Rural Emergency Medical Services (EMS) and Trauma – Resources
Selected recent or important resources focusing on Rural Emergency Medical Services (EMS) and Trauma.
Air Ambulance Use and Surprise Billing
Provides an overview of air ambulance services, including the types and number of air ambulance providers and suppliers, utilization rates by patients, average costs, and the potential for balance billing for air ambulance transport. Summarizes key policies and legislation related to air ambulances, including the No Surprises Act. Presents data on air ambulance utilization by rurality between 2014-2018.
Author(s): Gina Turrini, Joel Ruhter, Andre R. Chappel, Nancy De Lew
Date: 09/2021
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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Provides an overview of air ambulance services, including the types and number of air ambulance providers and suppliers, utilization rates by patients, average costs, and the potential for balance billing for air ambulance transport. Summarizes key policies and legislation related to air ambulances, including the No Surprises Act. Presents data on air ambulance utilization by rurality between 2014-2018.
Author(s): Gina Turrini, Joel Ruhter, Andre R. Chappel, Nancy De Lew
Date: 09/2021
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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Innovations in Overdose Response: Strategies Implemented by Emergency Medical Services Providers
Reports on the findings of an environmental scan conducted in collaboration with the National Association of EMS Officials looking for new and promising overdose response strategies for state and local EMS providers to increase access to treatment and recovery services. Discusses sharing data for public health surveillance and response, building system-wide partnerships, administering buprenorphine, developing post-overdose response teams, utilizing mobile integrated health clinics, and implementation barriers to be considered.
Date: 07/2021
Sponsoring organization: Association of State and Territorial Health Officials
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Reports on the findings of an environmental scan conducted in collaboration with the National Association of EMS Officials looking for new and promising overdose response strategies for state and local EMS providers to increase access to treatment and recovery services. Discusses sharing data for public health surveillance and response, building system-wide partnerships, administering buprenorphine, developing post-overdose response teams, utilizing mobile integrated health clinics, and implementation barriers to be considered.
Date: 07/2021
Sponsoring organization: Association of State and Territorial Health Officials
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Rural EMS Workforce: A Call to Action
Policy brief discussing rural emergency medical services (EMS) systems. Highlights challenges facing the rural EMS workforce, including the costs of training and reimbursement concerns. Outlines policy recommendations to strengthen rural EMS systems.
Author(s): Christopher McLaughlin, Olivia Riutta, Jonnathan Busko
Date: 02/2021
Sponsoring organization: National Rural Health Association
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Policy brief discussing rural emergency medical services (EMS) systems. Highlights challenges facing the rural EMS workforce, including the costs of training and reimbursement concerns. Outlines policy recommendations to strengthen rural EMS systems.
Author(s): Christopher McLaughlin, Olivia Riutta, Jonnathan Busko
Date: 02/2021
Sponsoring organization: National Rural Health Association
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Characteristics and Challenges of Rural Ambulance Agencies - A Brief Review and Policy Considerations
Examines challenges including prolonged response and transport times, insufficient payment by insurers, transitions from volunteer to paid workforce, and lack of plans and policies to coordinate services. Features recommendations for identifying public policy considerations to stabilize rural ambulance agencies.
Author(s): A. Clinton MacKinney, Keith J. Mueller, Andrew F. Coburn, et al.
Date: 01/2021
Sponsoring organization: Rural Policy Research Institute Rural Health Panel
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Examines challenges including prolonged response and transport times, insufficient payment by insurers, transitions from volunteer to paid workforce, and lack of plans and policies to coordinate services. Features recommendations for identifying public policy considerations to stabilize rural ambulance agencies.
Author(s): A. Clinton MacKinney, Keith J. Mueller, Andrew F. Coburn, et al.
Date: 01/2021
Sponsoring organization: Rural Policy Research Institute Rural Health Panel
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ACEP Rural Emergency Care Task Force 2020: Report to the ACEP Board of Directors
Final report of the American College of Emergency Physicians' 2020 Rural Emergency Care Task Force. Addresses objectives and offers recommendations for developing strategies to support the current rural emergency department (ED) workforce, promote training, facilitate use of telemedicine, and improve quality of patient care. Features statistics on characteristics of hospitals in rural areas, and includes information on typical rural ED hospital practice environments in areas with 6 levels of population density.
Date: 10/2020
Sponsoring organization: American College of Emergency Physicians
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Final report of the American College of Emergency Physicians' 2020 Rural Emergency Care Task Force. Addresses objectives and offers recommendations for developing strategies to support the current rural emergency department (ED) workforce, promote training, facilitate use of telemedicine, and improve quality of patient care. Features statistics on characteristics of hospitals in rural areas, and includes information on typical rural ED hospital practice environments in areas with 6 levels of population density.
Date: 10/2020
Sponsoring organization: American College of Emergency Physicians
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The Effect of Rural Hospital Closures on Emergency Medical Service Response and Transport Times
Examines ways in which rural hospital closures affect EMS response time, transport time, and total activation time, using data from 2010-2016. Features statistics comparing rates prior to rural hospital closure and immediately post-closure.
Author(s): Katherine E.M. Miller, Hailey J. James, George Mark Holmes, Courtney H. Van Houtven
Citation: Health Services Research, 55(2), 288-300
Date: 04/2020
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Examines ways in which rural hospital closures affect EMS response time, transport time, and total activation time, using data from 2010-2016. Features statistics comparing rates prior to rural hospital closure and immediately post-closure.
Author(s): Katherine E.M. Miller, Hailey J. James, George Mark Holmes, Courtney H. Van Houtven
Citation: Health Services Research, 55(2), 288-300
Date: 04/2020
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Exploring State Data Sources to Monitor Rural Emergency Medical Services Performance Improvement
Examines potential sources of data that State Flex Programs (SFPs) could utilize to analyze and improve rural emergency medical services (EMS). Discusses challenges facing rural EMS systems and the assessment of these systems by SFPs. Explores how SFPs can support rural EMS data collection initiatives.
Author(s): John Gale, Karen Pearson, Yvonne Jonk
Date: 03/2020
Sponsoring organization: Flex Monitoring Team
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Examines potential sources of data that State Flex Programs (SFPs) could utilize to analyze and improve rural emergency medical services (EMS). Discusses challenges facing rural EMS systems and the assessment of these systems by SFPs. Explores how SFPs can support rural EMS data collection initiatives.
Author(s): John Gale, Karen Pearson, Yvonne Jonk
Date: 03/2020
Sponsoring organization: Flex Monitoring Team
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Rural Emergency Medical Services Integration
Outlines tools and strategies for Emergency Medical Services (EMS) to use when integrating with other healthcare providers. Discusses approaches to the integration of medical direction, medical protocols, quality reviews, training and continuing education, and operations, among other topics.
Date: 11/2019
Sponsoring organizations: National Rural Health Resource Center, Paramedic Foundation, Technical Assistance and Services Center
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Outlines tools and strategies for Emergency Medical Services (EMS) to use when integrating with other healthcare providers. Discusses approaches to the integration of medical direction, medical protocols, quality reviews, training and continuing education, and operations, among other topics.
Date: 11/2019
Sponsoring organizations: National Rural Health Resource Center, Paramedic Foundation, Technical Assistance and Services Center
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Mobile Telehealth Units and Care Coordinators Improve Emergency Care Services for Rural Arizona Patients
Features an Arizona program focused on lowering ER readmissions through care coordination and EMS telehealth services. Explains how the telehealth services are provided via mobile telehealth units. Describes how care coordination helps meet the behavioral health needs of patients with chronic diseases.
Author(s): Jenn Lukens
Citation: Rural Monitor
Date: 08/2019
Sponsoring organization: Rural Health Information Hub
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Features an Arizona program focused on lowering ER readmissions through care coordination and EMS telehealth services. Explains how the telehealth services are provided via mobile telehealth units. Describes how care coordination helps meet the behavioral health needs of patients with chronic diseases.
Author(s): Jenn Lukens
Citation: Rural Monitor
Date: 08/2019
Sponsoring organization: Rural Health Information Hub
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Making Informed Decisions about Rural EMS
Provides an overview of the Informed Self-Determination Process, which can help a rural community make an informed decision about the level of emergency medical services (EMS) response the community wants and will support. Highlights how this approach was used in St. George, Maine.
Author(s): Tami Lichtenberg
Citation: Rural Monitor
Date: 04/2019
Sponsoring organization: Rural Health Information Hub
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Provides an overview of the Informed Self-Determination Process, which can help a rural community make an informed decision about the level of emergency medical services (EMS) response the community wants and will support. Highlights how this approach was used in St. George, Maine.
Author(s): Tami Lichtenberg
Citation: Rural Monitor
Date: 04/2019
Sponsoring organization: Rural Health Information Hub
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Additional resources are available related to this guide. See the full list of resources by topic for:
- Emergency department and urgent care services
- Emergency medical services
- Emergency medical technicians and paramedics
Last Updated: 12/17/2025