The recommendations and case studies contained in this report are designed to aid Appalachian county leaders in their efforts to formulate responses to the opioid epidemic.

This brief characterizes rural/urban disparities in the 2019 CMS hospital wage index by describing and comparing the wage indices of rural and urban hospitals by the number of beds, the amount of net patient revenue, and Medicare payment classification.

Briefing Paper presents state and national median values of the twenty-three financial indicators specifically designed to capture the financial performance of CAHs.

Along with genetic predisposition, environmental exposures, cultural influences, diet, and substance use, the lack of access to medical information and services has also contributed to the high AI/AN cancer mortality rates. However, researchers, nonprofits, tribal healthcare facilities, and cancer centers are stepping up to address these factors and create solutions. Across the nation, models for cancer research dissemination, prevention, and treatment are emerging to engage Native populations in cancer care.

This resource presents current hospital-based obstetric closure rates and characteristics of rural communities without and losing obstetric services, as well as the impact of limited access on maternal and child health.

Recap provides a summary of the research on rural women’s utilization of healthcare services, maternal substance use, and other health indicators.

A new proposed rule would update Medicare payment policies for hospitals under the Inpatient Prospective Payment System and the Long-Term Care HospitalProspective Payment System by proposing changes to the way Medicare pays hospitals.

Series of three policy briefs investigates 2015 to 2019 trends in risk of financial distress among rural hospitals by census region and Medicare payment classification, investigates 2019 geographic variation in risk of financial distress among rural hospitals, compares characteristics of communities served by rural hospitals predicted to be at high risk of financial distress to those served by rural hospitals predicted to not be at high risk of financial distress in 2019.

This study provides a more current examination of national data to understand whether preventive health services differences among rural and urban women can be explained by health status and sociodemographic characteristics.

An analysis of Medicare data for rural, fee-for-service Medicare beneficiaries who utilized home health from 2011 to 2013 found significant differences in care processes between community-entry and post-acute home health.

Fact sheet outlines barriers to electronic health record implementation in rural settings.

On April 23, 2019, the Centers for Medicare & Medicaid Services (CMS) proposed a rule that focuses the agency’s efforts on a singular objective: transforming the healthcare delivery system through competition and innovation to provide patients with better value and results. These policies would support the agency’s priority of “Rethinking Rural Health” and help guarantee people living in rural America have access to high quality, affordable healthcare. This fact sheet discusses major provisions of the proposed rule.

An analysis of Medicare data for rural, fee-for-service Medicare beneficiaries who utilized home health from 2011 to 2013 found significant differences in care processes between community-entry and post-acute home health.

This brief summarizes statistics on opioid misuse and overdose deaths in Appalachian communities, discusses key strategies and resources for addressing opioid misuse and overdose deaths, and provides recommendations for community leaders, funders, and policymakers.

This policy brief examines primary care clinician participation in the CMS Quality Payment Program (QPP), parsed by clinician type (e.g., physician, physician assistant, advanced practice nurse), clinician specialty (e.g., general internal medicine, family medicine, general pediatrics), clinician practice location, and Advanced Alternative Payment Model (A-APM) or Merit-Based Incentive Payment System (MIPS) program participation.

This report summarizes reporting rates and performance among all U.S. Critical Access Hospitals (CAHs) on Hospital Compare inpatient and outpatient process of care and structural measures for calendar year 2017. The Flex Monitoring Team also produces state-specific CAH reports with more detailed results.

Announcement from the Health Resources and Services Administration (HRSA) of a 30-day preview period for the review of the Health Center Program Service Area Considerations Request for Information (RFI). After the preview period, a 60-day comment period will begin to obtain information on service area considerations to inform HRSA decisions about the expansion of services through the addition of new delivery sites to existing health centers.

To develop recommendations to address the low case-volume challenge for rural providers, NQF convened a five-member Technical Expert Panel (TEP) comprised of statistical experts and measure methodologists. As part of the effort, the TEP reviewed previously identified approaches to the low case-volume challenge and offered four new recommendations. TEP members also suggested several additional ideas for future work that could further address the low case-volume challenge for rural providers.

A series of papers discussing oral health access and outreach to rural communities.

The Providers premieres on Independent Lens April 8, 2019. Tune in or stream at 10:00 p.m. Eastern/9:00 p.m. Central on PBS (check local listings). Set against the backdrop of the physician shortage and opioid epidemic in rural America, The Providers follows three healthcare providers in northern New Mexico. They work at El Centro, a group of safety-net clinics that offer care to all who walk through the doors.

This report describes recent experience with an intervention designed to address the challenges facing people with complex health and social needs in three rural Montana communities in Kalispell, Billings, and Helena. (MedStar Health Research Institute)

Madison County, North Carolina, stands out in a region lagging in health and opportunity. (U.S. News)

In this cross-sectional study of an estimated 223.7 million retail opioid prescriptions filled annually between 2006 and 2017, the amount of opioids prescribed increased up to 2010, then decreased, for a net reduction of 13%, with the greatest decrease occurring in 2017. One in 3 opioids were prescribed for a duration of 30 days or more, increasing 3% annually; in 5 of 6 measures studied, there was a 2- to-3-fold variation among states.

This brief uses data from the 2012–13 Medicare Current Beneficiary Survey (MCBS) to describe these differences, and combined with county-level data on MA issuer participation, this dataset also allows us to assess the degree to which issuers may engage in selective MA market entry on the basis of demographic characteristics.

This study demonstrates how a county's context can affect NAS rates. The rate of babies born with NAS varied across the 580 counties examined, but the rates were often highest in the most rural counties. The study also links higher NAS rates with high long-term unemployment rates, highlighting the sustained influence of poor economic conditions, especially in rural areas.

Brief examines county-level differences in premature death (years of potential life lost before age 75 per 100,000 people) by county-level racial and ethnic composition, across rural and urban counties and calculates whether there were rural-urban disparities in mortality within counties with similar racial and ethnic compositions.

This report describes the results of semi-structured discussions with officials representing seven state Medicaid programs and with providers and health center leadership representing 19 Federally Qualified Health Centers (FQHCs) in those states. It describes how rural and urban FQHCs use various forms of telehealth and how Medicaid policy influences the delivery of telehealth services to underserved populations.

In order to meet the needs of rural residents, hospitals and health systems must think innovatively about delivery models, community partnerships, telehealth, care teams and recruitment. Post describes examples from the field on how rural hospitals and health systems are strategically and efficiently rethinking workforce planning and development to deliver high-quality care to their communities.

This publication discusses the ability of small rural practices to successfully participate in CMS's Quality Payment Program.

The New York Academy of Medicine’s Journal of Urban Health February Special Supplement focuses on new research on opioid overdose.

In Appalachia the number of mental healthcare professionals per 100,000 residents was 35% lower than the national average. In the southern and north central sub-regions of Appalachia, it further decreases to 50% fewer mental healthcare professionals than the national average.1

Study demonstrates how to apply the capture–recapture method for population estimation directly in a rural Appalachian county (Cabell County, WV) to estimate the number of people who inject drugs (PWID).

As deaths from heroin, fentanyl, and prescription opioids soar in the U.S., a new study looks at the geographic factors driving the drug overdose epidemic.

This paper focuses on unique challenges in health insurance markets facing rural people, providers, and place by identifying how and when these challenges stem from what economists call “market failures,” defined narrowly or broadly. It reviews how previous government interventions and programs have sought to redress insurance market failures, and assesses the success (or lack thereof) of these interventions, and concludes with observations about the current landscape of rural insurance markets and suggestions for policy interventions and further research.

This publication compares the existing conditions of the opioid epidemic in Iowa to surrounding states, conditions related to the opioid crisis across Iowa counties and provides strategies and resources to address opioid abuse in Iowa communities.

The Journal of Rural Health is looking for paper submissions that describe current and historical social factors affecting youth obesity within rural Appalachia. Submissions are due by June 28, 2019.

This fact sheet describes some of the challenges rural communities face in providing access to evidence-based treatment and strategies used by federal and state agencies to enhance treatment capacity, including how one rural community responded to the opioid epidemic by addressing the specific needs of its residents.

This feature is the third post in a series, “Listening to Primary Care Physicians for Low-Income Patients,” that draws on focus group research to illustrate the challenges of serving low-income patients. This post uses primary care physicians’ words to illustrate how serving low-income patients in rural communities can be particularly challenging.

Data book contains a wide range of current county-level information on the resident population, economy, social environment, population health, health workforce, and the health care delivery system. It includes important data for public policy makers, health care professionals and administrators, rural health care advocates, and residents of rural and frontier Nevada.

Issue Brief highlights four strategies rural hospitals are using to improve value by reducing cost, improving quality or enhancing the patient experience.

Proposal from the National Organization of State Offices of Rural Health for rural-specific objectives to be considered for Healthy People 2030.

This paper examines the efforts of state Flex programs to support the development of Emergency Medical Services (EMS) time critical diagnoses (TCD) systems of care, which includes stroke, ST-Elevation Myocardial Infarction (STEMI), and trauma.

Brief works to define quality of care in rural hospital.

The Snapshot of Rural Health is prepared as a resource to highlight and advance interest in rural health issues in Colorado.

The purpose of this study was to determine what effect a rural-based 8-week surgical clerkship during the third year of medical school in a rural setting has on students’ opinions about rural living and practice.

The purpose of this Notice is to promote the expansion of the NCATS Clinical and Translational Science Awards (CTSA) Program’s efforts to accelerate clinical and translational research to address health disparities and the significant burden of conditions that disproportionately affect rural, minority, and other underserved populations.

Toolkit for population size estimation with specific emphasis on applying population estimation methods among people who inject drugs in rural communities.

A study recently published in JAMA Network Open looked at county-specific federal data and found that the more opioid-related marketing dollars were spent in a county, the higher the rates of doctors who prescribed those drugs and, ultimately, the more overdose deaths occurred in that county.

The majority of rural women give birth at their local hospitals and therefore rely on local maternity services. ii However, women have lost access to local services with over 10% of rural counties losing these services in the past fifteen years. Initial studies show a doubling of Infant mortality rate where counties have lost OB services, compared with a decrease in infant mortality rate where services are available. 39 Additionally, out of hospital birth, preterm birth and deliveries in hospitals lacking OB units increased.

Analysis of patient opioid prescription data from a national electronic health record vendor during 2014–2017 found that the percentage of patients prescribed an opioid was higher in rural than in urban areas. Significant decreases in opioid prescribing occurred across all urban-rural categories after the March 2016 release of the CDC Guideline for Prescribing Opioids for Chronic Pain.

Paper explores a series of health policies that have affected, or had the potential to affect, rural people, places, and/or providers in ways counteractive to policy intent.

Open-access study assesses rural-urban differences in obesity rates in older adults, and the potential for the associations between obesity and physical activity and dietary patterns to vary by rural-urban status.

Blog post highlights how the challenges of low population density and higher average fixed costs in rural areas can be addressed to offer affordable health insurance.

Report summarizes results of a series of forums to evaluate Ohio counties on strengths and challenges, equity, priorities, and state health assessment improvements.

Report presents commonly used indicators of substance use in New Mexico by race, gender, and age group.

Telehealth can connect geographically dispersed patients and providers and is a promising approach to expand access and enhance quality of Medication-Assisted Treatment (MAT) for Opioid Use Disorder (OUD).

Rural Americans are more likely than people in urban and suburban areas to say access to good doctors and hospitals is a major problem in their community. Nearly a quarter (23%) of Americans in rural areas say this, compared with 18% of urbanites and 9% of suburbanites, according to a Pew Research Center survey conducted earlier this year.

Republican Members of the House Ways and Means Committee have introduced a series of health care bills. These initiatives aim to cut excessive red tape and administrative burdens, increase access to care in rural areas, and improve the integrity of the Medicare program.

Rural communities are losing their hospitals across the United States. Eight-three hospitals have closed their doors since January 2010. This report seeks to answer the question, “What’s next for these rural communities?” and contains the findings from three rural Texas communities, a blueprint for next steps, and an appendix section of summary papers for further information.

A new report describes the influence of state and federal laws and polices on choice and competition in health care markets; and identifies actions that states or the Federal Government could take to develop a better functioning health care market.

Interactive presentation on the definitions of rural and urban, rural health indicators, geography and health outcomes, the social determinants of health, rural behavioral health, and identifying needs of the entire community rather than just priority populations. (New Mexico Public Health Institute)

Policy paper examines rural hospital and health system motivations for affiliation and present a non-exhaustive list of common affiliation structures with representative examples.

This report summarizes findings and recommendations from SPRC’s exploration of suicide surveillance among American Indian and Alaska Native (AI/AN) communities across the country. Each section describes challenges and provides strategies and resources to help AI/AN communities gather data on suicide to inform and evaluate their prevention efforts.

Data brief describes the progress hospitals made in four interoperability domains – sending, receiving, finding, and integrating electronic health information. The data brief shows that engagement in interoperability varies among small, rural, and critical access hospitals (CAHs).

Brief highlights the Alaska Health Workforce Coalition, which has facilitated many of the state’s workforce initiatives.

This brief highlights key regulatory changes to the Merit-based Incentive Payment System (MIPS) in 2018 and discusses the importance of the changes, particularly as they affect small and rural practices.

Analysis of federal data shows insurance plans in urban areas had significantly lower premiums than plans in rural areas for the most commonly purchased coverage under the Affordable Care Act.

Recap identifies rural disparities in age, health status, and income.

This policy brief updates a RUPRI Center brief published in 2014 and documents the continued growth in system affiliation by both metropolitan and non-metropolitan hospitals.

Indiana has achieved a number of successes to meet specific health care workforce development needs, such as providing Medicaid reimbursement for community health worker (CHW) services, a pre-nursing certificate pathway for certified nursing assistants (CNAs), and a framework for comprehensive review of state licensing. Many of these successes have been supported by the Indiana Governor’s Health Workforce Council, a cross-agency funded body that serves as a forum to convene stakeholders, establish priorities, and develop policy recommendations. This case study highlights how Indiana has utilized these types of cross-agency approaches to bolster health care workforce development.

Study analyzed mortality associated with some of the most common cancer types in the U.S.—breast, cervical, lung, prostate, and colon—over an eighteen-year period from 1999- 2016 and explored the roles played by rurality and region in this process.

Report analyzes three basic telehealth activities as practiced by consumers age 15 or older: (1) online health research; (2) online health maintenance (communication with health providers, including communicating with medical practitioners, maintaining records, and paying bills); and (3) online health monitoring via devices that exchange data remotely with medical personnel.

Using data combined from the 2013-2015 National Health Interview Surveys, this brief examines characteristics of individuals with Medicaid coverage - children and adults - in rural areas, as well as their access to care and use of services, comparing their experience to their privately insured and uninsured counterparts.

Issue brief provides a snapshot of how CAHs are using the CHNA process and information to address community needs.

This guide explains the various quality reporting programs that CAH’s may participate in. The programs are outlined via the areas the hospital covers (ex. Outpatient, Inpatient etc.) and the type of program the hospital is associated with (ex. HCAHPS, Medicare Beneficiary Quality Improvement Project, etc.).

The Center for Optimizing Rural Health is excited to partner with communities and facilities to identify opportunities to improve health outcomes, reduce costs and increase access to care. The first step will be for communities/facilities to apply to be a part of the Center’s outreach. Applications will be accepted October 30-November 30.

Snohomish County in Western Washington is taking a unique approach to tackle the opioid epidemic. Last year, leaders declared the opioid epidemic a life-threatening emergency. The county is now responding to the drug crisis as if it were a natural disaster, the same way it would mobilize to respond to a landslide or flu pandemic.

The mission of the ARPO Strike Force is to identify and investigate health care fraud schemes in the Appalachian region and surrounding areas, and to effectively and efficiently prosecute medical professionals and others involved in the illegal prescription and distribution of opioids.

Article examines rural domestic violence and intimate partner violence. Addresses prevalence rates, provider knowledge gaps, and associated healthcare costs.

To better understand the barriers to implementing policy; systems; and environmental (PSE) change initiatives within Supplemental Nutrition Assistance Program-Education (SNAP-Ed) programming in U.S. rural communities; as well as strategies to overcome these barriers, this study identifies: (1) the types of nutrition-related PSE SNAP-Ed programming currently being implemented in rural communities; (2) barriers to implementing PSE in rural communities; and (3) common best practices and innovative solutions to overcoming SNAP-Ed PSE implementation barriers.

Report summarizes results from the Rural Community Hospital Demonstration (RCHD). The demonstration's goal was to assess the feasibility and advisability of cost based reimbursement for small rural hospitals too large to be Critical access Hospitals (CAHs).

This study focused on the role of housing supply, demand, and affordability to assess future production needs for affordable rental housing in rural areas.

Blog post highlights the recent release of A Core Set of Rural-Relevant Measures and Improving Access to Care, which outlines challenges and offers solutions for both quality measurement and access issues particular to rural health care.

From the “do’s and don’ts” of screening to the “do’s and don’ts” when violence is disclosed, rural providers need to be prepared to meet the challenges of this ongoing public health crisis.

This report is the result of individuals who live in rural settings regarding their concerns about health care and economics, as well as their desire to continue living in their communities.

Fact sheet documents the responsibilities, capabilities, and challenges of rural and frontier healthcare coalitions (HCCs) in preparing for and responding to emergencies and disasters.

Brief explores how census data are used to determine which areas are considered rural, to inform other surveys that characterize rural residents, and to make funding decisions for federal programs that serve those residents.

Brief describes how the census will be conducted in rural areas and identifies strategies to ensure a more accurate count in these communities.

NEJM Catalyst surveyed their Insights Council members to understand the similarities and disparities between health care in rural and urban/suburban settings, and to get a clearer picture of the barriers that exist in delivering excellent care to rural settings.

This policy brief uses data from interviews with 22 key informants in 12 states, all of whom were experts in the issue of social isolation and/or rural health, to describe key challenges and opportunities related to rural social isolation.

Blog post outlines how policy focuses on payment reform, health care delivery, workforce development, partnerships, and research can improve rural health care in America.

Report highlights the state of rural America and provides recommendations on improving financial security, education, infrastructure, affordable housing, and access to affordable healthcare.

This report describes (1) how HHS supports and monitors rural hospitals' financial viability and rural residents' access to hospital services and (2) the number and characteristics of rural hospitals that have closed in recent years and what is known about the factors that have contributed to those closures.

This paper examines the status of insurance coverage for low-income citizen adults in the 46 states with significant rural populations.

The Collaborative for Rural Primary Care, Research, Education, and Practice (Rural PREP) is dedicated to making research more accessible through its community of practice activities. Rural PREP programs bring people together in a community of practice around education, training, and research.

Brief examined rates of diagnosis of maternal OUD and infant NAS at the time of childbirth for rural residents, based on the type of hospital where the birth occurred—rural hospital, urban non-teaching hospital, or urban teaching hospital.

The National Rural Health Resource Center developed this report following a Summit of key rural hospital and clinic stakeholders to identify the most important financial indicators and strategies to transition to value-based payment. This report is designed to help rural hospital and clinic leaders meet this transition with financial success.

After the national multibillion-dollar investment in health information technology (HIT) over the past decade, rural healthcare organizations are now exploring how electronic health record (EHR) data can deliver on its promise of improving patient care.

This initiative calls for the development of Rural Health Section composed of NACCHO members and partners working together on specific rural public health issues across multidisciplinary and programmatic expertise in support of NACCHO’s mission.

Report describes Medicare accountable care organization (ACO) growth in nonmetropolitan U.S. counties from 2016 to 2017. This data report, which includes data through December 2017, follows a similar analysis released in October 2016 that described ACO trends from 2013 to 2015.

Study describes the number and geographic distribution of 380 rural hospital mergers from 2005 through 2016.

Brief highlights transportation issues that Coloradoans have, preventing access to health care.

Brief summarizes results from a survey of rural health leaders on current value-based care priorities.

This policy brief assesses the changes in average HIM plan premiums from 2014 to 2018, before accounting for subsidies, with an emphasis on the widening variation across rural and urban places, providing information during Congressional debates on the future of the program.

This study examines whether rural residents are more likely than their urban counterparts to experience income shifts that could change their eligibility for expanded Medicaid.

This fact sheet describes the role of rural hospitals in serving Medicaid beneficiaries and how Medicaid programs pay rural hospitals.

A study of cancer and other health outcomes in a cohort of licensed pesticide applicators and their spouses. The study began in 1993 and has had over 89,000 participants.

This biannually-updated atlas provides information on people, jobs, and county classifications for rural America, including socioeconomic indicators, employment trends, income, rural-urban continuum, economic dependence, child poverty, and more.

Tool to allow users to map overdose hotspots and overlay them with data that provide additional context to opioid addiction and death - including the strength and diversity of local economies, ethnicity, educational attainment, and disability status of residents.

Table of the urban-rural continuum and modified RUCA Codes for all counties in the United States.

A crosswalk of ZIP Codes identifying the set of Non-Metro Counties and rural Census Tracts (CTs) that comprise rural areas as defined by FORHP.

Access to sites provides rural health statistics and data.

HSRR is a searchable database of information about research datasets, instruments/indices and software employed in Health Services Research, the Behavioral and Social Sciences and Public Health. The database includes brief descriptions of research resources and links to PubMed.

Website allows users to explore health data in their community and build downloadable reports, maps, and charts on 41 health measures at the county, regional, and state levels for the 13 Appalachian states.

A timely, multidimensional view of poverty-related need based on Salvation Army and federal data on meal assistance, housing assistance, and more.

The Market Saturation and Utilization Data Tool includes an interactive map and a data set that shows national-, state-, and county-level provider services and utilization data for selected health service areas.

Maps on all aspects of rural health care.

An interactive map to learn about, access or replicate actions rural leaders are taking in small towns across the country to address the opioid epidemic through prevention, treatment and recovery opportunities.

This Population Health Portal, created in cooperation with the Federal Office of Rural Health Policy, helps critical access hospitals, Flex Coordinators and rural health networks navigate the journey towards improved population health.

The report looks primarily at adult and child poverty levels in rural areas.

A USDA report that provides recent socioeconomic indicators in rural areas, including employment, population, poverty, and income trends.

RHIhub's Rural Data Visualization section provides access to a range of tools to explore issues that impact rural health. The visualizations are based on data from federal and other publicly available data sources, and illustrate that data in a variety of formats to show how rural areas compare. Data is also available for download.

The Rural Health Explorer includes several mapping tools focused on health outcomes, social determinants, and health care workforce in rural areas.

Links to general rural health resources as well as informational topic pages on specific rural health issues. Includes data, best practices, and case studies.

This chartbook presents statistical data on population demographics, health risk factors, age-specific and cause-specific mortality, access to care, health insurancecoverage, and mental health for urban and rural populations.

This study examines state- and county-level data on population, age, race and ethnicity, housing occupancy and housing tenure, education, labor force, employment and unemployment, income and poverty, health insurance coverage, disability status, migration patterns, and veteran status from the 2011-2015 American Community Survey (ACS) for the 13 Appalachian states.

This chartbook provides indicators of the health and well-being of children, the supportive and risk factors in the family environment, and aspects of the neighborhood that may support or threaten families and children in rural settings.

This report looks at the many factors, including incomes that did not rise with economic expansion, that contributed to a 6.6% rise in rural child poverty.

Use the Rural Health Value Team's comprehensive Value-Based Care Strategic Planning Tool (VBC Tool) to assess 121 different value-based care capacities in eight categories. After completion, users receive a Value-Based Care Readiness Report that can be used to assess an organization's readiness for value-based care and to develop value-based care action plans.

Site provides information on hiring grant writing consultants, considerations before applying, creating an evaluation plan, and more.

The NOFO combines evidence-informed (1) policy, systems, and environmental changes (obesity, tobacco), and (2) clinical-community linkages (diabetes, heart disease and stroke prevention) strategies which may be culturally-adapted to meet the needs of the American Indian and Alaska Native communities.

Initiative provides financial and technical assistance to eligible healthy food retail projects across the country. HFFI aims to provide financial resources and expertise necessary to expand access to healthy foods in underserved areas, to create and preserve quality jobs, and to revitalize low-income communities.

The Rural Health Fellows program is a yearlong, intensive training program that develops leaders who can articulate a clear and compelling vision for rural America.

Program to support treatment for and prevention of substance use disorder, including opioid abuse. The overall goal of the program is to reduce the morbidity and mortality associated with opioid overdoses in high-risk rural communities by strengthening the capacity of multi-sector consortiums to address: prevention, treatment, and/or recovery.

The Rural Communities Opioid Response Program (RCORP) is a $120 million opioid-focused initiative by the Health Resources and Services Administration (HRSA) aimed at reducing the morbidity and mortality of substance use disorder (SUD), including opioid use disorder (OUD), in rural counties at the highest risk for SUD. RCORP-Medication-Assisted Treatment Expansion (RCORP-MATE) will advance RCORP’s overall goal by establishing and/or expanding MAT programs in high-risk rural communities, thereby increasing the number of access points where rural individuals with opioid use disorder can receive evidence-based treatment.

This notice announces the opportunity to apply for funding under the Rural Communities Opioid Response Program – Rural Centers of Excellence on Substance Use Disorders (RCORP-RCOE). RCORP-RCOE is part of the RCORP initiative, which is a multiyear effort to reduce the morbidity and mortality of substance use disorder (SUD), including opioid use disorder (OUD), in rural communities at the highest risk for these conditions.

Summaries of funding programs provided by RAC.

The Robert Wood Johnson Foundation’s (RWJF) Healthy Communities theme is interested in identifying and funding a Rural Learning and Coordinating Center (Center) (final name TBD) to work alongside RWJF, rural communities, and others in the field committed to improving rural health equity and well-being in our nation. The Center will provide systematic learning and coordination across those working nationally and regionally to advance social and economic conditions in rural communities, which ultimately lead to better health and well-being.

The purpose of the Rural Maternity and Obstetrics Management Strategies program (RMOMS) is to is to improve the access to and continuity of maternal obstetrics care in rural communities.

SAMHSA is accepting applications for fiscal year (FY) 2019 Rural Opioid Technical Assistance Grants (Short Title: ROTA). The purpose of this program is to develop and disseminate training and technical assistance for rural communities on addressing opioid issues affecting these communities.

The purpose of the Rural Quality Program is to support planning and implementation of quality improvement activities for rural primary care providers or providers of health care services, such as a critical access hospital or a rural health clinic, serving rural residents.

The primary objective of the Socially Disadvantaged Groups Grant program is to provide technical assistance to socially-disadvantaged groups through cooperatives and Cooperative Development Centers.

Funding for clinical research focused on the development and utilization of technologies that can help address patient outcomes. Relevant areas of technology include remote healthcare delivery to patients via telehealth, robotics to enhance medication adherence, on-site care delivery, mobile heath to increase access and adherence, web-based decision support tools, and others.

The intent of this toolkit is to provide rural communities with the information, strategies, resources, and other important materials that could be helpful in implementing a program to improve access to care for people with disabilities.

This bibliography includes a two-part series; the first reviews the current state of rural healthcare and the second reviews graduate medical education financing.

This study locates agricultural health programs and courses and describes collaborations that exist between clinicians and agriculture-related agencies.

This catalog summarizes value-based programs from CMS and CMMI that are relevant to rural health care providers and populations.

Reports and chartbooks on rural health issues including Access to Care, Behavioral Health, Diabetes, Health Care Services, Maternal/ Perinatal Health, Child and Adolescent Health, Older Americans, Oral Health, Uninsured, and Border Health.

This guide from the Rural Assistance Center provides an overview of rural health research, needs assessments, and program evaluation, with tools and resources to support these activities.

Report use interviews with key informants in rural areas to identify assets in rural communities and to understand how these assets can accelerate changes to improve health and equity.

A listing of Federal programs that can be used to build resilient communities and address opioid misuse in rural communities.

Report analyzed data on 19 health indicators to identify counties whose health outcomes are better than those predicted based on socioeconomic and demographic data and other factors that influence health.

Policy brief outlines barriers, highlights federal programs and initiatives, and provides policy recommendations to improve oral health care in rural America.

This paper discusses the realities and challenges of designing a market structure that will result in affordable health insurance being offered in rural markets, and reviews the rural implications of policies affecting rural health insurance markets and health systems.

This “Life and Health in Rural America” report is based on a survey conducted for National Public Radio, the Robert Wood Johnson Foundation, and the Harvard T.H. Chan School of Public Health. The survey was conducted June 6 – August 4, 2018, among a nationally representative, probabilitybased telephone (cell and landline) sample of 1,300 adults ages 18 or older living in the rural United States. The purpose of this survey was to understand the current views and experiences of rural Americans on economic and health issues.

Between November 2017 and July 2018, the MAP Rural Health Workgroup focused on: (1) identifying a core set of the best available rural-relevant measures to address the needs of the rural population and (2) providing recommendations from a rural perspective regarding measuring and improving access to care. This report describes the selection criteria and processes used to generate the core set of measures, catalogs the core set of measures along with the rationale for inclusion for each measure, summarizes measurement gap areas identified by the Workgroup, and presents the Workgroup’s recommendations on access to care from a rural perspective.

Starting in 2017, this series of Morbidity and Mortality Weekly Report (MMWR) surveillance summaries highlights rural health issues and topics.

This series of policy briefs explores the range of elements that influence rural health, with special emphasis on the unique challenges and innovative solutions emerging in rural communities.

The toolkit compiles evidence-based and promising models and resources to support organizations implementing mental health programs in rural communities across the United States, with a primary focus on adult mental health.

This chartbook contains: an overview of the Quality and Disparities Reports (QDR), an overview of residents of rural areas, one of the priority populations of the QDR, summary of trends in health care quality and disparities for rural populations, and tracking of access and quality measures for rural populations.

The purpose of this website is to assist rural leaders with resources, information and best practices to help rural communities respond to and manage the opioid crisis.

Publications from the NC Rural Health Research Center examine various aspects of health disparities affecting rural populations.

Self-reported data from the 2012-2015 BRFSS were pooled to evaluate racial/ethnic disparities in health, access to care, and health-related behaviors among rural residents in all 50 states and DC, with a focus on rural adults.

Series of case studies focuses on how to improve rural healthcare by reinventing services, rethinking partnerships, refocusing on the population, reexamining policy, and rebuilding community.

A USDA report that provides recent trends in rural areas, including migration and population loss, income and employment, poverty, and broadband coverage.

Find a variety of briefs from the Economic Research Service at the USDA, including Rural Wealth Creation, Health Status and Health Care Access of Farm and Rural Populations, etc.

This webpage has assembled a selection of links concerning rural emergency preparedness and response.

Report explores the challenges to rural insurance markets, which are often not accounted for in the way insurance markets are structured, and considers recommendations to better support the use of managed care in rural areas.

Research, briefs, and reports related to rural health and rural health policy.

Rural Health Quarterly (RHQ) is a national rural health news magazine published by the F. Marie Hall Institute for Rural and Community Health and the Texas Tech University Health Sciences Center.

Rural Healthy People 2020's goal is to serve as a counterpart to Healthy People 2020, providing evidence of rural stakeholders' assessment of rural health priorities and allowing national and state rural stakeholders to reflect on and measure progress in meeting those goals. The specific aim of the Rural Healthy People 2020 national survey was to identify rural health priorities from among the Healthy People 2020's national priorities.

Compendium of all Rural Opioid Educational Resources available across the NOSORH website to aid individuals looking for education, tools, and other resources. This includes reports, webinar presentations, meeting presentations, and a compendium of resources and lessons learned from grantees of the Federal Office of Rural Health Policy's Rural Opioid Overdose Reversal (ROOR) grant program.

This toolkit presents practical strategies that can help rural communities build successful partnerships with philanthropies..

Report examines the persistent, recent, and emergent challenges facing rural hospitals and communities; and recommends updates to existing federal policies and areas for new federal investment to support rural hospitals and communities to ensure access to high-quality, affordable, and efficient health care.

This guide will help you learn about activities underway to address the opioid crisis in rural communities at the national, state, and local levels across the country. It identifies: initiatives and funding opportunities; rural program examples; and tools and resources focused on prevention, harm reduction, and treatment.

This page contains a variety of prepared information on the U.S. Department of Veterans Affairs' efforts to increase access to care for rural Veterans.

This systematic literature review examines the evidence regarding potential disparities between rural and urban areas in health care provision and delivery, and how differences in health care may contribute to disparities in health outcomes.

This report describes quality of health care received in 2017 by Medicare beneficiaries nationwide. Specifically, the report highlights rural-urban differences in health care experiences and clinical care and looks at how these differences vary by race and ethnicity.

Policy brief provides recommendations on how HHS can best address the social determinants of health in rural communities.

A topic page from Rural Health Information Hub on the social determinants for rural health, includes publications, information, and resources.

This study looks at the potentials for fewer available primary care physicians, especially in areas with lower population density and lower socioeconomic status.

Report summarizes recommendations from a bipartisan task force from the Bipartisan Policy Center and Senate to explore issues in Appalachia including education and workforce, job creation, energy and infrastructure, and health.

In a workshop held August 8-9, 2012, the use of telemedicine as a means to extend quality healthcare to isolated areas of the country was investigated.

This annual study explores the many factors negatively impacting rural provider sustainability while also examining lessons to learn from those facilities demonstrating the value of rural. Download requires free registration. (iVantage Health Analytics)

A brief module designed to acquaint rural health care teams on the issues regarding the social determinants of health.

A report from County Health Rankings and Roadmaps that discusses how to create healthier rural communities.

The CDC's Rural Health portal provides basic information, data, resources, public health programs, policy options, and success stories.

CMS is taking measureable steps toward improving access to health care for rural populations, including forming a council of experts tasked with addressing rural health issues, engaging stakeholders in rural communities, and partnering with health organizations to raise awareness.

The Center for Rural and Appalachian Health was established to improve the health of people living in our region, state, and throughout Appalachia. Their mission is to engage rural and Appalachian communities to advance health and improve quality of life, through research, collaboration, public health workforce development, and community activities.

The mission of USDA's Economic Research Service is to anticipate trends and emerging issues in agriculture, food, the environment, and rural America and to conduct high-quality, objective economic research to inform and enhance public and private decision making. Research topics include agriculture, food and nutrition, food safety, global markets, resources and environment, and rural economy.

Promotes better health care service in rural America.

The Flex Monitoring Team is a consortium of the Rural Health Research Centers at the Universities of Minnesota, North Carolina-Chapel Hill, and Southern Maine, funded by the Federal Office of Rural Health Policy to evaluate the impact of the Medicare Rural Hospital Flexibility Grant Program (the Flex Program).

The MAP Rural Health Workgroup, with oversight from the MAP Coordinating Committee, will provide recommendations on issues related to measurement challenges in the rural population. Additionally, the Workgroup will identify a core set of the best available (i.e., "rural relevant") measures and identify rural-relevant gaps in measurement.

The National Organization of State Offices of Rural Health (NOSORH) was established in 1995 to assist State Offices of Rural Health (SORH) in their efforts to improve access to, and the quality of, health care for America's 61 million rural citizens.

National nonprofit membership organization with more than 18,000 members. The association's mission is to provide leadership on rural health issues.

The National Rural Health Resource Center provides technical assistance, information, tools and resources for the improvement of rural health care. It serves as a national rural health knowledge center and strives to build state and local capacity.

Conducts, coordinates, promotes, and disseminates studies and analyses into issues affecting Veterans living in rural and highly rural areas, in cooperation with the medical, rehabilitation, health services and cooperative studies research programs.

Rural Health Information Hub (Rural Health Information Hub (RHIhub)) is a national resource on rural health and human services information. The Website offers online library, coverage of rural issues, state guides, toolkits, program models, and more. Provides customized assistance by phone or email. Funded by the Federal Office of Rural Health Policy.

The Federal Office of Rural Health Policy (FORHP) currently funds eight rural health research centers and three rural health policy analysis initiatives. The Gateway provides access to research and findings of the FORHP-funded Rural Health Research Centers,

Federal program that is dedicated entirely to producing policy-relevant research on health care in rural areas. Initiated in 1988, it is administered by the Office of Rural Health Policy (ORHP), Health Resources and Services Administration.

The Collaborative for Rural Primary care Practice, Research, Education and Practice (Rural PREP) project's mission is to improve and sustain rural health through community engagement and research in primary care health professions education.

Provides unbiased analysis and information on the challenges, needs, and opportunities facing rural America.

A nationally funded and recognized center established more than a decade ago to address the needs of rural and underserved populations across Texas and the nation. The SRHRC comprises a unique combination of faculty expertise in health policy, health economics, aging, long-term care, health law, epidemiology and biostatistics, and chronic disease.

Provides services for rural communities, local officials, organizations, businesses and rural citizens working to maintain the vitality of America's rural areas.