Spotlight on Rural Health

More than 45 million Americans—or 14 percent of the population—live in rural areas. Rural residents often encounter barriers to healthcare, including provider shortages or traveling long distances. Generally, rural communities have higher rates of chronic conditions and fewer resources to prevent and treat chronic conditions than urban communities.

Our Work

AIR leverages expertise in data analysis, technical assistance, human-centered design and stakeholder engagement to understand and help solve the healthcare challenges facing rural communities. Our work includes efforts to improve the performance of approximately 300 small and rural hospitals by assessing quality measures, supporting COVID pandemic response and preparedness, and identifying and disseminating best practices through the Centers for Medicare & Medicaid Services (CMS) Hospital Quality Improvement Contractor initiative.

AIR also is leading the evaluation of the Rural Community Hospital Demonstration (RCHD) for CMS. The RCHD provides enhanced reimbursement for inpatient services to small rural hospitals that do not qualify as critical access hospitals. The demonstration is designed to increase the capability of these hospitals to meet the health care needs of rural beneficiaries by examining the feasibility and advisability of establishing a new category of rural community hospitals for reimbursement policy. The mixed-methods evaluation examines the demonstration's effects on Medicare payments and hospital financial condition using CMS hospital cost report data, other secondary data sources, and interviews with hospital leaders. The evaluation includes a difference-in-differences design to generate impact estimates for the model.