WWAMI Rural Health Research Center

Current Projects

  • Access to and Provision of Child and Youth Behavioral Health Services in the Rural and Urban U.S.
    The need for behavioral health treatment for youth has been exacerbated by the COVID-19 pandemic. Little is known about the availability of youth behavioral health providers in rural areas. This study will investigate who provides behavioral health services to youth, how equitably the workforce is distributed, and gaps in service availability.
    Topics: Allied health professionals, Children and adolescents, Health disparities and health equity, Health services, Healthcare access, Mental and behavioral health, Nurses and nurse practitioners, Pharmacy and prescription drugs, Physician assistants, Physicians, Substance use and treatment, Workforce
  • Availability, Care Practices, and Quality of Hospice Providers Serving Rural versus Urban Communities
    This project will examine differences in availability of hospice care in rural versus urban communities as well as provider-level quality and care practices by rural-urban status of hospices. Findings will highlight potential rural-urban disparities in hospice care that can be used to inform future Medicare policy.
    Topics: Aging, Coronavirus Disease 2019 (COVID-19), Health disparities and health equity, Health services, Healthcare access, Hospice and palliative care, Medicare, Quality
  • Barriers and Facilitators to Providing Rural Clinical Training for Health Professions Students and Residents
    Scarce rural clinical training sites are the top barrier preventing medical schools, residencies, and nurse practitioner and physician assistant education programs, among other health professional training programs, from providing rural training to their students. This study aims to describe the barriers to offering rural clinical training and the potential solutions for establishing and sustaining interdisciplinary rural clinical training.
    Topics: Allied health professionals, Healthcare access, Nurses and nurse practitioners, Physician assistants, Physicians, Workforce
  • Changes in Buprenorphine Prescribing Following the Elimination of the Drug Enforcement Administration X Waiver Requirement
    The Drug Enforcement Administration requirement for an X waiver to prescribe buprenorphine for opioid use disorder was lifted in January 2023. This study aims to describe if and how this policy change has impacted the prescribing practices of clinicians and medication treatment access for patients with opioid use disorder.
    Topics: Health disparities and health equity, Health services, Healthcare access, Legislation and regulation, Mental and behavioral health, Nurses and nurse practitioners, Physician assistants, Physicians, Substance use and treatment, Workforce
  • Comparing Utilization and Quality of Home Health Care Between Medicare Fee-for-Service and Medicare Advantage Beneficiaries by Rural-Urban Status
    This project examines differences in home health use and quality by enrollment in Medicare Fee-for-Service (FFS) versus Medicare Advantage (MA) plans. Findings will include information on rural-urban and intra-rural variation in home health care to inform policies on access, payment, and quality for Medicare FFS and MA plans.
    Topics: Aging, Allied health professionals, Health disparities and health equity, Health services, Healthcare access, Healthcare financing, Home health, Medicare, Medicare Advantage (MA), Post-acute care, Quality
  • Dentist Supply, Dental Care Utilization, and Oral Health Among Rural and Urban U.S. Residents: Exploring Changes in the Past 15 Years
    This project will describe the national supply of the rural and urban dental workforce and investigate whether rural adults, compared to urban adults, report lower dental care utilization, higher prevalence of dental disease or both. This study will also look at whether disparities in oral health care and supply have changed over the past 15 years.
    Topics: Allied health professionals, Health disparities and health equity, Health services, Healthcare access, Oral health, Workforce
  • Disparities in Family Physician Burnout Before and During the COVID-19 Pandemic
    High levels of burnout during the COVID-19 pandemic have been documented among health professionals, particularly women and persons from underrepresented groups. This study examines how burnout has changed from 2019 through 2021 among family physicians as well as variation by rural/urban geography, other sociodemographics, and practice characteristics to identify physicians most in need of interventions to foster resilience and alleviate burnout.
    Topics: Mental and behavioral health, Physicians, Workforce
  • Examining the Potential Impact of Multiple Payment Policies on Rural Versus Urban Home Health Agencies
    This study estimates the impact of three recent and upcoming Medicare home health payment policies (revised rural add-on payments, new prospective payment system, and value-based purchasing demonstration) on reimbursement for home health agencies based on rural-urban status, community factors, and home health agency characteristics.
    Topics: Health services, Healthcare access, Healthcare financing, Home health, Medicare, Post-acute care
  • Methamphetamine Use, Mental Health Comorbidities, and Treatment in Rural and Urban Areas
    This study will investigate methamphetamine (meth) use in rural versus urban areas - including meth use in combination with opioids and alcohol, mental health comorbidities, and perceived need for and receipt of treatment by meth users and those with meth use disorder - to identify hotspots for targeting of prevention and treatment resources.
    Topics: Mental and behavioral health, Substance use and treatment
  • Palliative Care in the Rural U.S.
    This project will describe the availability of palliative care services in rural hospitals and community settings using data from the American Hospital Association Annual Survey, interviews with palliative care providers, and a survey of rural hospitals without palliative care services.
    Topics: Health disparities and health equity, Health services, Healthcare access, Hospice and palliative care, Hospitals and clinics
  • Specialist Physicians in the Rural and Urban U.S.: Supply, Distribution, and Access
    This project will describe the geographic distribution (rural/urban, regional, and intra-rural) of specialist physicians who care for patients experiencing conditions that account for the top four leading causes of rural mortality. It will also explore how patients in rural communities that lack these specialists obtain needed care.
    Topics: Cancer, Care management, Chronic diseases and conditions, Frontier health, Health disparities and health equity, Health services, Healthcare access, Physicians, Social determinants of health, Telehealth, Workforce
  • The Emerging Landscape of Rural Family Medicine Residency Training: Defining Models and Assessing Their Value
    Rural residency training options for family physicians are growing, as is the evidence for rural training in promoting rural practice choice. This study aims to use a new classification of six residency program types to describe and quantify programs and positions by type and compare relative effectiveness in producing rural physicians.
    Topics: Health disparities and health equity, Health services, Healthcare access, Physicians, Workforce
  • The Impact of Rural Surgery Training on General Surgeon Supply in Rural Communities
    A growing number of general surgery programs offer rural training that aims to address the dwindling supply of rural surgeons. This study aims to describe program models for providing rural general surgery training; quantify the availability of programs; and compare the models' effectiveness in producing rural surgeons.
    Topics: Health disparities and health equity, Health services, Healthcare access, Physicians, Workforce
  • Treatment, Provider, and Cost Differences for Rural and Urban Patients with Opioid Use Disorder Across the U.S.
    This study describes and compares the treatment that rural and urban patients with opioid use disorder (OUD) receive, documenting the workforce providing care, distance that patients travel to receive care, and cost of care. Findings will inform policies to ensure that rural patients with OUD have access to care from local healthcare providers.
    Topics: Health services, Healthcare access, Healthcare financing, Mental and behavioral health, Nurses and nurse practitioners, Pharmacy and prescription drugs, Physician assistants, Physicians, Substance use and treatment, Telehealth
  • Treatment, Provider, and Cost Differences for Rural and Urban Patients with Opioid Use Disorder and Medicaid Insurance Across the U.S.
    This project will analyze Medicaid claims data to compare the treatment that rural and urban patients with opioid use disorder receive, documenting the workforce providing care, the distance that patients travel to receive care, and the cost of care. Findings from this study can be used to improve policies regarding opioid use disorder treatment.
    Topics: Health disparities and health equity, Health services, Healthcare access, Healthcare financing, Legislation and regulation, Medicaid and CHIP, Mental and behavioral health, Nurses and nurse practitioners, Pharmacy and prescription drugs, Physician assistants, Physicians, Substance use and treatment, Telehealth, Workforce
  • Trends in Health Workforce Supply in the Rural U.S.
    Rural communities in the U.S. have struggled to recruit and sustain sufficient health professionals to ensure adequate access to care. This study uses multiple sources of data to describe the geographic distribution (rural/urban, regional, and intra-rural) of numerous types of health professionals.
    Topics: Allied health professionals, Healthcare access, Mental and behavioral health, Nurses and nurse practitioners, Oral health, Physician assistants, Physicians
  • Understanding Changes in the Rural Marriage and Family Therapist and Mental Health Counselor Workforces Under New Medicare Reimbursement Policy
    Marriage and family therapists and mental health counselors are newly eligible as of January 1, 2024, for reimbursement to provide care for Medicare enrollees. This study will describe the change in these clinicians in rural vs. urban communities and seek to understand barriers and solutions to fully realize the benefits of this new reimbursed policy for rural populations.
    Topics: Allied health professionals, Health disparities and health equity, Medicare, Mental and behavioral health, Workforce