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Healthcare Insights

Top 10 rural health clinics by total cost

Rural health clinics are a type of outpatient care facility that deliver primary care and laboratory services to patients living in rural communities.

The care these clinics provide is vital, as patients in rural areas are statistically more likely to be older, less affluent, less well-insured, and sicker than people living in urban areas. Rural healthcare providers are particularly impacted by the ongoing staffing shortage, as many nurses, physicians, and other healthcare specialists have left rural areas in search of higher paying positions and better opportunities.

Definitive Healthcare tracks nearly 6,000 rural health clinics operating in the U.S. Using ClinicView, we ranked the top rural health clinics in the country by total costs. In our database, the ‘total costs’ metric is pulled from the Medicare Cost Report and is the sum of all salary expenses, overhead costs, and the total cost of services.

Top 10 rural health clinics ranked by total costs for 2021

Rank RHC name State Definitive ID Total costs Explore dataset
Phelps Health Medical Group MO 2406 $73,641,842 Explore
Walla Walla Clinic - Main Campus WA 11607 $39,940,266 Explore
UnityPoint Clinic Family Medicine - Belle Plaine IA 8050 $30,302,409 Explore
Evergreen Family Medicine OR 10393 $29,717,560 Explore
Primary Care Centers of Eastern Kentucky – Hazard KY 8396 $27,059,052 Explore
Quincy Medical Group - 1025 Main IL 11572 $26,179,358 Explore
San Luis Walk-in Clinic - Babbitt Lane AZ 7490 $24,974,330 Explore
Hutchinson Clinic – Hutchinson KS 8320 $20,167,306 Explore
Medical Arts Clinic MO 9913 $16,277,975 Explore
10 Jones Regional Medical Center Family Medicine – Anamosa IA 8491 $16,116,483 Explore

Fig. 1: Data is from Definitive Healthcare’s ClinicView product and sourced from the Medicare Cost Report. Data is accurate as of November 2022. 

What rural health clinic has the highest total costs?

Coming in first place is the Phelps Health Medical Group which accrued more than $73 million in total costs. Phelps Health Medical Group is in Missouri and operates five rural health clinics in-network.

Looking up Phelps Health Medical Group in ClinicView will provide detailed financial and clinical information for each clinic. But for the purposes of this list, we have combined the total costs and visits of each rural clinic into one entry.

Walla Walla Clinic in Iowa is second with more than $39 million in total costs.

UnityPoint Clinic, Evergreen Family Medicine, the Quincy Medical Group, and the Primary Care Centers of Eastern Kentucky also appear on our list of the top 25 rural health clinics by total visits.

What’s the difference between a provider-based rural health clinic and an independent rural health clinic?

Another metric worth considering is that of rural health clinic classification. There are two types of rural health clinics in the U.S.: provider-based clinics and independent clinics.

Eight of the top ten rural health clinics on our list are classified as independent clinics. A rural health center with this designation is owned and operated by a healthcare provider or larger healthcare system, but the clinic itself does not qualify for provider-based status because the facility does not participate in Medicare. The rural health clinics affiliated with Phelps Health Medical Group, for example, are operated by a hospital system, but individually do not participate in Medicare.

Provider-based rural health clinics are owned and operated as a part of a hospital, home health agency, or nursing home and participate in Medicare.

Rural health clinics numbers #3 and #10 on our list currently lack a clinic type designation. However, that may not mean the clinics are classified as provider-based. We’ll update this Healthcare Insight as new information is sourced from the 2023 Medicare Cost Report.

How does Medicare define rural?

According to the Centers for Medicare & Medicaid Services and the United States Census Bureau, rural areas are considered to include all people, housing, and territories that are not within an urban area. Essentially, any area that is not urban is rural. Any area that contains 50,000 or more people is considered urban.

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