For decades, health care has been shifting from inpatient to outpatient settings. Ambulatory care refers to medical services performed same day on an outpatient basis (without admission to a hospital or other facility) and includes services ranging from wellness and disease management to surgical treatment and rehabilitation. These services are generally provided to keep patients… 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 »
Average Beneficiary CMS Hierarchical Condition Category (HCC) Risk Scores for Rural and Urban Providers
Risk adjustment mechanisms predict whether a given patient, or group of patients, is likely to be more or less costly to treat than the average population and provides a way to adjust payment accordingly. The Centers for Medicare & Medicaid Services (CMS) risk adjustment model is a hierarchical condition category (HCCs) score. Use of the… Read more »
Geographic Variation in Uncompensated Care between Rural and Urban Hospitals
Rural residents are less likely than urban residents to have health care coverage through their employer, more likely to be low-income, and oftentimes are unable to afford coverage on their own. For hospitals that serve rural residents, this often means higher rates of uncompensated care compared to urban hospitals. Recent policy changes could lead to an increase… Read more »
Senate Finance Committee Testimony: Rural Health Care in America: Challenges and Opportunities
On May 24, 2018, George Pink, PhD, Humana Distinguished Professor in the Department of Health Policy and Management at the Gillings School of Global Public Health, Deputy Director of the North Carolina Rural Health Research Program, and Senior Research Fellow at the Cecil G. Sheps Center for Health Services Research, testified before the Senate Finance Committee… Read more »
Rural and Urban Provider Market Share of Inpatient Post-Acute Care Services Provided to Rural Medicare Beneficiaries
As new Medicare payment models are implemented, there is some concern about how it will affect inpatient post-acute care in rural areas. Changes in referral patterns and utilization could make maintaining these services financially difficult in rural areas, which could ultimately reduce access to local PAC for rural residents. To learn more, the NC Rural… Read more »
Market Characteristics Associated with Rural Hospitals’ Provision of Post-Acute Care
Post-acute care (PAC) in rural hospitals, particularly Critical Access Hospitals (CAHs), represents an important source of PAC access in rural areas. In addition, a rural hospital’s financial health often depends on providing services that meet local need. Over time, some changes in Medicare payment policies have adversely affected rural providers. For example, when the Balanced… Read more »
Geographic Variation in the 2016 Profitability of Urban and Rural Hospitals
Rural hospital closures remain a worrisome issue for policy makers and communities: between 2010 and 2017, 83 rural hospitals closed. The NC Rural Health Research Program tracks these closures and studies potential predictors. Profitability is not the only predictor, but it is one of the main predictors of hospital closure. Researchers and policy makers are… Read more »
Rural Health Care Costs: Are They Higher and Why Might They Differ from Urban Health Care Costs?
Do health care costs differ between rural and urban populations, and if so, why might that be? Rural Americans are more vulnerable than their urban counterparts, which could lead us to suspect rural health care costs are higher. However, the answer may differ depending on how costs are measured and who is paying. By… Read more »
Evaluating the Workforce Outcomes of North Carolina’s Medical Education Programs
North Carolina Session Law 2017-57, Section 11J.2, the Current Operations Appropriations Act of 2017, directed the North Carolina Department of Health and Human Services (DHHS) and The University of North Carolina (UNC) to assess the degree to which physician training programs in North Carolina meet the healthcare needs of North Carolina’s citizens. The Program… Read more »
Range Matters: Rural Averages Can Conceal Important Information
Researchers often use averages to describe data. The average (or the mean) of a data set can be used to identify the central value of the group, or what is typical. While valuable, it’s also important to understand the range of data—the highs and lows. What might we miss by focusing on the average? When… Read more »
Access to Care: Populations in Counties with No FQHC, RHC, or Acute Care Hospital
Rural areas have more limited access to health care than urban areas. In 2013, there were 79.3 primary care physicians per 100,000 people in metropolitan counties, compared to only 55.1 per 100,000 people in non-metropolitan counties. To help provide a quick understanding of how many people may have more limited access to primary care and where… Read more »
Characteristics of Communities Served by Hospitals at High Risk of Financial Distress
Since 2005, there have been 124 rural hospital closures in the United States. Rural hospital closures can intensify already challenging health and economic issues for rural communities. People served by rural hospitals tend to be older, poorer, have access to fewer health care professionals, and have overall worse health outcomes than those served by urban hospitals. To… Read more »
Differences in Community Characteristics of Sole Community Hospitals
In 1983, Congress created the Sole Community Hospital (SCH) program to support small rural hospitals for which “by reason of factors such as isolated location, weather conditions, travel conditions, or absence of other hospitals, is the sole source of inpatient hospital services reasonably available in a geographic area to Medicare beneficiaries.” A SCH is often… Read more »
You must be logged in to post a comment.