Payer Mix of Rural Health Clinics and Federally Qualified Health Centers

This study will examine the payer mix of patients seeking care at Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs), important sources of primary care for rural patients. While previous studies have examined availability and geographic accessibility to these important services, studies have not examined the payer mix of these clinic types. Such information will fill important gaps in our understanding of who is being served by these clinics and what types of payers (private and public) are covering these patients, and subsequently, what payers are reimbursing these facilities. We anticipate that this study will provide important information to enable federal agencies and policymakers to inform development and implementation of policies, rules, and regulations. To that end, we propose the following research questions:

1. What are the trends in payer mixes over time for RHCs?
   1. By RHC type (provider-based vs. independent)? By ownership type (for-profit, nonprofit, or publicly owned)?
2. What are the trends in payer mixes over time for rural and urban FQHCs?
   1. Relatedly, how does payer mix vary across rural and urban FQHCs across U.S. Census Regions?