September 26, 2025

Rural Health Research: Rural-Urban Comparisons of Nursing Staff Turnover Among Skilled Nursing Facilities

This study from the University of South Carolina Rural Health Research Center assessed facility-level turnover rates for nursing and registered nurse (RN) personnel across levels of rurality and by region.

A total of 14,986 facilities were included in the August 2023 data released by the Centers for Medicare & Medicaid Services. Of those facilities, 72.3% were in urban areas.

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September 26, 2025

Rural Health Research: Health Insurance Coverage in Rural and Urban Areas in the U.S., 2023

This brief from the RUPRI Center for Rural Health Policy Analysis outlines the health insurance status of people in the U.S., by residence (rural and urban) in 2023, with additional breakdowns by age groups.

The analysis is based on data from the 2024 American Community Survey (ACS), released September 2024 by the U.S. Census Bureau, providing a snapshot of coverage for a point-in-time with national data.

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September 12, 2025

Research Alert: Comparing Utilization of Home Health Care Between Traditional Medicare and Medicare Advantage by Rural-Urban Status

This report describes differences in utilization of home health care between beneficiaries enrolled in Traditional Medicare (TM) and Medicare Advantage (MA), a publicly-funded, privately managed option for Medicare beneficiaries, and by rural-urban status. Researchers examined differences in use of home health overall, provision of specific services during home health, and receipt of care from high-quality home health agencies by enrollment in TM and MA, including plan type (e.g., preferred provider organization, health maintenance organization), and by rural-urban status, including intra-rural variation.

Key Findings:

• Beneficiaries enrolled in MA who are also living in rural communities may be underutilizing home health.
  • Compared to beneficiaries enrolled in MA, regardless of type of MA plan.
  • Utilization of home health was also significantly lower among beneficiaries living in rural versus urban communities, with progressively decreasing likelihood of home health utilization as rurality increased.
• Beneficiaries enrolled in MA were also significantly less likely to receive care form a high-quality home health agency compared to beneficiaries enrolled in TM, regardless of MA plan type, but there was no association between receiving care from a high-quality home health agency and rural-urban status.
• Utilization of specific services during home health varied based on enrollment in MA versus TM and rural-urban status.
  • In general, utilization of specific services was significantly lower for beneficiaries enrolled in MA compared to TM, but this pattern was not consistent for all services across all types of MA plans.
  • Beneficiaries living in rural communities generally had significantly lower utilization of physical therapy, occupational therapy, speech-language pathology, and medical social work services, but significantly higher utilization of home health aide services.

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July 25, 2025

Rural Health Research: Interstate Occupational Licensure Arrangements to Expand Access to Behavioral Health Services

This policy brief from the WWAMI Rural Health Research Center describes state-based provisions to expand behavioral health services through interstate licensure arrangements for:

• Psychologists,
• Social workers,
• Licensed professional counselors,
• Marriage and family therapists, and
• School psychologists

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July 15, 2025

The Impact of High Hospital Fixed-Cost Ratios on Rural Populations

This brief from the RUPRI Center for Rural Health Policy Analysis describes the regional variation in Critical Access Hospital (CAH) and Low-Volume Hospital (LVH) status with respect to average fixed-to-total-cost ratios, finding that CAHs tend to have the highest ratios, followed by LVHs. However, the average ratio for each status differs regionally across the United States.

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July 15, 2025

Geographic and Demographic Correlates of Living in Manufactured Homes: Implications for Health

Manufactured homes (formerly known as mobile homes) can provide an affordable housing option, especially in places with few other options. However, manufactured homes are associated with poorer health outcomes and are less well equipped to protect their residents from the effects of natural disasters than more permanent housing structures.

This brief from the University of Minnesota Rural Health Research Center examines rates of living in manufactured homes by rural and urban location, as well as rates among rural residents by region and socio-demographic characteristics. It also examines differences in crowded housing, housing quality, and housing cost burden by manufactured vs. more permanent housing structures.

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