Lan Zhao, PhD

Current Projects

Effect of Travel Distances on Access to Obstetric Care and Birth Outcomes in Rural Communities
Research center: Walsh Center for Rural Health Analysis
Funder: Office of Rural Health Policy (ORHP)
Topics: Maternal and child health, Physicians, Women
This study will assess whether the availability of obstetric providers in rural areas is sufficient to meet the need for obstetric care by measuring the distance patients must travel to obtain prenatal care and delivery and by examining health outcomes related to labor and delivery.

Completed Projects

Declining Access to Hospital-based Obstetric Services in Rural Areas: Causes and Impact , Lead researcher
Research center: Walsh Center for Rural Health Analysis
Funder: Office of Rural Health Policy (ORHP)
Topics: Health policy, Hospitals and clinics, Legislation and regulation, Maternal and child health, Women
This study examines the declining availability of hospital-based obstetric services in rural areas from the mid-1980s to the early 2000s. It examines potential causes for this trend and explores the effects of medical malpractice reforms.

Publications

• Achieving Equity in Medicare DSH Payments to Rural Hospitals: An Assessment of the Financial Impact of Recent and Proposed Changes to the DSH Payment Formula
  Author(s): Janet Sutton, Jeffrey Stensland, Lan Zhao, Michael Cheng
  Research center: Walsh Center for Rural Health Analysis
  Topics: Health care financing, Hospitals and clinics, Medicare
  Date: 05 / 2002
  Examines how Benefits Improvement and Protection Act revisions to the qualifying and distribution formulas of the Medicare disproportionate share hospital (DSH) program are likely to affect rural hospital financial performance as measured by hospital operating and total margins. Also considers the effect of establishing a uniform DSH formula. The study shows that paying rural hospitals based on the rules used for urban hospitals would produce financial benefits that could improve access to care in rural communities. Notably, nearly one-fifth of financially distressed rural hospitals could have remained "in the black" and an even greater proportion could have received additional funds to cover costs incurred by treating indigent members of the community if rural hospitals had been paid in 1998 under the same DSH formula. Among the chief economic winners would be the smallest rural hospitals, which generally are in worse financial condition than other hospitals. Findings suggest that elimination of rural and urban disparities in DSH payment could strengthen the rural health care safety net. Report available on request.
• Revisions to Medicare's Disproportionate Share Payment Policy to Incorporate Bad Debt and Charity Care
  Author(s): Julie A. Schoenman, Janet P. Sutton, Lan Zhao
  Research center: Walsh Center for Rural Health Analysis
  Topics: Health care financing, Hospitals and clinics, Medicare
  Date: 09 / 2005
  Investigates the impact of possible changes to the Medicare disproportionate share (DSH) payment policy, designed to incorporate information on the hospital's uncompensated care burden as well as to improve the payment formulae. DSH payments were computed for individual study hospitals under six alternative models, and compared to the payments now made under current law. For each alternative, the authors examined the overall financial impact by type of hospital and the characteristics of hospitals that would experience either large payment increases or decreases relative to the current system. These analyses are intended to help policymakers evaluate the likely impact of revising the DSH payment methodology.
• Why Are Fewer Hospitals in the Delivery Business?
  Author(s): Lan Zhao
  Research center: Walsh Center for Rural Health Analysis
  Topics: Health services, Hospitals and clinics, Maternal and child health
  Date: 06 / 2007
  Examines the declining availability of hospital-based obstetric services in rural areas from the mid-1980s to the early 2000s. Examines potential causes for this trend and explores the effects of medical malpractice reforms. Report available on request.