In the brief, , the NC Rural Health Research Program used data from the 2019 T-MSIS Analytic Files (TAF) to compare urban and rural residents enrolled in either fee for-service or managed care Medicaid. We looked at whether enrollees had 12 continuous months of full-scope benefits and whether they had full dual enrollment in Medicare… Read more »
Utilization of Inpatient and Emergency Services by Rural and Urban Medicaid Enrollees
In the brief, , the NC Rural Health Research Program used data from the 2019 T-MSIS Analytic Files (TAF) to compare urban and rural residents enrolled in either fee for-service or managed care Medicaid. We focused on inpatient and emergency department (ED) health care utilization. KEY FINDINGS Overall utilization by Medicaid enrollees, as measured by… Read more »
The First Year of Rural Emergency Hospitals: REHs Serve Relatively Disadvantaged Counties
The NC Rural Health Research Program brief, , provides a preliminary look at the types of communities with hospitals that converted to Rural Emergency Hospitals (REHs) in 2023. We: 1) describe the socio-economic, race and ethnicity, and health status and access characteristics of the communities served by REHs, and 2) compare the characteristics of counties… Read more »
News Media Coverage of Rural Hospital Closures and the Causes
The NC Rural Health Research Program wrote the brief, . to augment previous research with findings from a structured framework of attributed causes of closures through the analysis of news media reports. Media reports of closures offer a qualitative dimension that goes beyond numbers, allowing us to understand the deeper context surrounding a hospital closure…. Read more »
The Low-Volume Hospital Adjustment Before and During COVID-19
The NC Rural Health Research Program has been tracking the Low Volume Hospital (LVH) adjustment’s impact on rural hospitals. As policy makers consider legislation to maintain or alter the LVH adjustment before its expiration on December 31, 2024, the impact on more vulnerable communities is a relevant consideration. Read our July 2024 brief, . The… Read more »
2018-23 Profitability of Rural Hospitals by Ownership and System Affiliation
Access to care in many communities has been reduced by rural hospital closures. The causes of rural hospital closures are complex and multifaceted, but unprofitability has been identified as a major contributor. In this study, the NC Rural Health Research Program focuses on system affiliation and ownership as additional contributing factors. Using hospital cost report… Read more »
2018‐23 Profitability of Rural and Urban Hospitals by Medicare Payment Designation
The NC Rural Health Research Program has been tracking profitability of rural hospitals more than a decade. In a 2020 study, we found that: overall, profitability of rural hospitals decreased while the profitability of urban hospitals increased between 2016 and 2018. Since our 2020 study was published, the global COVID-19 pandemic emerged, and the federal… Read more »
2018-23 Profitability of Rural Hospitals by with and without Rural Health Clinics and Long-Term Care
Access to care in many communities has been reduced by rural hospital closures. The causes of rural hospital closures are complex and multifaceted, but unprofitability has been identified as a major contributor. In this study, the NC Rural Health Research Program focuses on whether hospitals operate rural health clinics (RHCs) or provide long-term care. Using… Read more »
Differences in Measurement of Operating Margin: An Update
Profitability is a determinant of hospital financial distress and closure. Operating margin is one of the key measures of hospital profitability. Accurate use of the measure relies on the quality of data, and previous studies found inconsistencies in how operating margin is calculated and reported. There are three definitions of operating margin; each will produce… Read more »
Using the Updated Financial Distress Index to Describe Relative Risk of Hospital Financial Distress
Using a recent revision of the Financial Distress Index (FDI) model, the NC Rural Health Research Program brief, describes the relative risk of experiencing financial distress for rural hospitals and selected urban hospitals (urban Critical Access Hospitals [CAHs], urban Medicare Dependent Hospitals [MDHs], and urban Sole Community Hospitals [SCHs] earning $500,000,000 or less in net… Read more »
COVID-19 Affected Rural and Urban Hospital Uncompensated Care
Uncompensated care are services provided that are never reimbursed, including charity care and unanticipated bad debt. High uncompensated care burden is a concern because it may contribute to smaller operating margins and rural hospital closures. This infographic, , compliments previous work The NC Rural Health Research Program has produced on uncompensated care. For the infographic. … Read more »
A Comparison of 2017-19 Uncompensated Care of Rural and Urban Hospitals by Net Patient Revenue, System Affiliation, and Ownership
The NC Rural Health Research Program’s brief, , extends our 2018 study of geographic variation in uncompensated care between rural and urban hospitals. In this study, we investigate the association of uncompensated care with net patient revenue, system affiliation, and ownership.
Rural Population Health in the United States: A Chartbook
This presents variations in U.S. population health in rural areas across all Census regions and states. Where the data allow, we also present rural population health findings stratified by sex, race, and ethnicity. This chartbook presents a full range of data across multiple geographic areas. When looking at data like these it is important to… Read more »
Characteristics of Rural Hospitals Eligible for Conversion to Rural Emergency Hospitals and Three Rural Hospitals Considering Conversion
This brief is a follow-up to the 2021 NC Rural Health Research Program’s brief, . The new brief, , presents updated data for REH-eligible hospitals, compares several financial and operational measures of three rural hospitals that are on public record as having expressed interest in REH conversion to the all REH-eligible hospitals, and discusses what… Read more »
Factors Predicting Swing Bed Versus Skilled Nursing Facility Use
In the brief, , the NC Rural Health Research Program, examines differences between patients discharged to swing beds versus SNFs, stratifying by admitting hospital type (i.e., rural CAH versus rural PPS hospital). Identification of key differences between patients discharged to swing beds versus SNFs can help inform further discourse on this financially and clinically important… Read more »