RUPRI Health Panel: Rural Policy Analysis and Applications

Research Products & Journal Articles

Browse the full list of research publications from this Rural Health Research Center.

Products – Freely accessible products include policy briefs, fact sheets, full reports, chartbooks, and interactive data websites.

Journal Articles – Articles in peer-reviewed journals may require a subscription or affiliation with a subscribing library. For these publications, Gateway lists the article citation, a brief summary, a link to additional information and access to the full-text of the article, if available.

2022

The Evolution of Hospital Designations and Payment in the U.S.: Implications for Rural Hospitals
Report
Date: 12/2022
Medicare hospital payment policies affecting rural hospitals play a significant role in the financial viability of rural hospitals. This report provides an overview of historic and current Medicare rural hospital payment policies and alternative payment models to understand their impact on rural hospitals and the communities they serve.
Meeting the Behavioral Health Needs of Farm Families in Times of Economic Distress
Policy Brief
Date: 02/2022
Economic fluctuations and periods of distress in farming cannot be eliminated, however, their impact on communities and individuals can be mitigated. Strategies for meeting the behavioral health needs of farm families by supporting community-based services, and expanding behavioral health services in rural contexts are highlighted in this work.
High-Performing Rural Health System
Policy Brief
Date: 01/2022
This document updates the RUPRI Health Panel's framework, for a high-performing rural health system, originally published in 2011. It offers a revised vision statement and updates the high-performing rural health system pillars (access, affordability, community health, and quality) and describes an underlying base of equity considerations.

2021

Advancing Population Health in Rural Places: Key Lessons and Policy Opportunities
Report
Date: 01/2021
This paper advances policy discussion of population health in rural places, focusing on the role of rural healthcare organizations. Lessons from ongoing programs provide policy considerations. Medicare and Medicaid programs should prioritize staff and infrastructure development, flexibility in covered benefits, and further expansion of telehealth.
Characteristics and Challenges of Rural Ambulance Agencies – A Brief Review and Policy Considerations
Report
Date: 01/2021
There are 23,272 ambulance agencies in the U.S., and 73% of those agencies report serving rural areas. This paper examines current rural ambulance agency characteristics and challenges and identifies public policy considerations designed to stabilize rural ambulance agencies.

2020

Considerations for Defining Rural Places in Health Policies and Programs
Report
Date: 05/2020
Rural definitions in statute and policy are used to direct resources to underserved people. But changes in population behavior and census processes have led to concern about historic methods of defining rural. This paper identifies key questions, reviews rural definitions, and discusses options for reconsidering rural definitions.

2018

Assessing the Unintended Consequences of Health Policy on Rural Populations and Places
Report
Date: 12/2018
This paper explores the unintended consequences of health policy through an analysis of policy actions that have affected, or had the potential to affect, rural people, places, and/or providers in ways counteractive to policy intent.
Insuring Rural America: Health Insurance Challenges and Opportunities
Policy Brief
Date: 07/2018
This brief discusses a series of policy considerations in three main categories: policies related to rural insurance risk, policies related to provider networks, and policies related to rural payment rates and structures.

2017

Rural Long-Term Services and Supports: A Primer
Date: 11/2017
This paper provides policymakers and other interested stakeholders a primer on the fundamentals of the rural LTSS system, rural access to and use of LTSS, and the opportunities and limitations of current federal and state LTSS policy for advancing rural health system transformation toward a high-performing rural health delivery system.
After Hospital Closure: Pursuing High Performance Rural Health Systems Without Inpatient Care
Date: 06/2017
A new paper describing opportunities for rural communities to develop a high performance rural health system after hospital closure, including three case studies that describe real-world transitions from hospital-based locus of care to new models of care delivery in rural places.

2015

Medicare Value-Based Payment Reform: Priorities for Transforming Rural Health Systems
Report
Date: 11/2015
As Medicare moves to value-based payment, healthcare groups are made more accountable for patient health. But the changes have been concentrated in urban areas. Policies meant to strengthen rural health systems are complicating payment and delivery system reform in rural areas. This study examines ways to include rural areas in the changes.
Care Coordination in Rural Communities Supporting the High Performance Rural Health System
Report
Date: 06/2015
This paper examines care coordination programs and processes that affect rural areas to discover what is happening in rural communities, how various programs and approaches are working, who benefits, and to make policy recommendations that will facilitate care coordination efforts in support of high performance rural health system development.

2012

The Current and Future Role and Impact of Medicaid in Rural Health
Date: 09/2012
This report outlines and describes the current Medicaid program and its importance to rural America. It also discusses rural implications of program expansion, including whether and how states choose to implement changes.

2011

The High Performance Rural Health Care System of the Future
Date: 09/2011
This project describes a future rural system that would be built on foundations of affordability, accessibility, community focus, high quality, and patient centeredness.
Place-Based Policies and Public Health: The Road to Healthy Rural People and Places
Date: 03/2011
This paper identifies how the Patient Protection and Affordable Care Act of 2010 can influence the determinants of health and contribute to the prosperity, equity, sustainability, and livability of rural places.

2010

Securing High Quality Health Care in Rural America: The Impetus for Change in the Affordable Care Act
Date: 12/2010
The Affordable Care Act calls for the development of a National Health Care Quality Strategy and Plan (National Quality Strategy) that will affect healthcare that is delivered to millions of Americans who live in rural areas and thousands of healthcare providers who care for them.
The Patient Protection and Affordable Care Act of 2010: Impacts on Rural People, Places, and Providers: A First Look
Date: 09/2010
This report summarizes six issue areas of the Affordable Care Act and discusses implications for access to services and improving the health status of rural residents. The issue areas are health insurance coverage; Medicare and Medicaid payment; quality, financing, and delivery system reform; public health; healthcare workforce; and long-term care.