Legislation and regulation
Research Products & Journal Articles
Browse the full list of research publications on this topic completed by the Rural Health Research Centers.
Products – Freely accessible products include policy briefs, fact sheets, full reports, chartbooks, and interactive data websites.
Journal Articles – Articles in peer-reviewed journals may require a subscription or affiliation with a subscribing library. For these publications, Gateway lists the article citation, a brief summary, a link to additional information and access to the full-text of the article, if available.
2022
-
Higher Electronic Health Record Functionality Is Associated With Lower Operating Costs in Urban—but Not Rural—Hospitals
Journal Article
Center for Economic Analysis of Rural Health
Date: 07/2022
This study examines the relationship between electronic health record use/functionality and hospital operating costs and compares the results across rural and urban facilities.
2021
-
Voices From the Field: A Qualitative Study of the Challenges and Promising Practices of Rural Public Health in Addressing HIV and Hepatitis C
Journal Article
Maine Rural Health Research Center
Date: 05/2021
Interviewing public health professionals from six rural states, researchers examined the challenges involving HIV, HCV, and serving rural people who inject drugs and determined strategies to address those challenges. -
Community Health Worker Sustainability: Funding, Payment, and Reimbursement Laws in the United States
Journal Article
Southwest Rural Health Research Center
Date: 04/2021
Recent changes have been made to community health worker (CHW) funding at the federal level, but payment structures vary from state to state. This paper aims to identify funding mechanisms that would enable CHW programs to sustain a robust workforce. -
Geographic Expansion of Medicaid Managed Care Organizations: Assessing Access to Primary Care in Nonmetropolitan Counties
Policy Brief
RUPRI Center for Rural Health Policy Analysis
Date: 03/2021
This brief evaluates the degree to which Medicaid beneficiaries in nonmetropolitan counties that were newly served by managed care organizations in 2012-2018 are able to access primary care, as determined by travel time. The study also examined the association between their primary care access and the strength of network adequacy state policies. -
Characteristics and Challenges of Rural Ambulance Agencies – A Brief Review and Policy Considerations
Report
RUPRI Health Panel: Rural Policy Analysis and Applications
Date: 01/2021
There are 23,272 ambulance agencies in the U.S., and 73% of those agencies report serving rural areas. This paper examines current rural ambulance agency characteristics and challenges and identifies public policy considerations designed to stabilize rural ambulance agencies.
2020
-
Considerations for Defining Rural Places in Health Policies and Programs
Report
RUPRI Health Panel: Rural Policy Analysis and Applications
Date: 05/2020
Rural definitions in statute and policy are used to direct resources to underserved people. But changes in population behavior and census processes have led to concern about historic methods of defining rural. This paper identifies key questions, reviews rural definitions, and discusses options for reconsidering rural definitions.
2019
-
The Development of Telehealth Laws in the U.S. from 2008 to 2015: A Legal Landscape
Policy Brief
Southwest Rural Health Research Center
Date: 11/2019
This study examines the scope and evolving nature of telehealth statutes and regulations in the U.S. Our research aims to understand changes in telehealth laws over time (2008-2015), variations in legal frameworks established across the U.S., and the extent that state laws regulate the primary care delivery through the use of telehealth. -
Primary Care Clinician Participation in the CMS Quality Payment
Policy Brief
RUPRI Center for Rural Health Policy Analysis
Date: 04/2019
Approximately 10% of primary care clinicians participate in Advanced Alternative Payment Models (A-APMs) and less than 30% of primary care clinicians participate in the Merit-Based Incentive Payment System. Metropolitan primary care clinicians are more likely to participate in A-APMs than nonmetropolitan primary care clinicians.
2018
-
Assessing the Unintended Consequences of Health Policy on Rural Populations and Places
Report
RUPRI Health Panel: Rural Policy Analysis and Applications
Date: 12/2018
This paper explores the unintended consequences of health policy through an analysis of policy actions that have affected, or had the potential to affect, rural people, places, and/or providers in ways counteractive to policy intent. -
Changes to the Merit-Based Incentive Payment System Pertinent to Small and Rural Practices, 2018
Policy Brief
RUPRI Center for Rural Health Policy Analysis
Date: 11/2018
This policy brief highlights key regulatory changes to the Merit-based Incentive Payment System that occurred in 2018. It discusses the implications of these changes with an emphasis on how these changes may affect small and rural practices.
2015
-
Health Insurance Marketplaces: Early Findings on Changes in Plan Availability and Premiums in Rural Places, 2014-2015
Policy Brief
RUPRI Center for Rural Health Policy Analysis
Date: 05/2015
Analysis of national county-level Health Insurance Marketplace (HIM) plan data for 2014 and 2015 shows there is no systematic pattern to rural experiences of HIMs, although some isolated places may be at risk for weak outcomes.
2010
-
The Patient Protection and Affordable Care Act: A Summary of Provisions Important to Rural Health Care Delivery
RUPRI Center for Rural Health Policy Analysis
Date: 06/2010
This paper provides a summary of legislative provisions contained in the Patient Protection and Affordability Act of 2010 (PPACA) that have particular meaning to rural residents and to the delivery of services in rural areas.
2005
-
Understanding the Impacts of the Medicare Modernization Act: Concerns of Congressional Staff
Journal Article
Maine Rural Health Research Center, RUPRI Center for Rural Health Policy Analysis, Upper Midwest Rural Health Research Center
Date: 2005
The most efficient mechanism for research to affect policy is to provide policy makers with information on issues about which they have voiced concern. The Rural Policy Research Institute's Health Panel conducted 2 focus groups with 16 congressional staff in 2004 to identify a set of researchable questions concerning rural healthcare.
2004
-
Indian Health Care Improvement Act: Implications for North Dakota Tribes
Upper Midwest Rural Health Research Center
Date: 11/2004
This policy brief provides an overview of healthcare issues facing American Indians in North Dakota, with discussion of the impact of the Indian Health Care Improvement Act. -
Definition of Rural in the Context of the MMA Access Standards for Prescription Drug Plans
North Carolina Rural Health Research and Policy Analysis Center, RUPRI Center for Rural Health Policy Analysis
Date: 09/2004
This study assesses how the definition of rural affects the potential impact of the access standards in the Proposed Rule to implement Title I of the MMA and finds that the congressional objective to achieve convenient access to pharmacies (other than mail order) would be more fully realized if the Proposed Rule definition of rural is changed. -
Rural Perspective Regarding Regulations Implementing Titles I and II of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA)
NORC Walsh Center for Rural Health Analysis, RUPRI Center for Rural Health Policy Analysis
Date: 08/2004
This policy paper provides, in chart form, sections of the MMA that were identified as having special concern to rural Medicare beneficiaries, medical care providers, and policy makers. -
Medicare Prescription Drug, Improvement, and Modernization Act of 2003, (P.L. 108-173): A Summary of Provisions Important to Rural Health Care Delivery
RUPRI Center for Rural Health Policy Analysis
Date: 01/2004
This paper provides a wide audience of rural health policy makers, advocates, and researchers a consolidated summary of legislative provisions contained in Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (P.L. 108-173) that have particular meaning to the delivery of services in rural areas.
2003
-
An Assessment of Proposals for a Medicare Outpatient Prescription Drug Benefit: The Rural Perspective
RUPRI Center for Rural Health Policy Analysis
Date: 01/2003
This policy paper assesses legislative proposals to add an outpatient prescription drug benefit to the Medicare program and their implications for the delivery of services and the welfare of beneficiaries in rural areas. -
Designing a Medicare Drug Benefit: Balancing Government-Based and Market-Based Approaches, the Implications for Rural Beneficiaries
NORC Walsh Center for Rural Health Analysis
Date: 01/2003
This study examines the relationship between various Medicare prescription drug benefit design characteristics and their impact on rural areas based on analysis of competing legislative proposals.
2002
-
State Licensure Laws and the Mental Health Professions: Implications for the Rural Mental Health Workforce
Maine Rural Health Research Center
Date: 05/2002
This paper investigates whether and the extent to which licensure laws that determine the permissible scope of practice for each of these professions may affect the availability of mental health services, particularly in rural communities. -
How State Rural Health Directors Obtain Policy-Relevant Research Information
NORC Walsh Center for Rural Health Analysis
Date: 03/2002
This policy brief summarizes how information pertinent to rural health policy activities of the state offices is obtained. -
Comments on Regulatory and Contractor Reform Legislation
RUPRI Center for Rural Health Policy Analysis
Date: 01/2002
This rural policy brief informs policy and reports on the rural issue of contractor reform following the passage of the Medicare Regulatory and Contracting Reform Act of 2001. The findings consist of responses from interviews with a range of healthcare professionals and experts.
2001
-
Access to Rural Pharmacy Services in Minnesota, North Dakota, and South Dakota
University of Minnesota Rural Health Research Center
Date: 07/2001
This paper describes the status of rural retail pharmacies in the three states; examines the availability of pharmacy services in rural areas of the states; and analyzes regulatory and policy issues that affect the delivery of pharmacy services in rural areas. -
Rural Implications of the Medicare, Medicaid, and SCHIP Benefits Improvement and Protection Act of 2000
RUPRI Center for Rural Health Policy Analysis
Date: 01/2001
This report covers rural health policy, SCHIP Benefit Improvement Plan, and legislation. -
Rural Implications of the Medicare, Medicaid, and SCHIP Benefits Improvement and Protection Act of 2000: Concerns, Legislation, and Next Steps
RUPRI Center for Rural Health Policy Analysis
Date: 01/2001
This rural policy brief provides an overview of the Medicare, Medicaid, and SCHIP Benefits Improvement and Protection Act of 2000 as it impacts rural health.
2000
-
The Area Wage Index of the Medicare Inpatient Hospital Prospective Payment System: Perspectives, Policies, and Choices
RUPRI Center for Rural Health Policy Analysis
Date: 08/2000
This policy paper summarizes the positions of various rural health advocates and records the actions taken by Congress and the Health Care Financing Administration to improve the wage index. Finally, it outlines the research needed to energize the policy discussion of the uses and methods of calculating the hospital wage index. -
Improving Prescription Drug Coverage for Rural Medicare Beneficiaries: Key Rural Considerations and Objectives for Legislative Proposals
Maine Rural Health Research Center, RUPRI Center for Rural Health Policy Analysis
Date: 06/2000
This policy paper combines the work from current projects of the Maine Rural Health Research Center and the Rural Health Panel of the Rural Policy Research Institute to provide a statement of specific rural considerations and objectives for any proposal that would add a prescription drug benefit to the Medicare program.