RUPRI Center for Rural Health Policy Analysis

Current Projects

• Concordance Between Social Needs Screening Provision, Programming, and Partnerships in Rural PPS Hospitals
  This study will examine how rural Prospective Payment System (PPS) hospitals differ from urban hospitals concerning social needs screening practices and alignment between social needs screening performance and corresponding programs/strategies and/or community partnerships to address social needs.
  Topics: Health services, Hospitals and clinics, Medicare Prospective Payment System (PPS), Networking and collaboration, Social determinants of health
  
• Differences in Rural and Urban Hospital Cost Structures: Evidence and Implications
  The project will compare fixed-to-variable cost ratios in U.S. rural and urban hospitals. We hypothesize that rural hospitals will realize proportionally greater fixed costs than urban hospitals, suggesting important hospital payment system implications.
  Topics: Health reform, Healthcare financing, Medicare
  
• How Does Participation in Medicare Accountable Care Organizations Affect Rural Hospital Financial Outcomes?
  This project will examine the impact of Medicare Accountable Care Organizations' (ACOs') participation on rural hospitals' financial outcomes. Findings from this project will provide policy-relevant information on how ACO participation affects rural hospitals' financial bottom lines, contributing to further program design.
  Topics: Care management, Health reform, Health services, Hospitals and clinics, Medicare
  
• Medicare Advantage Plan Growth in Rural America: Opportunities for Beneficiaries?
  County Medicare Advantage enrollment data and plan characteristic data will be used to create a model accounting for the availability of plans offering benefits addressing social determinants of health. Analyses will compare rural and urban counties, and examine county characteristics to explore potential equitable opportunities for rural beneficiaries because of geography and other factors.
  Topics: Medicare, Medicare Advantage (MA), Medicare Part D, Social determinants of health, Telehealth, Transportation
  
• Non-Metropolitan/Metropolitan Differences in Barriers to Care and Utilization of Preventive Care and Wellness Visits Among Traditional Medicare and Medicare Advantage
  This project proposes to use the Medicare Current Beneficiaries Survey to examine differences across geography and plan type (Medicare Advantage vs. traditional) with regards to barriers to care (e.g., costs) and use of preventive services (e.g., flu shot).
  Topics: Health services, Healthcare access, Medicare Advantage (MA)
  
• RHCs and CAHs Participating in SSP: Characteristics of the Providers and Communities
  This project describes characteristics of Rural Health Clinics (RHCs) and Critical Access Hospitals (CAHs) participating in the Medicare Shared Savings Program (SSP), and the communities they serve. Comparisons will be made to RHCs and CAHs not participating in the SSP.
  Topics: Critical Access Hospitals (CAHs), Healthcare financing, Medicare, Rural Health Clinics (RHCs)
  
• Rural Nursing Home Staffing, and Resident Health, Closure, and Financial Performance
  There are concerns about availability and quality of care provided in nursing homes in rural areas. This project aims to evaluate staffing levels and shortages, the health status of residents, closures, and financial performance of rural nursing homes both before and during the COVID-19 pandemic.
  Topics: Aging, Long-term care, Post-acute care
  
• Rural-based Accountable Care Organizations Accepting Downside Risk
  The RUPRI Center will update its studies of rural provider participation in accountable care organizations, including differences between those who exit the program, those who remain, and those who enter. In particular, this project will address participation decisions made after a rule change in July 2019 that requires conversion to two-sided risk.
  Topics: Critical Access Hospitals (CAHs), Federally Qualified Health Centers (FQHCs), Health reform, Hospitals and clinics, Legislation and regulation, Medicare
  
• Rural-Urban Differences in Medicare Advantage Plan Quality Scores
  This project updates previous RUPRI Center publications focused on rural-urban differences in access to, and enrollment in, Medicare Advantage plans with four- and five-star quality ratings.
  Topics: Health services, Healthcare financing, Medicare, Medicare Advantage (MA)