Projects
Current Projects:
North Carolina Rural Health Research and Policy Analysis Center (NC RHR & PAC) – 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 NC RHR & PAC 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 topics 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 rural specific Medicaid data. The NC RHR & PAC has also been designed to have staff, data, and resources to address other issues as they become salient.
Principal Investigator: Mark Holmes, Ph.D.
Funding Source: Office of Rural Health Policy, HRSA
Total Project Period: 08/15/04 – 08/31/12
Rapid Response to Requests for Rural Data Analysis and Issue Specific Rural Research
In order to ensure that rural policy is designed to protect and improve the health of rural residents, data and issue specific rural research on the unique characteristics of rural people, health care providers, and the health care infrastructure, and the potential impact of policy and challenges rural areas face in health care delivery must be made available to policy makers, rural organizations and ORHP in a timely manner. To that end the North Carolina Rural Health Research Program, in conjunction with the RUPRI Center, provides rapid rural-focused data analysis and issue-specific rural research studies in response to emerging policy issues.
Principal Investigator: George Pink, PhD
Funding Source: Office of Rural Health Policy, HRSA
Total Project Period: 09/08 – 08/12
Medicare Rural Hospital Flexibility Program Evaluation
The North Carolina Rural Health Research and Policy Analysis Center is collaborating with the University of Minnesota and the University of Maine in a comprehensive multi-year review of the Medicare Hospital Flexibility Program (Flex Program). UNC will use a combination of primary and secondary data to evaluate the program effects in a number of focal areas, including:
· Financial Performance Measures of Critical Access Hospitals
· CAH Conversion Tracking
· Predicting Financial Distress of Critical Access Hospitals
Principal Investigator: Mark Holmes, PhD.
Funding Source: Office of Rural Health Policy, HRSA (subcontract with the University of Minnesota)
Total Project Period: 09/08 – 08/13
Recently Completed Projects:
Rural Medicaid and CHIP Mini-Studies
Medicaid and the Children’s Health Insurance Program (CHIP) are important sources of health insurance coverage in rural communities and it is likely that the importance of Medicaid/CHIP will grow as job-based health insurance coverage continues to erode and policymakers pursue the goal of expanding coverage. This project is composed of three mini-studies that: 1) Update our State Profiles of Medicaid and CHIP in Rural and Urban Areas website, adding information on Medicaid Disproportionate Share Hospital (DSH) payments to rural hospitals; 2) Analyze trends in Medicaid/CHIP enrollment in rural and urban areas over the past two to three years; and 3) Explore the future role of CHIP given increasing levels of childhood poverty.
Principal Investigator: Rebecca Slifkin, PhD
Funder: Federal Office of Rural Health Policy
Total Project Period: 9/1/09 – 8/31/10
Evaluation of the PAP Pilot Project - The purpose of this project is to conduct an evaluation of the PAP pilot initiative. The MARP program has worked well in North Carolina and offers the potential to greatly enhance low-income rural residents’ access to needed pharmaceuticals. However, the extent to which the North Carolina model can be replicated in other states, and the infrastructure and personnel necessary to support such implementation and long term sustainability have yet to be determined. This evaluation will address these issues in order to provide guidance to ORHP as to reasonable strategies for improving rural residents’ access to pharmaceuticals.
Principal Investigator: Andrea Radford, PhD
Funding Source: HRSA
Total Project Period: 9/1/09-8/31/10
The Importance of Surgery to Rural Hospital Financial Condition and Market Share
This study explores the provision of surgical services in rural hospitals and its relationship to financial performance. The percentage of rural hospitals that offer surgical services and the number that have discontinued surgical services over the last decade will be described, and, for those that have discontinued services, the impact on financial condition will be explored
Principal Investigator: Rebecca Slifkin, PhD
Funder: Federal Office of Rural Health Policy
Total Project Period: 9/1/09 – 8/31/10
Factors Associated with Provision of Ambulance Services by Rural Hospitals
This project continues our work from the last three years that has focused on the provision of emergency medical services ( EMS) in rural areas. This two-part project will explore the trends in provision of EMS/ambulance services among rural and urban hospitals. National hospital data files will be used to determine the proportion of rural and urban hospitals that have ongoing EMS/ambulance services and the proportion that have recently acquired or discontinued these services, and to explore geographic and organizational factors associated with hospital ownership of ambulance services. The second part of the study will use focused in-depth interviews with hospital administrators with existing, newly acquired or discontinued ambulance services in each US Census region to gain a better understanding of the factors that influence their decision regarding ambulance service and benefits received by hospitals that offer these important prehospital health care services.
Principal Investigator: Rebecca T. Slifkin, M.H.A., Ph.D
Funding Source: Office of Rural Health Policy, HRSA
Total Project Period: 09/08 – 08/10
Community Care NC Technical Support - This contract will continue to provide technical support to and research for the Community Care of North Carolina Program. Through this contract, the center enables ORDRHD to meet its mission of providing access to underserved populations, who would otherwise be unable to receive needed primary care services due to geographic, economic, or other barriers, as well as testing new and innovative strategies for health improvement and cost containment.
Principal Investigator: Timothy Carey, MD; Annette Dubard, PhD
Primary Funding Source: North Carolina Office of Rural Health and Research
Total Project Period: 7/1/09 – 6/30/10
Technical Assistance and Consultation to the Office of Research, Demonstrations and Rural Health Development (ORDRHD) Staff – These funds are being used to assist in fulfilling the ORDRHD mission by benefiting the Critical Access Hospital Network, the Safety Net Advisory Council, and the Community Health Program. Expected outcomes include improved knowledge of: 1) reporting requirements, 2) policy and provider issues, and 3) Community Health Center grant participants..
Principal Investigators: Andrea Radford, PhD
Funding Source: Office of Research, Demonstration and Rural Development, NC Department of Health and Human Services
Total Project Period: 09/26/05 – 06/30/10
