Are Rural Health Clinics Part of the Rural Safety Net?
Key Findings: 86% of independent RHCs offer free care, sliding fee scales, or both; 97% were currently accepting new Medicaid/SCHIP patients; RHC's patient mix has a higher proportion of Medicaid/SCHIP patients in counties not served by a federally funded Community Health Center (CHC). Lacking the grant funds and federal technical assistance provided to CHCs to build service capacity, few RHCs have had the resources to expand their scope of services. The Affordable Care Act has made it clear that partnering with CHCs is an option for RHCs that find themselves serving safety net populations. More study is needed laying out the details of such arrangements, the reimbursement and governance implications, and the relative advantages and disadvantages from the perspectives of the CHC, the RHC, the physician, and especially, the patient.