In this policy brief, we report findings from a study that used nationwide hospital inpatient discharge data to examine the trends and regional variations of rural hospital charges due to ambulatory care sensitive conditions (ACSCs) in the United States, by insurance type, from 2000 to 2004. Hospital charges due to ACSCs are reported by region and payment source. Changes in the percentage of hospital charges generated by ACSCs may indicate opportunities for cost savings through use of care management. The data presented in this policy brief indicate potential benefit from targeting resources designed to support ambulatory primary care.