Maine Rural Health Research Center

Current Projects

Adolescent Alcohol Use in Rural Areas: What Are the Issues?
This study will use the National Survey on Drug Use and Health (NSDUH) to examine the effect of developmental, individual, and environmental factors on adolescent alcohol use across the urban-rural continuum.
Funder: Office of Rural Health Policy (ORHP)
Topic: Substance abuse

Assessing HIT Readiness of Rural Health Clinics: A National Survey
We will design and conduct a national survey of rural health clinics, both independent and provider-based, to determine the current level of health information technology adoption and readiness in these clinics
Funder: Office of Rural Health Policy (ORHP)
Topics: Health information technology, Rural Health Clinics (RHCs), Technology

Challenges and Opportunities for Improving Rural Long-Term Services and Supports under the Affordable Care Act
This project will examine strategies, models, and policy options for improving access to, and quality of, rural long-term services and supports. Through focused policy analyses, we will highlight the rural options, opportunities, and barriers of implementing the coordinated care, health home, and long-term services and supports provisions in the Affordable Care Act.
Funder: Office of Rural Health Policy (ORHP)
Topics: Aging, Health policy, Long term care

Health Insurance Stability among Rural Children Following Public Coverage Expansions
While estimates indicate that the uninsured rate among rural children has dramatically decreased since the 1997 passage of the State Children's Health Insurance Program (CHIP), it is not clear whether or not coverage has become more stable and uninsured spells shorter. The purpose of this study is to investigate changes in insurance stability among rural and urban children following CHIP, and whether this is affected by specific state eligibility and enrollment policies or clusters of policies. Using the 1996, 2001, and 2004 panels of the Survey of Income and Program Participation (SIPP), we will measure rural-urban differences in uninsured spell length and frequency, sources of coverage before and after uninsured spells, movement between sources of coverage, how these measures of stability have changed over time, and the factors that relate to greater continuity of coverage among rural children.
Funder: Office of Rural Health Policy (ORHP)
Topics: Children, Health insurance and the uninsured, Medicaid and S-CHIP

Out-of-Pocket Costs Among Rural Medicare Beneficiaries
The purpose of this project is to examine out-of-pocket spending among Medicare beneficiaries, to identify whether there are rural-urban differences in out-of-pocket costs, and to explore what factors account for these differences. Should Medicare redesign occur, this study will provide important information against which to assess the possible impact of different design options on rural Medicare beneficiaries.
Funder: Office of Rural Health Policy (ORHP)
Topics: Disabilities, Health policy, Medicare

Patterns of Care for Rural and Urban Children with Mental Health Problems
This study will assess whether use of office-based care and psychotropic medicine by children differs between rural and urban areas, as well as the role of insurance coverage and availability of mental health providers on use of these services.
Funder: Office of Rural Health Policy (ORHP)
Topics: Children, Health disparities, Mental health

Prevalence and Impact of High Deductible Health Insurance Plans in Rural Areas
This study will use national health survey data to examine whether privately insured rural residents are more likely than their urban counterparts to have plans with high deductibles. It will also assess whether high deductible health plans create health care barriers for rural residents, and if these differ from the barriers experienced by those in urban areas.
Funder: Office of Rural Health Policy (ORHP)
Topics: Health disparities, Health insurance and the uninsured

Role of Rural Health Clinics in a Changing Rural Primary Care Landscape
This project builds upon our past work with Rural Health Clinics (RHCs) to examine the challenges faced by RHCs in serving as part of the rural health care safety net; expanding service capacity to include mental health, dental, and obstetrical care; coping with primary care and other workforce shortages; implementing health information technology; and preparing for proposed changes in conditions of participation requirements and payment provisions. This study will use data collected from a national telephone survey of RHCs, data from past surveys of RHCs; and Medicare cost reports.
Funder: Office of Rural Health Policy (ORHP)
Topic: Rural Health Clinics (RHCs)

Rural E-Mental Health: Models That Enhance Access, Service Delivery, and Integration of Care
E-mental health programs have been developed in rural areas as a promising approach to address the chronic challenges of low availability of mental health clinicians, long travel distances, and stigma surrounding mental health care. The literature has established the technical feasibility of these programs and interest remains strong in developing and implementing them more broadly. However, we lack a clear understanding of the viability of current rural e-mental health programs - both the business case for starting and sustaining them and the clinical case for what services and functions may be provided _ and what impact they have had. The current rural health environment is changing significantly and it is important to understand where and how e-mental health programs have been established and sustained, what impact they have had, and what value they may add to other initiatives. To address this gap we will conduct interviews with between 24-30 current rural e-mental health programs.
Funder: Office of Rural Health Policy (ORHP)
Topics: Mental health, Telehealth

Transformation of Rural Health Clinics: Are They Ready to Serve as Patient-Centered Medical Homes?
Rural Health Clinics (RHCs) face pressure to transform their practices by becoming patient-centered medical homes (PCMHs). This study will document the readiness of RHCs to serve as PCMHs and provide information to assist policymakers in developing technical assistance and other policy resources to support RHCs in doing so.
Funder: Office of Rural Health Policy (ORHP)
Topics: Health policy, Rural Health Clinics (RHCs)

Topics Centers Researchers Other Resources Search		Maine Rural Health Research Center Current Projects Adolescent Alcohol Use in Rural Areas: What Are the Issues? This study will use the National Survey on Drug Use and Health (NSDUH) to examine the effect of developmental, individual, and environmental factors on adolescent alcohol use across the urban-rural continuum. Funder: Office of Rural Health Policy (ORHP) Topic: Substance abuse Assessing HIT Readiness of Rural Health Clinics: A National Survey We will design and conduct a national survey of rural health clinics, both independent and provider-based, to determine the current level of health information technology adoption and readiness in these clinics Funder: Office of Rural Health Policy (ORHP) Topics: Health information technology, Rural Health Clinics (RHCs), Technology Challenges and Opportunities for Improving Rural Long-Term Services and Supports under the Affordable Care Act This project will examine strategies, models, and policy options for improving access to, and quality of, rural long-term services and supports. Through focused policy analyses, we will highlight the rural options, opportunities, and barriers of implementing the coordinated care, health home, and long-term services and supports provisions in the Affordable Care Act. Funder: Office of Rural Health Policy (ORHP) Topics: Aging, Health policy, Long term care Health Insurance Stability among Rural Children Following Public Coverage Expansions While estimates indicate that the uninsured rate among rural children has dramatically decreased since the 1997 passage of the State Children's Health Insurance Program (CHIP), it is not clear whether or not coverage has become more stable and uninsured spells shorter. The purpose of this study is to investigate changes in insurance stability among rural and urban children following CHIP, and whether this is affected by specific state eligibility and enrollment policies or clusters of policies. Using the 1996, 2001, and 2004 panels of the Survey of Income and Program Participation (SIPP), we will measure rural-urban differences in uninsured spell length and frequency, sources of coverage before and after uninsured spells, movement between sources of coverage, how these measures of stability have changed over time, and the factors that relate to greater continuity of coverage among rural children. Funder: Office of Rural Health Policy (ORHP) Topics: Children, Health insurance and the uninsured, Medicaid and S-CHIP Out-of-Pocket Costs Among Rural Medicare Beneficiaries The purpose of this project is to examine out-of-pocket spending among Medicare beneficiaries, to identify whether there are rural-urban differences in out-of-pocket costs, and to explore what factors account for these differences. Should Medicare redesign occur, this study will provide important information against which to assess the possible impact of different design options on rural Medicare beneficiaries. Funder: Office of Rural Health Policy (ORHP) Topics: Disabilities, Health policy, Medicare Patterns of Care for Rural and Urban Children with Mental Health Problems This study will assess whether use of office-based care and psychotropic medicine by children differs between rural and urban areas, as well as the role of insurance coverage and availability of mental health providers on use of these services. Funder: Office of Rural Health Policy (ORHP) Topics: Children, Health disparities, Mental health Prevalence and Impact of High Deductible Health Insurance Plans in Rural Areas This study will use national health survey data to examine whether privately insured rural residents are more likely than their urban counterparts to have plans with high deductibles. It will also assess whether high deductible health plans create health care barriers for rural residents, and if these differ from the barriers experienced by those in urban areas. Funder: Office of Rural Health Policy (ORHP) Topics: Health disparities, Health insurance and the uninsured Role of Rural Health Clinics in a Changing Rural Primary Care Landscape This project builds upon our past work with Rural Health Clinics (RHCs) to examine the challenges faced by RHCs in serving as part of the rural health care safety net; expanding service capacity to include mental health, dental, and obstetrical care; coping with primary care and other workforce shortages; implementing health information technology; and preparing for proposed changes in conditions of participation requirements and payment provisions. This study will use data collected from a national telephone survey of RHCs, data from past surveys of RHCs; and Medicare cost reports. Funder: Office of Rural Health Policy (ORHP) Topic: Rural Health Clinics (RHCs) Rural E-Mental Health: Models That Enhance Access, Service Delivery, and Integration of Care E-mental health programs have been developed in rural areas as a promising approach to address the chronic challenges of low availability of mental health clinicians, long travel distances, and stigma surrounding mental health care. The literature has established the technical feasibility of these programs and interest remains strong in developing and implementing them more broadly. However, we lack a clear understanding of the viability of current rural e-mental health programs - both the business case for starting and sustaining them and the clinical case for what services and functions may be provided _ and what impact they have had. The current rural health environment is changing significantly and it is important to understand where and how e-mental health programs have been established and sustained, what impact they have had, and what value they may add to other initiatives. To address this gap we will conduct interviews with between 24-30 current rural e-mental health programs. Funder: Office of Rural Health Policy (ORHP) Topics: Mental health, Telehealth Transformation of Rural Health Clinics: Are They Ready to Serve as Patient-Centered Medical Homes? Rural Health Clinics (RHCs) face pressure to transform their practices by becoming patient-centered medical homes (PCMHs). This study will document the readiness of RHCs to serve as PCMHs and provide information to assist policymakers in developing technical assistance and other policy resources to support RHCs in doing so. Funder: Office of Rural Health Policy (ORHP) Topics: Health policy, Rural Health Clinics (RHCs)