Introduction
How do we ensure access to affordable, quality health care for
our rural citizens? How do we select Medicare and Medicaid reimbursement
approaches that help rural health care facilities keep their doors
open? How can we attract health care providers to rural communities?
Rural health policy is the set of principles and plans of action
our government uses to address these and other rural health issues.
Rural health policy takes place at the Federal, State and local
levels of government. Many people and organizations are involved
in the formulation of rural health policy, including lawmakers,
government agencies, membership organizations, rural health researchers,
rural providers, rural patients, and concerned citizens.
These groups work to identify potential improvements to the provision
and availability of health care services in rural communities
through the implementation of health policy that addresses the
specific needs and concerns facing rural areas.
Frequently Asked Questions
Tools
AHA Issues: Rural Health Care
Web site
Information on American Hospital Association (AHA) advocacy activities related to rural hospitals. Includes news, resources, and more.
AHA Section for Small or Rural Hospitals
Web site
Information on American Hospital Association (AHA) advocacy activities on behalf of small and rural hospitals. Includes information about the Section, advocacy activities, publications, and other resources.
Code of Federal Regulations
Web site
The Code of Federal Regulations (CFR) is the codification of the general and permanent rules published in the Federal Register by the executive departments and agencies of the Federal Government. It is divided into 50 titles that represent broad areas subject to Federal regulation. Each volume of the CFR is updated once each calendar year and is issued on a quarterly basis.
Code of Federal Regulations: Title 42 Public Health
Web site
Provides access to Code of Federal Regulations' health related provisions, including Medicare and Medicare.
Daily Health Policy Report
Web site
Daily news stories on a variety of health policy issues. Includes a searchable archive.
Directory of Rural Health Contacts: Congressional Committees and Advisory Bodies
Web site
Contact information for Congressional committees and advisory bodies of interest to the rural health community.
Directory of Rural Health Contacts: House Rural Health Care Coalition
Web site
Contact information for members of the U.S. House of Representatives' Rural Health Care Coalition.
Directory of Rural Health Contacts: Senate Rural Health Caucus
Web site
Contact information for U.S. Senators who are members of the Senate Rural Health Caucus.
Geographic Eligibility for Rural Health Grant Programs
Web site
Identifies the Non-Metropolitan counties that are eligible for Rural Health Grant Programs. In addition, ZIP Codes in areas of Metropolitan counties that meet certain criteria of eligibility are also listed for these grant programs.
Health Policy Picks
Web site
A monthly selection of recent publications, such as technical reports, conference proceedings, and other material produced by organizations and government agencies that conduct health care policy analysis and research.
HealthCast
Web site
Webcasting service that provides access to a wide range of health policy events, including seminars, conferences, press briefings, and congressional hearings
KaiserEDU
Web site
Detailed resource lists and tutorials on health policy and public health topics, with links to publications, data, and organizations. Topics covered include Medicare, Medicaid, the uninsured, quality of care, and more. Designed for health policy students and faculty.
NRHA Issue Papers and Policy Briefs
Web site
Links to NRHA publications addressing policy issues of interest to the rural health community.
NRHA Rural Health Advocacy
Web site
Information concerning the National Rural Health Association's advocacy efforts to support rural health.
Office of Rural Health Policy: Policy Overview
Web site
Provides information and resources from the Federal Office of Rural Health Policy related to ORHP's rural health policy work.
ORHP All Programs Meeting 2007: Speaker Presentations
Web site
Contains links to the speaker presentations at the ORHP All Programs Conference, August 27-29, 2007 in Washington, DC.
Regulations.gov
Web site
Supports public participation in the Federal decision-making process by allowing users to view and submit comments on proposed and final regulations.
Rural Health Disparities Information Guide
Web site
Information, resources, and frequently asked questions related to rural health disparities.
Rural Health Research and Policy Centers
Web site
Overview of the purpose of the rural health research centers program. Includes information on funded research centers and research underway by the rural health research centers.
Rural Health Research Gateway
Web site
Provides access to all of the research and findings of the Office of Rural Health Policy's Rural Health Research Centers. Covers current and completed research projects and publications resulting from those projects. Includes information about the research centers and individual researchers.
Rural Health Research: Health policy
Web site
Provides summaries of current and completed rural health research projects and related publications addressing the topic of health policy, produced by the Office of Rural Health Policy's funded rural health research centers.
Seeking Rural Health Data: A Tool Kit
Web site
Provides State Offices of Rural Health with a toolkit for accessing and utilizing national, databases that are readily available, free, and have useful rural information.
Funding
Commonwealth Fund Health Grants
Supports independent research on health and social issues and makes grants to improve health care practice and policy.
Inactive Funding
Inactive Funding Opportunities -
Lists additional funding programs for this topic that are not currently accepting applications. Programs that are inactive may be offered again in the future.
Regulations, Forms & Other Useful Documents
2004 Report to the Secretary: Rural Health and Human Service Issues
Sponsoring organization: National Advisory Committee on Rural Health and Human Services Report to the Secretary of the U.S.
Department of Health and Human Services. Overview of key issues and trends affecting health and human service delivery in rural communities. Detailed information on the coordination of behavioral health and primary care, access to oral health care, and access to human services for the elderly. Date: 04 / 2004
2005 Report to the Secretary: Rural Health and Human Service Issues
Sponsoring organization: National Advisory Committee on Rural Health and Human Services Report to the Secretary of the U.S.
Department of Health and Human Services. Includes chapters focused on collaborations in rural
communities, rural access to obstetrical services, obesity in rural communities, and rural welfare reform. Includes recommendations to address these issues. Date: 04 / 2005
2006 Report to the Secretary: Rural Health and Human Service Issues
Sponsoring organization: National Advisory Committee on Rural Health and Human Services Report to the Secretary of the U.S.
Department of Health and Human Services. Includes chapters focused on pharmaceuticals and pharmacy services, health information technology, and family caregiver support. Includes recommendations to address these topics. Date: 01 / 2006
2007 Report to the Secretary: Rural Health and Human Service Issues
Sponsoring organization: National Advisory Committee on Rural Health and Human Services Report to the Secretary of the U.S. Department of Health and Human Services. Examines three key topics in health and human services and their effects in rural areas: Medicare Advantage in Rural Communities, Head Start in Rural Communities, and Substance Abuse in Rural America. Includes recommendations to address these topics.
Date: 01 / 2007
American Hospital Association Section for Small or Rural Hospitals 2006 Annual Report
Author(s): AHA Section for Small or Rural Hospitals Sponsoring organization: American Hospital Association Describes advocacy and other efforts taken by the American Hospital Association and its Section for Small or Rural Hospitals in 2006 to address the needs of rural hospitals. Date: 2006
Bridging Rural Health Research and Policy: Dissemination Strategies
Author(s): Keith J. Mueller, Timothy D. McBride, Andrew F. Coburn, Rebecca T. Slifkin, Mary K. Wakefield, A. Clinton MacKinney Sponsoring organization: Rural Policy Research Institute (RUPRI) Rural Health Panel Describes five strategies for effective dissemination and expanded use of rural health
services research and discusses the infrastructure needed to enhance rural health research dissemination. Date: 08 / 2007
Choosing Rural Definitions: Implications for Health Policy
Author(s): Andrew F. Coburn, A. Clinton MacKinney, Timothy D. McBride, Keith J. Mueller, Rebecca T. Slifkin, Mary K. Wakefield Sponsoring organization: Rural Policy Research Institute (RUPRI) Rural Health Panel Provides an overview of rural definitions and their policy implications. Discusses the factors that should be considered in selecting among rural definitions. Date: 03 / 2007
Compendium of Recommendations by the National Advisory Committee on Rural Health
Sponsoring organization: National Advisory Committee on Rural Health and Human Services A list of recommendations, arranged by broad subject area, made by the National Advisory Committee on Rural Health and Human Services in its reports to the Secretary of the U.S. Department of Health and Human Services.
Health Care Quality: The Rural Context
Sponsoring organization: National Advisory Committee on Rural Health and Human Services Report to the Secretary of the U.S. Department of Health and Human Services. Examines the current state of the debate over health care quality and patient safety and how it affects rural communities. Date: 04 / 2003
Health Care That Works for All Americans
Sponsoring organization: Citizens' Health Care Working Group Final recommendations by the Citizens' Health Care Working Group to Congress and the President. The recommendations describe a vision and plan for achieving broad-based change in health care in America. Addresses health care cost, coverage and access. Date: 09 / 2006
Improving Knowledge Transfer among Health Researchers and Decisionmakers at the Border: An Expert Meeting
Sponsoring organization: Office of Rural Health Policy Summary of a June 26, 2007 meeting to identify ways to improve the translation and dissemination of U.S.-Mexico border health research produced in the United States so as to maximize its use by decisionmakers in health policy and practice. Date: 06 / 2007
Knowing What Works in Health Care: A Roadmap for the Nation
Sponsoring organization: Institute of Medicine Results of the Robert Wood Johnson Foundation request that the Institute of Medicine convene a committee to recommend methods to better identify the most effective health care services. This report provides a blueprint for a national clinical effective assessment program. Date: 2008
Medicaid and Its Importance to Rural Health
Author(s): Keith J. Mueller, Andrew F. Coburn, A. Clinton MacKinney, Timothy D. McBride, Rebecca T. Slifkin, Mary Wakefield Sponsoring organization: Rural Policy Research Institute (RUPRI) Rural Health Panel Overview of the impact that Medicaid has on rural health. Covers the role of Medicaid in rural areas as a source of health insurance, as a revenue source for rural providers, and as a contributor to the community by supporting its health care system and local economy. Date: 05 / 2006
Medicare Advantage Plans in Rural America
Author(s): Andrew F. Coburn, A. Clinton MacKinney, Timothy D. McBride, Keith J. Mueller, Rebecca T. Slifkin, Mary K. Wakefield Sponsoring organization: Rural Policy Research Institute (RUPRI) Rural Health Panel Identifies key policy issues and questions concerning the impact of Medicare
Advantage (MA) in rural areas. Date: 10 / 2007
Medicare Reform: A Rural Perspective. A Report of the National Advisory Committee on Rural Health
Sponsoring organization: National Advisory Committee on Rural Health and Human Services Report to the Secretary of the U.S. Department of Health and Human Services. Examines the status of the Medicare program as it
relates to rural beneficiaries. Focuses on key policy issues to ensure that rural
beneficiaries are treated equitably under a
newly designed Medicare program. Discusses rural health care finance, access, quality, and workforce. Discusses Medicare reform and makes recommendations. Date: 05 / 2001
National Rural Assembly Final Report
Sponsoring organization: W.K. Kellogg Foundation Final report of the First National Rural Assembly. Covered Demographic Transitions; A Changing Rural Economy; Investment and Resource Distribution; Community Institutions and Civic Leadership; and Environmental Challenges. Date: 06 / 2007
Office of Rural Health Policy FY 2006 Annual Report
Sponsoring organization: Office of Rural Health Policy Annual report of the work of the federal Office of Rural Health Policy (ORHP) for Fiscal Year 2005. Includes information on ORHP's budget, policy activities, special projects, grant programs, and staff. Date: 07 / 2007
Office of Rural Health Policy Strategic Plan, FY 2005-2010
Sponsoring organization: Office of Rural Health Policy Strategic plan listing the mission, vision and goals for the years 2005-2010 for the Health Resources and Services Administration's (HRSA) Office of Rural Health Policy (ORHP). Date: 08 / 2005
Quality Through Collaboration: The Future of Rural Health Care (Full Report)
Sponsoring organization: Institute of Medicine Examines the quality of health care in rural America. Includes recommendations to improve health care quality and safety in rural communities. Addresses workforce, information technology, finance and other factors that impact rural health care quality. Date: 11 / 2004
Report to the Congress: Medicare Payment Policy, 2008
Sponsoring organization: Medicare Payment Advisory Commission Annual review of Medicare payment policies, with recommendations to Congress. Discussions of rural aspects of Medicare payment policies are included throughout the report. (Large file) Date: 03 / 2008
Report to the Congress: Promoting Greater Efficiency in Medicare
Sponsoring organization: Medicare Payment Advisory Commission Describes the changing beneficiary profile
in Medicare and its implications for the program. Examines approaches to promote greater efficiency
in the Medicare program. Includes discussion of Medicare Advantage (MA), the wage index, and Medicare coverage of drugs. Date: 06 / 2007
Report to the Congress: Rural Payment Provisions in the Medicare Prescription Drug, Improvement, and Modernization Act of 2003
Sponsoring organization: Medicare Payment Advisory Commission Examines the impact of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) provisions on rural hospital payments. Present the effect of eight MMA provisions
on Medicare inpatient and outpatient payments to traditional (non-CAH) hospitals. Summarizes the MMA changes to Critical Access Hospital (CAH) payment policies discussed in MedPAC's interim report. Examines the effects of higher payments on hospital costs. Date: 12 / 2006
Rural Definitions for Health Policy and Research
Author(s): L. Gary Hart, Eric H. Larson, Denise M. Lishner Compares several rural definitions and discusses their strengths and weaknesses. Also addresses the issues related to using geographic definitions in policy and research. Journal citation: American Journal of Public Health Volume 95 Issue 7 Pages: 1149-1152 Date: 07 / 2005
Rural Public Health: Issues and Considerations
Sponsoring organization: National Advisory Committee on Rural Health and Human Services Report to the Secretary of the U.S.
Department of Health and Human Services. Overview of the rural public health infrastructure. Addresses public health leadership, workforce preparedness, support for safety net providers, the impact of managed care, telecommunications, and funding for rural public health. Date: 02 / 2000
State Rural Initiatives: Where the Money Comes From
Discusses how states are financing rural programs, projects and initiatives. Includes descriptions of over 40 programs, projects or initiatives that are statewide in scope. Date: 01 / 2006
Targeted Look at the Rural Health Care Safety Net
Sponsoring organization: National Advisory Committee on Rural Health and Human Services Report to the Secretary of the U.S. Department of Health and Human Services. Discusses the safety net, the web of professionals and institutions that provide care to the poor and uninsured regardless of ability of pay. Also covers key safety net programs under the purview of the Secretary of Health and Human Services. Its findings fall into three categories: ensuring access to hospital services, ensuring access to primary care, and maintaining an adequate workforce. Date: 04 / 2002
Toward More Effective Use of Research in State Policymaking
Author(s): Jack A. Meyer, Tanya T. Alteras, Karen Adams Sponsoring organization: Commonwealth Fund Offers a conceptual framework to support effective use of health services research in state health policymaking. Provides practical lessons and communication strategies. Includes a case study of Massachusetts' health care reform legislation. Date: 12 / 2006
Journals
Federal Register
Official daily publication for Rules, Proposed Rules, and Notices of Federal agencies and organizations, as well as Executive Orders and other Presidential Documents. Among its numerous notices are notices of funding availability.
Health Affairs
Peer-reviewed publication focusing on U.S. health policy and health care. Content is available free online after three years.
Journal of Rural Health
Offers research of projects to improve rural health, statistics, and mathematical models. Provides summaries of recently published rural health research. Provides links to author, subject and abstract indexes.
Rural Roads
NRHA magazine focusing on human-interest stories and successful rural programs.
Organizations
AcademyHealth
Academic/Research
Promotes interaction across the health research and policy arenas by bringing together a broad spectrum of players to share their perspectives, learn from each other, and strengthen their working relationships.
American Hospital Association (AHA)
National organization
Represents and serves all types of hospitals, health care networks, patients and communities.
Medicare Payment Advisory Commission (MedPAC)
Federal government
An independent federal body that advises the U.S. Congress on issues affecting the Medicare program.
National Academy for State Health Policy (NASHP)
National organization
Works to help states achieve excellence in health policy and practice. Conducts policy analysis, provides training and technical assistance to states, and convenes state, regional, and national forums.
National Advisory Committee on Rural Health and Human Services (NACRHHS)
Federal government
21-member citizens' panel of nationally recognized rural health experts that provides recommendations on rural issues to the Secretary of the Department of Health and Human Services.
National Association of Community Health Centers (NACHC)
National organization
Provides services and technical assistance to community, migrant, and homeless health centers.
National Association of Rural Health Clinics (NARHC)
National organization
Works to improve the delivery of quality, cost-effective health care in rural underserved areas through the Rural Health Clinics (RHC) Program.
National Health Policy Forum (NHPF)
National organization
A non-partisan health policy information exchange program that works to foster more informed government decision-making. NHPF primarily serves the senior staff in Congress, the executive branch and congressional support agencies.
National Organization of State Offices of Rural Health (NOSORH)
National organization
Works to foster and promote legislation, information exchange, education, and liaison activities with all State Offices of Rural Health, the federal Office of Rural Health Policy, the National Rural Health Association, and other organizations.
National Rural Health Association (NRHA)
National organization
Promotes leadership, ideas, information, communication, education, research, advocacy, and methods to improve rural health. Composed of individual and organizational members who share a common interest in rural health.
National Rural Network (NRN)
National organization
Works to create awareness and understanding of those public policies which enhance the viability of Rural America.
NORC Walsh Center for Rural Health Analysis
Academic/Research
One of eight Rural Health Research Centers funded by the Office of Rural Health Policy. Focuses on changes in Medicare payments to rural providers,
access to care for rural residents, and rural public health infrastructure.
North Carolina Rural Health Research and Policy Analysis Center (Cecil G. Sheps Center)
Academic/Research
One of eight Rural Health Research Centers funded by the Office of Rural Health Policy. Works to identify rural health problems through policy-relevant analyses, geographic and graphical presentation of data, and information dissemination. Focuses on rural hospitals and healthcare delivery organizations and access.
Office of Rural Health Policy (ORHP)
Federal government
Promotes better health care service in rural America. Part of the Health Resources and Services Administration, U.S. Department of Health and Human Services. Focuses on matters affecting rural hospitals and health care, coordinating activities within the department that relate to rural health care, and maintaining a national information clearinghouse.
RUPRI Center for Rural Health Policy Analysis
Academic/Research
One of eight Rural Health Research Centers funded by the Office of Rural Health Policy. Focuses on rural health care financing/system reform, rural systems building, and meeting the health care needs of special rural populations.
Rural Policy Research Institute (RUPRI)
Academic/Research
Conducts policy-relevant research and facilitates public dialogue to assist policymakers in understanding the rural impacts of public policies and programs.
Rural Policy Research Institute (RUPRI) Rural Health Panel
Academic/Research
Provides decision makers with timely, objective, and expert analysis of the implications of policy for rural health.
Terms & Acronyms
Advocacy Communication and action taken by an individual or organization in support of an issue or cause.
Final Rule The final version of a regulation issued by a regulatory agency to implement some aspect of a law and published in the Federal Register.
Health Policy Principles and plans of action to address issues of concern to the provision and availability of health care services.
Membership Organization A group of individuals or organizations that works together to achieve goals relevant to the concerns and needs of the membership.
Policy Principles and plans of action that a government uses to address an issue and achieve specific goals.
Proposed Rule A draft version of a regulation issued by a regulatory agency that will be used to implement some aspect of a law. Proposed rules are published in the Federal Register along with a request for comments from interested parties.
Regulatory Agency A government agency that is assigned to enforce laws passed by the government, often by issuing and enforcing specific rules related to those laws.
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