Estimated Costs of Rural Freestanding Emergency Departments

Since 2005, more than 100 rural hospitals have closed and more are at risk. Rural hospital closures jeopardize access to emergency services in the affected communities. As communities react to and/or prepare for closures, providers and policy makers seek a viable alternative for emergency services provided in a rural hospital setting. A rural freestanding emergency… Read more »

Estimating Eligibility and Uptake of Federally Facilitated Marketplace Insurance in North Carolina in the Second Open Enrollment Period

As the Federally Facilitated Marketplace (FFM) enters its third open enrollment period, focus is shifting toward examining which communities have lower uptake in coverage and how to increase enrollment. In national analysis of the first open enrollment period, Holmes and colleagues found that rural areas had lower rates of plan selections. However, these estimates are… Read more »

A Comparison of Closed Rural Hospitals and Perceived Impact

From 2010 through 2014, 47 rural hospitals,  ceased providing inpatient services in 23 states across the country (“closed”). Among the 47 closed hospitals, 26 hospitals no longer provide any health care services (“abandoned”), and 21 continue to provide a mix of health services but no inpatient care (“converted”). These closures have affected approximately 800,000 people… Read more »

The 21st Century Rural Hospital: A Chart Book

Hospitals have changed over recent decades. Hospital stays are shorter. Procedures once requiring hospitalization are now done in an outpatient setting. Hospitals have moved beyond providing mainly inpatient and emergency department care. They have become vertically integrated systems with “one-stop shopping” for all of one’s health care needs. The transformation of hospitals has also occurred… Read more »

Rural Provider Perceptions of the ACA: Case Studies in Four States

The Affordable Care Act (ACA) expanded health insurance coverage to previously uninsured populations by allowing states to expand Medicaid coverage to adults with incomes up to 138% of the federal poverty level (FPL) as well as by creating health insurance marketplaces to subsidize affordable coverage. However, states with a higher number or proportion of rural… Read more »

Do Current Medicare Rural Hospital Payment Systems Align with Cost Determinants?

The financial performance of small, rural hospitals has long been a concern to federal and state agencies. Federal law makers have enacted legislation authorizing the Medicare program to develop reimbursement methods that provide higher payments to hospitals that serve rural communities (Critical Access Hospitals, Sole Community Hospitals, Medicare-Dependent Hospitals, and Standard Prospective Payment Systems hospitals). Current… Read more »

Rural-Urban Differences in Continuity of Care among Medicare Beneficiaries

In response to the Affordable Care Act and other reforms in the health care market, new models of care are being tested and implemented across the country. Care and payment models such as patient-centered medical homes, Accountable Care Organizations (ACOs), and bundled payments depend on linkages between different types of health care providers to ensure… Read more »