Publications

Recent Publications

Medicaid Plays A Key Role for Maternal and Infant Health in Rural Communities

This paper examines the role of Medicaid in covering women of childbearing age (19 through 44 years old) living in small towns and rural areas. ​

The Rural Emergency Hospital Model: Year Two Progress Report

In response to increasing rural hospital closures, Congress established the Rural Emergency Hospital (REH) model. The model launched on January 1, 2023, to provide struggling facilities a novel care delivery option in the Medicare program when their full closure would cause significant hardship to their community.

Training a rural oral health workforce: Effects of rural background on dentist practice choice

This study compares access to, and services offered by, Certified Community Behavioral Health Clinics (CCBHCs) in rural and urban communities. The increasing numbers of CCBHCs in rural communities combined with their range of offered services holds promise towards increasing the availability of care for rural communities within an integrated model.

Composition of the Public Health Workforce: Distribution, Training, and Tenure​

Local health departments play a critical role in promoting the overall health and well-being of communities across the country, and influxes of response-related funding and attention make it challenging to build and sustain a consistent and well-trained public health workforce. This article describes the composition of the local public health workforce (including staffing levels, demographic characteristics, tenure, and training in public health) at the local, agency-level.

Health Funding Across Agencies: Rural Health​

The Coalition of Health Funding (CHF) released their new Rural Health one-pager. The one-pager focuses on the interagency collaborations that help provide funding and access to rural healthcare. 

Rural Populations are Shifting Older

The Economic Research Service (ERS) at the U.S. Department of Agriculture reports on recent data showing that the number of rural people of working age (between 15 and 64 years old) has fallen in recent years, dropping to 28 million in 2023 from more than 30 million in 2010.  At the same time, the number of rural residents aged 65 and over grew from 7.4 million in 2010 to 9.7 million in 2023.

Topic Areas

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Community Health
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Dental/Oral Health
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Direct Care
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General Rural Health
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Maternal Health
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Mental & Behavioral Health
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Primary Care
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Public Health

Physician Training in Rural and Health Center Settings More Than Doubled, 2008–24

This paper examines the growth of graduate medical education programs in rural areas and federally qualified health centers (FQHC) between academic years 2008–09 and 2023–24. 

​​Bipartisan Policy Center April 2025 Report

The Bipartisan Policy Center's (BPC) April 2025 report, Sustaining Rural Hospital Access: Adjustments to Medicare Rural Hospital Designations, presents a set of actionable policy recommendations to preserve rural hospitals that are vital to 60 million Americans living in rural communities. ​

U.S. Nursing Workforce by the Numbers

NCSBN — the world leader in nursing regulatory knowledge and advancement — released its 2024 National Nursing Workforce Study, surveying 800,000 nurses to understand the state of the workforce. The study is considered to be the largest and most comprehensive research study of the nursing workforce, uncovering the data points which have far reaching implications for the health care system at large and for patient populations.

Why Are Rural Areas Losing Independent Healthcare Providers?
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Rural areas have lost 2,500 independent physicians during a five-year period from 2019 to 2024. At the same time, the number of physician-owned practices in rural areas dropped by 3,300. According to Intelliworx, there are 3 reasons why rural areas are losing independent providers. Read the article to find out more.
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Healthcare News of Note: U.S. will be short 3.2 million lower-wage healthcare workers within 5 years, says Mercer

The main findings of the 2021 study can be summarized into four key points:
  1. A shortage of labor at the low end of the wage spectrum will limit access to home care.
  2. Primary care will increasingly be provided by non-physicians.
  3. There will be surpluses of nursing talent in some areas of the south and southwest and shortages elsewhere.
  4. A six-figure hiring rush for mental health providers will emerge by 2026.

Many rural patients drive an hour or more for surgery, study finds​

Timely access to health care services is increasingly threatened for rural residents, with 151 rural hospitals closing between 2010 and 2024.1,2 Compared with nonprocedural services, provision of surgical care faces unique ongoing challenges related to the workforce, resources, and centralization of procedures.3 Although cross-sectional evaluations of travel disparities in obtaining surgical care for rural vs urban patients have been described,4 trends over time and in the recent context of emerging resource constraints in rural settings are unknown. This study quantified changes in travel times for rural patients undergoing surgical care.​

NCHS Urban-Rural Classification Scheme for Counties​

The National Center for Health Statistics (NCHS) has developed a six-level urban-rural classification scheme for U.S. counties and other jurisdictions that are the equivalent of counties in their area. 

Rising Rural Mortality Rates from Natural Causes for Working-Age Adults Lead to Widening Gap with Urban Counterparts

The gap between rural and urban mortality rates from natural causes is widening.  This growing disparity reflects both an improvement in urban health and a decline in rural health, which could have negative implications for rural families, communities, employment, and the rural economy.​

Utilizing Federal Data Sources to Support Nursing Workforce Analysis
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Many federal agencies collect data which can be used for health workforce analysis, however, identifying the most appropriate data sources to address a specific nursing workforce issue can be challenging. 
This article examines 18 federal data sources relevant to nursing workforce analysis. Researchers provide descriptions of each data source, evaluate their suitability for nursing workforce studies, share examples of previous studies utilizing these datasets, and identify their limitations. 

Special Collection of Papers Focused on The Health Workforce ​

CHWS and the Health Workforce Research Centers (HWRCs) recently collaborated with Health Affairs Scholar to release a special collection of papers focused on the health workforce. This collection explores key issues affecting the health workforce today, including workforce shortages, the effects of health professions regulation, and the physical and mental well-being of health care workers.
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Rural Workforce Recruitment and Retention Factors
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The United States continues to grapple with a severe and worsening shortage of health care professionals, particularly in rural areas. The Health Resources and Services Administration (HRSA) reported that as of September 2023, approximately one-third of the nation's population lived in a primary care health professional shortage area (HPSA), 77 million lived in a dental health HPSA, and almost half lived in a mental health HPSA. Workforce shortages in rural areas strain local economies, with primary care physicians contributing significantly to economic stability.

Health Professional Retention in Underserved Areas: Findings from the National Health Service Corps Loan Repayment Program Participants in the United States ​

The National Health Service Corps (NHSC) provides loan repayment for a two or three-year service commitment from clinicians to work in underserved areas. We observed that technical assistance and job resources were more influential on clinicians’ intentions, compared to individual- or community-level characteristics. Organizations with efficient and supportive work environments may help retain clinicians in underserved areas.

Changing Medicare Payment to Strengthen Primary Care

CMS has taken steps to recognize the importance of primary care and the time and effort required for care teams to develop long-lasting, trusting relationships with patients.

Growing the Rural Physician Workforce: Decades of Federal Funding Impacts Rural Graduate Medical Education

In October 2023, the Bureau of Healthcare Workforce (BHW) released its physician workforce projections, noting that by 2036, metro areas will see a 6% shortage of physicians. In contrast, rural America is anticipating a 56% shortage.