Possible issues with existing rural hospital financing models suggest that newer, outpatient-centric payment methods may be more effective in providing financial relief to rural hospitals. In light of this, the NC Rural Health Research Program explores the current financial importance of outpatient care to rural hospitals in the brief, Trends in Revenue Sources among Rural Hospitals.
Specifically, the objective of our study was to estimate changes in outpatient care as a source of revenue for rural hospitals from 2011-2019. Ideally, the results can provide stakeholders and lawmakers with additional support in understanding the contemporary role that outpatient service lines have in rural hospitals, thereby allowing them to develop policies that more effectively support rural health care providers and the communities they serve.
A Comparative Study of Financial Data Sources for Critical Access Hospitals: Audited Financial Statements, the Medicare Cost Report, and the Internal Revenue Service Form 990
Rural hospitals are being adversely affected by short-term and long-term challenges related to financial and regulatory burdens such as sequestration, 340B payment reductions, declining patient volumes, and increases in the under and uninsured.
This study estimated and compared total Medicare expenditures for episodes of care that include post-acute stays in either swing beds or skilled nursing facilities (SNFs). Results informed federal and state agencies, rural providers and communities as to how post-acute care in swing bed versus a SNF affects the trajectory of costs and utilization for rural Medicare beneficiaries.
About this project Lead researcher: Mark Holmes, PhD Project funded: September 2012 Project completed: July 2021 Preventable hospital readmissions are a significant problem for patients and insurers. Swing beds are the only post-acute care in many very rural communities but research on the ability of swing bed care to prevent readmission is limited. A better… Read more »
About this project Authors: Tyler L Malone, George H Pink, George M Holmes This article was originally published in the Journal of Rural Health in March, 2021. Abstract Purpose: To investigate (1) all-payer inpatient volume changes at rural hospitals and (2) whether trends in inpatient volume differ by organizational and geographic characteristics of the hospital and… Read more »
About this project Research staff: Thomas C. Ricketts & Kerry James Project completed: May 2001 This is a continuation of a multi-center assessment of the Rural Informal Safety Net. During January through August 1999, the North Carolina Rural Health Research and Policy Analysis Program conducted exploratory site visits to four rural North Carolina communities: Bayboro-Pamlico… Read more »
About this project Lead researcher: Randy Randolph, MRP Project completed: August 2001 This project will investigate the following questions regarding the 1997 revisions to Statistical Policy Directive No. 15, Race and Ethnic Standards for Federal Statistics and Administrative Reporting, a revision of the federal standards for collecting data on race and ethnicity, to be adopted… Read more »
About this project Lead researcher: Rebecca T. Slifkin, PhD Project completed: February 2001 The goal of this project is to incorporate information from multiple data sources in order to describe more fully the health care infrastructure in rural towns. Provider data, used to place providers within ZIP codes, includes census of physicians, physician assistants, and… Read more »
About this project Research staff: Rebecca T. Slifkin, PhD Project completed: August 2002 More than half of all Medicaid recipients are enrolled in some form of managed care, but participation in rural areas remains behind that of urban areas. In 1997, the North Carolina Rural Health Research Program conducted a study under an Agency for… Read more »
About this project Lead researcher: Rebecca T. Slifkin, PhD Project completed: August 2002 For this project we will create a monograph that uses maps to illustrate population location and changes at both the state and national level, and overlays these changes with provider supply. Using the 1990 and the 2000 census, we will describe the… Read more »
About this project Lead researcher: William N. Zelman, PhD Project completed: August 2002 The North Carolina Rural Health Research Program at the University of North Carolina’s (UNC) Cecil G. Sheps Center for Health Services Research and the Department of Health Policy and Administration, also at UNC, are collaborating with the other Rural Health Research and… Read more »
About this project Contact: Andrea Radford, DrPH Project funded: September 2011 Project completed: April 2013 With approximately 3800 located across the nation, RHCs are an important component of the rural health infrastructure. Using Medicare outpatient claims data the degree to which Medicare beneficiaries are utilizing available RHCs will be determined and a profile of those… Read more »
About this project Contact: Mark Holmes, PhD, 919.966.7100, mark_holmes@unc.edu Project funded: September 2010 Project completed: December 2014 Recent health reform has included a number of models of care provision and/or payment, for example, bundled payments and Accountable Care Organizations (ACOs), which depend on linkages between different types of health care providers. The national discourse has… Read more »
About this project Contact: Mark Holmes, PhD Project funded: September 2013 In January 2014, some states will expand eligibility through the Medicaid program, while other states will not. Because rural residents are likely to be disproportionately affected by Medicaid expansion, understanding this interstate variation has important policy implications. Publications How Does Medicaid Expansion Affect Insurance… Read more »