Rural Health Research Program

Projects

Current Projects

• Medicare Rural Hospital Flexibility Program Evaluation – The Sheps Center’s current role in this evaluation focuses on three areas. 1) Development of aFinancial Performance Measurement System: This project uses research and expert opinion to select dimensions and indicators of financial performance, develop appropriate bases or methods of peer comparison, investigate the relationship between quality of care and financial performance, and identify characteristics of high performing CAHs. 2) CAH Conversion Tracking:The Sheps Center continues its work tracking CAH conversions. 3)Quality Financial Relationships: This joint project with the University of Minnesota will investigate the relationship between CAH financial performance and quality of care.

  Principal Investigator: Rebecca T. Slifkin, M.H.A., Ph.D.

  Funding Source: Office of Rural Health Policy, HRSA (subcontract with the University of Minnesota)

  Total Project Period: 09/03 – 08/08
  
  

• North Carolina Rural Health Research and Policy Analysis (NCRHRPA)Center – Extending and expanding the work of the North Carolina Rural Health Research Program at UNC-CH, this project primarily focuses on Federal insurance programs (Medicare and Medicaid) and their effect on rural populations and providers. In addition, faculty and professionals working with the NCRHRPA Center respond to short-term queries using the unique availability of multiple national and special datasets to investigate key rural health policy issues. The following four projects are under investigation: 1) Rural Emergency Medical Services: Workforce and Medical Direction, 2) Issues Surrounding Consumer Directed Health Care in Medicaid Programs, 3) Assessing the Impact of Transfer of Pharmacy Services for Duel-Eligible Beneficiaries to Medicare Part D, and 4) State Facts about Medicaid: Rural Specific Data. The NC RHRPA Center has also been designed to have staff, data and resources to address other issues as they become salient.

  Principal Investigator: Rebecca T. Slifkin, M.H.A., Ph.D.

  Funding Source: Office of Rural Health Policy, HRSA

  Total Project Period: 08/15/04 – 08/14/08 [Third Award]
  
  

• Rapid Response to Requests for Rural Data Analysis and Issue-specific Rural Research Studies – The North Carolina Rural Health Research & Policy Analysis Center (NC RHR & PAC), described previously, will provide rapid response for rural-focused data analysis and conduct issue-specific rural research studies in response to emerging policy issues. In order to ensure that rural policy is designed to protect and improve the health of rural residents, data on the unique characteristics of rural people, health care providers, and the health care infrastructure and the potential impact of health policy will be made available to policy makers, rural organizations and ORHP. The support of rural health policy can also require issue-specific studies involving greater time and resources and more complex study design than rapid response data analysis. Under this cooperative agreement, the NC RHR & PAC, in collaboration with the two other ORHP-funded rural policy analytic centers, the Rural Policy Research Institute Center for Rural Health Policy Analysis and the Walsh Center for Rural Health Analysis, will provide these vital services to individuals and organizations involved with rural health policy.

  Co-Principal Investigators: Rebecca T. Slifkin, M.H.A., Ph.D.

  Funding Source: Office of Rural Health Policy, HRSA

  Total Project Period: 09/06 – 08/09
  
  

• Update the Impact Testing of the Proposed Revised Methodology for Designating Underserved Areas – The previous impact testing was based on data from 1998-1999 and was conducted in 2000-2001. In order to proceed with the review process for the Notice of Proposed Rulemaking within the Department of Health and Human Services and then with the Office of Management and Budget (OMB), it is important to update the testing to judge the effectiveness of the proposed model using more up-to-date data. A number of questions regarding the impact, including identification of areas that may lose or gain eligibility for certain resources, the impact on existing programs targeting the underserved and specific questions about the proposed methodology will be addressed with the updated impact testing.

  Principal Investigator: Thomas C. Ricketts, III, M.P.H., Ph.D.

  Funding Source: Bureau of Health Professions, HRSA

  Total Project Period: 04/06/07 – 09/05/07

• Update of Need for Assistance (NFA) Scales, Benchmarks, and Data Resource Guide – This project will extend and enhance work done previously for the Bureau of Primary Health Care (BPHC) in the development of NFA criteria and benchmarks. This includes 1) reviewing the current NFA data requirements and the benchmarks and reference data for Barrier and Disparities measures as well as the data required for all applicants; 2) assessing the currency and applicability of the data, benchmarks, and scoring; and 3) making recommendations for changes or substitutions of data or specific criteria. In addition, the Data Resources Guide that is made available to applicants to support their background work will be updated.

  Principal Investigator: Thomas C. Ricketts, III, M.P.H., Ph.D.

  Funding Source: Bureau of Primary Health Care, HRSA

  Total Project Period: 09/26/07 – 09/25/08

Recently Completed Projects

• Frontier Extended Stay Clinic Demonstration Model Evaluation Assistance – A Frontier Extended Stay Clinic (FESC) Demonstration proposed by the Alaska FESC Consortium led by the Southeast Alaska Rural Health Consortium has been implemented through subcontracts with the Alaska Center for Rural Health (ACRH) and community care giving organizations. The evaluation component of the demonstration is being led by the ACRH. The Sheps Center reviews the evaluation plans, provides a critique of those plans, and offers, where appropriate, alternatives or additions to the plans.

  Principal Investigator: Thomas C. Ricketts, III, M.P.H., Ph.D.

  Funding Source: Southern Alaska Regional Health Consortium

  Total Project Period: 09/04 – 03/07 (extended)
  
  

• Evaluating the Need for Assistance Criteria and Weighting of Overall Criteria in the Requirements of Funding New Start and Expansion Grant Applications for Health Centers – This project extends and enhances work done previously for the Bureau of Primary Health Care (BPHC) by 1) examining the current and proposed changes to the Need For Assistance (NFA) criteria; 2) examining data submitted by applicants for assistance through the BPHC, and 3) testing the effects of optional weighting and scaling of the data on decision making for funding in BPHC programs. The project answers two key questions: 1) Does the modified methodology for the NFA proposed by the Sheps Center under a prior contract work to accurately reflect and improve the assessment of relative need of different applicants? and 2) Are the review criteria properly selected and weighted appropriately to help assure that the Health Center program accurately and effectively targets the neediest areas?

  Principal Investigator: Thomas C. Ricketts, III, M.P.H., Ph.D.

  Funding Source: Bureau of Health Professions, HRSA

  Total Project Period: 10/04 – 12/06 (extended)
  
  

• Identifying Correlates of Low Use of Distance Education Resources Among Emergency Medical Technicians (EMTs) – This study describes the use of different types of distance education resources and identifies demographic and emergency medical services (EMS) systems level factors that are associated with different levels of use. The relationships between use and EMT demographics, EMS systems, and other factors are being explored using the 1999 Educational Snapshot Survey Data component of the Longitudinal Emergency Medical Technician Attributes and Demographics Study (LEADS) as well as data from the 1999 Core survey.

  Principal Investigator: P. Daniel Patterson, Ph.D., M.P.H., EMT-B

  Funding Source: Office of Rural Health Policy, HRSA (subcontract with Rural EMS and Trauma Technical Assistance Center)

  Total Project Period: 09/05 – 08/06
  
  

• Southern Rural Access Evaluation Project – This is a comprehensive evaluation and monitoring system for the Robert Wood Johnson Foundation Southern Rural Access Program, a long-term effort to improve access to basic health care in eight of the most rural and medically-underserved states in the country. With guidance from the Foundation, the evaluation team is basing its evaluation efforts on three types of data: 1) information from periodic progress reports submitted by state grantees documenting completion of implementation and outcome targets specified early in their efforts; 2) telephone survey data from 4,800 rural inhabitants assessing their use of health services, satisfaction with the care they receive, perceived barriers to care, and related indicators of access; and 3) data on practitioner counts, characteristics, and locations drawn from national, state licensure, and other state sources.

  Co-Principal Investigators: Donald E. Pathman, M.D. and Thomas C. Ricketts, III, M.P.H., Ph.D.

  Funding Source: Robert Wood Johnson Foundation

  Total Project Period: 05/00 – 09/06 (extended)