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National Study of Rural Health Clinics
Dramatic growth in the Rural Health Clinics (RHCs) program has raised important policy questions about the cost of this program and the role that RHCs perform in expanding access to primary care services in rural underserved areas. This study provides an updated comprehensive picture of the RHC program which will be disseminated in a chartbook format. The study addresses the following questions:
- Where are RHCs located relative to the underservice problems and access needs of rural areas?
- To what extent are RHCs providing care to uninsured, underinsured and other vulnerable populations?
- To what extent are RHCs participating in network building activities to expand access and service capacity?
- How do provider-based and independent RHCs compare in terms of staffing levels and patterns, services provided, populations served, payer mix, hours of operation, and financial performance?
- How have RHCs been affected by the growth in rural managed care plans, both commercial and public?
- To what extent are RHCs participating in the training of health professions students?
The data sources for this study include: a mailed survey of a random sample of 1,600 RHCs stratified by type (independent vs. provider-based) and age, the provider of services component of the HCFA Online Survey Credentialing and Reporting (OSCAR) files, the Area Resource File (ARF), and the Rural-Urban Commuting Area (RUCA) Codes, Version 1.1 Zip Code Approximation file.
Publications
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Characteristics and Roles of Rural Health Clinics in the United States: A Chartbook
Author(s): John A. Gale, Andrew F. Coburn
Date: 01 / 2003
Reports on the results of a national survey of Rural Health Clinics (RHCs). Information was collected on a wide range of topics of concern to RHCs including: 1) the characteristics and operations of the clinics; 2) their location relative to the underservice problems and access needs of rural areas; 3) safety net functions of RHCs; 4) staffing, recruitment and financial issues; and 5) involvement in the training of health care professionals. Among the findings: most RHCs continue to serve rural, underserved communities; RHCs are filling a valuable safety net role by serving Medicaid, uninsured, and low-income patients and providing free and reduced cost care; recruitment and retention is a problem for RHCs, and some RHCs face continued financial challenges despite cost-based reimbursement. RHCs continue to be an important source of primary care and safety net services in rural communities. Legislative efforts to address concerns about the program have included the refinement of the shortage area criteria used by the RHC program (Balanced Budget Act of 1997) and the implementation of a Medicaid prospective payment system (Benefits Improvement and Protection Act of 2000). Additional research is needed to understand the impact of these changes on the RHCs and the residents of rural communities served by them.
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