Becoming a Rural Health Clinic (RHC)

  1. Does your clinic qualify as a rural site?

    All results from these resources should be considered general and preliminary only. Final determination of rural status is done by the State of Oregon. Please contact John Pilmer at Health Care Regulation and Quality Improvement (HCRQI for final determination of rural status: | (971) 673-0540.

    1. The clinic is not in an urbanized area:

      1. Map of Census Urbanized Areas
      2. U.S. Department of Health and Human Services (HHS) Rural Assistance Center's Am I Rural? Tool gives you a custom report of rural status for your clinic address.

    2. The clinic is in a current Health Professions Shortage Area (HPSA) or a Medically Underserved Area (MUA) issued or renewed within the previous four years.

      HPSA: The age of the designation is calculated as the last day of the year 4 years from the date of the original designation, or the date the area was last designated. For example, a clinic that is located in an area that was most recently designated or updated on June 1, 2010, would be considered as meeting this location requirement through December 31, 2014. In Oregon, HPSA scores are updated every three years by the Oregon Primary Care Office . To ensure your area’s HPSA score has not expired, contact: | 503-373-1779.

      MUAs do not expire however if you are using an MUA for RHC purposes and do not have a HPSA, the MUA must have been issued within the past four years.

      1. Compare your site against Maps and lists of HPSA and MUA in Oregon.

      2. Search HPSA & MUA by address.

  2. Is there a financial benefit to RHC status for your clinic?

    RHCs (and FQHCs) receive special Medicare and Medicaid rates. The RHC rate benefit can vary from clinic to clinic depending on the type of services that the clinic provides and the payer mix of the patient population. Options:

    1. As an introductory resource, a basic Medicare-focused financial analysis worksheet is available in Starting a Rural Health Clinic, Appendix F.

    2. Our office can assist you with a more detailed Medicare and Medicaid financial impact analysis of your current Fee-for-Service rates vs. current RHC rates. Please contact: Stacie Rothwell, Program Manager | | 503-494-4450 | toll-free 866-674-4376.

    3. Wipfli LLP can provide various services to clinics considering RHC status. See Wipfli’s menu of RHC services.
  3. Does your clinic meet RHC personnel requirements?

    More than 50% of services must be Primary Care: Family Care, Internal Medicine, OB/GYN, and Pediatrics. An RHC must:

    1. Employ a Nurse Practitioner (NP) or Physician Assistant (PA)

      RHCs may contract with NPs, PAs, Certified Nurse Midwives (CNM), Clinical Psychologists (CP), and Clinical Social Workers (CSW) when at least one NP or PA is employed by the RHC.

    2. Have a NP, PA, or CNM (employee + contract) working at the clinic at least 50 percent of the time the clinic operates.

Our Workforce team can assist you with recruitment and retention of practitioners.