Upper Midwest Rural Health Research Center

Completed Projects

Acute and Post-Acute Care Bundled Payments and Care Coordination in Rural Environments
The purpose of this project is to: 1) Identify opportunities and potential unintended consequences for rural providers of current proposals for implementing bundled payments for acute and post-acute care episodes; 2) Describe modifications to current bundling proposals that will address rural-specific issues; and 3) Identify quality measures related to care coordination that are relevant for rural patients whose services are reimbursed by a bundled payment.
Funder: Office of Rural Health Policy (ORHP)
Topics: Health services, Quality

Assessing the Rural Relevance of Hospital Outpatient Quality Measures
The purpose of this project is to: 1) determine the diagnoses that are most commonly treated and the procedures most commonly performed in rural hospital outpatient settings; and 2) to evaluate the rural relevance of the proposed new CMS outpatient quality measures and other potential outpatient quality measures.
Funder: Office of Rural Health Policy (ORHP)
Topics: Hospitals and clinics, Quality

Beyond Simple Ranking: Identifying and Empirically Testing Alternative Approaches for Recognizing Quality in Rural Hospitals
The purpose of this project is to explore several alternative methods for assessing the relative quality of hospitals using data from the Hospital Quality Incentive Demonstration Project and Hospital Compare.
Funder: Office of Rural Health Policy (ORHP)
Topics: Hospitals and clinics, Quality

Critical Access Hospital Readiness for CMS Value-Based Purchasing
The purpose of this project will be to assess Critical Access Hospital readiness for participation in a Value-based Purchasing program similar to that proposed by CMS for Prospective Payment System hospitals.
Funder: Office of Rural Health Policy (ORHP)
Topics: Critical Access Hospitals and Rural Hospital Flexibility Program, Health care financing, Quality

Developing Quality Measures and Communication Strategies for Rural Patient Transfers
The purpose of this project is to quantify the complexity of the coordination of patient care in rural health care systems and to expand our work on developing quality measures for rural patients whose care is transferred between providers.
Funder: Office of Rural Health Policy (ORHP)
Topic: Quality

Health Information Technology and Quality in Rural Hospitals
The purpose of this project is to: 1) examine the adoption of health information technology (HIT) among rural hospitals and identify hospital and market characteristics that facilitate or impede HIT diffusion; 2) measure the effect of HIT on clinical quality in rural hospitals; and 3) identify technologies that may be promoted to improve quality of care in rural areas.
Funder: Office of Rural Health Policy (ORHP)
Topics: Health information technology, Hospitals and clinics, Quality

Hospitalizations of Rural Children for Ambulatory Care Sensitive Conditions
This project uses state inpatient discharge data from six states, data from the Area Resource File and the AHRQ Pediatric Quality Indicators to examine Ambulatory Care Sensitive Condition admission rates for rural children.
Funder: Office of Rural Health Policy (ORHP)
Topics: Children, Chronic diseases and conditions

Impact of Expansion of Ambulatory Surgery Centers on Rural Hospitals and Communities
This project will examine the extent of freestanding ambulatory surgery center (ASC) expansion into rural communities between 1998 and 2005, the market factors driving that expansion, and the impact of ASCs on the operational and financial viability of rural hospitals located in the same communities.
Funder: Office of Rural Health Policy (ORHP)
Topics: Health care financing, Health services

Impact of Health Insurance Coverage on Native Elder Health: Implications for Addressing the Health Care Needs of Rural American Indian Elders
This project examined the types of health insurance coverage of rural Native American elders ages 55 and older, and examine how different types of health insurance coverage and lack of health insurance coverage impact access to health care services among Native American elders by geographic location (rural frontier, rural non-frontier and urban).
Funder: Office of Rural Health Policy (ORHP)
Topics: Aging, American Indians and Alaska Natives, Frontier health, Health insurance and the uninsured, Minority health, Rural statistics and demographics

Implementation of Telepharmacy in Rural Hospitals: Potential for Improving Medication Safety
The purpose of this project is to describe successful telepharmacy activities and to analyze policy issues related to the implementation of telepharmacy projects in rural hospitals. These policy issues include the potential impact of telepharmacy use on the quality of pharmaceutical services and medication safety for rural patients.
Funder: Office of Rural Health Policy (ORHP)
Topics: Hospitals and clinics, Pharmacy and prescription drugs, Quality, Telehealth

Nursing Workforce Impact on Rural Hospital Performance Improvement in the Hospital Quality Incentive Demonstration Project
The purpose of this project is to examine the impact of nurse staffing on hospital performance improvement in the CMS/premier Inc. Hospital Quality Incentive Demonstration project with specific interest in whether and how this relationship differs in rural hospitals as compared to urban hospitals.
Funder: Office of Rural Health Policy (ORHP)
Topics: Hospitals and clinics, Quality, Workforce

Patient Assessments and Quality of Care in Rural Hospitals
This study will 1)analyze the relationships between rural patients' perspectives of hospital quality of care and key hospital characteristics that may influence patients' experiences of hospital care; and 2) assess whether rural patients' perspectives of hospital quality of care are related to quality measures focused on the provision of recommended care for medical conditions.
Funder: Office of Rural Health Policy (ORHP)
Topics: Health services, Quality

Pay-for-Performance and Quality Improvement in Rural Hospitals
This project will estimate the impact on rural hospitals in the U.S. of a pay-for-performance (PFP) program similar to the CMS-sponsored Premier, Inc. Hospital Quality Incentive Demonstration; synthesize the major factors that will influence the inclusion of rural hospitals in PFP programs; and make recommendations for the design of PFP programs that will appropriately reward rural hospitals for improving quality.
Funder: Office of Rural Health Policy (ORHP)
Topics: Health care financing, Hospitals and clinics, Quality

Potentially Preventable Rural Hospital Readmissions
This project focuses on the analysis of potentially preventable rural hospital readmissions, a potential quality indicator receiving considerable attention from policymakers and payers. Using 3-M algorithm software and MedPAR inpatient claims data from 9 geographically representative states, this study will explore the relationship between readmission rates and geographic regions, categories of rural hospitals, discharge destination, clinical diagnoses and patient attributes.
Funder: Office of Rural Health Policy (ORHP)
Topics: Hospitals and clinics, Quality

Role of Rural Hospitals in Community-Centered Systems of Care: Supporting Population Health Improvement for Rural Communities
This project will assess the degree to which rural hospitals engage in activities that facilitate community responsiveness and the provision of community-oriented services, using 1996 to 2004 data from the American Hospital Association Annual Survey and the Area Resource File.
Funder: Office of Rural Health Policy (ORHP)
Topics: Health services, Hospitals and clinics

Rural Emergency Department Staffing: Implications for the Quality of Emergency Care Provided in Rural Areas
This project will describe emergency department (ED) staffing patterns in rural hospitals; determine how the certification, training, and experience of ED physicians and other providers in different ED staffing models vary; and assess the implications of rural ED staffing for the quality of emergency care in rural areas, continuity of care, and rural EDs' role as safety net providers.
Funder: Office of Rural Health Policy (ORHP)
Topics: Emergency medical services (EMS), Hospitals and clinics, Quality, Workforce

Rural Implications of Health Care Reform: Issues Related to Quality of Care, Health Information Technology and Care Coordination
The purpose of this project is to provide support to the Office of Rural Health Policy on rural health care reform issues.
Funder: Office of Rural Health Policy (ORHP)
Topics: Health policy, Health services

Successful Implementation of Medication Safety Initiatives in Rural Hospitals: The Role of Pharmacists and Technology
This project will assess the capacity of rural hospitals to implement medication safety practices that reduce the likelihood of serious adverse drug events, and will identify factors that facilitate successful implementation of medication safety practices in rural hospitals.
Funder: Office of Rural Health Policy (ORHP)
Topics: Hospitals and clinics, Pharmacy and prescription drugs, Quality, Technology

Topics Centers Researchers Other Resources Search		Upper Midwest Rural Health Research Center Completed Projects Acute and Post-Acute Care Bundled Payments and Care Coordination in Rural Environments The purpose of this project is to: 1) Identify opportunities and potential unintended consequences for rural providers of current proposals for implementing bundled payments for acute and post-acute care episodes; 2) Describe modifications to current bundling proposals that will address rural-specific issues; and 3) Identify quality measures related to care coordination that are relevant for rural patients whose services are reimbursed by a bundled payment. Funder: Office of Rural Health Policy (ORHP) Topics: Health services, Quality Assessing the Rural Relevance of Hospital Outpatient Quality Measures The purpose of this project is to: 1) determine the diagnoses that are most commonly treated and the procedures most commonly performed in rural hospital outpatient settings; and 2) to evaluate the rural relevance of the proposed new CMS outpatient quality measures and other potential outpatient quality measures. Funder: Office of Rural Health Policy (ORHP) Topics: Hospitals and clinics, Quality Beyond Simple Ranking: Identifying and Empirically Testing Alternative Approaches for Recognizing Quality in Rural Hospitals The purpose of this project is to explore several alternative methods for assessing the relative quality of hospitals using data from the Hospital Quality Incentive Demonstration Project and Hospital Compare. Funder: Office of Rural Health Policy (ORHP) Topics: Hospitals and clinics, Quality Critical Access Hospital Readiness for CMS Value-Based Purchasing The purpose of this project will be to assess Critical Access Hospital readiness for participation in a Value-based Purchasing program similar to that proposed by CMS for Prospective Payment System hospitals. Funder: Office of Rural Health Policy (ORHP) Topics: Critical Access Hospitals and Rural Hospital Flexibility Program, Health care financing, Quality Developing Quality Measures and Communication Strategies for Rural Patient Transfers The purpose of this project is to quantify the complexity of the coordination of patient care in rural health care systems and to expand our work on developing quality measures for rural patients whose care is transferred between providers. Funder: Office of Rural Health Policy (ORHP) Topic: Quality Health Information Technology and Quality in Rural Hospitals The purpose of this project is to: 1) examine the adoption of health information technology (HIT) among rural hospitals and identify hospital and market characteristics that facilitate or impede HIT diffusion; 2) measure the effect of HIT on clinical quality in rural hospitals; and 3) identify technologies that may be promoted to improve quality of care in rural areas. Funder: Office of Rural Health Policy (ORHP) Topics: Health information technology, Hospitals and clinics, Quality Hospitalizations of Rural Children for Ambulatory Care Sensitive Conditions This project uses state inpatient discharge data from six states, data from the Area Resource File and the AHRQ Pediatric Quality Indicators to examine Ambulatory Care Sensitive Condition admission rates for rural children. Funder: Office of Rural Health Policy (ORHP) Topics: Children, Chronic diseases and conditions Impact of Expansion of Ambulatory Surgery Centers on Rural Hospitals and Communities This project will examine the extent of freestanding ambulatory surgery center (ASC) expansion into rural communities between 1998 and 2005, the market factors driving that expansion, and the impact of ASCs on the operational and financial viability of rural hospitals located in the same communities. Funder: Office of Rural Health Policy (ORHP) Topics: Health care financing, Health services Impact of Health Insurance Coverage on Native Elder Health: Implications for Addressing the Health Care Needs of Rural American Indian Elders This project examined the types of health insurance coverage of rural Native American elders ages 55 and older, and examine how different types of health insurance coverage and lack of health insurance coverage impact access to health care services among Native American elders by geographic location (rural frontier, rural non-frontier and urban). Funder: Office of Rural Health Policy (ORHP) Topics: Aging, American Indians and Alaska Natives, Frontier health, Health insurance and the uninsured, Minority health, Rural statistics and demographics Implementation of Telepharmacy in Rural Hospitals: Potential for Improving Medication Safety The purpose of this project is to describe successful telepharmacy activities and to analyze policy issues related to the implementation of telepharmacy projects in rural hospitals. These policy issues include the potential impact of telepharmacy use on the quality of pharmaceutical services and medication safety for rural patients. Funder: Office of Rural Health Policy (ORHP) Topics: Hospitals and clinics, Pharmacy and prescription drugs, Quality, Telehealth Nursing Workforce Impact on Rural Hospital Performance Improvement in the Hospital Quality Incentive Demonstration Project The purpose of this project is to examine the impact of nurse staffing on hospital performance improvement in the CMS/premier Inc. Hospital Quality Incentive Demonstration project with specific interest in whether and how this relationship differs in rural hospitals as compared to urban hospitals. Funder: Office of Rural Health Policy (ORHP) Topics: Hospitals and clinics, Quality, Workforce Patient Assessments and Quality of Care in Rural Hospitals This study will 1)analyze the relationships between rural patients' perspectives of hospital quality of care and key hospital characteristics that may influence patients' experiences of hospital care; and 2) assess whether rural patients' perspectives of hospital quality of care are related to quality measures focused on the provision of recommended care for medical conditions. Funder: Office of Rural Health Policy (ORHP) Topics: Health services, Quality Pay-for-Performance and Quality Improvement in Rural Hospitals This project will estimate the impact on rural hospitals in the U.S. of a pay-for-performance (PFP) program similar to the CMS-sponsored Premier, Inc. Hospital Quality Incentive Demonstration; synthesize the major factors that will influence the inclusion of rural hospitals in PFP programs; and make recommendations for the design of PFP programs that will appropriately reward rural hospitals for improving quality. Funder: Office of Rural Health Policy (ORHP) Topics: Health care financing, Hospitals and clinics, Quality Potentially Preventable Rural Hospital Readmissions This project focuses on the analysis of potentially preventable rural hospital readmissions, a potential quality indicator receiving considerable attention from policymakers and payers. Using 3-M algorithm software and MedPAR inpatient claims data from 9 geographically representative states, this study will explore the relationship between readmission rates and geographic regions, categories of rural hospitals, discharge destination, clinical diagnoses and patient attributes. Funder: Office of Rural Health Policy (ORHP) Topics: Hospitals and clinics, Quality Role of Rural Hospitals in Community-Centered Systems of Care: Supporting Population Health Improvement for Rural Communities This project will assess the degree to which rural hospitals engage in activities that facilitate community responsiveness and the provision of community-oriented services, using 1996 to 2004 data from the American Hospital Association Annual Survey and the Area Resource File. Funder: Office of Rural Health Policy (ORHP) Topics: Health services, Hospitals and clinics Rural Emergency Department Staffing: Implications for the Quality of Emergency Care Provided in Rural Areas This project will describe emergency department (ED) staffing patterns in rural hospitals; determine how the certification, training, and experience of ED physicians and other providers in different ED staffing models vary; and assess the implications of rural ED staffing for the quality of emergency care in rural areas, continuity of care, and rural EDs' role as safety net providers. Funder: Office of Rural Health Policy (ORHP) Topics: Emergency medical services (EMS), Hospitals and clinics, Quality, Workforce Rural Implications of Health Care Reform: Issues Related to Quality of Care, Health Information Technology and Care Coordination The purpose of this project is to provide support to the Office of Rural Health Policy on rural health care reform issues. Funder: Office of Rural Health Policy (ORHP) Topics: Health policy, Health services Successful Implementation of Medication Safety Initiatives in Rural Hospitals: The Role of Pharmacists and Technology This project will assess the capacity of rural hospitals to implement medication safety practices that reduce the likelihood of serious adverse drug events, and will identify factors that facilitate successful implementation of medication safety practices in rural hospitals. Funder: Office of Rural Health Policy (ORHP) Topics: Hospitals and clinics, Pharmacy and prescription drugs, Quality, Technology