- Weathering the Storm Together: Community Resiliency Hubs Hold the Promise of Local Self-Sufficiency and Supportive Mutual Aid
- Virginia Tech Researchers Bring Rural Families into the Nation's Largest Study of Early Brain and Child Development
- Expanding Access to Cancer Care for Rural Veterans
- VA: Veterans Rural Health Advisory Committee, Notice of Meeting
- Scaling Rural Wellness with Clever Collaboration
- Stroudwater Associates Enhances Rural Healthcare Dashboard with New Data to Support State Rural Transformation Grant Applications
- Harvest Season Is Here: Busy Times Call for Increased Focus on Safety and Health
- HHS Dispatches More Than 70 Public Health Service Officers to Strengthen Care in Tribal Communities
- Wisconsin Rural Hospitals Team up to Form Network
- CMS Launches Landmark $50 Billion Rural Health Transformation Program
- American Heart Association Provides Blood Pressure Kits at Southeast Arkansas Regional Libraries to Support Rural Health
- Broadening Access to Minimally Invasive Surgery Could Narrow Rural-Urban Health Gaps
- Instead of Selling, Some Rural Hospitals Band Together To Survive
- Help Line Gives Pediatricians Crucial Mental Health Information to Help Kids, Families
- Rural Health: A Strategic Opportunity for Governors
Bipartisan Bill Reintroduced to Reauthorize Medicare Rural Hospital Flexibility Act
U.S. Senators Maggie Hassan (D-NH), John Barrasso (R-WY), Catherine Cortez Masto (D-NV), and Marsha Blackburn (R-TN) reintroduced the Rural Hospital Flexibility Act, which provides rural hospitals with critical funding to support training, technical support, and equipment to better serve patients. This legislation comes at a time when health facilities across the country – including in rural areas – face major challenges in keeping their doors open. The reintroduction of this legislation coincided with yesterday’s National Rural Health Day when the country recognizes the work of rural health professionals.
“At a time when strains on the health care system put at risk the ability of rural health care providers to keep their doors open, it is crucial that we provide hospitals and doctors in rural communities with the support that they need,” said Senator Hassan. “Reauthorizing and modernizing the Medicare Rural Hospital Flexibility program is a commonsense way to ensure that New Hampshire’s rural hospitals have access to the support, training, and equipment that they need to give Granite Staters the best possible care.”
“Wyoming’s frontier and rural hospitals know better than anyone what their patients and communities need,” said Senator Barrasso. “The Rural Flex program gives them the tools and flexibility to keep their doors open and continue delivering high-quality care. Hospitals rely on this program to strengthen their workforce, update critical technology, and improve patient outcomes. Our legislation will ensure they are free from one-size-fits-all Washington mandates that simply don’t work in rural America.”
“The Rural Hospital Flex program has long helped Nevada’s rural hospitals serve the needs of their communities,” said Senator Cortez Masto. “This commonsense, bipartisan bill will allow health care facilities across the Silver State to keep their doors open and ensure that Nevadans in all 17 counties have access to the high-quality, affordable health care they need.”
“For over 25 years, the FLEX program has been instrumental in supporting rural hospitals and healthcare providers, ensuring access to quality care for millions of Americans,” said Senator Blackburn. “The Medicare Rural Hospital Flexibility Program Reauthorization Act would build on this legacy by modernizing the program to support quality improvement, behavioral health services, telehealth, and innovative care models. This reauthorization reflects our commitment to ensuring that rural hospitals and clinics can continue to serve as lifelines for their communities, providing high-quality, sustainable care well into the future.”
“The National Rural Health Association (NRHA) applauds Senators Hassan, Barrasso, Cortez Masto, and Blackburn for leading the reintroduction of the Rural Hospital Flexibility Act. NRHA is proud to support this legislation that continues to improve healthcare for rural communities and keep rural hospitals open. This bill will reauthorize the Medicare Rural Hospital Flexibility (Flex) Program, which functions as a lifeline for rural America. Flex plays an integral role in helping Critical Access Hospitals improve their financial status and focus on enhancing quality of care, which supports rural communities’ access to excellent, sustainable healthcare,” said Alan Morgan, CEO, National Rural Health Association.
“The National Organization of State Offices of Rural Health (NOSORH) applauds Senator Hassan and her Senate colleagues for introducing this strong bipartisan bill. This bill seeks to provide stability to the FLEX grant program which provides states with funding needed to support Critical Access Hospitals in New Hampshire and all 50 states,” said Tammy Norville, CEO of the National Organization of State Offices of Rural Health.
The legislation permanently reauthorizes the Medicare Rural Hospital Flexibility program, which supports Critical Access Hospitals – small, rural hospitals that have fewer than 25 beds and are located either more than 35 miles from the nearest hospital or more than 15 miles in areas with mountainous terrain or only secondary roads. New Hampshire has 13 Critical Access Hospitals located throughout the state.
This bipartisan bill is part of Senator Hassan’s continued efforts to support rural health care. Senator Hassan leads bipartisan legislation to support rural health care facilities in providing urgent obstetric care. Earlier this year she also introduced the Keep Obstetrics Local Act (KOLA), to address the rising trend of labor and delivery unit closures in rural and underserved areas.
New Report Highlights Pennsylvania Trends in Housing
The latest Pennsylvania Data Center brief explores trends in Pennsylvania housing data over the past 20 years, now possible through the release of the 2024 ACS 1-Year Estimates.
With data from 2005 through 2024, we now have access to two decades of data to explore housing, demographic, and socioeconomic trends over time.
Read the full brief here
Emergency Rental Assistance Linked with Reduced COVID-19 Deaths in the U.S.
Faculty affiliate Dr. Joel Segel, Associate Professor of Health Policy and Administration, published a study in Public Health assessing the relationship between emergency rental assistance and COVID-19 deaths during the pandemic. In addition to expanded unemployment insurance and stimulus funds, some counties offered emergency rental assistance during the pandemic to support renters experiencing income loss that impeded their ability to meet rent obligations.
In the paper, “Pandemic relief policies and public health: A study on emergency rental assistance and COVID-19 deaths in the USA,” Dr. Segel and his collaborators examined characteristics of counties that enacted emergency rental assistance programs, and whether they had lower COVID-19 mortality rates than their counterparts.
Their analysis of 2,993 US counties revealed that counties that enacted COVID-19 emergency rental assistance differed significantly from those that did not in race/ethnicity, education levels, income, poverty rates, healthcare resources, and health outcomes. Counties that had COVID-19 emergency rental assistance had an average of 636 fewer deaths per 100,000 residents than similar counties that did not.
These findings highlight the importance of financial support in early-stage pandemic responses before large-scale medical interventions can be administered, offering insights for future pandemic preparedness.
Li N, Segel JE, Shen C. Pandemic relief policies and public health: A study on emergency rental assistance and COVID-19 deaths in the USA. Public Health. 2025;247:105896. doi:10.1016/j.puhe.2025.105896
A link to the full text of the article is here.
Rural U.S. Loses 1 in 9 Family Physicians in 6 Years, Study Finds
From Becker’s Hospital Review
The rural family physician workforce shrank 11% from 2017 to 2023, marking an ongoing shortage in primary care access, according to a study published in November in the Annals of Family Medicine.
Lead author Colleen Fogarty, MD, professor and chair of the Department of Family Medicine at the University of Rochester (N.Y.), and co-authors Hoon Byun, DrPH, of the Robert Graham Center for Policy Studies in Family Medicine and Primary Care in Washington, D.C., and Alison Huffstetler, MD, of Richmond-based Virginia Commonwealth University’s Department of Family Medicine, used the American Medical Association Physician Masterfile to identify actively practicing U.S. family physicians and their practice locations during the study period.
The authors found an 11% nationwide drop in family physicians in rural areas, with year-over-year declines reported across all regions from 2017 to 2023. The Northeast saw the steepest percentage loss (15.3%), while the West saw the smallest (3.2%).
“The data reflect what we already experience and know about physician shortages, but the year-over-year numbers for rural areas were astonishing to me. The speed at which this has happened is remarkable and terrible,” Dr. Fogarty said in a Nov. 24 news release from the University of Rochester.
She noted that the decline is occurring even as more young adults move to rural areas, and she attributed the trend to factors including physician burnout and overwork.
One positive finding from the study: The percentage of practicing female family physicians in rural areas rose from 35.5% in 2017 to 41.8% in 2023. Still, Dr. Fogarty pointed to ongoing challenges, such as uncertainty around visa requirements for residents and international medical graduates.
“Ensuring an adequate rural family physician workforce likely requires a tailored regional approach, such as medical school pathway programs from rural communities,” the authors wrote.
Read the full study here.
National Dental Association Releases Medicaid Toolkit for Dentists
The American Dental Association (ADA) released a toolkit to support dentists in providing care to Medicaid patients while maintaining financial viability. The guide provides concrete strategies for credentialing, scheduling, team utilization and administrative coordination to help mitigate common issues that lead to lost revenue or patient attrition.
New Fact Sheets Released on Diabetes and Oral Health
New fact sheet alert!
PCOH and the Pennsylvania Department of Health Oral Health Program just published two new fact sheets for patients and providers about the connection between diabetes and oral health. These have been added to PCOH’s Resource page and will be available to order in print on the Request Materials page in 2026.
Click here to view Diabetes and Oral Health (for providers).
Click here to view Diabetes and Your Teeth.
Brief Examines Rural/Urban Differences in Barrier to Care, Use of Preventive Care in Medicare and Medicare Advantage
A new policy brief examined rural and urban differences in barrier to care and use of preventive care services among enrollees in traditional Medicare and Medicare Advantage. We used Medicare Current Beneficiary Survey data to examine barriers to care, such as out of pocket costs, and utilization measures, such as flu shots and cholesterol tests, comparing rural and urban Medicare Advantage enrollees, rural and urban traditional Medicare enrollees, and rural traditional and Medicare Advantage enrollees. Several key findings include:
- Rural Medicare Advantage enrollees faced more barriers in accessing health services due to cost, compared to both their urban counterparts and to all traditional Medicare enrollees.
- A higher percentage of rural Medicare Advantage enrollees reported trouble getting care due to cost compared to rural traditional Medicare enrollees.
- A lower proportion of rural enrollees in both traditional Medicare and Medicare Advantage received a flu shot compared to their urban counterparts.
- Female Traditional Medicare enrollees living in rural areas were the least likely to utilize health care services compared to both their urban counterparts and Medicare Advantage enrollees.
By Gawain J. Williams, MBA; Dan M. Shane, PhD; Whitney E. Zahnd, PhD; Keith J. Mueller, PhD
Contact Information: Whitney Zahnd; whitney-zahnd@uiowa.edu
National Rural Health Day 2025 Community Stars Announced
In celebration of November 20, 2025, the National Association of State Offices of Rural Health published a collection of stories about individuals and organizations across the U.S. that have made positive differences in the health of the rural communities they serve through innovation, leadership, commitment, collaboration, education, and communication.
Access the collection here: National Rural Health Day 2025 Community Stars
National Analysis of Motor Vehicle Sheds Light on Need
Identifying the percentage of non-drivers and those who lack access to a motor vehicle in the population is key in understanding the level of need in a community for other transportation options and for making the case to people who assume that driving is and must always be the default.
Anna Zivarts, author of the book When Driving Is Not an Option, outlined the general size and importance of this non-driver category in transportation planning, and offered estimates for Washington state. For Pennsylvania, it has been instructive to assemble information about the number of young people, the very old, those with disabilities that preclude driving and those who cannot afford a vehicle or fuel, but it has been a quite rough estimate until now, largely based on the percentage of the population in the state that do not have drivers’ licenses (30% here).
But a new study from the National Resources Defense Council (NRDC) takes this topic on nationally. On the Who Doesn’t Have a Car? website, they map all the federal legislative districts and provide detail on the numbers of people of driving age, the number of minors with potential for independent mobility, and the number of vehicles available per household.
Their initial fact sheet for Pennsylvania is available here. It is informative, though also could use a bit of further clarification. We look forward to seeing this resource used in planning moving forward.
What Pennsylvania’s $50.1 Billion Budget Does for Rural Hospitals, Communities
By Marley Parish of Spotlight PA State College |
As federal Medicaid cuts loomed over Pennsylvania’s rural hospitals, health advocates focused on safeguarding funding for these already strained facilities and programs that help keep their doors open during this year’s state budget talks.
The $50.1 billion state budget — passed by the legislature and signed by Democratic Gov. Josh Shapiro after a four-month impasse — maintains support for rural and critical access hospitals. It preserves spending on programs that have faced cuts and closures in rural areas. And it increases state Medicaid spending as the feds prepare to cut roughly $1 trillion in funding over the next decade because of the so-called “big, beautiful” budget bill.
While stakeholders are pleased with the state’s final deal, it only offers some relief for rural Pennsylvania, where hospitals operate on thin margins and Medicaid helps keep the lights on. Advocates — now focused on next year’s budget — are hoping Pennsylvania can secure a piece of a new $50 billion federal program to address longstanding challenges to accessing care in rural communities.
The Hospital and Healthsystem Association of Pennsylvania (HAP), which represents more than 235 hospitals statewide, welcomed the preservation of past funding — such as $7.9 million for critical access hospitals and $10.6 million for obstetric and neonatal services — president and CEO Nicole Stallings told Spotlight PA.
The budget includes $10 million in one-time payments to rural hospitals, which will draw a $25.1 million federal match. Financially distressed hospitals will also receive $13.5 million, and while those dollars aren’t exclusively earmarked for rural facilities, Stallings expects they’ll still benefit.
Lisa Davis, director of the Pennsylvania Office of Rural Health, said the boost for Medical Assistance, or Medicaid programs — a more than $775 million increase collectively — is “really needed” amid an expected increase in uninsured patients and uncompensated care due to the federal cuts.
“No state in the country can really adequately fill those losses, but I think being able to have this increased funding for Medicaid is good,” Davis told Spotlight PA.