Transforming Rural Health Through Innovation and Evidence
Rural health systems are at a crossroads. Hospital closures, workforce shortages, and outdated infrastructure threaten people’s access to high-quality preventive and specialty care. Mathematica serves as a resource for the Centers for Medicare & Medicaid Services (CMS) and state and local leaders looking to improve access and financing in rural areas.
Our team of rural policy experts, data scientists, methodologists, and technologists design, test, and scale solutions that improve care quality and access, meet social needs, and introduce payment reform in rural areas.
Partnering with States to Transform Rural Health Care
CMS’s new Rural Health Transformation Program presents a critical opportunity for state leaders to secure federal funding to redesign care delivery, strengthen access to care, and improve outcomes.
Mathematica and our strategic partners can help states on their journey to rural health transformation—providing application, strategy, technical assistance, and program design support so states can cut through complexity, secure buy-in from stakeholders, and develop a plan for lasting impact. We’ll work side-by-side with our state partners to understand what’s most important to them and to deliver sustainable and scalable rural health solutions rooted in data, evidence, and local needs and policy priorities.
Making Rural Health Care Data More Accessible
Amid rising health care costs, program administrators and policymakers need increased transparency into the factors driving that growth to understand how best to chart a path forward. Insight gathered from health care pricing and usage data can help inform and enhance decisions about opportunities to improve quality and affordability of care for rural communities.
To drive clear and accessible data use and support data-driven decisions, Mathematica designed our Rural Health Potentially Avoidable Utilization (PAU) Dashboard to equip more than 2,000 rural hospitals across the United States with data on the percentage of Medicare revenue from PAU in emergency department or inpatient care settings—helping hospitals identify where to invest to reduce their PAU.
We’ve also partnered to develop hospital cost and quality dashboards, such as the Hospital Cost Tool and the Health Systems Dashboard, to give policymakers and researchers tools to better understand and improve hospital pricing and quality.
Query Rural Hospital Cost Data
Query our Rural Health PAU Dashboard by state and view PAU rates for more than 2,000 hospitals.
View DashboardEstablishing Rural Emergency Hospitals
Hospital closures remain a persistent challenge in rural communities, creating a shortage of accessible health care providers and leaving rural residents to travel long distances to receive essential care. To address these closures, policymakers and CMS created the Rural Emergency Hospital (REH) designation. REHs are designed to maintain access to critical outpatient hospital services and 24-hour emergency and observation services in communities that might be unable to support or sustain a small rural hospital.
For small rural hospitals, critical access hospitals, and rural community partners interested in exploring the benefits and feasibility of converting to an REH, Mathematica supports the Rural Emergency Hospital Technical Assistance Center. Through this center, we provide direct technical assistance, including custom financial modeling, virtual learning events, and developing and sharing educational resources.
Assisting Small Rural Hospitals and Communities
Mathematica provides direct technical assistance to small rural hospitals, critical access hospitals, and rural community stakeholders who are interested in exploring the benefits and feasibility of converting to Rural Emergency Hospitals.
Learn MoreImplementing Payer Models That Promote Better Care
To curb rising health care costs and incentivize better care coordination, primary care follow-up, and community health partnerships in rural areas, CMS and other health care payers have been partnering with federal and state leaders to explore the potential of alternative payment models.
Mathematica brings a strong foundation of experience to help navigate these efforts. We’ve partnered with states, federal agencies, payers, and providers to design and implement hospital global budgets and other alternative payment models in rural settings with multi-payer participation, such as the Vermont All-Payer Accountable Care Organization Model and the Pennsylvania Rural Health Model. For our work in Pennsylvania, we are collaborating with the Pennsylvania Rural Health Redesign Center and the CMS Innovation Center to support recruitment efforts, develop requirements for data submission, design new payment models and adjustments, produce financial analysis, calculate global budgets, and aggregate and analyze data for payers and providers.
Aligning Financial Incentives and Population Health
Our experience in Pennsylvania taught us that the global budget payment model can provide a powerful incentive for hospitals to reduce potentially avoidable utilization by improving the population health in their local communities.
Learn MoreUsing Evidence to Strengthen Rural Behavioral Health Care
Rural communities face unique barriers such as geographic isolation, provider shortages, economic distress, and limited access to broadband and transportation—all challenges that intensify behavioral health needs.
Mathematica partners with governments, health systems, and community organizations to generate and apply rigorous evidence that states need to guide rural behavioral health transformation. We help identify gaps in access and outcomes through robust data analysis, evaluate the impact of interventions, and translate findings into action-oriented recommendations. For example, we analyzed a large health system in the Dakotas and rural Minnesota that incorporated behavioral health services into primary care. This approach achieved measurable improvements in quality-of-care processes and reduced emergency department use. We have also evaluated programs that support parents with substance use challenges who are involved in the child welfare system, identifying strategies that promote recovery and strengthen family reunification. These examples provide a roadmap for scaling approaches that improve outcomes while adapting to the realities of rural communities.
Working with Iowans to Strengthen Community-Based Services
We collaborated with Iowans to develop recommended approaches to strengthen the state’s community-based services system. We are also developing a transformation plan to support efforts to better provide these services to Medicaid beneficiaries with health, disability, and aging needs.
Learn MoreMeet Your Partners in Progress
Our interdisciplinary teams turn complexity into clarity—and data into impact. Contact our staff to talk about how we can improve access to high-quality care in rural areas in your state.
