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Aging and Rural Communities

HRSA’s Goal to Preserve Seniors' Access to Healthcare in Rural Communities

HRSA recognizes the needs of the elderly population in rural areas and continues to evolve and focus its programs to meet their health needs. The following are some of HRSA’s rural activities:

Office of Rural Health Policy

HRSA’s Office of Rural Health Policy (ORHP) is the leading Federal proponent for better health care services for the 55 million people that live in rural America.  Housed in HRSA, ORHP has a department-wide responsibility to analyze the impact of health care policy on rural communities.  ORHP informs and advises the Secretary, and works to ensure that rural considerations are taken into account throughout the policy-making process.

The State Office of Rural Health grant program, which funds the 50 States, ensures that there is a focal point for rural health issues on a variety of activities ranging from quality improvement to assistance with grant writing.

ORHP funds the Rural Research Centers Program. One research center analyzed trends in Medicare Advantage plans for rural beneficiaries.  This work helped the Department focus resources on increasing Medicare Advantage enrollment in rural areas.  Another research center tracks Medicare pharmacy benefits to help ensure increased access to drug coverage for seniors.

ORHP efforts include assisting in the enrollment of more than 180 rural hospitals in the 340B Discount Drug program.  A change in the law under the Medicare Modernization Act of 2003 allowed qualifying rural hospitals which take care of a large percentage of poor and elderly to qualify for this program.  ORHP works extensively with the States to identify eligible hospitals and assist them in the application process for gaining access to low-cost pharmaceuticals.

ORHP collaborates with CMS to promote the Program of All-Inclusive Care for the Elderly (PACE) in rural areas.  The PACE program provides a range of services to help keep Medicare and Medicaid beneficiaries out of nursing homes.

National Health Service Corps

The NHSC is a service program and its clinicians go wherever the need is great, where others choose not to go.  By statute, the Program requires its recruited clinicians to serve targeted areas where they are needed most by linking educational support with a clinical placement (through a scholarship or loan repayment) to serve patients most in need of primary care services.

From 1993 to 2006, the NHSC provided almost 18,000 total years of dedicated service from its clinicians practicing in rural areas.  Moreover, the most current retention rate of NHSC clinicians in rural areas is approximately 75 percent.  To overcome shortages and scarcities in rural areas and to expose students to hands-on primary care rotations, the Agency supports State and community recruitment efforts including retention of their grow-your-own health professionals.

Geriatric Program

HRSA responds to the growing needs of the elderly in rural areas with its geriatric programs.  For instance, the Comprehensive Geriatric Education grant supports nursing personnel by preparing nurses aides, licensed practical nurses, registered nurses, and faculty to care for the elderly.  This program also funds the development of curricula and provides continuing education to individuals who provide geriatric care.  Americans are living longer, healthier, and more independently than ever before.  Health professionals prepared in geriatrics are critical in preventing health problems in the elderly population.


Rural areas generally have a greater elderly population than urban areas.  With physical access to care the greatest challenge that many elderly rural patients face, HRSA funds telehealth projects to help eliminate this barrier.  Some HRSA grantees work on telehealth projects involving home monitoring, chronic disease management, psycho-behavioral management, telestroke and oncology.  These programs are especially crucial for the growing elderly population in rural areas.


CMS Rural Health Fact Sheet about Federally Qualified Health Centers (FQHC): This CMS publication includes a background; FQHC designation; covered FQHC services; FQHC preventive primary services that are not covered; FQHC Prospective Payment System (PPS); FQHC payments; Medicare Prescription Drug, Improvement, and Modernization Act of 2003 provisions that impact FQHCs; and Resources. Learn More.