MAP Rural Health Final Report - 2018 

More than 59 million individuals—approximately 19 percent of the U.S. population—live in rural areas. Data indicate that those living in rural areas in the U.S. are more disadvantaged, collectively, than those in urban or suburban areas, particularly with respect to sociodemographic factors, health status and behaviors, and access to the healthcare delivery system. In recognizing the lack of representation from rural stakeholders in the Measures Application Partnership (MAP) pre-rulemaking process, CMS tasked the National Quality Forum (NQF) to establish a MAP Rural Health Workgroup. Between November 2017 and July 2018, the MAP Rural Health Workgroup focused on two primary tasks: (1) identifying a core set of the best available rural-relevant measures to address the needs of the rural population and (2) providing recommendations from a rural perspective regarding measuring and improving access to care. In conjunction with these tasks, the Workgroup also identified and prioritized rural-relevant gaps in measurement and provided input on alignment and coordination of measurement efforts. This report describes the selection criteria and processes used to generate the core set of measures, catalogs the core set of measures along with the rationale for inclusion for each measure, summarizes measurement gap areas identified by the Workgroup, and presents the Workgroup’s recommendations on access to care from a rural perspective.