Rural Health
Resources by Topic: Healthcare business and finance
Drive Time to Care and Retention in HIV Care: Rural–Urban Differences Among Medicaid Enrollees in the United States South
Presents a study on the role geography plays in HIV care retention and maintenance. Draws data from Medicaid enrollees in 13 southern states including the District of Columbia and compares patient drive times to care in rural and urban areas. Breaks down data by county social determinants of health, healthcare supply, and HIV prevalence, as well as patient characteristics.
Author(s): April D. Kimmel, Rose S. Bono, Zhongzhe Pan, et al.
Citation: Journal of Rural Health, 41(1), e12877
Date: 2025
Type: Document
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Presents a study on the role geography plays in HIV care retention and maintenance. Draws data from Medicaid enrollees in 13 southern states including the District of Columbia and compares patient drive times to care in rural and urban areas. Breaks down data by county social determinants of health, healthcare supply, and HIV prevalence, as well as patient characteristics.
Author(s): April D. Kimmel, Rose S. Bono, Zhongzhe Pan, et al.
Citation: Journal of Rural Health, 41(1), e12877
Date: 2025
Type: Document
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The Uneven Impact of Medicaid Expansion on Rural and Urban Black, Latino/a, and White Mortality
Examines mortality rates and the corresponding impact of Medicaid expansion on Black, Latino/a, and White populations, broken down by rural versus urban location. Utilizes 2009-2019 data of Average Treatment Effect on the Treated (ATET) estimates to provide statistical breakdowns and graphic representation of how Medicaid expansion has impacted mortality rates for varying populations.
Author(s): J. Tom Mueller, Regina S. Baker, Matthew M. Brooks
Citation: Journal of Rural Health, 41(1), e12859
Date: 2025
Type: Document
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Examines mortality rates and the corresponding impact of Medicaid expansion on Black, Latino/a, and White populations, broken down by rural versus urban location. Utilizes 2009-2019 data of Average Treatment Effect on the Treated (ATET) estimates to provide statistical breakdowns and graphic representation of how Medicaid expansion has impacted mortality rates for varying populations.
Author(s): J. Tom Mueller, Regina S. Baker, Matthew M. Brooks
Citation: Journal of Rural Health, 41(1), e12859
Date: 2025
Type: Document
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How Community Health Centers Respond to Rural Hospital Closures
Describes how community health centers work to fill gaps in healthcare services and impact the economy when a local rural hospital closes.
Author(s): Nick Widmyer, Lena Ben-Gideon
Date: 12/2024
Type: Document
Sponsoring organization: National Association of Community Health Centers
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Describes how community health centers work to fill gaps in healthcare services and impact the economy when a local rural hospital closes.
Author(s): Nick Widmyer, Lena Ben-Gideon
Date: 12/2024
Type: Document
Sponsoring organization: National Association of Community Health Centers
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The Pennsylvania Rural Health Model (PARHM): Fourth Annual Evaluation Report
Evaluates the fourth performance year of the Pennsylvania Rural Health Model (PARHM), an initiative designed to test if global budgets can help rural hospitals improve their financial viability, provide flexibility to meet locally defined community health needs, and reduce overall healthcare spending. Provides an overview of the model and describes the implementation experience of participating hospitals and payers. Presents a descriptive quantitative assessment of financial performance, spending and utilization, access to care, and quality of care outcomes from 2016, the model's baseline, through 2022. Includes three case studies discussing three themes: experiences with global budget reconciliation, behavioral health transformation, and interactions and alignment between PARHM and other value-based care programs.
Additional links: Appendix, Findings at a Glance
Date: 12/2024
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Evaluates the fourth performance year of the Pennsylvania Rural Health Model (PARHM), an initiative designed to test if global budgets can help rural hospitals improve their financial viability, provide flexibility to meet locally defined community health needs, and reduce overall healthcare spending. Provides an overview of the model and describes the implementation experience of participating hospitals and payers. Presents a descriptive quantitative assessment of financial performance, spending and utilization, access to care, and quality of care outcomes from 2016, the model's baseline, through 2022. Includes three case studies discussing three themes: experiences with global budget reconciliation, behavioral health transformation, and interactions and alignment between PARHM and other value-based care programs.
Additional links: Appendix, Findings at a Glance
Date: 12/2024
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Rural-Urban Medicaid and CHIP Enrollee Comparisons Using the 2019 T-MSIS Analytic File
Compares urban and rural residents enrolled in fee-for-service or managed care Medicaid, using data from the 2019 Transformed Medicaid Statistical Information System (T-MSIS) Analytic Files (TAF). Features demographics and statistics on Medicaid enrollment, with breakdowns by levels of rurality.
Author(s): Kristie Thompson, Hannah Friedman, Lily Wang, Mark Holmes
Date: 12/2024
Type: Document
Sponsoring organization: North Carolina Rural Health Research Program
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Compares urban and rural residents enrolled in fee-for-service or managed care Medicaid, using data from the 2019 Transformed Medicaid Statistical Information System (T-MSIS) Analytic Files (TAF). Features demographics and statistics on Medicaid enrollment, with breakdowns by levels of rurality.
Author(s): Kristie Thompson, Hannah Friedman, Lily Wang, Mark Holmes
Date: 12/2024
Type: Document
Sponsoring organization: North Carolina Rural Health Research Program
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Utilization of Inpatient and Emergency Services by Rural and Urban Medicaid Enrollees
Analyzes differences in healthcare utilization among rural versus urban Medicaid enrollees. Utilizes 2019 Transformed Medicaid Statistical Information System (T-MSIS) Analytic Files data to examine inpatient and emergency department (ED) use by Rural Urban Commuting Area (RUCA) codes of metropolitan, large rural, small rural, and isolated rural Medicaid populations as well as Frontier and Remote (FAR) area codes. Includes additional demographic breakdowns by age, race/ethnicity, and sex.
Author(s): Hannah Friedman, Kristie Thompson, Lily Wang, Mark Holmes
Date: 12/2024
Type: Document
Sponsoring organization: North Carolina Rural Health Research Program
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Analyzes differences in healthcare utilization among rural versus urban Medicaid enrollees. Utilizes 2019 Transformed Medicaid Statistical Information System (T-MSIS) Analytic Files data to examine inpatient and emergency department (ED) use by Rural Urban Commuting Area (RUCA) codes of metropolitan, large rural, small rural, and isolated rural Medicaid populations as well as Frontier and Remote (FAR) area codes. Includes additional demographic breakdowns by age, race/ethnicity, and sex.
Author(s): Hannah Friedman, Kristie Thompson, Lily Wang, Mark Holmes
Date: 12/2024
Type: Document
Sponsoring organization: North Carolina Rural Health Research Program
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Hospital Margins Rebounded in 2023, But Rural Hospitals and Those With High Medicaid Shares Were Struggling More Than Others
Examines hospital margins for non-federal general short-term hospitals in the U.S. from 2018 through 2023, with a focus on operating margins. Analyzes RAND Hospital Data to explore the extent to which hospitals profited or lost money on patient care and other operating activities. Discusses differences in operating margins by hospital characteristics, including hospital ownership type, commercial share, size, rural or urban location, and Medicare rural payment designation.
Date: 12/2024
Type: Document
Sponsoring organization: KFF
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Examines hospital margins for non-federal general short-term hospitals in the U.S. from 2018 through 2023, with a focus on operating margins. Analyzes RAND Hospital Data to explore the extent to which hospitals profited or lost money on patient care and other operating activities. Discusses differences in operating margins by hospital characteristics, including hospital ownership type, commercial share, size, rural or urban location, and Medicare rural payment designation.
Date: 12/2024
Type: Document
Sponsoring organization: KFF
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Extended Reality Telehealth for Rural Spaces
Discusses how extended reality technologies, including virtual reality, augmented reality, and immersive mixed reality, can be used in physical and occupational therapy, mental healthcare, elder care, and veterans healthcare services. Describes potential barriers to implementing extended reality telehealth practices, focusing on rural providers and facilities. Highlights examples of rural broadband and healthcare providers collaborating to implement telehealth services.
Author(s): Joshua Seidemann
Date: 12/2024
Type: Document
Sponsoring organization: NTCA: The Rural Broadband Association
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Discusses how extended reality technologies, including virtual reality, augmented reality, and immersive mixed reality, can be used in physical and occupational therapy, mental healthcare, elder care, and veterans healthcare services. Describes potential barriers to implementing extended reality telehealth practices, focusing on rural providers and facilities. Highlights examples of rural broadband and healthcare providers collaborating to implement telehealth services.
Author(s): Joshua Seidemann
Date: 12/2024
Type: Document
Sponsoring organization: NTCA: The Rural Broadband Association
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Critical Access Hospital Financial Sustainability Guide
Provides guidance and assistance to state Medicare Rural Hospital Flexibility (Flex) Program personnel, leaders of Critical Access Hospitals (CAHs), and others helping CAHs manage long-term financial stability. Presents potential interventions CAHs may use to address ongoing and systemic financial challenges in rural healthcare.
Date: 12/2024
Type: Document
Sponsoring organizations: EideBailly, National Rural Health Resource Center
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Provides guidance and assistance to state Medicare Rural Hospital Flexibility (Flex) Program personnel, leaders of Critical Access Hospitals (CAHs), and others helping CAHs manage long-term financial stability. Presents potential interventions CAHs may use to address ongoing and systemic financial challenges in rural healthcare.
Date: 12/2024
Type: Document
Sponsoring organizations: EideBailly, National Rural Health Resource Center
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Market Selection Insights for New Mental Healthcare Facilities in Rural Illinois
Analyzes rural areas in Illinois that have an appropriate demand center, traffic flow, and mental healthcare need to locate a new mental healthcare facility. Provides a metro versus nonmetro list of residential mental health and substance use facilities as well as projected finances of a new mental health facility in a nonmetro location.
Author(s): Adee Athiyaman
Date: 12/2024
Type: Document
Sponsoring organization: Illinois Institute for Rural Affairs
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Analyzes rural areas in Illinois that have an appropriate demand center, traffic flow, and mental healthcare need to locate a new mental healthcare facility. Provides a metro versus nonmetro list of residential mental health and substance use facilities as well as projected finances of a new mental health facility in a nonmetro location.
Author(s): Adee Athiyaman
Date: 12/2024
Type: Document
Sponsoring organization: Illinois Institute for Rural Affairs
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