Rural Health Care Needs Identified

Conference to develop an agenda for rural health policy research

In 2000, the National Rural Health Association held a conference that would develop an agenda for research on rural health policy.

The National Rural Health Association, based in Kansas City, Mo., is a nonprofit organization that focuses on rural health issues, organized the conference.

Key Results

  • The meeting, "The National Rural Health Research-Agenda-Setting Conference," was held August 13–15, 2000, in Washington, and was attended by 100 health researchers, policy-makers, and practitioners.

    The overall goal of the conference was to identify the research needed to influence federal, state and private sector decision makers regarding rural health issues and then to prioritize those research needs.

    After an introductory presentation by Tom Ricketts, Ph.D., director of the Rural Research Program at the University of North Carolina, Chapel Hill, conference attendees divided into nine breakout groups, each of which focused on a separate topic area, to develop a comprehensive list of priority research questions. (See the Bibliography for details.)

    In a second round of sessions, participants identified cross-cutting themes that emerged from the initial discussions.

    Among the research areas and the priority research questions the participants identified were the following:
    • Medicare financing: How can special Medicare payment formulas be designed both to be administratively simple and to reflect rural providers' need for higher Medicare reimbursement? Are there gaps in the adequacy of benefit structures due to urban/rural differences?
    • Medicaid financing: What is the responsibility of the Medicaid program in rural health care? What are the value and impact of Medicaid subsidies to rural communities?
    • Quality of care in rural areas: Are there two standards of quality of care: rural and non-rural? Is this acceptable? What is the link between quality care and finance/costs, patient characteristics, patient mobility and technology?
    • Rural public health: How can programs overcome population-specific attitudinal barriers to the seeking of health care? What are federal agencies, foundations, and other private-sector groups doing to sponsor or incorporate research?
    • Hospitals and community systems: What federal and local subsidies are needed? How viable are rural hospitals in light of decaying plants, limited access to capital, and the need for technical improvements?
    • Health professions: What is the most effective and efficient provider-type configuration for rural towns and within clinics? What are the barriers to implementation of the policies and practices that would place physicians in rural areas?
    • Access to services: How are the safety nets of rural communities configured, and how adequate are they? What are the determinants of access and of disparities in access?
    • Behavioral health: What is the status or role of rural schools in delivering mental health services? What are appropriate approaches to access to specialty care for rural special populations such as children and adolescents, people with severe and persistent mental illness, and older adults?
    • Long-term care: Does access to long-term care services — and in particular, access to non-medical residential care and to home and community-based services — differ for rural and urban residents and for minorities? What role are rural hospitals and other health care providers playing in addressing long-term care needs in rural communities?
    A conference report was published, and 300 copies were distributed to conference funders and participants.


The Robert Wood Johnson Foundation (RWJF) supported this project through a grant of $29,891.

Other sponsors of the project included:

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