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 »

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 »

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 »

Medicaid Managed Care in Rural Areas: Innovative Case Management Strategies

About this project Lead researcher: Pam Silberman, JD, DrPH Project completed: January 2003 Continuing the work on tracking and assessing the extent of Medicaid-managed care in rural areas, the project will focus on states with innovative case management strategies and look specifically at how these programs operate in rural communities. Year Two of the project… Read more »

Labor Costs and the Area Wage Index in Skilled Nursing Facilities

About this project Lead researcher: Kathleen Dalton, PhD Project completed: February 2003 This project will examine regional patterns in Skilled Nursing Facility (SNF) hourly wages, using data from Fiscal Year 1997 cost reports for all freestanding and hospital-based facilities. We will analyze wage differentials by community size and regional location with the objective of comparing… Read more »

Information Technology Engineering Support for Health Resources and Services Administration Data Systems/Geospatial Data Warehouse, GIS Technologies, GEMS Support and General Office of Information Technology Systems Support

About this project Lead researcher: Thomas C. Ricketts, PhD Project completed: October 2003 This project will develop or update a comprehensive national data set that describes the supply and distribution of primary care professionals in the United States and related need factors for use by the Health Resources and Services Administration and others in the… Read more »

Factors Contributing to Unit Cost Instability in the Low-Volume Hospital

About this project This project will study year-to-year variation in Medicare inpatient costs within rural hospitals, with a special focus on factors affecting unit costs in low-volume providers. Lead researcher: Kathleen Dalton, PhD Project completed: January 2003 We propose to analyze panel data constructed from eight years of Medicare hospital files, covering reports filed for… Read more »

Rural Hospital Profitability during the Global COVID-19 Pandemic Requires Careful Interpretation

The North Carolina Rural Health Research Program has been tracking rural hospital profitability for more than a decade, as many small rural hospitals struggle with profitability compared to their urban counterparts. The findings brief, , describes the pre-pandemic (2011-19) trend of rural hospital profitability and explains why possible increases in reported profitability during the pandemic… Read more »

Predictors of Hospital Choice among Rural Patients Seeking Elective Surgery: A Scoping Review

Hospital choice for surgery affects both patient outcomes and hospital viability, a greater understanding of rural patients’ surgical care-seeking behavior could enhance rural health and rural hospital financial stability. Specifically, insight on modifiable determinants of care-seeking behavior can inform policies to promote behavior that is consistent with evidence-based public health recommendations (e.g., undergoing common, low-risk… Read more »