Rural Health Policy – Resources

The Effectiveness of Policies to Improve Primary Care Access for Underserved Populations: An Assessment of the Literature
Review of research literature to assess whether policy initiatives targeting primary care access for rural and underserved populations has been effective in reducing healthcare disparities. Initiatives considered include availability, accessibility, accommodation, affordability, and acceptability.
Additional links: Fact Sheet: Alleviating Structural Barriers to Obtaining Primary Care Services, Fact Sheet: Bringing Outpatient Clinics into Communities, Fact Sheet: Ensuring Comfort and Communication in the Delivery of Primary Care Services, Fact Sheet: Increasing the Availability of Primary Care Clinicians, Fact Sheet: Removing Financial Barriers to Primary Care
Author(s): Maanasa Kona, Megan Houston, Nia Gooding
Date: 01/2022
Sponsoring organization: Milbank Memorial Fund
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ASTHO Legislative Prospectus: Rural Health
Discusses legislative trends to support rural healthcare access and facilities. Includes information on developing loan repayment programs for medical providers in rural areas, supporting behavioral healthcare, expanding telehealth, and creating broadband infrastructure.
Date: 12/2021
Sponsoring organization: Association of State and Territorial Health Officials
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Public Health Forward: Modernizing the U.S. Public Health System
Provides a framework for policymakers and public health officials to guide investments and decision-making to implement a public health system to address challenges beyond the COVID-19 pandemic with a focus on equity. Covers six core areas: financing, laws and governance, community engagement, partnerships, workforce, and data and information technology. Highlights challenges and considerations for rural communities and Tribal nations throughout.
Date: 12/2021
Sponsoring organization: Bipartisan Policy Center
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Medicare: Information on the Transition to Alternative Payment Models by Providers in Rural, Health Professional Shortage, or Underserved Areas
Describes the participation of providers in rural and health professional shortage areas in Advanced APMs from 2017 through 2019. Discusses challenges providers in rural, shortage, and underserved areas face in transitioning to APMs, as well as actions CMS takes to help these providers transition to APMs. Includes data by practice and provider type.
Additional links: Full Report
Date: 11/2021
Sponsoring organization: Government Accountability Office
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Medicaid and Housing Partnerships: A Resource for Local Health Departments
Explores how local health departments (LHDs) in rural areas can utilize Medicaid managed care levers to address homelessness and housing security issues. Summarizes results from a gap analysis and readiness assessment which identified key opportunities to help prepare 3 LHDs in rural North Carolina counties for the transition to Medicaid-managed care. Identifies action steps for these counties to strengthen housing supports that can also inform similar initiatives in other states.
Author(s): Matthew Ralls, Kathy Moses, Rob Houston
Date: 07/2021
Sponsoring organization: Center for Health Care Strategies
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Medicaid and Rural Health
Provides an overview of rural residents, including socioeconomic characteristics, insurance status, and health status. Explores the availability of healthcare providers in rural areas, with a focus on primary care providers and hospitals. Discusses the role of Medicaid in rural health, as well as Medicaid policies and services that are important for providing healthcare in rural communities.
Date: 04/2021
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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Supporting and Sustaining Rural Hospitals
Describes state and federal actions to support and safeguard rural hospitals. Discusses appropriated funding opportunities for struggling hospitals, Medicaid coverage and eligibility, alternative payment models, and technical assistance programs.
Author(s): Noah Cruz
Date: 04/2021
Sponsoring organization: National Conference of State Legislatures
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American Rescue Plan Act of 2021 (P.L. 117-2): Private Health Insurance, Medicaid, CHIP, and Medicare Provisions
Provides an overview of the provisions of the American Rescue Plan Act of 2021 that relate to private health insurance, Medicaid, the State Children's Health Insurance Program (CHIP), and Medicare. Includes information on provisions specific to rural providers.
Date: 04/2021
Sponsoring organization: Congressional Research Service
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Determining Rural Communities: Current Changes and Updated Federal Program Eligibility
Presentation slides from a March 11, 2021, webinar discussing the various definitions of rural used by the federal government. Provides an overview of revisions to the eligibility for grant programs administered by the Federal Office of Rural Health Policy (FORHP), as well as a proposal from the U.S. Census Bureau to reclassify certain counties as rural. Describes implications for FORHP funding programs.
Date: 03/2021
Sponsoring organizations: Federal Office of Rural Health Policy, National Organization of State Offices of Rural Health
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Geographic Expansion of Medicaid Managed Care Organizations: Assessing Access to Primary Care in Nonmetropolitan Counties
Presents a study on primary care access for Medicaid beneficiaries in nonmetropolitan counties who were enrolled through managed care organizations (MCOs) from 2012 to 2018. Details the level of access to primary care in the nonmetropolitan counties of 15 states and compares the rates of access for beneficiaries enrolled through MCOs established before 2012 and after 2012. Discusses findings and makes recommendations for policy makers.
Author(s): Linda Li, Matthew Najarian, Abigail R. Barker, et al.
Date: 03/2021
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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