Usual Source of Primary Care for Rural Medicare Beneficiaries Before and During COVID-19

Having a usual source of primary care (USC) is a key driver of a person's health. During the past several years, several factors may have influenced USC in rural areas, including:

• Payment changes, such as the 4-1-2021 increase in the Rural Health Center per visit upper payment limit from $87.52 to $100 that was part of the changes included in Section 130 of the Consolidated Appropriations Act of 2021
• Three more States have expanded Medicaid
• Growing shortages of primary care providers in rural areas
• The short- and long-term effects of the pandemic, such as telehealth

This study will describe the USC for rural Medicare beneficiaries. The study will use Centers for Medicare & Medicaid Services claims data to provide insight into how COVID-19 may have affected USC of Medicare beneficiaries and who is serving as a USC for Medicare enrollees in rural areas, and what portion of Medicare enrollees are receiving care from a rural USC.

Publications

• Usual Source of Care for Rural Medicare Fee-for-Service Beneficiaries in 2021
  Policy Brief
  North Carolina Rural Health Research and Policy Analysis Center
  Date: 02/2026
  This brief explains where rural Medicare fee-for-service patients usually go for routine care and which groups struggle to find a regular provider. Its purpose is to help policymakers understand access gaps so they can strengthen rural health care and reduce barriers.