On November 12, the Primary Care Collaborative (PCC) released its 2025 Evidence Report, Closing the Distance in Rural Primary Care: Evidence, Stories, and Solutions. Healthcare Innovation’s contributing editor, David Raths, detailed the findings in a recent article, outlining seven specific recommendations for policymakers to strengthen and sustain primary care in rural settings. The report found that even as clinician shortages persist, rural practices manage a wider range of patient needs than urban practices, including chronic disease and behavioral health, while providing or referring patients to community-based services.
During a webinar hosted by PCC on the same day the organization released its report, Alison Huffstetler, M.D., from the AAFP Robert Graham Center, discussed how rural primary care is built on strong community relationships and has a broad clinical scope—but faces major challenges due to chronic underfunding and recent policy changes. She observed that rural care heavily relies on FQHCs (Federally Qualified Health Centers) and RHCs (rural health clinics) as independent practices diminish, and programs like the National Health Service Corps and Teaching Health Centers remain highly effective recruitment pipelines.
Huffstetler identified three key quantitative trends: rural clinicians still offer more comprehensive care than urban ones; primary care spending is declining overall; and, although a higher share of rural clinicians work in primary care, absolute numbers remain low.
American Board of Family Medicine’s (ABFM) President Warren Newton pointed out that rural health care has long been a warning sign for the country, noting that mortality rates and life expectancy started declining in rural areas well before similar patterns appeared nationwide.
Former South Dakota Medicaid Director Bill Snyder emphasized that payer mix and Medicaid cuts jeopardize the sustainability of rural practices. He noted that the report offers various strategies to enhance the feasibility of value-based care in rural settings, such as modifying benchmarks, timelines, and population goals. Nevertheless, he pointed out that many rural clinics lack the resources and capacity to implement and sustain these models. For value-based care to thrive in rural areas, he argued, programs must be developed from the outset considering the unique needs and conditions of rural communities.
The PCC urged policymakers to strengthen RHCs and FQHCs, implement hybrid payment models, reauthorize and expand the Teaching Health Center and National Health Service Corps programs, and provide stronger oversight to ensure that new federal rural health funding reaches rural communities.
