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Rural Health
Resources by Topic: Rural-urban differences

Impact of COVID-19 on Clinical Trials Costs to Patients
Examines the direct and indirect costs of COVID-19 clinical trial participation to patients and the impact of utilizing remote technologies. Presents an environmental scan of articles published between 2010 and 2023 and discusses barriers to clinical trial participation experienced by underrepresented and rural populations.
Author(s): Keri Calkins, Emily Crabtree, Emily Harrison, Nyna Williams, Kirsten Barrett
Date: 06/2025
Type: Document
Sponsoring organization: Mathematica
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Screening and Referral Programs for Diabetes and Cardiovascular Disease: Can Community Pharmacists Bridge the Care Gap?
Examines the community-based valued-driven care initiative (CVCI) in community pharmacies to evaluate its effectiveness related to screening and referral (S&R) to treat cardiovascular disease (CVD) and diabetes mellitus (DM). Analyzes patient demographics and success rates of CVD and DM S&R in 6 community pharmacies, with both rural and urban locations represented.
Author(s): Melanie Livet, Amber Watson, Shweta Pathak, et al.
Citation: Exploratory Research in Clinical and Social Pharmacy, 17, 100539
Date: 03/2025
Type: Document
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Impact of the Medicare Improvements for Patients And Providers Act on Mental Health Service Utilization And Spending among Older Adults
Examines the impact of the Medicare Improvements for Patients and Providers Act (MIPPA) on outpatient mental healthcare utilization. Utilizes 2008-2017 Medicare claims and administrative data to analyze MIPPA in a pre-implementation phase as well as 4 post-implementation phases. Includes data on mental healthcare outpatient visits by age group, race, dual eligibility status, substance use disorder, comorbidities, and urban, large rural, small rural, or isolated rural location.
Author(s): Matt Toth, Brent Gibbons, Abbie Levinson, et al.
Date: 01/2025
Type: Document
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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Postpartum Health Care Use in Medicaid During the COVID-19 Public Health Emergency: Implications for Extending Postpartum Coverage
Examines the impact of Medicaid continuous enrollment during the COVID-19 public health emergency (PHE) on postpartum healthcare utilization. Utilizes 2018-2023 claims data from the Centers for Medicare and Medicaid Services (CMS) Transformed Medicaid Statistical Information System (T-MSIS) to analyze a pre-PHE versus PHE cohort of women. Includes healthcare utilization data with breakdowns according to age, race/ethnicity, eligibility group (Medicaid or other form), rural versus urban location, maternity care desert status, severe maternal morbidity and/or chronic health condition, postpartum month, and state.
Author(s): Amelia Whitman, Anupama Warrier, Sarah Gordon, et al.
Date: 01/2025
Type: Document
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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Rural–Urban Disparities in State-Level Diabetes Prevalence Among US Adults, 2021
Analyzes diabetes disparities among rural and urban populations in 41 states in the U.S. Utilizes 2021 Behavioral Risk Factor Surveillance System data to examine rural versus urban disparities and odds ratios (OR) for diabetes in different states.
Author(s): Olga Khavjou, Zohra Tayebali, Pyone Cho, Kristopher Myers, Ping Zhang
Citation: Preventing Chronic Disease, 21
Date: 01/2025
Type: Document
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A Rural-Urban Analysis of Buprenorphine Therapy During and After Pregnancy Among the Commercially Insured
Explores the use of evidence-based buprenorphine treatment and adherence during the peri-pregnancy period among commercially insured individuals by rurality. Analyzes data on 1,331,040 people between 15 and 44 years-old with diagnosis codes for pregnancy and labor/delivery from January 1, 2015, to December 31, 2019.
Author(s): KariLynn Dowling-McClay, Bill Brooks, Daniel Krauss, et al.
Date: 01/2025
Type: Document
Sponsoring organization: ETSU/NORC Rural Health Research Center
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Projecting the Impact of the $2,000 Part D Out-Of-Pocket Cap for Medicare Part D Enrollees with High Prescription Drug Spending
Examines the impact of the Medicare Part D $2,000 cap on out-of-pocket prescription drugs. Provides projected savings according to low-income subsidy (LIS) status, state, and demographic characteristics, including urban, rural-micropolitan, rural-other, or unclassified geographic location.
Date: 01/2025
Type: Document
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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The State of Rural Minnesota: 2025
Presents an overview of rural Minnesota. Includes interactive county-level data and statistics on population migration, economic vitality, employment, income, race/ethnicity, rural versus urban comparisons, and more.
Author(s): Kelly Asche, Marnie Werner
Date: 01/2025
Type: Document
Sponsoring organization: Center for Rural Policy and Development
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Evaluating Medicare Advantage Benchmark Setting Methodology on Rural Counties
Examines how the current Medicare Advantage benchmark setting process and methods impact rural and urban counties. Presents data on the Medicare fee-for-service spending quartiles by metropolitan and non-metropolitan counties and the effects of caps on benchmark payments by geography.
Author(s): Dan M. Shane, Edmer Lazaro, Fred Ullrich, Keith Mueller
Date: 01/2025
Type: Document
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Medicaid's Role in Small Towns and Rural Areas
Discusses the roles Medicaid and the Children's Health Insurance Program (CHIP) play in providing health coverage to residents of small towns and rural areas. Presents data from the U.S. Census Bureau's American Community Survey (ACS) on the percentage of children, non-elderly adults, and older adults covered by Medicaid and CHIP in 2023, and compares the share of Medicaid coverage of these groups by metro areas and small town/rural residence. Describes Medicaid coverage of American Indian and Alaska Native (AI/AN) in metro and non-metro areas. Includes lists of the top 20 small towns and rural areas with the highest share of children, non-elderly adults, and older adults covered by Medicaid.
Author(s): Joan Alker, Aubrianna Osorio, Edwin Park
Date: 01/2025
Type: Document
Sponsoring organization: Georgetown University Health Policy Institute
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