Rural Hospital Mergers from 2005 through 2016

Hospital mergers and acquisitions are changing the face of health care in both rural and urban communities across the country. There are many factors driving mergers, such as cost savings, increased access to capital, increased access to technology, etc., but concerns about rural hospital mergers have also been voiced, including reduced negotiating power with insurers,… Read more »

Geographic Variation in Uncompensated Care between Rural and Urban Hospitals

Rural residents are less likely than urban residents to have health care coverage through their employer, more likely to be low-income, and oftentimes are unable to afford coverage on their own. For hospitals that serve rural residents, this often means higher rates of uncompensated care compared to urban hospitals. Recent policy changes could lead to an increase… Read more »

Market Characteristics Associated with Rural Hospitals’ Provision of Post-Acute Care

Post-acute care (PAC) in rural hospitals, particularly Critical Access Hospitals (CAHs), represents an important source of PAC access in rural areas. In addition, a rural hospital’s financial health often depends on providing services that meet local need.  Over time, some changes in Medicare payment policies have adversely affected rural providers. For example, when the Balanced… Read more »

Geographic Variation in the 2016 Profitability of Urban and Rural Hospitals

Rural hospital closures remain a worrisome issue for policy makers and communities: between 2010 and 2017, 83 rural hospitals closed. The NC Rural Health Research Program tracks these closures and studies potential predictors. Profitability is not the only predictor, but it is one of the main predictors of hospital closure. Researchers and policy makers are… Read more »

Evaluating the Workforce Outcomes of North Carolina’s Medical Education Programs

          North Carolina Session Law 2017-57, Section 11J.2, the Current Operations Appropriations Act of 2017, directed the North Carolina Department of Health and Human Services (DHHS) and The University of North Carolina (UNC) to assess the degree to which physician training programs in North Carolina meet the healthcare needs of North Carolina’s citizens. The Program… Read more »

Range Matters: Rural Averages Can Conceal Important Information

Researchers often use averages to describe data.  The average (or the mean) of a data set can be used to identify the central value of the group, or what is typical. While valuable, it’s also important to understand the range of data—the highs and lows.  What might we miss by focusing on the average? When… Read more »

Differences in Community Characteristics of Sole Community Hospitals

In 1983, Congress created the Sole Community Hospital (SCH) program to support small rural hospitals for which “by reason of factors such as isolated location, weather conditions, travel conditions, or absence of other hospitals, is the sole source of inpatient hospital services reasonably available in a geographic area to Medicare beneficiaries.” A SCH is often… Read more »

Health Disparities in Appalachia

“Creating a Culture of Health in Appalachia: Disparities and Bright Spots” is an innovative research initiative that aims to identify factors that support a culture of health in Appalachian communities. “Health Disparities in Appalachia” is the first report in a series exploring health issues in Appalachia. It measures population health and documents disparities in health… Read more »

Rural-Urban Variations in Medicare Live Discharge Patterns from Hospice, 2012-2013

For the last decade-and-a-half, the proportion of patients discharged from the Medicare hospice program prior to death – known as a “live discharge” – has increased across the country with significant hospice-level geographic variations. Despite clear geographic variations in live discharge rates and known rural-urban disparities (e.g., patients of rural hospices have higher satisfaction), previous… Read more »