Frontier definitions list

Just as there are many different definitions of “rural,” there are a number of ways of designating frontier areas.The various definitions of frontier are summarized below.

Matrix for identifying frontier areas (NCFC)

  • FRONTIER: A New Definition
    This report is the result of a consensus process convened by NCFC and the Office of Rural Health Policy in 1997. A multi-disciplinary group of frontier and rural leaders spent nearly a year developing a matrix that weights population density, distance in miles and travel time in minutes from a market-service area.
  • Matrix for Identifying Frontier Areas
    The matrix for determining frontier areas developed in 1997-98 in a a consensus process convened by NCFC and the Office of Rural Health Policy.
  • Matrix for Identifying Frontier Areas – 2007 Update
    This report updates work done in 1997-98 to develop a consensus definition of “frontier.”

The Frontier and Remote Areas (FAR) methodology (ORHP, USDA)

On November 5, 2012, a new methodology for identifying “frontier and remote” (FAR) areas was released by the the Office of Rural Health Policy (ORHP) and the U.S. Department of Agriculture (USDA). The FAR methodology uses travel time to population centers to categorize areas as FAR level 1-4. The aim is to provide a geographically detailed, multi-level delineation of frontier areas for use in policy and research.

Frontier Health Professional Shortage Area (Affordable Care Act)

“The term ‘frontier health professional shortage area’ means an area —

“(A) with a population density less than 6 persons per square mile within the service area; and
“(B) with respect to which the distance or time for the population to access care is excessive.”

Frontier State (Affordable Care Act)

“‘Frontier State’ means a State in which at least 50 percent of the counties in the State are frontier counties…counties in which the population per square mile is less than 6.”

California’s Frontier Methodology

California’s Office of Statewide Health Planning and Development defines a “Medical Service Study Area” as frontier if it has a population density of less than 11 persons per square mile and it has no census defined place within the area with a population exceeding 50,000.

Rural-Urban Commuting Area (RUCA) Codes

Rural-Urban Commuting Area Codes, are use the Bureau of Census Urbanized Area and Urban Cluster definitions in combination with work commuting information to characterize all of the nation’s Census tracts regarding their rural and urban status and relationships. Census tracts identified as “isolated rural” (RUCA Codes 10.0-10.6) are often considered Frontier.

Office for the Advancement of Telehealth Methodology for Designating Frontier Areas (2006)

This report established a “Frontier Area” designation process for programs implemented through the Office for the Advancement of Telehealth

Department of Health and Human Services Definition of Frontier (2008)

“Frontier Area means those areas identified by the Secretary (through the Frontier Work Group of the Office for the Advancement of Telehealth) as frontier areas, or, until an official list of frontier areas is issued, those U.S. counties or county-equivalent units with a population density less than or equal to 6 persons per square mile.”

Frontier Extended Stay Clinic Criteria

Criteria for elegibility as a Frontier Extended Stay Clinic Demonstration Program

Frontier Community Health Integration Demonstration Program Frontier Definition

Defines frontier using population density for the purposes of the Frontier Community Health Integration Demonstration Program.