In the Rural Healthy People 2020 survey, 78% of respondents identified "access" as the top rural health priority. In many rural communities, FQHCs, RHCs, and acute hospitals are the dominant providers of ambulatory care (which is defined as medical services performed on an outpatient basis, without admission to a hospital or other facility.) However, many rural communities suffer from health professional shortages and residents often encounter difficulties in accessing ambulatory care as a result. Previous studies have profiled services provided by FQHCs, RHCs, and acute hospitals (in which the unit of analysis is the provider), but there has been little attention to where rural Medicare beneficiaries go for ambulatory care (in which the unit of analysis would be rural Medicare beneficiaries). Furthermore, no studies could be found that describe how the types of ambulatory care that rural Medicare obtain at rural FQHCs and hospitals differ from care obtained at urban FQHCs and acute hospitals. This project characterized the volume, cost, and case mix of ambulatory care provided to rural Medicare beneficiaries by rural and urban FQHCs, RHCs, acute hospitals, and all other providers. Rural beneficiaries were identified from the Master Beneficiary Summary File (MBSF), and provider claims for the beneficiaries were obtained from the Medicare Outpatient Research Identifiable File (RIF).

Publications

• Cost-Sharing as a Barrier to Accessing Care at FQHCs and RHCs for Rural Medicare Beneficiaries
  North Carolina Rural Health Research and Policy Analysis Center
  Date: 06/2019
  The purpose of this study is to investigate cost barriers to accessing care at Federally Qualified Health Centers and Rural Health Clinics for the rural Medicare population.
• Facility-Based Ambulatory Care Provided to Rural Medicare Beneficiaries in 2014
  Chartbook
  North Carolina Rural Health Research and Policy Analysis Center
  Date: 03/2019
  This chartbook uses available Medicare claims data to describe facility-based (i.e., excludes private practitioners) ambulatory care provided to rural Medicare beneficiaries and includes claims, costs, and common diagnoses.