About this project Lead researcher: Pam Silberman, JD, DrPH Project completed: January 2003 Continuing the work on tracking and assessing the extent of Medicaid-managed care in rural areas, the project will focus on states with innovative case management strategies and look specifically at how these programs operate in rural communities. Year Two of the project… Read more »
Labor Costs and the Area Wage Index in Skilled Nursing Facilities
About this project Lead researcher: Kathleen Dalton, PhD Project completed: February 2003 This project will examine regional patterns in Skilled Nursing Facility (SNF) hourly wages, using data from Fiscal Year 1997 cost reports for all freestanding and hospital-based facilities. We will analyze wage differentials by community size and regional location with the objective of comparing… Read more »
Information Technology Engineering Support for Health Resources and Services Administration Data Systems/Geospatial Data Warehouse, GIS Technologies, GEMS Support and General Office of Information Technology Systems Support
About this project Lead researcher: Thomas C. Ricketts, PhD Project completed: October 2003 This project will develop or update a comprehensive national data set that describes the supply and distribution of primary care professionals in the United States and related need factors for use by the Health Resources and Services Administration and others in the… Read more »
Factors Contributing to Unit Cost Instability in the Low-Volume Hospital
About this project This project will study year-to-year variation in Medicare inpatient costs within rural hospitals, with a special focus on factors affecting unit costs in low-volume providers. Lead researcher: Kathleen Dalton, PhD Project completed: January 2003 We propose to analyze panel data constructed from eight years of Medicare hospital files, covering reports filed for… Read more »
Rural Hospital Profitability during the Global COVID-19 Pandemic Requires Careful Interpretation
The North Carolina Rural Health Research Program has been tracking rural hospital profitability for more than a decade, as many small rural hospitals struggle with profitability compared to their urban counterparts. The findings brief, , describes the pre-pandemic (2011-19) trend of rural hospital profitability and explains why possible increases in reported profitability during the pandemic… Read more »
Predictors of Hospital Choice among Rural Patients Seeking Elective Surgery: A Scoping Review
Hospital choice for surgery affects both patient outcomes and hospital viability, a greater understanding of rural patients’ surgical care-seeking behavior could enhance rural health and rural hospital financial stability. Specifically, insight on modifiable determinants of care-seeking behavior can inform policies to promote behavior that is consistent with evidence-based public health recommendations (e.g., undergoing common, low-risk… Read more »
Unmet Needs for Health Care Services: An Analysis of Children with Special Health Care Needs in Rural Areas
About this project Parental report of having an unmet need for care is frequently used as a measure of poor access to medical services; however, this unvalidated measure is usually dependent on parental perceptions of the need for care. Lead researcher: Rebecca T. Slifkin, PhD Project completed: August 2004 This project will assess the extent… Read more »
Rural Hospital Closures, 1990-2000: Community Profiles and Economic Indicators Before and After the Event
About this project Lead researcher: Rebecca T. Slifkin, PhD Project completed: December 2004 This study investigated the economic impact of hospital closures in non- metropolitan counties, taking into account the economic characteristics and employment trends that may have preceded the event. Between 1990 and 2000 there were 460 community hospital closures in the U.S. that… Read more »
Changes in the Supply, Distribution, Workload and Reimbursement Patterns of Pharmacists in Rural Areas
About this project Lead researcher: Erin Fraher, MPH Project completed: August 2004 This study examined the supply, distribution, workload, and reimbursement patterns of pharmacists in rural areas. Pharmacist licensure data from five geographically diverse states with high rural populations were analyzed to determine demographic characteristics, employment patterns, and educational preparation of practicing pharmacists in rural… Read more »
Analytic Capacity to Respond to Changes in Medicare and Medicaid, Data Assistance to Policy Staff at the Federal Office of Rural Health Policy, and Production of Short Policy Briefs
About this project Lead researcher: Rebecca T. Slifkin, PhD Project completed:December 2004 Medicare payment rates to a variety of providers are constantly evolving, both through new legislation proposed in the Congress and regulatory changes proposed by the Centers for Medicare and Medicaid Services (CMS). This project revolves around educating congressional staff and other key individuals… Read more »
Analysis of the Cesarean Section Rates in Rural Hospitals
About this project Lead researcher: Rebecca T. Slifkin, PhD Project funded: September 2003 Project completed: August 2006 The purpose of this study is to examine practice patterns for deliveries in rural hospitals, with a focus on cesarean section (c-section) rates, which are rising nationally. The diffusion of best practices may be slower to reach rural communities, and consequently,… Read more »
Trends in Swing Bed and Skilled Nursing Facility Use in Rural Hospitals, 1996-2003
About this project Lead researcher: Rebecca T. Slifkin, PhD Project completed: August 2005 Topics: Aging, Hospitals and clinics, Long-term care, Medicare Prospective Payment System (PPS) This study will examine trends in the distribution of skilled nursing facility (SNF) services in rural hospitals during a period of dramatic change in Medicare reimbursement, most notably the transition from cost-based reimbursement… Read more »
Special Study of EMS Issues
About this project Lead researcher: Andrew F. Coburn, PhD The University of Southern Maine and the University of North Carolina at Chapel Hill will collaborate to conduct a special study of EMS issues during Year 2 of the Flex Project (2004-05). The study will focus on state, community, and hospital-level initiatives designed to build the… Read more »
Role of Intensive Care Units in Critical Access Hospitals
About this project Lead researcher: Rebecca T. Slifkin, PhD Project completed: February 2005 The number of small rural hospitals that have chosen to convert to CAH status has been greater than many people had anticipated, and concern has been voiced by some individuals about whether the provision of services in an intensive care unit (ICU)… Read more »
Impact of The Medicaid Budget Crisis on Rural Communities: A 50-State Survey
Understanding how the Medicaid budget crisis affects communities Lead researcher: Rebecca T. Slifkin, PhD Most states are facing severe budget crises, forcing them to reduce Medicaid program costs. States have many different options to reduce Medicaid expenditures, including cutting optional eligibles or optional services, reducing provider payments and increasing recipient cost sharing. Many of the… Read more »