is also available.
Type: Website
Sponsoring organization: U.S. Department of Health and Human Services
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Hill-Burton Free and Reduced Cost Health Care
Information on free or below cost health care available to people who meet poverty guidelines from certain health care facilities that received federal funds for construction or renovation under the Hill-Burton program.
Type: Website
Sponsoring organization: Health Resources and Services Administration
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InsureKidsNow.gov
Supplies information on free and low-cost health insurance programs for children including Medicaid and CHIP (Children's Health Insurance Program).
Type: Website
Sponsoring organization: U.S. Department of Health and Human Services
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State Health Facts
Contains state-level data on demographics, health status, healthcare costs and access, healthcare providers, and more. Individual state profiles and 50-state comparisons.
Type: Database
Sponsoring organization: Kaiser Family Foundation
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Additional resources are available related to this guide. See the full list of resources by topic for:


Last Updated: 11/14/2017