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 »
Background Paper on Skilled Nursing Facilities in Rural Areas
About this project Lead researcher: Rebecca T. Slifkin, PhD Project completed: January 2002 This study will synthesize existing literature on skilled nursing facilities (SNFs) and present an overview of the issues and legislation relevant to SNFs in rural areas. The general characteristics of SNFs (size, type, ownership, complexity of case-mix) and how these characteristics may… Read more »
Arguing for Rural Health: Justice and Fairness in Advocating for Rural Health Policy
About this project Lead researcher: Thomas C. Ricketts, PhD Project completed: June 2002 The development of policy for rural health care in the United States has occurred in a reactive manner. Within rural health advocacy, there little attention has been paid to the structure of the arguments that are presented, however logical or effective they… Read more »
Analysis of Options for Revisions to the Criteria for Designation for Medically Underserved Areas (MUAs) and Health Professional Shortage Areas (HPSAs)
About this project Lead researcher: Laurie Goldsmith, MSc Project completed: April 2002 This project has several activities related to the development of new indices of underserviced for rural areas: Apply the existing Medically Underserved Areas/Populations (MUA/P) and Health Professional Shortage Area (HPSA) criteria to a current national database for all counties and for current subcounty… Read more »
Analysis of Options for Criteria to Determine Underservice
About this project Lead researcher: Thomas C. Ricketts, PhD Project completed: December 2002 This project extends existing work on the analysis of options for criteria to determine underservice. The research will: Complete additional analyses of options for revisions to the criteria for designation of Medically Underserved Areas and Health Professional Shortage Areas; Develop a design… Read more »
National Rural Hospital Flexibility Program Review
About this project Lead researcher: Melissa A. Fruhbeis, MSPH Project completed: August 2003 The North Carolina Rural Health Research and Policy Analysis Center and the UNC Department of Health Policy and Administration are collaborating with the other rural health research and policy analysis centers in a comprehensive review of the Rural Hospital Flexibility Program (Flex… Read more »