About this project Lead researcher: Rebecca T. Slifkin, PhD Project funded: September 2003 Project completed: August 2006 The purpose of this study is to examine practice patterns for deliveries in rural hospitals, with a focus on cesarean section (c-section) rates, which are rising nationally. The diffusion of best practices may be slower to reach rural communities, and consequently,… Read more »
Trends in Swing Bed and Skilled Nursing Facility Use in Rural Hospitals, 1996-2003
About this project Lead researcher: Rebecca T. Slifkin, PhD Project completed: August 2005 Topics: Aging, Hospitals and clinics, Long-term care, Medicare Prospective Payment System (PPS) This study will examine trends in the distribution of skilled nursing facility (SNF) services in rural hospitals during a period of dramatic change in Medicare reimbursement, most notably the transition from cost-based reimbursement… Read more »
Special Study of EMS Issues
About this project Lead researcher: Andrew F. Coburn, PhD The University of Southern Maine and the University of North Carolina at Chapel Hill will collaborate to conduct a special study of EMS issues during Year 2 of the Flex Project (2004-05). The study will focus on state, community, and hospital-level initiatives designed to build the… Read more »
Role of Intensive Care Units in Critical Access Hospitals
About this project Lead researcher: Rebecca T. Slifkin, PhD Project completed: February 2005 The number of small rural hospitals that have chosen to convert to CAH status has been greater than many people had anticipated, and concern has been voiced by some individuals about whether the provision of services in an intensive care unit (ICU)… Read more »
Impact of The Medicaid Budget Crisis on Rural Communities: A 50-State Survey
Understanding how the Medicaid budget crisis affects communities Lead researcher: Rebecca T. Slifkin, PhD Most states are facing severe budget crises, forcing them to reduce Medicaid program costs. States have many different options to reduce Medicaid expenditures, including cutting optional eligibles or optional services, reducing provider payments and increasing recipient cost sharing. Many of the… Read more »
Access to Health Care for Young Rural Medicaid Beneficiaries
About this project Lead researcher: Victoria Freeman, DrPH, RN Project funded: September 2004 Project completed: December 2005 This study examined access to health care among rural children ages 0-17 who are enrolled in some type of Medicaid managed care program, and compared this access across types of programs and, within program type, to that of… Read more »
Rapid and Flexible Analysis of Data from Centers for Medicare and Medicaid Services
About this project Research center: North Carolina Rural Health Research and Policy Analysis Center Lead researcher: Rebecca T. Slifkin, PhD Project funded: April 2004 Project completed: August 2006 This project provides rapid and flexible analysis of Centers for Medicare and Medicaid Services (CMS) data in response to requests from the federal Office of Rural Health… Read more »
Premium Assistance Programs: Exploring Public-Private Partnerships as a Vehicle for Expanding Health Insurance to Rural Uninsured
About this project Lead researcher: Rebecca T. Slifkin, PhD Project funded: September 2004 Project completed: February 2006 Many states have created public-private partnerships to expand health insurance coverage to the uninsured. Among these, one group of programs, “premium assistance programs,” are designed to help lower-wage workers pay the premium costs of their employer-sponsored health insurance…. Read more »
Financial Performance of Critical Access Hospitals, Pre- and Post-Conversion
About this project Lead researcher: Rebecca T. Slifkin, PhD Project funded: September 2003 Project completed: August 2006 One of the objectives of the Flex program is to provide a greater degree of financial stability for CAHs through the use of cost-based reimbursement. Making use of the financial indicators developed by project staff, the focus of… Read more »
State Facts about Medicaid: Rural Specific Data
About this project Lead researcher: Rebecca T. Slifkin, PhD Medicaid is an important source of health insurance coverage for both rural residents and rural providers. Rural residents are more likely to live in poverty than urban residents, and are less likely to have employer-sponsored health insurance coverage. As a result, rural residents are more likely… Read more »
Rural Hospital Participation in the 340B Drug Discount Program
About this project Lead researchers: Claudia Schur, PhD and Rebecca T. Slifkin, PhD Project completed: August, 2007 The 340B drug pricing program enables certain types of safety net organizations to obtain deeply discounted medications, at prices below the “best price” typically offered to Medicaid agencies. In the past, few rural hospitals qualified for the 340B… Read more »
Challenges for Rural Emergency Medical Services: Medical Oversight
About this project Contact: Victoria Freeman, DrPH, RN Project funded: September 2005 Project completed: August 2007 This two-year study will examine the status of medical direction for rural Emergency Medical Services (EMS) systems, the nature of the challenges and impediments to obtaining adequate medical direction in rural areas and issues surrounding the recruitment and retention… Read more »
Occupational Mix Differences Across PPS Hospitals: Analysis of Hospital Occupation Mix Survey Data and Implications for Rural Hospital Payments
About this project Lead researcher: Rebecca T. Slifkin, PhD Project funded: September 2004 Project completed: February 2007 This study addresses the occupation-mix adjustment that has recently been added to the computation of the area wage index used to adjust Medicare prospective rates for all institutional healthcare providers. Project staff will review the policy objectives as… Read more »
Describing Geographic Access to Physicians in Rural America Using Statistical Applications in GIS
About this project Contact: Thomas C. Ricketts, PhD Project funded: September 2004 Project completed: May 2007 This study is testing the use of geographically weighted regression (GWR) to assess the influence of distance and travel time on the distribution of physicians in rural America. The Medicare Modernization Act contains financial provisions aimed at changing the… Read more »
Rural Hospital Flexibility Performance Monitoring Project- Grant Years 2003-2008
About this project Lead researcher: Ira Moscovice, PhD Project funded: September 2003 Project completed: August 2008 Under contract with the federal Office of Rural Health Policy, the Rural Health Research Centers at the Universities of Minnesota, North Carolina, and Southern Maine (the Flex Monitoring Team) are cooperatively conducting a performance monitoring project for the Medicare… Read more »