Rural Health
Resources by Topic: Scope of practice
State Strategies to Support the Future of the Primary Care Physician and Nursing Workforce
Discusses primary care physician and nursing workforce challenges, including the shortage of these providers in rural and underserved areas. Describes policies and strategies implemented by states to address these challenges. Offers resources for states, health systems, and academic institutions exploring innovative strategies to address healthcare workforce challenges.
Author(s): Elaine Chhean, Anita Cardwell, Lauren Block, Sarah Tocher
Date: 12/2022
Sponsoring organization: National Academy for State Health Policy
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Discusses primary care physician and nursing workforce challenges, including the shortage of these providers in rural and underserved areas. Describes policies and strategies implemented by states to address these challenges. Offers resources for states, health systems, and academic institutions exploring innovative strategies to address healthcare workforce challenges.
Author(s): Elaine Chhean, Anita Cardwell, Lauren Block, Sarah Tocher
Date: 12/2022
Sponsoring organization: National Academy for State Health Policy
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'Filling the Cracks': How a Rural Maine Community Kept its 24/7 Urgent Care Open with Paramedics
Features a pilot program serving rural Maine where paramedics take shifts staffing the local health center after-hours and on weekends.
Author(s): Gretel Kauffman
Citation: Rural Monitor
Date: 10/2022
Sponsoring organization: Rural Health Information Hub
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Features a pilot program serving rural Maine where paramedics take shifts staffing the local health center after-hours and on weekends.
Author(s): Gretel Kauffman
Citation: Rural Monitor
Date: 10/2022
Sponsoring organization: Rural Health Information Hub
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Provider and Patient Satisfaction With the Dental Therapy Workforce at Apple Tree Dental
Describes satisfaction of clinical providers, organizational administrators, and patients with the dental therapy workforce at Apple Tree Dental Centers, a not-for-profit community dental organization with locations in urban and rural Minnesota. Features demographics with breakdowns by urban or rural location of clinic and residence of patients.
Author(s): Margaret Langelier, Simona Surdu, Ellen O'Malley
Date: 05/2022
Sponsoring organization: Center for Health Workforce Studies
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Describes satisfaction of clinical providers, organizational administrators, and patients with the dental therapy workforce at Apple Tree Dental Centers, a not-for-profit community dental organization with locations in urban and rural Minnesota. Features demographics with breakdowns by urban or rural location of clinic and residence of patients.
Author(s): Margaret Langelier, Simona Surdu, Ellen O'Malley
Date: 05/2022
Sponsoring organization: Center for Health Workforce Studies
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The Northern Border Region: A Health-Focused Landscape Analysis
Chartbook examining population health and healthcare access for Maine, New Hampshire, New York, and Vermont, and for the region overall. Identifies strengths and assets of the Northern Border region states, as well as opportunities for improvement. Features demographics and statistics on quality of care, health outcomes, health behaviors, mortality rates and causes, Health Professional Shortage Areas, telehealth policies, and telehealth grants awarded from 2018-2021. Includes maps showing locations of substance use treatment facilities, Rural Health Clinics, Federally Qualified Health Centers, and hospitals.
Author(s): Katherine Ahrens, Amanda Burgess, Carly Milkowski, et al.
Date: 04/2022
Sponsoring organizations: Maine Rural Health Research Center, Northern Border Regional Commission
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Chartbook examining population health and healthcare access for Maine, New Hampshire, New York, and Vermont, and for the region overall. Identifies strengths and assets of the Northern Border region states, as well as opportunities for improvement. Features demographics and statistics on quality of care, health outcomes, health behaviors, mortality rates and causes, Health Professional Shortage Areas, telehealth policies, and telehealth grants awarded from 2018-2021. Includes maps showing locations of substance use treatment facilities, Rural Health Clinics, Federally Qualified Health Centers, and hospitals.
Author(s): Katherine Ahrens, Amanda Burgess, Carly Milkowski, et al.
Date: 04/2022
Sponsoring organizations: Maine Rural Health Research Center, Northern Border Regional Commission
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Learning From COVID-19-Related Flexibilities: Moving Toward More Person-Centered Medicare and Medicaid Programs
Presents a person-centered framework to facilitate policymakers' decisions regarding the future of COVID-19-related temporary regulatory flexibilities. Identifies priority flexibilities that should be considered for permanence, modification, or further evaluation. Covers regulatory flexibilities regarding telehealth, scope of practice, Medicare Advantage requirements, and more. Includes rural references throughout.
Date: 03/2022
Sponsoring organizations: Health Management Associates, Manatt Health, The Scan Foundation
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Presents a person-centered framework to facilitate policymakers' decisions regarding the future of COVID-19-related temporary regulatory flexibilities. Identifies priority flexibilities that should be considered for permanence, modification, or further evaluation. Covers regulatory flexibilities regarding telehealth, scope of practice, Medicare Advantage requirements, and more. Includes rural references throughout.
Date: 03/2022
Sponsoring organizations: Health Management Associates, Manatt Health, The Scan Foundation
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How Actual Practice of Emergency Medical Services Personnel Aligns with the Recommended National Scope of Practice in Rural Versus Urban Areas of the U.S.
Results of a study examining the extent to which EMS professionals perform skills that correspond to their credential levels, and determining whether there are variations in adherence to guidelines between agencies serving rural or urban populations and agencies with unpaid versus paid staffing models. Examines credentials for emergency medical responders, emergency medical technicians (EMTs), advanced EMTs, and paramedics, and uses data from EMS encounters in 2018 from 1,056 EMS agencies nationally. Features statistics on various procedures and predictors of performing a procedure within the scope of practice model, with breakdowns by 4 levels of population density.
Author(s): Davis G. Patterson, Benjamin A. Stubbs, Nikiah G. Nudell
Date: 02/2022
Sponsoring organization: UW Center for Health Workforce Studies
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Results of a study examining the extent to which EMS professionals perform skills that correspond to their credential levels, and determining whether there are variations in adherence to guidelines between agencies serving rural or urban populations and agencies with unpaid versus paid staffing models. Examines credentials for emergency medical responders, emergency medical technicians (EMTs), advanced EMTs, and paramedics, and uses data from EMS encounters in 2018 from 1,056 EMS agencies nationally. Features statistics on various procedures and predictors of performing a procedure within the scope of practice model, with breakdowns by 4 levels of population density.
Author(s): Davis G. Patterson, Benjamin A. Stubbs, Nikiah G. Nudell
Date: 02/2022
Sponsoring organization: UW Center for Health Workforce Studies
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How States Can Expand Health Care Access in Rural Communities
Discusses policy options states could use to increase access to care and the supply of healthcare providers in rural areas. Covers financial assistance programs for medical and dental education; malpractice reform; scope of practice changes for advanced practice registered nurses, physician assistants, and dental health aide therapists; telemedicine parity; and mobile clinics.
Date: 02/2022
Sponsoring organization: Center for American Progress
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Discusses policy options states could use to increase access to care and the supply of healthcare providers in rural areas. Covers financial assistance programs for medical and dental education; malpractice reform; scope of practice changes for advanced practice registered nurses, physician assistants, and dental health aide therapists; telemedicine parity; and mobile clinics.
Date: 02/2022
Sponsoring organization: Center for American Progress
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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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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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Expanding Pharmacists' Prescriptive Authority: Options for Reform
Explores why states may want to consider expanding pharmacists' prescriptive authority. Presents state policy options for expanding prescriptive authority for pharmacists, including advantages and disadvantages of each and examples from states. Also addresses potential concerns about the increased prescriptive authority of pharmacists.
Author(s): James Broughel, Elise Amez-Droz
Date: 12/2021
Sponsoring organization: Mercatus Center
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Explores why states may want to consider expanding pharmacists' prescriptive authority. Presents state policy options for expanding prescriptive authority for pharmacists, including advantages and disadvantages of each and examples from states. Also addresses potential concerns about the increased prescriptive authority of pharmacists.
Author(s): James Broughel, Elise Amez-Droz
Date: 12/2021
Sponsoring organization: Mercatus Center
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Relationship Between Population Density and Scope of Practice for Certified Registered Nurse Anesthetists in Arizona
Study surveyed 230 Certified Registered Nurse Anesthetists (CRNA) in Arizona to compare scope of practice and population density as well as scope of practice and job satisfaction. Discusses regulations and barriers in scope of practice for CRNAs and other healthcare professionals nationally in the context of recruitment and retention.
Author(s): Michael A. MacKinnon
Citation: AANA Journal, 89(4), 325-333
Date: 08/2021
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Study surveyed 230 Certified Registered Nurse Anesthetists (CRNA) in Arizona to compare scope of practice and population density as well as scope of practice and job satisfaction. Discusses regulations and barriers in scope of practice for CRNAs and other healthcare professionals nationally in the context of recruitment and retention.
Author(s): Michael A. MacKinnon
Citation: AANA Journal, 89(4), 325-333
Date: 08/2021
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