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Rural Health and Primary Care

Mission and Priorities

The Rural Health and Primary Care Program's mission is to promote and assure access to quality health care for Maine's residents living in rural and medically underserved areas. The Program accomplishes this through the administration of federal grants by dedicated program staff.

The Program's priorities provide a bridge between the mission and activities to fulfill it.

  • Strengthen and improve Maine's health care safety net.
  • Provide leadership and facilitate communication and coordination among the health care sector, government entities, academics, community leaders, and other stakeholders.
  • Assure access to expertise and resources that address public health care services, with a fucus on rural and underserved areas.
  • Build capacity by fostering local workforce solutions.

Successes

Maine has made encouraging progress in rural health care.

  • The Rural Health and Primary Care Program provides grant support for all 19 rural hospitals in Maine.
  • The percentage of Mainers reporting poor general health is among the lowest in the nation.
  • Maine ranks 2nd in the U.S. for the number of primary care physicians practicing in rural counties (99.5 per 100,000). The national average for rural counties is 54.5 per 100,000.
  • Maine ranks 8th in the U.S. for the number of psychiatrists practicing in rural counties. Maine has 6.2 per 100,000 residents. The U.S. rural average is 3.4.
  • The State Loan Repayment Program has assisted more than 80 Mainers in health care professions.
  • Since its inception in 1997, the Conrad J-1 Visa Program has brought nearly 700 health care providers to Maine.

Challenges to Health Care Access

Access to health care can be complex and often becomes more of a challenge in rural and underserved areas of Maine.

  • People who have low income and are uninsured have more trouble finding a health care provider, are less likely to seek medical services, and have greater difficulty paying their medical bills.
  • Lack of transportation is the most frequent, non-cost reason people with low income delay medical care.
  • Almost 20% of adults without a high school diploma do not have a regular health care provider, compared with 14% of high school graduates, 11% of those with some college, and 8% with a bachelor's degree or higher.
  • Compared to white adults, members of racial or ethnic minority groups are more likely not to have a regular health care provider (21% vs. 12%) and more likely to have gone without care in the prior year because of cost (17% vs. 10%).

The Health Care Safety Net

Critical Access Hospitals (CAHs)

The Medicare Rural Hospital Flex Program enables certain rural hospitals to be classified as CAH. A CAH is able to improve its financial stability through enhanced Medicare reimbursement and reduced operating costs.

Rural Health Clinics (RHCs)

The Rural Health Clinic Services Act was enacted to address an inadequate supply of physicians serving Medicare patients in rural areas and to increase the use of non-physician practitioners, such as nurse practitioners and physician assistants in rural areas. RHCs receive special Medicare and Medicaid rates, depending on the services the clinic provides and the payer mix of the patient population. RHCs may operate as public, private, or non-profit entities.

Federally Qualified Health Centers (FQHCs) and Look-Alikes

FQHCs are safety net providers that provide services typically furnished in an outpatient clinic. FQHCs include community health centers, migrant health centers, health care for the homeless health centers, public housing primary care centers, and health center program "lookalikes." They also include outpatient health programs or facilities operated by a tribe or tribal organization or by an urban Indian organization.

Safety Net Dental Sites

Safety net dental clinics ensure access to essential oral health care for individuals and families who are uninsured, underinsured, or face other barriers to care. By offering preventative and restorative services through sliding-fee scales, public insurance, or reduced-cost programs, these clinics support healthier communities, particularly in rural and underserved areas.

Rural Health Transformation Program

The Rural Health Transformation Program is a federal initiative designed to help rural communities improve health outcomes by strengthening care delivery, expanding access, and supporting value-based payment models. It focuses on aligning funding, data, and technical assistance so rural providers can better coordinate care, address workforce challenges, and meet the unique needs of rural populations.

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