Rural Health
Resources by Topic: Service delivery models
Primary Care Access and the Role of Telemedicine for Traditional Medicare Beneficiaries
Examines how in-person and telehealth primary care use, access, and continuity of care varied among Medicare beneficiaries between 2017 and 2023, using traditional Medicare claims and administrative data. Includes data comparisons by level of rurality, among other factors.
Author(s): Ishani Ganguli, Nicolas E. Daley, Andrew Hicks, et al.
Citation: JAMA Health Forum, 7(5), e260979
Date: 05/2026
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Examines how in-person and telehealth primary care use, access, and continuity of care varied among Medicare beneficiaries between 2017 and 2023, using traditional Medicare claims and administrative data. Includes data comparisons by level of rurality, among other factors.
Author(s): Ishani Ganguli, Nicolas E. Daley, Andrew Hicks, et al.
Citation: JAMA Health Forum, 7(5), e260979
Date: 05/2026
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Integrated Care for Kids (InCK) Model: Evaluation Report 3
Presents findings from the first two years of the implementation of the Integrated Care for Kids (InCK) Model, which aims to improve health outcomes for Medicaid-enrolled children with complex physical and behavioral health needs. Provides an overview of the InCK Model and profiles each InCK award recipient's model; the impacts of the InCK Model on navigation and coordination, utilization and expenditures, quality of care, and beneficiary and caregiver experience of care; and the extent to which service changes or disruptions occurred and impacted care delivery. Identifies award recipients serving rural areas.
Additional links: Findings at a Glance
Date: 05/2026
Sponsoring organizations: Abt Associates, Centers for Medicare & Medicaid Services
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Presents findings from the first two years of the implementation of the Integrated Care for Kids (InCK) Model, which aims to improve health outcomes for Medicaid-enrolled children with complex physical and behavioral health needs. Provides an overview of the InCK Model and profiles each InCK award recipient's model; the impacts of the InCK Model on navigation and coordination, utilization and expenditures, quality of care, and beneficiary and caregiver experience of care; and the extent to which service changes or disruptions occurred and impacted care delivery. Identifies award recipients serving rural areas.
Additional links: Findings at a Glance
Date: 05/2026
Sponsoring organizations: Abt Associates, Centers for Medicare & Medicaid Services
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National Association of Rural Health Clinics 2026 Policy Survey Report
Summarizes results of a 2026 national survey of Rural Health Clinics (RHCs). Presents data on the average payer mix, telehealth use and management trends, Medicare Advantage (MA) contracts and reimbursement rates compared to traditional Medicare rates, value-based care participation, challenges, and more.
Date: 04/2026
Sponsoring organization: National Association of Rural Health Clinics
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Summarizes results of a 2026 national survey of Rural Health Clinics (RHCs). Presents data on the average payer mix, telehealth use and management trends, Medicare Advantage (MA) contracts and reimbursement rates compared to traditional Medicare rates, value-based care participation, challenges, and more.
Date: 04/2026
Sponsoring organization: National Association of Rural Health Clinics
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2025 National CAH Quality Inventory & Assessment National Report
Presents a high-level summary of key data points from the September-November 2025 National Critical Access Hospital (CAH) Quality Inventory and Assessment. Includes data on CAH system affiliation; median average daily census and emergency department volume; median swing bed admissions and swing bed length of stay; hospital inpatient, behavioral health and specialty care, and outpatient and other service lines; CAH quality payment model participation; and CAH quality improvement topic priorities.
Author(s): Madeleine Pick, Robert Barclay
Date: 04/2026
Sponsoring organization: Flex Monitoring Team
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Presents a high-level summary of key data points from the September-November 2025 National Critical Access Hospital (CAH) Quality Inventory and Assessment. Includes data on CAH system affiliation; median average daily census and emergency department volume; median swing bed admissions and swing bed length of stay; hospital inpatient, behavioral health and specialty care, and outpatient and other service lines; CAH quality payment model participation; and CAH quality improvement topic priorities.
Author(s): Madeleine Pick, Robert Barclay
Date: 04/2026
Sponsoring organization: Flex Monitoring Team
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Peer Recovery Supports for Behavioral Health in Rural Communities
Discusses behavioral health peer recovery support services in rural and agricultural communities. Highlights innovative and promising practices for overcoming behavioral health barriers, such as addressing stigma, social isolation, and scarcity of services through community and peer supports.
Date: 04/2026
Sponsoring organization: Substance Abuse and Mental Health Services Administration
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Discusses behavioral health peer recovery support services in rural and agricultural communities. Highlights innovative and promising practices for overcoming behavioral health barriers, such as addressing stigma, social isolation, and scarcity of services through community and peer supports.
Date: 04/2026
Sponsoring organization: Substance Abuse and Mental Health Services Administration
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Strategies for Critical Access Hospital Financial and Operational Performance Improvement: A Systematic Review
Summarizes findings from a systematic review of peer-reviewed and grey literature published since 2000 regarding financial and operational performance improvement interventions implemented by Critical Access Hospitals (CAHs) and rural hospitals in the United States and in other developed countries. Identifies key intervention areas, including service line optimization, revenue and cost management, and technology adoption, among others. Describes how State Flex Programs and hospital administrators can use these findings to inform decision-making and resource allocation.
Author(s): Angelina Budko, Laura Bozovich McFadyen, Carrie Baldwin-SoRelle, et al.
Date: 04/2026
Sponsoring organization: Flex Monitoring Team
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Summarizes findings from a systematic review of peer-reviewed and grey literature published since 2000 regarding financial and operational performance improvement interventions implemented by Critical Access Hospitals (CAHs) and rural hospitals in the United States and in other developed countries. Identifies key intervention areas, including service line optimization, revenue and cost management, and technology adoption, among others. Describes how State Flex Programs and hospital administrators can use these findings to inform decision-making and resource allocation.
Author(s): Angelina Budko, Laura Bozovich McFadyen, Carrie Baldwin-SoRelle, et al.
Date: 04/2026
Sponsoring organization: Flex Monitoring Team
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Reported Receipt of Mental Health Services by Adolescents Aged 12 to 17 in the Rural and Urban U.S., 2021
Describes the mental health services received by adolescents in rural and urban counties nationwide in 2021. Presents data on the percentage of adolescents that received mental health services by rurality. Includes data on rural and urban adolescents' receipt of inpatient and outpatient mental health services across Census regions; services provided in specialty mental health settings; and services provided by a therapist or counselor, in a general medical setting, or via telehealth.
Author(s): Janessa M. Graves, Gina A. Keppel, Lisa A. Garberson, C. Holly A. Andrilla
Date: 04/2026
Sponsoring organization: WWAMI Rural Health Research Center
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Describes the mental health services received by adolescents in rural and urban counties nationwide in 2021. Presents data on the percentage of adolescents that received mental health services by rurality. Includes data on rural and urban adolescents' receipt of inpatient and outpatient mental health services across Census regions; services provided in specialty mental health settings; and services provided by a therapist or counselor, in a general medical setting, or via telehealth.
Author(s): Janessa M. Graves, Gina A. Keppel, Lisa A. Garberson, C. Holly A. Andrilla
Date: 04/2026
Sponsoring organization: WWAMI Rural Health Research Center
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A Chartbook on the Characteristics and Needs of Frontier Critical Access Hospitals
Summarizes findings from a 2025 national survey of executives from 117 Critical Access Hospitals (CAHs) in frontier counties. Includes data on the distribution and characteristics of frontier CAHs. Identifies themes related to financial and operational challenges, service availability, and access to care in frontier settings.
Author(s): John A. Gale, Rebecca Stearns, Zachariah Croll, Jayne Foley
Date: 04/2026
Sponsoring organization: Flex Monitoring Team
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Summarizes findings from a 2025 national survey of executives from 117 Critical Access Hospitals (CAHs) in frontier counties. Includes data on the distribution and characteristics of frontier CAHs. Identifies themes related to financial and operational challenges, service availability, and access to care in frontier settings.
Author(s): John A. Gale, Rebecca Stearns, Zachariah Croll, Jayne Foley
Date: 04/2026
Sponsoring organization: Flex Monitoring Team
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Racial and Ethnic Disparities in Access to Acute Stroke Capabilities in California: Association with Rurality and Telestroke Access
Examines disparities in presentation to emergency departments (EDs) with or without acute stroke capability among patients with acute stroke by race and ethnicity, and variations in these associations by patient rurality and ED telestroke status, using 2021 NEDI-California and NEDI-USA survey data.
Author(s): Kori S. Zachrison, Renee Y. Hsia, Krislyn M. Boggs, et al.
Citation: Journal of Stroke & Cerebrovascular Diseases, 35(4), 108607
Date: 04/2026
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Examines disparities in presentation to emergency departments (EDs) with or without acute stroke capability among patients with acute stroke by race and ethnicity, and variations in these associations by patient rurality and ED telestroke status, using 2021 NEDI-California and NEDI-USA survey data.
Author(s): Kori S. Zachrison, Renee Y. Hsia, Krislyn M. Boggs, et al.
Citation: Journal of Stroke & Cerebrovascular Diseases, 35(4), 108607
Date: 04/2026
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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: 04/2026
Sponsoring organization: National Consortium of Telehealth Resource Centers
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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: 04/2026
Sponsoring organization: National Consortium of Telehealth Resource Centers
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