Category: Research

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

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

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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Obstetric Care Access Declined in Rural and Urban Hospitals Across US States, 2010-2022

July 15, 2025

Obstetric Care Access Declined in Rural and Urban Hospitals Across US States, 2010-2022

With support from the Federal Office of Rural Health Policy, a team of researchers from the University of Minnesota, Harvard University, and the University of Pennsylvania found widespread loss of obstetric services across states, especially among rural hospitals, during the 12-year period studied.

By 2022, eight states had more than two-thirds of rural hospitals without obstetric services.

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Rural Health Research: Preventing Medical Debt Among Rural Residents: Example Programs from Hospitals in Minnesota and Montana

June 17, 2025

Rural Health Research: Preventing Medical Debt Among Rural Residents: Example Programs from Hospitals in Minnesota and Montana.

Medical debt, which includes unpaid bills, loans, and other debt incurred from health care expenses, affects roughly 15% of adults in the U.S. this is despite more than 90% of U.S. adults having some form of health insurance.

Medical debt is an important social driver of health, with disproportionate impacts for populations already experiencing greater health risks. Overall, rural residents report more problems paying medical bills and are more likely to be unable to pay their medical bills altogether in comparison to urban residents.

This case series from the University of Minnesota Rural Health Research Center examines how two rural hospitals aim to reduce medical debt for their patient populations and address barriers to medical debt relief.

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Rural Health Research: Federal and State Reimbursement for Youth Behavioral Health Services

May 1, 2025

Rural Health Research: Federal and State Reimbursement for Youth Behavioral Health Services

The prevalence of behavioral health conditions, including depression, suicidal ideation, and substance use continue to increase among young people in the United States (U.S.). Medicaid is an important source of health coverage for youth in the rural U.S., covering 47% of youth. Because Medicaid is jointly funded by states and the federal government and is administered by each state within federal guidelines, reimbursement policies for behavioral health care vary across states.

This brief provides a structured review of the state-level policies and federal and state funding mechanisms that may affect the supply of behavioral health services for children and youth through 24 years of age.

Among the findings:

  • Medicaid reimbursement and coverage policies for behavioral health professionals vary across and within states.
  • A review of individual state Medicaid manuals indicates that social workers and psychologists are eligible for Medicaid manuals indicates that social workers and psychologists are eligible for Medicaid reimbursement for behavioral health services in all 50 states and the District of Columbia. Marriage and family therapists (MFTs) are eligible for reimbursement by all but two state Medicaid programs.
  • All 50 states and the District of Columbia allow reimbursement of social workers and psychologists for behavioral health services provided through school-based Medicaid programs, while approximately one-third of states omit MFTs from the list of providers eligible for reimbursement within school-based Medicaid programs.

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RTRC Telehealth Policy Brief Highlights Need for More Health Equity Focused Research

January 7, 2025

RTRC Telehealth Policy Brief Highlights Need for More Health Equity Focused Research

In December 2024, the Rural Telehealth Research Center (RTRC) released a Research and Policy Brief titled, The Role of Relaxed Telehealth Policy on Health Equity in Telehealth Utilization and Outcomes During the COVID-19 Public Health Emergency: A Living Systematic Review.

The brief underscores the significant telehealth policy changes that have occurred since the beginning of the COVID-19 pandemic as the foundation for enabling the ability to better understand the variety of implications of increased telehealth use, such as access to care, health outcomes, and cost. For this study in particular, the RTRC sought to conduct a systematic review of the ways in which telehealth has been shown to address health disparities.

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Rural Health Research: Utilization of Inpatient and Emergency Services by Rural and Urban Medicaid Enrollees

December 19, 2024

Rural Health Research: Utilization of Inpatient and Emergency Services by Rural and Urban Medicaid Enrollees

This brief used data from the 2019 Transformed Medicaid Statistical Information System (T-MSIS) Analytic Files (TAF) to compare urban and rural residents enrolled in either fee-for-service or managed care Medicaid. Researchers focused on inpatient and emergency department (ED) health care utilization.

Key Findings:

  • Overall utilization by Medicaid enrollees, as measured by number of ED visits, number of inpatient admissions, inpatient length-of-stay, and inpatient readmission rate, is higher in urban areas than in rural areas.
  • Among enrollees who are at least 65 years old, most of whom had Medicare-Medicaid dual eligibility, rural Medicaid enrollees had higher rates of inpatient admissions and ED visits than urban enrollees, while among those in the age categories of below 18 and 18-64 years old, urban enrollees had higher rates. Readmission rates and average inpatient length-of stay were higher in urban enrollees across all age categories.
  • Non-Hispanic Black enrollees had the highest utilization rates compared to enrollees that were non-Hispanic White, and Hispanic of any race. Hispanic enrollees of any race had the lowest utilization rates. Utilization was lowest in Isolated Rural Areas, and often highest in Large Rural areas.
  • Rural female enrollees (except those in Isolated Rural Areas) had higher rates of ED use compared to urban enrollees, while rural male enrollees had lower ED utilization than those in urban areas. Compared to urban areas, male and female enrollees in rural areas had shorter inpatient lengths-of-stay and lower readmission rates.

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Rural Health Research: Variation in Elder Abuse State Statutes by State Level of Rurality

December 19, 2024

Rural Health Research: Variation in Elder Abuse State Statutes by State Level of Rurality

As older adults become a larger proportion of the population, their social and health needs continue to warrant further attention. This is particularly true for older adults in rural areas, where they are a relatively faster growing demographic compared with older adults in urban areas.

One public health concern that needs closer study is older adult maltreatment or elder abuse, and specifically social-contextual factors that lead to geographic differences in preventing and addressing abuse.

This policy brief from the University of Minnesota Rural Health Research Center examines elements of state-level elder abuse statutes’ definitions and reporting requirements to investigate potential differences in these policies by state rurality.

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New Health Workforce Projections Data Available

December 6, 2024

New Health Workforce Projections Data Available

The Health Resources and Services Administration (HRSA) just released the latest projections for the national supply, demand, and distribution of health care workers.

Use the Workforce Projections Dashboard to explore supply and demand trends by occupation, state, year, and more.

Check out Health Workforce projections for an overview of projections for different groups of workers, such as nurses and physicians, and details on our programs that seek to address future shortages.

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