Having a usual source of primary care (USC) is a key driver of a person's health. During the past several years, several factors may have influenced USC in rural areas, including:

• Payment changes, such as the 4-1-2021 increase in the Rural Health Center (RHC) per visit upper payment limit from $87.52 to $100 that was part of the changes included in Section 130 of the Consolidated Appropriations Act of 2021
• Three more States have expanded Medicaid
• Growing shortages of primary care providers in rural areas
• The short- and long-term effects of the pandemic, such as telehealth

This study will describe the USC for rural Medicare beneficiaries. The study will use Centers for Medicare & Medicaid Services claims data to provide insight into how COVID-19 may have affected USC of Medicare beneficiaries and who is serving as a USC for Medicare enrollees in rural areas, and what portion of Medicare enrollees are receiving care from a rural USC.