Health Disparities in Appalachia

“Creating a Culture of Health in Appalachia: Disparities and Bright Spots” is an innovative research initiative that aims to identify factors that support a culture of health in Appalachian communities. “Health Disparities in Appalachia” is the first report in a series exploring health issues in Appalachia. It measures population health and documents disparities in health… Read more »

Rural-Urban Variations in Medicare Live Discharge Patterns from Hospice, 2012-2013

For the last decade-and-a-half, the proportion of patients discharged from the Medicare hospice program prior to death – known as a “live discharge” – has increased across the country with significant hospice-level geographic variations. Despite clear geographic variations in live discharge rates and known rural-urban disparities (e.g., patients of rural hospices have higher satisfaction), previous… Read more »

Evaluating Retention in BCRS Programs: Final Report

Through its 40-year history, the National Health Service Corps (NHSC) has supported more than 40,000 primary care, mental health and dental health clinicians with scholarships and loan repayment incentives to work in Health Professional Shortage Areas. Retaining these clinicians after they complete their service commitments (which are typically 2-5 years) is key to the NHSC’s… Read more »

Regional Differences in Urban and Rural Mortality Trends

Previous research has established both that there is a gap in nationwide urban-rural mortality and that this gap is increasing over time. Existing and ongoing work has found that the urban-rural mortality gap may vary regionally. This brief builds upon previous research and explores the differences in mortality trends between urban and rural locations by… Read more »

Rural and Urban Hospitals in the United States

The table below shows the number of rural and urban hospitals in the United States as of January 1, 2016. The source of the data is the 2016 Provider of Services file produced by the Centers for Medicare and Medicaid Services.  Hospitals are classified as rural by using the definition provided by the Federal Office… Read more »

Opioid Poisoning Related Hospital Use in North Carolina

Nationally, the opioid epidemic is expanding at a rapid pace. Deaths from opioid overdose quadrupled from 1999 to 2016.  North Carolina is experiencing a faster increase in drug overdose deaths than the nation as a whole. However, opioid use does not always manifest in death. One report estimates that there are four inpatient visits and… Read more »

Rural Health Snapshot (2017)

Disparities in health status and access to health care exist between people living in rural areas and those in urban areas.   The displays selected indicators of access to health care, health behavior/risk factors, and mortality rates, comparing rural to urban residents.

U.S. Hospital List (2016)

The North Carolina Rural Health Research Program produces a list of rural and urban U.S. hospitals each year.  This list includes 4,768 acute and 1,373 specialty hospitals that were reported open on January 1, 2016.  

The Financial Importance of the Sole Community Hospital Payment Designation

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.” As such, Medicare SCH… Read more »

The Impact of the Low Volume Hospital (LVH) Program on the Viability of Small, Rural Hospitals

Thanks to a temporary, but substantial expansion of the Centers for Medicare & Medicaid Services (CMS) Low Volume Hospital (LVH) Program, around 500 rural hospitals benefit from LVH payment adjustment. When it was originally implemented in 2005 only five rural hospitals qualified. Under the program, CMS provides an additional payment to qualifying hospitals for the higher costs associated with… Read more »

Trends in Risk of Financial Distress among Rural Hospitals

From January 2005 to July 2016, 118 rural hospitals have closed permanently, not including seven others that closed and subsequently reopened. The number of closures has increased each year since 2010, and in the first half of 2016, the closure rate surpassed two closures per month. Hospital closures impact millions of rural residents in communities… Read more »

Profitability of Rural and Urban Hospitals (Infographic)

More Americans are now aware of the financial challenges faced by rural hospitals. Media coverage of the 76 rural hospital closures between January 2010 and July 2016 has highlighted the health care access and economic challenges facing rural America. Rural hospital closures are not a new phenomenon – hundreds of rural hospitals closed in the 1980s and… Read more »