About this project In recent months, there have been numerous media reports of rural hospital closures and their adverse effect on communities. Contact: George H. Pink, PhD Research staff: Kristie Thompson, MA Project funded: September 2014 Project completed: December 2015 In the face of hospital closure, one alternative for maintaining access to healthcare is a… Read more »
21st Century Rural Hospital: Outpatient Services and Access to Care
About this project The services rural hospitals provide have changed dramatically over the past decades as they have expanded to provide outpatient services that are both needed by their communities and that support their financial viability. Contact: Victoria Freeman, DrPH, RN Project funded: September 2012 Project completed: March 2015 In this study we will explore… Read more »
What Would be the Financial Consequence of Eliminating Low Volume Hospital Payments?
About this project The standard mechanism for Medicare payment for hospital services is the Prospective Payment System, but hospitals receive an additional payment if they qualify as a low-volume hospital (LVH). Contact: George H. Pink, PhD Project funded: September 2015 Project completed: October 2016 Created in 1987, the LVH classification was set to expire at… Read more »
Rural Health Clinics: Medicare & Medicaid Profile (Year 2)
About this project Year 2 of a project developing a longitudinal data collection/tracking mechanism of key RHC Medicare claims data and cost report elements. Contact: Mark Holmes, PhD Project funded: September 2013 Project completed: March 2016 RHC Medicaid data for a sample of states also will be requested and analyzed to determine utilization patterns and… Read more »
How Have Changes in Insurance Coverage Under Health Reform Affected Uncompensated Care and Financial Performance in Rural Hospitals? (Year 2)
About this project The implementation of the Patient Protection and Affordable Care Act (ACA) is changing hospital reimbursement in important ways. Lead researcher: Mark Holmes, PhD Project funded: September 2015 Project completed: August 2016 One of the most significant changes is the expansion of health insurance coverage to previously uninsured populations. Since rural residents are… Read more »
How Have Changes in Insurance Coverage Under Health Reform Affected Uncompensated Care and Financial Performance in Rural Hospitals?
About this project This two-year project will explore the effects of changes in insurance coverage under health reform on the following outcomes in rural hospitals: (1) bad debt; (2) charity care; (3) payer mix (Medicare, Medicaid, other); (3) financial performance; and (4) hospital revenue cycle management. Lead researcher: Mark Holmes, PhD Project funded: September 2014… Read more »
Can a Model Predict Financial Distress Among Rural Hospitals?
About this project This project will extend an existing model of CAH financial distress to other types of rural hospitals. Lead researcher: Mark Holmes, PhD Project funded: September 2014 Project completed: August 2016 A valid model would be helpful to ORHP and state Offices of rural Health interested in predicting financial distress or closure of… Read more »
The Financial and Community Experience of Sole Community Hospitals in Comparison to Other Rural Hospitals
About this project The standard mechanism for Medicare payment for hospital services is the Prospective Payment System (PPS), but a hospital classification available to hospitals that maintain health services in isolated areas is the Sole Community Hospital (SCH). Lead researcher: George H. Pink, PhD Project funded: September 2015 Project completed: November 2017 Sole Community Hospitals… Read more »
Exploring Regional Differences in Rural and Urban Mortality Trends
About this project Lead researcher: Mark Holmes, PhD Contact: Mark Holmes, PhD Project funded: September 2016 Project completed: August 2017 This brief builds upon previous research and explores the differences in mortality trends between urban and rural locations by census division from 1999 to 2015. Using data from CDC WONDER’s Compressed Mortality File, we calculated… Read more »
Characteristics of Rural Hospitals at High Risk of Financial Distress
About this project The project updates the Financial Distress Index Model (FDI) with current hospital and market data and evaluates changes in risk status and geographic distribution over time. Research center: North Carolina Rural Health Research and Policy Analysis Center Lead researcher: George H. Pink, PhD Project funded: September 2016 Project completed: December 2017 We… Read more »
Post-Acute Care for Rural Medicare Beneficiaries
About this project Increasingly, attention on Medicare payment policy has turned to post-acute services. Research has shown that discharges to post-acute care (PAC) facilities have increased substantially over the past two decades. Lead researcher: Mark Holmes, PhD Project funded: September 2016 Project completed: April 2018 Concurrently, hospital lengths of stay progressively decreased, particularly for discharges… Read more »
How Rural Communities Respond and Recover after a Hospital Closure
About this project Previous research has shown hospital closures have immediate negative health and economic effects on a rural community. Lead researcher: Mark Holmes, PhD Project funded: September 2016 Project completed: July 2019 What is less understood is the longer-term recovery period: does the healthcare infrastructure adapt to the loss of the hospital, or does… Read more »
Financial Impact of Reimbursing CAH Swing Bed Days at the SNF PPS Rate
About this project Under current reimbursement methods, the Medicare program pays more per day for a skilled nursing patient in a Critical Access Hospital (CAH) swing bed than it does for a similar patient who is in a skilled nursing facility. Lead researcher: Kristin Reiter, PhD, 919.843.8619, reiter@email.unc.edu Project funded: September 2018 Project completed: August… Read more »
Do Rural Communities Have a Higher Rate of Avoidable Deaths?
About the project The rural-urban gap in mortality had been growing steadily over the last three decades, and a growing body of work had looked into the reasons for this growing disparity, specifically the causes of deaths. Research center: North Carolina Rural Health Research and Policy Analysis Center Lead researcher: Mark Holmes, PhD Project funded:… Read more »
Ambulatory Care Provided to Rural Medicare Beneficiaries by Rural and Urban FQHCs, RHCs, and Acute Hospitals
About the project In the Rural Healthy People 2020 survey, 78% of respondents identified “access” as the top rural health priority. Research center: North Carolina Rural Health Research and Policy Analysis Center Lead researcher: George H. Pink, PhD Project funded: September 2017 Project completed: March 2019 In many rural communities, FQHCs, RHCs, and acute hospitals… Read more »