Beth Virnig, PhD

Phone: 612.624.4426
Fax: 612.624.2196
E-mail: virni001@umn.edu

Rural Health Research Center
University of Minnesota
420 Delaware Street SE
Box 729
Minneapolis, MN 55455

Current Projects

Access to State-of-the-Art Hospice Care for Rural and Minority Hospice Users
Research center: ORHP-funded Individual Grantees
Funder: American Cancer Society (ACS)
Topics: Health services, Hospice and palliative care, Medicare
This project will develop and map hospice care service areas that will allow for the measurement of access to hospice care for rural and minority Medicare beneficiaries who die of cancer, and recommend options for increasing access to hospice care in underserved rural areas.

Completed Projects

National Study of Home Health Access in Rural America, Lead researcher
Research center: ORHP-funded Individual Grantees
Funder: Office of Rural Health Policy (ORHP)
Topics: Health services, Home health, Hospice and palliative care, Medicare
This project will develop home health care service areas that will allow for the measurement of access to home health care for rural Medicare beneficiaries who die of cancer, and recommend options for increasing access to home health care in underserved rural areas.

Publications

• Do Rural Elders Have Limited Access to Medicare Hospice Services?
  Author(s): Beth A. Virnig, Ira S. Moscovice, Sara B. Durham, Michelle M. Casey
  Research centers: Minnesota Rural Health Research Center , Upper Midwest Rural Health Research Center
  Topics: Aging, Hospice and palliative care, Medicare
  Citation: Journal of the American Geriatrics Society, 52(5), 731-5
  Date: 2004
  The authors examined whether there are urban-rural differences in use of the Medicare hospice benefit before death and whether those differences suggest that there is a problem with access to hospice care for rural Medicare beneficiaries. Rates of hospice care before death were negatively associated with degree of rurality. The lowest rate of hospice use, 15.2% of deaths, was seen in rural areas not adjacent to an urban area. The highest rate of use, 22.2% of deaths, was seen in urban areas. Rural areas adjacent to urban areas had an intermediate level of hospice use (17.0% of deaths). Hospices based in rural areas had a smaller number of elderly patients each year than hospices based in urban areas, and were more likely to have very low volumes. The authors conclude that the consistently lower use of Medicare hospice services before death and smaller sizes of rural hospices suggests that the combination of Medicare hospice payment policies and hospice volumes are problematic for rural hospices. Adjusting Medicare payment policies might be a critical step to assure availability of hospice services for terminally ill beneficiaries regardless of where they live.
• Providing Hospice Care in Rural Areas: Challenges and Strategies to Address Them
  Author(s): Michelle M. Casey, Ira S. Moscovice, Beth A. Virnig, Sara B. Durham
  Research center: Minnesota Rural Health Research Center
  Topics: Health services, Hospice and palliative care
  Citation: American Journal of Hospice and Palliative Medicine, 22(5), 363-8
  Date: 2005
  Hospices in rural settings face challenges in the provision of hospice care as a result of their location and the size of their service area population. To ascertain the challenges that hospices face in serving rural communities, researchers conducted in-depth case studies of four different models of hospice care in rural areas. The authors describe strategies used by the case study hospices and recommend policies that could increase access to hospice care for rural Medicare beneficiaries and other rural residents. National initiatives to improve end-of-life care need to consider the special challenges faced by rural hospices.
• Use of the Hospice Benefit by Rural Medicare Beneficiaries
  Author(s): Beth Virnig, Ira Moscovice, Sara Kind, Michelle Casey
  Research center: Minnesota Rural Health Research Center
  Topics: Hospice and palliative care, Medicare
  Report Number: Working Paper No. 43
  Date: 08 / 2002
  Identifies urban-rural differences in hospice use in rural service areas.