In April 2024, the Federal Office of Rural Health Policy (FORHP) proposed a change to its current definition of “rural” used in administering rural health grant programs. The current definition of rural utilized by FORHP includes the following:
- All non-metro counties
- All outlying metro counties without an urbanized area (50,000 or more people )
- All metro census tracts with Rural Urban Commuting Area Codes (RUCA) four through 10
- Metro census tracts of at least 400 square miles in an area with a population density of 35 or less per square mile with RUCA codes two through three
The proposal introduced by FORHP adds a rugged terrain aspect to the rural definition. The change is intended to target census tracts that are at least 20 square miles in size. Areas like this are more likely to face travel difficulties that may result in barriers to receiving healthcare services. Highly rugged census tracts with a RUCA code of one would not be classified as rural under the proposal because they contain populations from urban areas. Areas that already meet the rural criteria above will not be impacted by this proposal.
In addition, FORHP is making a technical clarification related to the U.S. Census Bureau’s removal of the definitions of “urbanized area” and “urban cluster” after the 2020 census. Since the current definition of rural references urbanized areas, FORHP is changing that element to read, “Outlying metro counties with no urban population from an urban area of 50,000 or more people.”
Forvis Mazars will be closely monitoring the progress of this proposal and its potential impacts on rural healthcare providers and their communities. If you have questions or need assistance, please reach out to one of our professionals.