Michael D. Shambaugh-Miller, PhD

Rural Policy Research Institute (RUPRI) Center for Rural Health Policy Analysis

Phone: 402.559.5260
E-mail: mdmiller@unmc.edu

Preventive & Societal Medicine, Section on Health Services Research & Rural Health Policy
University of Nebraska (RUPRI)
984350 Nebraska Medical Center
Omaha, NE 68198-4350

Completed Projects (1)

Locating Community Pharmacies (Independent and Chain) in Rural America, Lead researcher
Research center: Rural Policy Research Institute (RUPRI) Center for Rural Health Policy Analysis
Funder: Office of Rural Health Policy (ORHP)
Topics: Health services, Pharmacy and prescription drugs
A comprehensive database of all rural U.S. pharmacies including pharmacy name, pharmacy type (chain or independent), town, ZIP code, county, state, RUCA code, and Federal Information Processing Standards will be developed. The databases will be usable in most widely used statistics and geographic information systems software packages.

Publications (8)

Analysis of Availability of Medicare+Choice, Commercial HMO, and FEHBP Plans in Rural Areas: Implications for Medicare Reform
Author(s): Timothy McBride, Courtney Andrews, Keith Mueller, Michael Shambaugh-Miller
Research center: Rural Policy Research Institute (RUPRI) Center for Rural Health Policy Analysis
Topic: Medicare
Date: 03 / 2003
Examines viability of introducing private competition into the Medicare program. Discusses availability of Medicare+Choice1 (M+C), commercial HMO, and Federal Employees Health Benefits Program (FEHBP) plans in rural (nonmetropolitan) counties.
Availability and Use of Health Plan Choices in Rural America: Medicare+Choice, Commercial HMO, and Federal Employees Health Benefit Program Plans
Author(s): Timothy McBride, Courtney Andrews, Keith Mueller, Michael Shambaugh-Miller
Research center: Rural Policy Research Institute (RUPRI) Center for Rural Health Policy Analysis
Topics: Health insurance and the uninsured, Medicare
Date: 10 / 2003
Discusses availability of Medicare + Choice (M+C), commercial HMO, and Federal Employee Health Benefit Program (FEHBP) insurance plans, and the potential impact of M+C service delivery area changes on health care access in rural areas.
Changing Rural Populations and Impact on Public Policy
Author(s): Keith Mueller, Michael D. Shambaugh-Miller
Research center: Rural Policy Research Institute (RUPRI) Center for Rural Health Policy Analysis
Topics: Health policy, Rural statistics and demographics
Date: 10 / 2002
Population movement in rural areas and health policy issues
Definition of Rural in the Context of the MMA Access Standards for Prescription Drug Plans
Author(s): Keith J. Mueller, Rebecca T. Slifkin, Michael D. Shambaugh-Miller, Randy K. Randolph
Research centers: North Carolina Rural Health Research and Policy Analysis Center, Rural Policy Research Institute (RUPRI) Center for Rural Health Policy Analysis
Topics: Defining rural, Legislation and regulation, Pharmacy and prescription drugs
Report Number: RUPRI Policy Paper P2004-7, North Carolina Working Paper No. 79
Date: 09 / 2004
Access to local pharmacy services is dependent upon the extent to which prescription drug plans offering the Medicare benefit incorporate local rural pharmacies into their provider networks. This will be based on market considerations and on the requirements for local access contained in the MMA and regulation, which in turn will be shaped by how "rural" is defined. This paper assesses how the definition of rural affects the potential impact of the specific access standards in the Proposed Rule to implement Title I of the MMA, and finds that the congressional objective to achieve convenient access to pharmacies (other than mail order) would be more fully realized if the Proposed Rule definition of rural is changed.
Health Services at Risk in "Vulnerable" Rural Places
Author(s): Michael D. Shambaugh-Miller, Julie Stoner, Louis Pol, Keith Mueller
Research center: Rural Policy Research Institute (RUPRI) Center for Rural Health Policy Analysis
Topic: Health services
Report Number: Rural Policy Brief Vol. 7, Number 5 (PB2002-5)
Date: 10 / 2002
Describes, applies, and discusses implications of a method to identify places in rural America that are at risk of (vulnerable to) being without adequate health care services because 1) they lack a sufficient number of people to support a practice/provider, 2) they lack a sufficient number of people who are able to pay the full cost of care, 3) the population size and composition do not warrant the level of services currently available.
Medicare Physician Payment
Author(s): A. Clinton MacKinney, Michael D. Shambaugh-Miller, Keith Mueller
Research center: Rural Policy Research Institute (RUPRI) Center for Rural Health Policy Analysis
Topics: Medicare, Physicians
Date: 01 / 2003
Resource-Based Relative Value Scale (RBRVS) has replaced the 25 year-old Medicare CPR charge system.
Medicare Physician Payment: Practice Expense
Author(s): A. Clinton MacKinney, Timothy D. McBride, Michael D. Shambaugh-Miller, Keith J. Mueller
Research center: Rural Policy Research Institute (RUPRI) Center for Rural Health Policy Analysis
Topics: Medicare, Physicians
Report Number: Rural Policy Brief Vol. 8, No. 9 (PB2003-9)
Date: 10 / 2003
Examines the physician practice expense component of Medicare payment, which proportionately results in greater geographic physician payment variation than does the physician work payment. The practice expense adjustment methodology warrants careful validation to demonstrate that the index measures actual geographic practice cost differences. A complete understanding of the reasons for different payments will inform both physicians who want to know why the same procedure results in less reimbursement in one place than it does in another and policymakers who want to address that concern.
Reliance on Independently Owned Pharmacies in Rural America
Author(s): Michael D. Shambaugh-Miller, Nicole Vanosdel, Keith J. Mueller
Research center: Rural Policy Research Institute (RUPRI) Center for Rural Health Policy Analysis
Topic: Pharmacy and prescription drugs
Report Number: Rural Policy Brief No. 2007-6
Date: 11 / 2007
Policy brief providing locations of independently owned pharmacies in rural America that are the sole sources of access to local pharmaceutical services. In over 2,000 rural communities, the only local pharmacy is independently owned, and in 1,044 of those communities, there is no other pharmacy within 10 miles. The information in this brief lays a foundation for analyzing vulnerability of pharmacy services in rural America and identifies the questions that research and policy activities should address. State maps show the locations of communities with only one pharmacy, independently owned.

Topics Centers Researchers Other Resources Search		Michael D. Shambaugh-Miller, PhD Rural Policy Research Institute (RUPRI) Center for Rural Health Policy Analysis Phone: 402.559.5260 E-mail: mdmiller@unmc.edu Preventive & Societal Medicine, Section on Health Services Research & Rural Health Policy University of Nebraska (RUPRI) 984350 Nebraska Medical Center Omaha, NE 68198-4350 Completed Projects (1) Locating Community Pharmacies (Independent and Chain) in Rural America, Lead researcher Research center: Rural Policy Research Institute (RUPRI) Center for Rural Health Policy Analysis Funder: Office of Rural Health Policy (ORHP) Topics: Health services, Pharmacy and prescription drugs A comprehensive database of all rural U.S. pharmacies including pharmacy name, pharmacy type (chain or independent), town, ZIP code, county, state, RUCA code, and Federal Information Processing Standards will be developed. The databases will be usable in most widely used statistics and geographic information systems software packages. Publications (8) Analysis of Availability of Medicare+Choice, Commercial HMO, and FEHBP Plans in Rural Areas: Implications for Medicare Reform Author(s): Timothy McBride, Courtney Andrews, Keith Mueller, Michael Shambaugh-Miller Research center: Rural Policy Research Institute (RUPRI) Center for Rural Health Policy Analysis Topic: Medicare Date: 03 / 2003 Examines viability of introducing private competition into the Medicare program. Discusses availability of Medicare+Choice1 (M+C), commercial HMO, and Federal Employees Health Benefits Program (FEHBP) plans in rural (nonmetropolitan) counties. Availability and Use of Health Plan Choices in Rural America: Medicare+Choice, Commercial HMO, and Federal Employees Health Benefit Program Plans Author(s): Timothy McBride, Courtney Andrews, Keith Mueller, Michael Shambaugh-Miller Research center: Rural Policy Research Institute (RUPRI) Center for Rural Health Policy Analysis Topics: Health insurance and the uninsured, Medicare Date: 10 / 2003 Discusses availability of Medicare + Choice (M+C), commercial HMO, and Federal Employee Health Benefit Program (FEHBP) insurance plans, and the potential impact of M+C service delivery area changes on health care access in rural areas. Changing Rural Populations and Impact on Public Policy Author(s): Keith Mueller, Michael D. Shambaugh-Miller Research center: Rural Policy Research Institute (RUPRI) Center for Rural Health Policy Analysis Topics: Health policy, Rural statistics and demographics Date: 10 / 2002 Population movement in rural areas and health policy issues Definition of Rural in the Context of the MMA Access Standards for Prescription Drug Plans Author(s): Keith J. Mueller, Rebecca T. Slifkin, Michael D. Shambaugh-Miller, Randy K. Randolph Research centers: North Carolina Rural Health Research and Policy Analysis Center, Rural Policy Research Institute (RUPRI) Center for Rural Health Policy Analysis Topics: Defining rural, Legislation and regulation, Pharmacy and prescription drugs Report Number: RUPRI Policy Paper P2004-7, North Carolina Working Paper No. 79 Date: 09 / 2004 Access to local pharmacy services is dependent upon the extent to which prescription drug plans offering the Medicare benefit incorporate local rural pharmacies into their provider networks. This will be based on market considerations and on the requirements for local access contained in the MMA and regulation, which in turn will be shaped by how "rural" is defined. This paper assesses how the definition of rural affects the potential impact of the specific access standards in the Proposed Rule to implement Title I of the MMA, and finds that the congressional objective to achieve convenient access to pharmacies (other than mail order) would be more fully realized if the Proposed Rule definition of rural is changed. Health Services at Risk in "Vulnerable" Rural Places Author(s): Michael D. Shambaugh-Miller, Julie Stoner, Louis Pol, Keith Mueller Research center: Rural Policy Research Institute (RUPRI) Center for Rural Health Policy Analysis Topic: Health services Report Number: Rural Policy Brief Vol. 7, Number 5 (PB2002-5) Date: 10 / 2002 Describes, applies, and discusses implications of a method to identify places in rural America that are at risk of (vulnerable to) being without adequate health care services because 1) they lack a sufficient number of people to support a practice/provider, 2) they lack a sufficient number of people who are able to pay the full cost of care, 3) the population size and composition do not warrant the level of services currently available. Medicare Physician Payment Author(s): A. Clinton MacKinney, Michael D. Shambaugh-Miller, Keith Mueller Research center: Rural Policy Research Institute (RUPRI) Center for Rural Health Policy Analysis Topics: Medicare, Physicians Date: 01 / 2003 Resource-Based Relative Value Scale (RBRVS) has replaced the 25 year-old Medicare CPR charge system. Medicare Physician Payment: Practice Expense Author(s): A. Clinton MacKinney, Timothy D. McBride, Michael D. Shambaugh-Miller, Keith J. Mueller Research center: Rural Policy Research Institute (RUPRI) Center for Rural Health Policy Analysis Topics: Medicare, Physicians Report Number: Rural Policy Brief Vol. 8, No. 9 (PB2003-9) Date: 10 / 2003 Examines the physician practice expense component of Medicare payment, which proportionately results in greater geographic physician payment variation than does the physician work payment. The practice expense adjustment methodology warrants careful validation to demonstrate that the index measures actual geographic practice cost differences. A complete understanding of the reasons for different payments will inform both physicians who want to know why the same procedure results in less reimbursement in one place than it does in another and policymakers who want to address that concern. Reliance on Independently Owned Pharmacies in Rural America Author(s): Michael D. Shambaugh-Miller, Nicole Vanosdel, Keith J. Mueller Research center: Rural Policy Research Institute (RUPRI) Center for Rural Health Policy Analysis Topic: Pharmacy and prescription drugs Report Number: Rural Policy Brief No. 2007-6 Date: 11 / 2007 Policy brief providing locations of independently owned pharmacies in rural America that are the sole sources of access to local pharmaceutical services. In over 2,000 rural communities, the only local pharmacy is independently owned, and in 1,044 of those communities, there is no other pharmacy within 10 miles. The information in this brief lays a foundation for analyzing vulnerability of pharmacy services in rural America and identifies the questions that research and policy activities should address. State maps show the locations of communities with only one pharmacy, independently owned.