Rural Health
Resources by Topic: Healthcare quality
When Ambulances Wait at the Emergency Department: Hospital Factors and Offload times in California
Analyzes ambulance patient offload time (APOT) between emergency medical services (EMS) and 310 emergency departments (ED) in California in 2022 to determine associations with hospital characteristics including rurality and number of ED treatment stations. The study data precedes a 2023 state law establishing statewide standards for APOT and so aims to offer baseline metrics for understanding policy impact.
Author(s): Esmeralda Melgoza, Madeline Fedmeier, Crystal Chen, Hiram Beltrán-Sánchez, Renee Y. Hsia
Citation: Health Affairs Scholar, 4(5)
Date: 05/2026
view details
Analyzes ambulance patient offload time (APOT) between emergency medical services (EMS) and 310 emergency departments (ED) in California in 2022 to determine associations with hospital characteristics including rurality and number of ED treatment stations. The study data precedes a 2023 state law establishing statewide standards for APOT and so aims to offer baseline metrics for understanding policy impact.
Author(s): Esmeralda Melgoza, Madeline Fedmeier, Crystal Chen, Hiram Beltrán-Sánchez, Renee Y. Hsia
Citation: Health Affairs Scholar, 4(5)
Date: 05/2026
view details
Dementia Diagnostic Deserts: Workforce and Geographic Inequities in the Diagnostic Pathway for Cognitive Impairment
Describes the "Triple Disadvantage Zones" or the places where rurality, Primary Care Health Professional Shortage Areas, and social deprivation converge to create a dementia diagnostic desert resulting in both delayed diagnosis and over-testing. Discusses training gaps for nurse practitioners and physician assistants as well as policy measures to mitigate diagnosis errors.
Author(s): Zhijing Xu, Ying Xue, Yaguang Zheng, Bei Wu
Citation: Health Affairs Scholar, 4(5)
Date: 05/2026
view details
Describes the "Triple Disadvantage Zones" or the places where rurality, Primary Care Health Professional Shortage Areas, and social deprivation converge to create a dementia diagnostic desert resulting in both delayed diagnosis and over-testing. Discusses training gaps for nurse practitioners and physician assistants as well as policy measures to mitigate diagnosis errors.
Author(s): Zhijing Xu, Ying Xue, Yaguang Zheng, Bei Wu
Citation: Health Affairs Scholar, 4(5)
Date: 05/2026
view details
2024 QPP Participation and Performance Results: At-a-Glance
Provides an overview of the results of the Quality Payment Program (QPP) for the 2024 performance year. Highlights the percentages of small and rural providers receiving negative, neutral, and positive payment adjustments for 2026.
Date: 05/2026
Sponsoring organization: Centers for Medicare & Medicaid Services
view details
Provides an overview of the results of the Quality Payment Program (QPP) for the 2024 performance year. Highlights the percentages of small and rural providers receiving negative, neutral, and positive payment adjustments for 2026.
Date: 05/2026
Sponsoring organization: Centers for Medicare & Medicaid Services
view details
Tennessee's Community Health Worker Strategy Is Succeeding. Which State Will Be Next?
Discusses the role community health workers (CHWs) can play in improving healthcare outcomes and addressing unmet needs in both rural and urban communities. Details Tennessee's state-funded implementation of a evidence-based CHW infrastructure, and highlights the outcomes over the first two years of the program. Explores how this approach could be implemented in other states.
Author(s): Victor Wu, Brea Burke, Nikayla Boyd, et al.
Citation: Health Affairs Forefront
Date: 05/2026
view details
Discusses the role community health workers (CHWs) can play in improving healthcare outcomes and addressing unmet needs in both rural and urban communities. Details Tennessee's state-funded implementation of a evidence-based CHW infrastructure, and highlights the outcomes over the first two years of the program. Explores how this approach could be implemented in other states.
Author(s): Victor Wu, Brea Burke, Nikayla Boyd, et al.
Citation: Health Affairs Forefront
Date: 05/2026
view details
Beyond the Shortage: What Rural Medicine Still Gets Right
Commentary describing the importance of continuity in rural healthcare, leading to better outcomes and increased patient trust. Discusses the advantages of clinicians knowing their patients well.
Author(s): James R. Burmeister, Ida J. Rubino
Citation: Family Medicine, 58(5), 370-371
Date: 05/2026
view details
Commentary describing the importance of continuity in rural healthcare, leading to better outcomes and increased patient trust. Discusses the advantages of clinicians knowing their patients well.
Author(s): James R. Burmeister, Ida J. Rubino
Citation: Family Medicine, 58(5), 370-371
Date: 05/2026
view details
Changes in Staffing, Resident Health, Closure, and Financial Performance of Rural Nursing Homes from 2017 to 2022
Examines changes in various characteristics of nursing homes, using data from 2017-2022. Features statistics with breakdowns by metropolitan, micropolitan, and small/isolated rural areas.
Author(s): Gulrukh Mehboob, Hari Sharma, Fred Ullrich, Keith Mueller
Date: 05/2026
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
view details
Examines changes in various characteristics of nursing homes, using data from 2017-2022. Features statistics with breakdowns by metropolitan, micropolitan, and small/isolated rural areas.
Author(s): Gulrukh Mehboob, Hari Sharma, Fred Ullrich, Keith Mueller
Date: 05/2026
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
view details
2026 Merit-Based Incentive Payment System Automatic Extreme and Uncontrollable Circumstances Policy
Addresses the automatic Merit-Based Incentive Payment System (MIPS) extreme and uncontrollable circumstances (EUC) policy as it applies to individual MIPS eligible clinicians for 2026. Table 2 features information on reweighting for clinicians in a small practice.
Date: 05/2026
Sponsoring organization: Centers for Medicare & Medicaid Services
view details
Addresses the automatic Merit-Based Incentive Payment System (MIPS) extreme and uncontrollable circumstances (EUC) policy as it applies to individual MIPS eligible clinicians for 2026. Table 2 features information on reweighting for clinicians in a small practice.
Date: 05/2026
Sponsoring organization: Centers for Medicare & Medicaid Services
view details
Trends in Medicare Advantage Quality for Nonmetropolitan Enrollees, 2019-2023
Examines quality of care in Medicare Advantage (MA) plans by geography, region, and plan type. Analyzes average ratings of 2019-2023 MA plans on a 1-5 star rating scale according to metro, micro, or noncore rural location. Provides additional data on MA enrollments by rural concentration of contracts as well as star ratings by benchmark quartile and quality bonus capping.
Author(s): Abigail Barker, Eliot Jost, Timothy McBride, Keith J. Mueller
Date: 05/2026
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
view details
Examines quality of care in Medicare Advantage (MA) plans by geography, region, and plan type. Analyzes average ratings of 2019-2023 MA plans on a 1-5 star rating scale according to metro, micro, or noncore rural location. Provides additional data on MA enrollments by rural concentration of contracts as well as star ratings by benchmark quartile and quality bonus capping.
Author(s): Abigail Barker, Eliot Jost, Timothy McBride, Keith J. Mueller
Date: 05/2026
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
view details
Merit-based Incentive Payment System (MIPS): 2026 MIPS Promoting Interoperability Performance Category Hardship Exception Application Guide
Provides guidance on how clinicians can apply for a MIPS hardship exception. Highlights guidance for having your MIPS Promoting Interoperability performance category reweighted to 0% in cases of insufficient internet connectivity, decertified electronic health record technology, or other circumstances out of the clinicians' control.
Date: 05/2026
Sponsoring organization: Centers for Medicare & Medicaid Services
view details
Provides guidance on how clinicians can apply for a MIPS hardship exception. Highlights guidance for having your MIPS Promoting Interoperability performance category reweighted to 0% in cases of insufficient internet connectivity, decertified electronic health record technology, or other circumstances out of the clinicians' control.
Date: 05/2026
Sponsoring organization: Centers for Medicare & Medicaid Services
view details
Telehealth Resource Center Skills Matrix
Outlines the technical assistance and subject matter expertise of the 14 federally funded Telehealth Resource Centers in specific telehealth topics, clinical specialties, and areas of telehealth implementation.
Date: 05/2026
Sponsoring organization: National Consortium of Telehealth Resource Centers
view details
Outlines the technical assistance and subject matter expertise of the 14 federally funded Telehealth Resource Centers in specific telehealth topics, clinical specialties, and areas of telehealth implementation.
Date: 05/2026
Sponsoring organization: National Consortium of Telehealth Resource Centers
view details