About this article Purpose Medicare cost reports (MCR), Internal Revenue Service form 990s (IRS 990), and audited financial statements (AFS) vary in their content, detail, purpose, timeliness, and certification. The purpose of this study was to compare selected financial data elements and characterize the extent of differences in financial data and ratios across the MCR,… 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 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 determine: 1) Are there… Read more »
A comparative study of financial data sources for critical access hospitals: audited financial statements, the Medicare cost report, and the Internal Revenue Service form 990
A Comparative Study of Financial Data Sources for Critical Access Hospitals: Audited Financial Statements, the Medicare Cost Report, and the Internal Revenue Service Form 990
Current and Longer Term Challenges of Rural Hospitals: A Survey of Rural Hospital Executives
Rural hospitals are being adversely affected by short-term and long-term challenges related to financial and regulatory burdens such as sequestration, 340B payment reductions, declining patient volumes, and increases in the under and uninsured.
How Do Costs for Rural Medicare Beneficiaries Using Swing Beds Compare to Those Using Skilled Nursing Facilities?
This study estimated and compared total Medicare expenditures for episodes of care that include post-acute stays in either swing beds or skilled nursing facilities (SNFs). Results informed federal and state agencies, rural providers and communities as to how post-acute care in swing bed versus a SNF affects the trajectory of costs and utilization for rural Medicare beneficiaries.
Hospital Readmission Following Care in a Swing Bed
About this project Lead researcher: Mark Holmes, PhD Project funded: September 2012 Project completed: July 2021 Preventable hospital readmissions are a significant problem for patients and insurers. Swing beds are the only post-acute care in many very rural communities but research on the ability of swing bed care to prevent readmission is limited. A better… Read more »
Decline in Inpatient Volume at Rural Hospitals
About this project Authors: Tyler L Malone, George H Pink, George M Holmes This article was originally published in the Journal of Rural Health in March, 2021. Abstract Purpose: To investigate (1) all-payer inpatient volume changes at rural hospitals and (2) whether trends in inpatient volume differ by organizational and geographic characteristics of the hospital and… Read more »
Rural Informal Safety Net: The Development of a Research and Evaluation Design and a Preliminary Assessment
About this project Research staff: Thomas C. Ricketts & Kerry James Project completed: May 2001 This is a continuation of a multi-center assessment of the Rural Informal Safety Net. During January through August 1999, the North Carolina Rural Health Research and Policy Analysis Program conducted exploratory site visits to four rural North Carolina communities: Bayboro-Pamlico… Read more »
Impacts of Multiple Race Reporting
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 »