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 »

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 »

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 »

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 »

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 »

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 »

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” 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 »

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 »

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 »

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 »

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 »

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 »

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 »

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 »