About this project Lead researcher: Randy Randolph, MRP Project completed: August 2001 This project will investigate the following questions regarding the 1997 revisions to Statistical Policy Directive No. 15, Race and Ethnic Standards for Federal Statistics and Administrative Reporting, a revision of the federal standards for collecting data on race and ethnicity, to be adopted… Read more »
Describing the Health Care Infrastructure in Rural Towns
About this project Lead researcher: Rebecca T. Slifkin, PhD Project completed: February 2001 The goal of this project is to incorporate information from multiple data sources in order to describe more fully the health care infrastructure in rural towns. Provider data, used to place providers within ZIP codes, includes census of physicians, physician assistants, and… Read more »
Tracking the Implementation of Medicaid Managed Care in Rural Areas
About this project Research staff: Rebecca T. Slifkin, PhD Project completed: August 2002 More than half of all Medicaid recipients are enrolled in some form of managed care, but participation in rural areas remains behind that of urban areas. In 1997, the North Carolina Rural Health Research Program conducted a study under an Agency for… Read more »
Rural Population and Providers: Mapping the 2000 Census
About this project Lead researcher: Rebecca T. Slifkin, PhD Project completed: August 2002 For this project we will create a monograph that uses maps to illustrate population location and changes at both the state and national level, and overlays these changes with provider supply. Using the 1990 and the 2000 census, we will describe the… Read more »
Evaluation of the Rural Hospital Flexibility Act and the Critical Access Hospital Program
About this project Lead researcher: William N. Zelman, PhD Project completed: August 2002 The North Carolina Rural Health Research Program at the University of North Carolina’s (UNC) Cecil G. Sheps Center for Health Services Research and the Department of Health Policy and Administration, also at UNC, are collaborating with the other Rural Health Research and… Read more »
Use of Rural Health Clinics by Medicare Beneficiaries
About this project Contact: Andrea Radford, DrPH Project funded: September 2011 Project completed: April 2013 With approximately 3800 located across the nation, RHCs are an important component of the rural health infrastructure. Using Medicare outpatient claims data the degree to which Medicare beneficiaries are utilizing available RHCs will be determined and a profile of those… Read more »
Patterns of Care in Small Rural Areas: Implications for New Models of Care Provision and Payment such as Bundled Payments and Accountable Care Organizations
About this project Contact: Mark Holmes, PhD, 919.966.7100, mark_holmes@unc.edu Project funded: September 2010 Project completed: December 2014 Recent health reform has included a number of models of care provision and/or payment, for example, bundled payments and Accountable Care Organizations (ACOs), which depend on linkages between different types of health care providers. The national discourse has… Read more »
Early Rural Experiences of Changes to Medicaid: Year 1
About this project Contact: Mark Holmes, PhD Project funded: September 2013 In January 2014, some states will expand eligibility through the Medicaid program, while other states will not. Because rural residents are likely to be disproportionately affected by Medicaid expansion, understanding this interstate variation has important policy implications. Publications How Does Medicaid Expansion Affect Insurance… Read more »
Comprehensive Study of Swing Bed Use in Rural Hospitals
About this project Lead researcher: Mark Holmes, PhD Project funded:September 2010 Project completed:February 2014 Under the Medicare program, rural hospitals with 100 or fewer licensed routine care beds are eligible to participate in the swing bed program, meaning that a bed can be used for either an acute care patient or a postacute patient who… Read more »
Rural Health Clinics: Medicare & Medicaid Profile
About this project Contact: Andrea Radford, DrPH Project funded: September 2012 Project completed: August 2015 Rural health clinics are a critical element of the rural healthcare system with approximately 3800 located throughout the United States, but due to limited reporting requirements relatively little is known about them. We are beginning to collect data on Medicare… Read more »
Identifying Limitations of PPS Reimbursement for Rural Hospitals
About this project Contact: Mark Holmes, PhD Project funded:September 2013 Project completed:January 2015 This project will investigate the potential financial and access consequences of returning rural hospitals to PPS payment. Characteristics of the hospitals and communities at highest risk of adverse consequences will be identified. Publications Do Current Medicare Rural Hospital Payment Systems Align… Read more »
Early Rural Experiences of Changes to Medicaid
About this project Lead researcher:Pam Silberman, JD, DrPH Project completed: February 2015 The Affordable Care Act included provisions for a substantial expansion in Medicaid, but the Supreme Court ruled that states could not be compelled to expand. Many states decided not to expand. These states are disproportionately Southern and rural. Medicaid expansion’s effect on… Read more »
Policy Analysis Using the Financial Distress Model: Does Medicaid Expansion Affect the Risk of Hospital Financial Distress and Closure?
About this project Lead researcher: Mark Holmes, PhD Project funded: September 2015 Project completed: August 2016 The NC RHRC has recently developed a model to predict financial distress in rural hospitals. This study will demonstrate the use of this model to analyze policies affecting rural hospitals. In particular, the purpose of this study is to… Read more »
Creating a Culture of Health in Appalachia: Disparities and Bright Spots
“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. This multi-part health research project will produce a series of reports. The first report measures population health and documents disparities in health outcomes within the… Read more »
Rural Hospital Wages and the Prospective Payment System Wage Index: 1990-1997
About this project Lead researcher: Kathleen Dalton, PhD Project completed: January 2001 The hospital wage index is used by HCFA to adjust hospital DRG payments for regional variation in the cost of labor. There has been concern among rural policy analysts that the index is biased against rural markets, and that it results in systematic… Read more »