Medicaid Payment and Delivery System Reform: Challenges and Opportunities for Rural Health Systems

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Compared to their urban counterparts, rural populations tend to be older, poorer, and sicker and have less access to employer-sponsored insurance plans. Consequently, a higher proportion of rural people are potentially eligible for Medicaid. Indeed, as of 2014, 22 percent of rural residents were enrolled in Medicaid while 20 percent were enrolled in Medicare, signifying that Medicaid has surpassed Medicare as the largest source of public health coverage in rural areas, and is second in coverage only to employer-sponsored insurance plans.