Access to Care: Populations in Counties With No FQHC, RHC, or Acute Care Hospital


Rural areas have more limited access to healthcare than urban areas. In 2013, there were 79.3 primary care physicians per 100,000 people in metropolitan counties, compared to only 55.1 per 100,000 people in non-metropolitan counties. This disparity highlights the need to focus on increasing access to primary care in rural areas.

To help ensure access to primary care in rural areas, the Federal government supports special healthcare provider designations that provide enhanced Medicare and or Medicaid reimbursement to certain types of hospitals and clinics—programs such as the Health Professional Shortage Area (HPSA) designation, Essential Communities Providers (ECP) designation, Federally Qualified Health Centers (FQHCs), and Rural Health Centers (RHCs). This brief focuses on three main facilities that provide primary care in rural areas to outline how many people are likely to have limited access to primary care and where they live.

Results: Across the country, there are more than 17 million people who live in rural counties without a Rural Health Clinic (RHC), more than 15 million in rural counties without a Federally Qualified Health Center (FQHC), and nearly 4.5 million in rural counties without an acute care hospital. There are 660,893 individuals living in rural counties without any FQHC, RHC, or acute care hospital. A disproportionate number of these people (33%) live in counties located in the South Atlantic census division.

North Carolina Rural Health Research and Policy Analysis Center
Meagan Clawar, Randy Randolph, Kristie Thompson, George Pink