Navigating Health Care Access for Rural Residents in the US

Updated: November 22, 2023

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Rural America is home to 14% of the U.S. population; as of July 2021 it grapples with various health care challenges, such as lack of access, higher uninsured rates than urban areas, hospital closures and a shortage of medical professionals.

Innovative solutions, like telehealth and mobile clinics, are bridging some gaps. Supportive financial and health programs and federally qualified health centers also provide assistance. Rural residents should prioritize health insurance literacy and establish emergency medical funds for effective health care management.

Health Care in Rural America

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Compared to urban dwellers, rural Americans have a higher mortality rate from heart disease, cancer, accidental injuries, respiratory conditions and stroke.

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Over a third of rural Americans have skipped needed medical care because of cost.

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Rural areas have higher individual health insurance premiums and fewer plan choices.

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Between 2005 and 2019, more than 150 rural hospitals closed; currently, another 600 are at risk of closing due to financial challenges.

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88% of rural Americans were either considering or favoring telehealth as of 2022.

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Mobile clinics have a median of 3,491 visits annually.

Health Care Quality and Disparities in Rural Areas

Rural Americans often experience health care differently from their urban counterparts. Challenges such as health care worker shortages, higher chronic illness rates and socioeconomic factors contribute to a complex health profile in rural areas. Let's explore the specific health care challenges prevalent in rural America.

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    Geographical and Transportation Challenges

    Long distances and isolation in rural areas make accessing health care difficult. With limited public transportation, a simple doctor's visit can become a major challenge.

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    Hospital Closures

    Service reductions and hospital closures further worsen geographical and transportation challenges. Between 2005 and 2019, more than 150 rural hospitals closed, and currently, over 600 are at risk of closing due to financial losses and insufficient reserves.

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    Health Care Worker Shortages

    Nearly two-thirds of primary health professional shortage areas are rural communities. The scarcity of health care professionals like doctors, nurses and specialists hampers immediate and ongoing management of prevalent chronic conditions. It also creates barriers to routine health checks.

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    Lack of Specialized Health Care Services

    Specialized health care services are often limited or unavailable in rural communities. For instance, 10% of all rural ZIP Code Tabulation Areas (ZCTAs) lack access to home health care, and 60% of mental health professional shortage areas are in rural parts of the U.S. as of September 2022.
    According to Tulane University, this shortage extends to hospice, palliative care and substance use disorder services. Women's health services, including reproductive, obstetric and maternal health, are also less accessible. Rural Americans are less likely to have dental insurance and more likely to experience a shortage of dental professionals.

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    Chronic Illness Risks

    Compared to those living in urban areas, rural Americans face a higher likelihood of early death from the five leading causes of death: heart disease, cancer, unintentional injury, chronic lower respiratory disease and stroke. According to the Centers for Disease Control and Prevention, this heightened risk is due to a lack of health care services and socioeconomic obstacles, such as:

    • Increased chronic disease risk from smoking prevalence in rural areas.
    • Limited access to healthy food options in low-income, rural neighborhoods.
    • Poorer health outcomes are linked to older, lower-income rural demographics.
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    Reduced Health Insurance Access and Affordability

    Since the Affordable Care Act (ACA) was enacted, the number of uninsured non-elderly adults in rural areas dropped from 24% in 2010 to 16% in 2019. However, throughout this period, rural areas consistently experienced uninsured rates of two to three percentage points higher than urban areas. Rural residents in states without Medicaid expansion face much higher uninsured rates — 22% uninsured in non-expansion states versus 12% in expansion states as of 2019. Another study reported that rural communities have higher individual health insurance premiums and fewer plan options than urban and suburban areas.

Innovative Solutions and Best Practices

Innovative approaches — such as telehealth, community-driven initiatives, collaborative care models and mobile health units — are helping transform rural health care, bridge gaps and overcome traditional barriers to access and quality.


The adoption of telehealth offers a lifeline to those in remote locations. Videoconferencing and cloud-based systems allow local physicians to conduct remote consultations and treat patients. Virtual consultations eliminate distance, reduce travel burdens and provide timely care. Although challenges like reliable internet access and technology adaptability persist, telehealth is a pivotal advancement in rural health care delivery.

  • Test Your Tech: Ensure your devices and internet connection are telehealth-ready before appointments.
  • Prepare Questions: Write down symptoms and questions to maximize your virtual visit.
  • Privacy Matters: Choose a private, quiet space for your telehealth sessions to maintain confidentiality.

Community Initiatives

Local efforts like health education workshops and the appointment of health ambassadors foster a proactive approach to wellness. For instance, the Community Health Worker model in Texas leverages trusted community members to bridge the gap between health care providers and rural populations. The Delta Health Alliance's Indianola Promise Community in Mississippi integrates health education into every aspect of community life. These initiatives help raise health literacy and empower residents to take charge of their health.

  • Get Involved: Join local health initiatives or start one to address specific community needs.
  • Spread the Word: Share information about health workshops and programs with neighbors and friends.
  • Become a Health Ambassador: Volunteer to be a health ambassador to increase health literacy in your community.

Collaborative Models

Partnerships between rural and urban health care systems are essential for bridging the service gap in remote areas – from shared resources and expertise to joint training programs. For example, the University of Mississippi Medical Center (UMMC) has established a telehealth network that connects rural hospitals to its specialists, providing support in emergency care and other medical services. The Pennsylvania Rural Health Model transitions hospitals from traditional fee-for-service to a global budget, focusing on preventive care and the overall health needs of the community. These models demonstrate the potential for urban-rural partnerships to enhance health care delivery and outcomes in rural settings.

  • Connect With Networks: Reach out to health care networks that partner with rural communities for better access to care.
  • Seek Specialized Services: Inquire about telehealth services for specialized care that may not be available locally.
  • Advocate for Partnerships: Encourage local health care providers to partner with urban centers for expanded services.

Mobile Health Units

Mobile health units help bring medical services directly to rural residents, offering screenings, vaccinations and routine check-ups for preventive care and chronic disease management. They reduce the need for long-distance travel and help provide a more accessible rural health care system. For example, the Mobile Health Clinics Association dispatches a fleet of mobile units to underserved rural communities, providing essential services such as primary care and health education.

  • Track the Schedule: Stay informed about the scheduled visit of mobile health units in your area.
  • Utilize All Services: Take advantage of the screenings, vaccinations and check-ups offered.
  • Provide Feedback: Share your experience to help improve mobile health services for your community.

Subsidized Health Programs for Rural Residents

For rural residents seeking support, various government-subsidized health programs are available to help manage health care costs and access services. These initiatives can help you secure the necessary aid for both immediate and long-term health needs.

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    Medicaid is a joint federal and state program that helps cover medical expenses for millions of Americans, including low-income adults, children, pregnant women, older adults and individuals with disabilities who qualify. It is designed to assist those in financial need by covering a wide range of health services.

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    Medicare is a comprehensive federal health insurance program primarily for people aged 65 and over, but it's also available to younger individuals with certain disabilities or conditions. It offers different coverage tiers, called parts, to help with medical costs, from hospital stays to prescription drugs.

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    Premium Tax Credit (PTC)

    The PTC offers a refundable credit to help eligible individuals and families afford their health insurance premiums when they purchase plans through the Health Insurance Marketplace. Recent legislative changes have broadened PTC eligibility, making it more accessible for those with higher incomes or those who received unemployment benefits in 2021.

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    Children’s Health Insurance Program (CHIP)

    CHIP provides low-cost health coverage tailored for children, bridging the gap for families that earn too much to qualify for Medicaid but struggle to afford private insurance. It covers a broad spectrum of services to meet children's health needs, from routine check-ups to vaccinations.

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    Supplemental Nutrition Assistance Program (SNAP)

    SNAP, formerly known as food stamps, offers nutritional support to eligible, low-income individuals and families, facilitating access to adequate food and diet. The program is a cornerstone in the fight against hunger and a pathway to health and well-being for those facing economic hardships.

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    Federally Qualified Health Centers (FQHCs)

    FQHCs are community-based health care providers that deliver comprehensive care in underserved areas, regardless of a patient's ability to pay, offering services on a sliding fee scale. They provide primary care, preventive health services, dental care, mental health services and more, often integrating social support services.

Financial Planning for Health Care

Start with a thorough understanding of health insurance and the associated costs, and select the right coverage to lay the foundation for sound financial health management. From there, leverage tax-advantaged savings accounts and establish an emergency fund to ensure preparedness for routine and unexpected medical expenses.

Enhance Your Health Insurance Literacy

Begin with understanding health insurance and its benefits. Utilize community programs to increase your knowledge and ensure your coverage meets your current health care needs. You may use MoneyGeek’s online resources and tools to stay informed about health insurance:

Understand Health Care Costs

Before choosing a health insurance plan, consider all costs involved, including premiums, deductibles, out-of-pocket maximums and in-network provider coverage. For example, lower premiums generally come with higher out-of-pocket costs. A thorough understanding of costs can help you avoid unexpected expenses and make informed decisions, especially in rural areas with limited provider options. Read MoneyGeek’s resources to understand the full cost of health insurance and health care:

Choose the Right Insurance Plan

Compare plans or consider government programs like Medicaid or Medicare if you qualify. Weigh monthly premiums against out-of-pocket costs. Reassess your plan annually as your health care requirements and financial situation may evolve. Evaluate your options using MoneyGeek’s health insurance tools and resources:

Set Up Health Savings and Spending Accounts

Consider setting up Health Savings Accounts (HSA) or Flexible Spending Accounts (FSA). These accounts allow you to allocate funds for medical expenses on a pre-tax basis and are particularly advantageous for those with high-deductible health plans.

Establish an Emergency Medical Fund

Build an emergency fund to prepare for unforeseen health care expenses and ensure access to necessary medical care without the burden of immediate financial worry.

Resources for Rural Residents

MoneyGeek has compiled a selection of helpful resources for rural Americans, offering support and information to improve access to health care and community services.

About Nathan Paulus

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Nathan Paulus is the Head of Content Marketing at MoneyGeek, with nearly 10 years of experience researching and creating content related to personal finance and financial literacy.

Paulus has a bachelor's degree in English from the University of St. Thomas, Houston. He enjoys helping people from all walks of life build stronger financial foundations.