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 »
Unstable Demand and Cost per Case in Low-Volume Hospitals
About this project This Findings Brief looks at the effects of year-to-year changes in annual inpatient discharges on costs per Medicare discharge. Low-volume hospitals, regardless of location, experience significantly greater total variability in inpatient demand across years, and greater changes in annual discharges that cannot be forecasted as part of an individual hospitals’ trend over… Read more »
Unpredictable Demand and Low-Volume Hospitals
Unpredictable Demand and Low-Volume Hospitals background This Findings Brief assesses the degree to which the annual number of patient discharges varies from year to year for low volume hospitals. To the extent that demand for inpatient services is unpredictable, it is hard for administrators to set budget and recruitment goals, which are generally based on… Read more »
Design of enhanced primary care case management programs operating in rural communities: Lessons learned from 3 states
Executive summary States are beginning to develop alternative managed care strategies for their Medicaid populations, including enhanced primary care case management (PCCM) programs that incorporate features originally developed for fully capitated managed care programs, such as care coordination and quality improvement efforts. Such alternative approaches have proven to be especially useful in rural communities, where… Read more »
Rural-Urban Issues in the Wage Index Adjustment for Prospective Payment in Skilled Nursing Facilities
In July of 1998, the method for determining payments for Medicare services in skilled nursing facilities (SNFs) began a three-year transition from retrospective cost-based reimbursement to a SNF prospective payment system (SNF PPS). SNF PPS is based on national rates with an adjustment for differences in local wages that is based upon the Medicare inpatient… Read more »
Cesarian section rates in rural hospitals
Executive summary Childbirth by cesarean section (c-section) is major abdominal surgery that carries risk to both mother and baby. There are reasons to suggest that c-section rates at rural hospitals might be different than c-section rates at urban hospitals. The diffusion of best practices, such as the safe delivery of infants by vaginal births to… Read more »
Contracting With Medicare Advantage Plans: A Brief for Critical Access Hospital Administrators
Contracting With Medicare Advantage Plans: A Brief for Critical Access Hospital Administrators overview This document summarizes the experience of CAH administrators with contracts offered by Medicare Advantage (MA) plans. Telephone surveys were conducted with CAH administrators across the country to learn about their experiences with MA plans. This brief includes information about the contract terms… Read more »
Trends over Time in the Provision of Skilled Nursing Care in Critical Access Hospitals
Trends over Time in the Provision of Skilled Nursing Care in Critical Access Hospitals executive summary This study examines trends in the delivery of skilled nursing facility (SNF) services in both hospital-based units and swing beds during a period of dramatic change in Medicare payments for post-acute care, focusing on critical access hospitals (CAHs). In… Read more »
Rural Hospitals’ Experience with the 340B Drug Pricing Program
Overview The 340B Drug Pricing Program (hereafter referred to as the 340B program) enables certain types of safety net organizations to obtain deep discounts on medications delivered during outpatient care, at prices below what is typically offered to Medicaid agencies. Prior to the 2003 Medicare Modernization Act (MMA), few rural hospitals qualified for the 340B… Read more »
One Year In: Sole Community Rural Independent Pharmacies and Medicare Part D
Background The Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) established funding to allow up to 43 million Medicare beneficiaries to enroll in plans providing comprehensive outpatient prescription drug coverage, beginning in January 2006. The new Medicare Part D program changed the means by which Medicare beneficiaries purchase prescription drugs, which affects the… Read more »
Rural-Urban Differences in Characteristics of Local EMS Agencies
BACKGROUND This Findings Brief describes the general characteristics of local rural EMS agencies and important ways that they differ from the characteristics of agencies located in urban areas. The data are from a national survey of 1,425 local EMS directors that was conducted in 2006-07. KEY FINDINGS Rural EMS agencies typically serve a smaller population… Read more »