Geographic Access to Health Care for Rural Medicare Beneficiaries: A National Study


Rural residents generally have fewer visits with medical specialists and travel farther for medical services for care than their urban counterparts. These issues can pose serious challenges for older Medicare beneficiaries. This study compared, at a national and Census Division level, total number of visits received, where rural and urban Medicare beneficiaries received care, which types of providers were seen, and how far beneficiaries traveled to obtain care.

In 2014, rural beneficiaries received slightly more total visits than urban beneficiaries. Rural beneficiaries received the majority of their visits (51.7%) from generalist physicians, nurse practitioners, and physician assistants compared to 38.1% among urban beneficiaries. Median one-way travel times for rural residents from isolated small rural areas were particularly long, often exceeding one hour for serious conditions such as cancer and ischemic heart disease. Overcoming problems with geographic access to care issues will require a rurally committed generalist workforce that offers a wide range of services and assures efficient access to specialist services when necessary.

WWAMI Rural Health Research Center
Eric Larson, Holly Andrilla, Lisa Garberson, David Evans