For almost four decades, Rural Health Clinics (RHCs) (currently numbering about 4,100) have served patients from underserved rural areas. Although Medicaid is an important payer for RHCs, little is known about Medicaid patients and the services provided to them partly because of the complexity of identifying claims generated from RHCs in Medicaid claims data sources…. Read more »
Identifying Rural Health Clinics in Medicaid Data
In 1977, Public Law 95-210 created the Rural Health Clinic (RHC) Medicare and Medicaid reimbursement designation for qualified primary care practices. RHCs must be located in non-urban areas with documented health care shortages. There are currently more than 4,100 RHCs across the U.S. Some RHCs operate as independent medical practices, while others are part of… Read more »
2012-14 Profitability of Urban and Rural Hospitals by Medicare Payment Classification
More Americans are now aware of the financial challenges faced by rural hospitals. Media coverage of the 66 rural hospital closures between January 2010 and January 2016 has highlighted the health care access and economic challenges facing rural America. Rural hospital closures are not a new phenomenon – hundreds of rural hospitals closed in the… Read more »
Geographic Variation in Risk of Financial Distress among Rural Hospitals
From 2005 to 2015, 112 rural hospital closures have been identified (North Carolina Rural Health Research Program, 2015). Although six of these closed hospitals have since reopened, the remaining closures impact millions of rural residents in communities that are typically older and poorer, more dependent on public insurance programs, and in worse health than residents… Read more »
Prediction of Financial Distress among Rural Hospitals
From 2005 through 2015, more than 100 rural hospitals have closed their doors to patients in need of inpatient services. Though a handful of these closed hospitals have since reopened, the remaining closures leave millions of rural residents at greater risk of negative health and economic hardship due to the loss of local acute care services. Policymakers,… Read more »
Estimated Costs of Rural Freestanding Emergency Departments
Since 2005, more than 100 rural hospitals have closed and more are at risk. Rural hospital closures jeopardize access to emergency services in the affected communities. As communities react to and/or prepare for closures, providers and policy makers seek a viable alternative for emergency services provided in a rural hospital setting. A rural freestanding emergency… Read more »
Estimating Eligibility and Uptake of Federally Facilitated Marketplace Insurance in North Carolina in the Second Open Enrollment Period
As the Federally Facilitated Marketplace (FFM) enters its third open enrollment period, focus is shifting toward examining which communities have lower uptake in coverage and how to increase enrollment. In national analysis of the first open enrollment period, Holmes and colleagues found that rural areas had lower rates of plan selections. However, these estimates are… Read more »
A Comparison of Closed Rural Hospitals and Perceived Impact
From 2010 through 2014, 47 rural hospitals, ceased providing inpatient services in 23 states across the country (“closed”). Among the 47 closed hospitals, 26 hospitals no longer provide any health care services (“abandoned”), and 21 continue to provide a mix of health services but no inpatient care (“converted”). These closures have affected approximately 800,000 people… Read more »
A Critique of the Office of the Inspector General’s Report on Swing Beds in Critical Access Hospitals
In March 2015, the Office of the Inspector General (OIG) issued a report on Medicare’s expenditures on swing beds in Critical Access Hospitals (“Medicare Could Have Saved Billions At Critical Access Hospitals If Swing Bed Services Were Reimbursed Using The Skilled Nursing Facility Prospective Payment System Rates.” Department of Health and Human Services, Office of… Read more »
The 21st Century Rural Hospital: A Chart Book
Hospitals have changed over recent decades. Hospital stays are shorter. Procedures once requiring hospitalization are now done in an outpatient setting. Hospitals have moved beyond providing mainly inpatient and emergency department care. They have become vertically integrated systems with “one-stop shopping” for all of one’s health care needs. The transformation of hospitals has also occurred… Read more »
Rural Provider Perceptions of the ACA: Case Studies in Four States
The Affordable Care Act (ACA) expanded health insurance coverage to previously uninsured populations by allowing states to expand Medicaid coverage to adults with incomes up to 138% of the federal poverty level (FPL) as well as by creating health insurance marketplaces to subsidize affordable coverage. However, states with a higher number or proportion of rural… Read more »
Do Current Medicare Rural Hospital Payment Systems Align with Cost Determinants?
The financial performance of small, rural hospitals has long been a concern to federal and state agencies. Federal law makers have enacted legislation authorizing the Medicare program to develop reimbursement methods that provide higher payments to hospitals that serve rural communities (Critical Access Hospitals, Sole Community Hospitals, Medicare-Dependent Hospitals, and Standard Prospective Payment Systems hospitals). Current… Read more »
Rural-Urban Differences in Continuity of Care among Medicare Beneficiaries
In response to the Affordable Care Act and other reforms in the health care market, new models of care are being tested and implemented across the country. Care and payment models such as patient-centered medical homes, Accountable Care Organizations (ACOs), and bundled payments depend on linkages between different types of health care providers to ensure… Read more »
Best Practices for Health Insurance Marketplace Outreach and Enrollment in Rural Areas
The Affordable Care Act provided coverage through the Health Insurance Marketplace to nearly seven million people during the first open enrollment period. Yet, research suggests that the enrollment rates for eligible individuals living in rural areas was less than enrollment rates for those living in urban areas. That may be due, in part, to specific challenges… Read more »
Priorities for Autism Research |Stakeholder Survey
Are you an autism stakeholder – a self-advocate, family member, provider, policymaker or researcher? Please tell us your priorities for autism research by taking a brief confidential survey. The survey asks questions about your interest in autism, what you value in treatment options, and where you feel investment should be made in future research. LINK… Read more »
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