Occupancy Rates in Rural and Urban Hospitals: Value and Limitations in Use as a Measure of Surge Capacity

As policymakers deal with the effects of the novel coronavirus pandemic on the hospital infrastructure, understanding the differences in occupancy rates between rural and urban hospitals may help state and local officials in their planning for dealing with surge demand. Historically, rural hospitals have reported lower occupancy rates than urban hospitals and more licensed than… Read more »

Rural Health 101: An Overview of Rural Health Research

The PDF is a shorter primer on rural health for researchers in health and health services. It provides information on: a spectrum of rural definitions and the importance of selecting a standardized definition; rural mortality; and some common challenges with rural data analysis.

Delineating Rural Areas in the United States

One challenge in addressing rural-urban disparities is the lack of a common definition. Multiple federal systems exist using different levels of geography (e.g, county versus census tract). Multiple definitions of the “rurality” of a place or population means that the degree of the disparity may vary (or even switch direction) depending on the definition. The… Read more »

Risk Factors and Potentially Preventable Deaths in Rural Communities

As the rural-urban mortality gap continues to expand, researchers have been exploring the reasons why the gap exists and how some of the deaths might be prevented. Studies show a higher percentage of rural residents die from preventable causes, specifically heart disease, cancer, unintentional injury, chronic lower respiratory disease,1 and stroke than urban residents.2,3 Researchers… Read more »

A Rural Urban Comparison of the Proposed 2020 Wage Index

On April 23, 2019, the Centers for Medicare & Medicaid Services (CMS) released its annual proposed update for the hospital Inpatient Prospective Payment System for fiscal year 2020 that starts in October 2019.  In the proposed update, CMS recognizes that the current wage index system perpetuates and exacerbates the disparities between high and low wage… Read more »

Rural/Urban and Regional Variation in the 2019 CMS Hospital Wage Index

The Medicare hospital Inpatient Prospective Payment System (IPPS) is designed to pay hospitals for services provided to Medicare beneficiaries based on a national standardized amount adjusted for the patient’s condition and related treatment. Further, Social Security Act Section 1886(d)(3)(E) requires that the standardized amount be adjusted for differences in hospital wage levels among labor markets,… Read more »

2019 Wage Index Differences and Selected Characteristics of Rural and Urban Hospitals

The Medicare hospital Inpatient Prospective Payment System (IPPS) is designed to pay hospitals for services provided to Medicare beneficiaries based on a national standardized amount adjusted for the patient’s condition and related treatment. Further, Social Security Act Section 1886(d)(3)(E) requires that the standardized amount be adjusted for differences in hospital wage levels among labor markets,… Read more »

Trends in Risk of Financial Distress among Rural Hospitals, 2015 to 2019

In 2016, the NC Rural Health Research Program developed and utilized the Financial Distress Index (FDI) model to identify hospitals at high risk of financial distress and assess trends in varying risk of financial distress over time to help inform strategies to prevent or mitigate the effects of closures. We found the proportion of rural… Read more »

MAT Waiver Trainings

North Carolina, like many states in our country, is grappling with increases in opioid use disorder. One promising strategy to address this public health issue included in the North Carolina Opioid Action Plan (https://www.ncdhhs.gov/about/department-initiatives/opioid-epidemic/north-carolinas-opioid-action-plan) is through Medication-Assisted Therapy (more info here: https://www.samhsa.gov/programs-campaigns/medication-assisted-treatment/training-materials-resources). Clinicians who are interested in providing MAT need to receive special training and a… Read more »

Rural Hospital Mergers from 2005 through 2016

Hospital mergers and acquisitions are changing the face of health care in both rural and urban communities across the country. There are many factors driving mergers, such as cost savings, increased access to capital, increased access to technology, etc., but concerns about rural hospital mergers have also been voiced, including reduced negotiating power with insurers,… Read more »