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  • Foreword from Acting Administrator of the Health Resources and Services Administration (HRSA) and Associate Administrator of the Federal Office of Rural Health Policy (FORHP), U.S. Department of Health and Human Services
  • Jim Macrae, MA, MPP (bio) and Tom Morris, MPA (bio)

As Acting Administrator for the Health Resources and Services Administration (HRSA) and Associate Administrator of the Federal Office of Rural Health Policy (FORHP) of the U.S. Department of Health and Human Services, we welcome you to this special theme issue that features promising and evidence-based solutions to longstanding rural health care delivery and quality issues. This supplement spotlights methods that rural stakeholders have employed to address the health concerns and disease burden in communities that lack adequate access to care.

As the home of rural-specific grant programs, research, and policy within the Department of Health and Human Services, FORHP plays an integral role in rural health care delivery and improving the health of rural communities. Today, FORHP continues to build a programmatic evidence base for its rural grant programs to ensure that programs are informed by past investments and incorporate lessons learned to inform current and future grantees. The FORHP also engages providers that lack experience in quality measure reporting and value-based incentives. For example, FORHP collaborated with a geographically diverse sample of Rural Health Clinics (RHCs) to pilot-test the use and reporting of quality measures relevant to primary care. This effort developed a foundation for supporting RHC efforts to respond to the changing health care environment. The featured research and stories within this issue highlight promising practice models that inform our counsel to the Secretary on the impact of Medicare and Medicaid regulations on rural providers and communities.

While HRSA’s work to build rural health care capacity at the state and community level is centered in FORHP, every part of HRSA has a role in this effort. For example, at least 40% of community health centers are either physically located in or serve rural patients. The Maternal, Infant, and Early Childhood Home Visiting Program has facilitated the provision of evidence-based home visiting services to expectant mothers and parents of pre-kindergarten children in over 400 rural counties. Additionally, [End Page vii] Bureau of Health Workforce programs have supported more than 11,000 rural training sites and educated more than 180,000 students in primary care, oral health, geriatrics, public health, and behavioral health in rural communities. Today, one of three National Health Service Core clinicians serves at a rural site. As HRSA works to expand access and improve the quality of health care during this period of delivery system transformation, it will be important to identify creative and effective models that build on HRSA’s efforts to ensure those living in rural communities have access to the comprehensive care they need.

This special themed issue of the Journal of Health Care for the Poor and Underserved provides information on innovation and outcomes from rural communities across the nation. The key insights and themes contained in these articles are valuable to informing the ongoing health system transformation efforts. [End Page viii]

Jim Macrae and Tom Morris

JIM MACRAE is Acting Administrator of the Health Resources and Services Administration (HRSA). TOM MORRIS is Associate Administrator of the Federal Office of Rural Health Policy (FORHP), U.S. Department of Health and Human Services.

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