Rising healthcare expenditures have in recent years been a burden for rural persons, rural employers, and taxpayers. Several factors have contributed to rising healthcare expenditures, including changes in the healthcare needs of the population, rising income of the population, insurance-induced demand, provider price changes, and technological change. Some of these factors have disproportionately affected rural areas, and rural areas have in recent years seen higher increases in some expenditure categories such as physician office-based visits and prescription drugs. Those differences suggest strategies to contain health expenditure increases may be different in rural areas and may be best determined on a local basis.