Rural Health Knowledge Center

Rural healthcare refers to the health services available to people who live in rural areas, along with the facilities, professionals, and systems that provide them. It includes primary care clinics, Rural Health Clinics, Critical Access Hospitals, community health centers, pharmacies, emergency medical services, and telehealth.

There is no single definition of "rural." Federal agencies define it in different ways for different purposes. The U.S. Census Bureau classifies areas as urban or rural based mainly on population and housing density, while HRSA's Federal Office of Rural Health Policy uses its own approach to decide which areas are eligible for its rural health programs. As a result, a place may count as rural under one definition but not another.

Under the Census Bureau's definition, 20.0% of people in the United States lived in rural areas at the time of the 2020 Census, about one in five. Rural healthcare often involves longer travel distances, smaller facilities, and fewer specialists than care in cities.

Sources: Rural Health Information Hub, What is Rural? (opens in a new tab); U.S. Census Bureau, Nation’s Urban and Rural Populations Shift Following 2020 Census (opens in a new tab); Health Resources and Services Administration (HRSA), Rural Health (opens in a new tab)

Federally qualified health centers (FQHCs), often called community health centers, are community-based clinics that receive support from the Health Resources and Services Administration (HRSA). They are located in both rural and urban areas, often in places where access to care is limited.

Health centers serve people regardless of their ability to pay or their insurance status. They offer a sliding fee scale, which means the amount a patient pays is based on household income and family size. Many accept Medicaid, Medicare, and private insurance as well.

Services vary by location but commonly include primary care, preventive care, and in many cases dental, behavioral health, and pharmacy services. Some health centers also help patients with transportation, translation, or enrolling in health coverage.

To look for a health center near you, you can search by address or ZIP code using HRSA's Find a Health Center tool at findahealthcenter.hrsa.gov. Contact the center directly to confirm services, hours, and costs.

Sources: Health Resources and Services Administration (HRSA), Find a Health Center (opens in a new tab); Rural Health Information Hub, Federally Qualified Health Centers (FQHCs) and the Health Center Program (opens in a new tab)

Telehealth is the use of technology, such as video calls, phone calls, secure messaging, and remote monitoring devices, to receive or provide healthcare without being in the same room as your clinician.

Common examples include a video appointment with a doctor or counselor, a phone check-in about a prescription, sending a photo of a skin condition for review, or using a home blood pressure cuff that shares readings with a care team.

In rural areas, telehealth can reduce travel time and help people reach specialists or behavioral health services that are not available nearby. However, it is not right for every situation. Many needs, such as physical exams, lab tests, imaging, and vaccinations, still require an in-person visit, and telehealth is not for emergencies.

Video visits also depend on a device and a reliable internet connection. Insurance coverage for telehealth varies, so it is a good idea to check with your provider and health plan before your visit.

Sources: U.S. Department of Health and Human Services, Telehealth.HHS.gov (opens in a new tab); Rural Health Information Hub, Telehealth and Health Information Technology in Rural Healthcare (opens in a new tab)

Several options may help lower the cost of care, depending on your situation.

Community health centers, also called federally qualified health centers, provide care regardless of ability to pay and offer a sliding fee scale based on income. You can search for one using HRSA's Find a Health Center tool.

Health coverage can also make care more affordable. Depending on your income, household size, and state, you may qualify for Medicaid or the Children's Health Insurance Program (CHIP), or for financial help with a plan through the Health Insurance Marketplace at HealthCare.gov.

Other steps that may help include asking a clinic or hospital about financial assistance or payment plans, asking whether a generic medication is available, and checking with your local health department about low-cost services such as immunizations and screenings.

If you are unsure where to start, many health centers and community organizations have staff who can help you understand coverage options.

Sources: Health Resources and Services Administration (HRSA), Find a Health Center (opens in a new tab); Centers for Medicare & Medicaid Services, HealthCare.gov (opens in a new tab); Centers for Medicare & Medicaid Services, Medicaid.gov (opens in a new tab)

Rural communities rely on a wide range of healthcare professionals. These include physicians (especially family medicine), nurse practitioners, physician assistants, registered nurses, licensed practical nurses, pharmacists, dentists and dental hygienists, mental health counselors and social workers, emergency medical technicians and paramedics, physical and occupational therapists, laboratory and imaging technologists, and community health workers.

Healthcare careers require different amounts of education. Some, such as certain technician or assistant roles, can be entered with a certificate or associate degree, while others require bachelor's, graduate, or professional degrees plus licensure.

Many rural areas are designated by HRSA as Health Professional Shortage Areas, meaning there are not enough clinicians to meet local need. Programs such as the National Health Service Corps offer scholarships or loan repayment to eligible clinicians who agree to work in shortage areas. Requirements change, so check official program websites for current details.

Sources: Rural Health Information Hub, Rural Healthcare Workforce (opens in a new tab); U.S. Bureau of Labor Statistics, Occupational Outlook Handbook, Healthcare Occupations (opens in a new tab); Health Resources and Services Administration (HRSA), National Health Service Corps (opens in a new tab)

People in rural areas can face several overlapping barriers to getting care.

Distance is one of the most common. The nearest clinic, pharmacy, hospital, or specialist may be far away, and travel can be harder in bad weather. Transportation adds to this challenge, since public transit is limited in many rural areas and not everyone has a reliable vehicle.

Workforce shortages also matter. Many rural areas have fewer healthcare professionals than they need, which can lead to long waits or limited services, especially for specialty, dental, and behavioral health care. Some rural hospitals have closed or reduced services.

Cost and coverage can be barriers as well, including insurance status, out-of-pocket expenses, and time away from work. Limited broadband internet can make telehealth harder to use. Privacy concerns in small communities may also affect whether some people seek care, particularly for mental health.

These factors vary widely from one community to another.

Sources: Rural Health Information Hub, Healthcare Access in Rural Communities (opens in a new tab); Rural Health Information Hub, Transportation to Support Rural Healthcare (opens in a new tab); Centers for Disease Control and Prevention (CDC), Rural Health (opens in a new tab)