Rural Health
Resources by Topic: Policy
Billing of Distant Site Telehealth Services in Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs)
Presents instructions on how Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs) should bill distant site telehealth services for services provided on or after October 1, 2026.
Date: 05/2026
Sponsoring organization: Centers for Medicare & Medicaid Services
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Presents instructions on how Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs) should bill distant site telehealth services for services provided on or after October 1, 2026.
Date: 05/2026
Sponsoring organization: Centers for Medicare & Medicaid Services
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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
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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
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The Decentralized Academic Health Center: A 21st-Century Model for Rural Health Innovation
Discusses the role of academic health centers in addressing rural health needs and proposes the Decentralized Academic Health Center (D-AHC) model. Compares the traditional model with D-AHC and discusses implementation through teaching and workforce, research and data, clinical partnerships and digital health, community engagement and policy, financial sustainability, and provider and community readiness. Includes a 5-phase roadmap for implementation.
Author(s): Patrick C. Hardigan, Johannes Vieweg
Citation: Health Affairs Scholar, 4(5)
Date: 05/2026
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Discusses the role of academic health centers in addressing rural health needs and proposes the Decentralized Academic Health Center (D-AHC) model. Compares the traditional model with D-AHC and discusses implementation through teaching and workforce, research and data, clinical partnerships and digital health, community engagement and policy, financial sustainability, and provider and community readiness. Includes a 5-phase roadmap for implementation.
Author(s): Patrick C. Hardigan, Johannes Vieweg
Citation: Health Affairs Scholar, 4(5)
Date: 05/2026
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Governors' Policy Actions on Behavioral Health Access
Provides examples of behavioral health priorities outlined in state Rural Health Transformation Programs, including integrated care models, scaling telehealth services, and workforce incentives. Describes how states can incorporate supplemental grant funding to promote sustainable growth of the behavioral health workforce.
Date: 05/2026
Sponsoring organization: National Governors Association
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Provides examples of behavioral health priorities outlined in state Rural Health Transformation Programs, including integrated care models, scaling telehealth services, and workforce incentives. Describes how states can incorporate supplemental grant funding to promote sustainable growth of the behavioral health workforce.
Date: 05/2026
Sponsoring organization: National Governors Association
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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
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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
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States Find Innovative Ways to Support Rural and Small Water Systems
Discusses strategies that state have implemented to provide clean and affordable water to rural communities. Highlights maintenance costs of small water systems, funding challenges, and provides successful practices for states to support local water systems.
Date: 05/2026
Sponsoring organization: Pew
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Discusses strategies that state have implemented to provide clean and affordable water to rural communities. Highlights maintenance costs of small water systems, funding challenges, and provides successful practices for states to support local water systems.
Date: 05/2026
Sponsoring organization: Pew
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How Do Changes in Medicare Reimbursement for Mental Health Services Impact Access for Rural Older Adults?
Examines how policies allowing marriage and family therapists (MFTs) and mental health counselors (MHCs) to independently bill Medicare have impacted mental healthcare access among Medicare beneficiaries living in rural areas. Utilizes interview data from 14 leaders representing rural health systems and mental health organizations regarding their perceptions on mental healthcare access, Medicare reimbursement policy, and the inclusion of MFTs and MHCs as mental health providers for Medicare recipients.
Author(s): Natalia V. Oster, C. Holly A. Andrilla, Davis G. Patterson, Signe Burchim, Janessa M. Graves
Citation: Journal of Rural Health, 42(2), e70162
Date: 05/2026
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Examines how policies allowing marriage and family therapists (MFTs) and mental health counselors (MHCs) to independently bill Medicare have impacted mental healthcare access among Medicare beneficiaries living in rural areas. Utilizes interview data from 14 leaders representing rural health systems and mental health organizations regarding their perceptions on mental healthcare access, Medicare reimbursement policy, and the inclusion of MFTs and MHCs as mental health providers for Medicare recipients.
Author(s): Natalia V. Oster, C. Holly A. Andrilla, Davis G. Patterson, Signe Burchim, Janessa M. Graves
Citation: Journal of Rural Health, 42(2), e70162
Date: 05/2026
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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
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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
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Governors' Policy Actions in Rural Health Workforce
Describes policy actions taken by governors to advance healthcare career pathways, education and training, and recruitment and retention, as well as policies related to licensure and scope of practice. Includes examples from state Rural Health Transformation Program project narratives.
Date: 05/2026
Sponsoring organization: National Governors Association
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Describes policy actions taken by governors to advance healthcare career pathways, education and training, and recruitment and retention, as well as policies related to licensure and scope of practice. Includes examples from state Rural Health Transformation Program project narratives.
Date: 05/2026
Sponsoring organization: National Governors Association
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A Look at New or Expanded Medicaid and Public Health Partnerships from 2025: Findings from A Survey of State Medicaid Programs
Identifies themes from a survey of state Medicaid directors regarding new or expanded public health initiatives that were implemented in fiscal year (FY) 2025 or planned for FY 2026. Summarizes initiatives related to maternal and child health, child and youth mental health, opioid use disorder (OUD), lead screening, infectious disease, and workforce. Describes rural-related initiatives and examples throughout.
Author(s): Alisha Rao, Anna Mudumala, Elizabeth Hinton, Cory Caldwell
Date: 05/2026
Sponsoring organization: KFF
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Identifies themes from a survey of state Medicaid directors regarding new or expanded public health initiatives that were implemented in fiscal year (FY) 2025 or planned for FY 2026. Summarizes initiatives related to maternal and child health, child and youth mental health, opioid use disorder (OUD), lead screening, infectious disease, and workforce. Describes rural-related initiatives and examples throughout.
Author(s): Alisha Rao, Anna Mudumala, Elizabeth Hinton, Cory Caldwell
Date: 05/2026
Sponsoring organization: KFF
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