Current Projects

Funded by the Federal Office of Rural Health Policy, HRSA:

21st Century Rural Hospital: Outpatient Services and Access to Care

The rural hospital has changed dramatically with hospitals becoming increasingly outpatient-centered. This project is designed to inform policymakers about rural hospitals’ provision of outpatient care, including publication of a Primer, detailing the variability in outpatient services provision by key characteristics that can be used to examine the potential impact of proposed policy changes on patients’ ability to access different services.

Expected completion date: August 2013. (Contact: Victoria Freeman, DrPH, RN victoria_freeman@unc.edu, 919/966-6168)

Hospital Readmission Following Care in a Swing Bed

This study builds on our portfolio of swing bed work by examining the rate of hospital readmission for patients who receive post-acute care in swing beds compared to skilled nursing facilities and will inform the discussion on use, cost, and benefit of swing bed care.

Expected completion date: August 2013. (Contact: Kristin Reiter, PhD reiter@email.unc.edu, 919/843-8619)

Rural Health Clinics: Medicare & Medicaid Profile

This study builds on our work with the 2009 RHC Medicare claims. This project will result in the development of a longitudinal data collection/tracking mechanism of key RHC Medicare claims data and cost report elements (provider-based cost reports only at this point in time). RHC Medicaid data for a sample of states will be requested and analyzed to determine utilization patterns and identification of potential quality metrics.

Expected completion date: August 2013. (Contact: Andrea Radford, DrPH aradford@schsr.unc.edu, 919/966-7922)

Rural Hospital Mergers and Acquisitions – Who is Being Acquired and What Happens Afterwards?

This study compares the financial and market characteristics of recently acquired rural hospitals to other rural hospitals and investigates the post-acquisition change in services and financial performance of these hospitals. This study will inform rural advocates, federal and state agencies, and regulators as to how mergers and acquisitions (M&As) of small rural hospitals affect access to care for Medicare beneficiaries, and the potential financial consequences of M&As to small rural hospitals.

Expected completion date: August 2013. (Contact: George Pink, PhD gpink@email.unc.edu, 919/966-1457)

Patterns of Care in Small Rural Areas: Implications for New Models of Care Provision and Payment such as Bundled Payments and Accountable Care Organizations

This two year project analyzes patterns of care-seeking in rural communities to assess likely effects on rural health care systems of new reimbursement models.

Expected completion date: August 2012. (Contact: Mark Holmes, PhD gholmes@ad.unc.edu, 919/966-5541)

A Comprehensive Study of Swing Bed Use in Rural Hospitals

This two year project will comprehensively address questions about how swing beds are used by rural hospitals. In the second year of this study we will examine whether patients served in swing beds differ in meaningful ways from those in skilled nursing facilities.

Expected completion date: August 2012. (Contact: Victoria Freeman, PhD victoria_freeman@unc.edu, 919/966-5541)

Use of Rural Health Clinics by Medicare Beneficiaries

This project will look at Medicare beneficiaries’ utilization of available RHCs and develope a descriptive profile of Medicare beneficiaries who utilize RHCs, including both geographic and diagnostic elements and a comparison to Medicare beneficiaries who utilize FQHCs. .

Expected completion date: August 2012. (Contact: Andrea Radford, DrPH aradford@schsr.unc.edu, 919/966-5541)