Thomas C. Ricketts, PhD

North Carolina Rural Health Research and Policy Analysis Center

Phone: 919.966.5541
Fax: 919.966.5764
E-mail: tom_ricketts@unc.edu

Rural Health Research and Policy Analysis Center
University of North Carolina - Chapel Hill
725 Airport Road CB 7590
Chapel Hill, NC 27599-7590

Completed Projects

Analysis of Options for Criteria to Determine Underservice, Lead researcher
Research center: North Carolina Rural Health Research and Policy Analysis Center
Funder: Office of Rural Health Policy (ORHP)
Topic: Workforce

Arguing for Rural Health: Justice and Fairness in Advocating for Rural Health Policy, Lead researcher
Research center: North Carolina Rural Health Research and Policy Analysis Center
Funder: Office of Rural Health Policy (ORHP)
Topic: Health policy

Describing Geographic Access to Physicians in Rural America Using Statistical Applications in GIS
Research center: North Carolina Rural Health Research and Policy Analysis Center
Funder: Office of Rural Health Policy (ORHP)
Topics: Health services, Physicians
This study will use a geographically weighted regression to assess the influence of distance and travel time on the distribution of physicians in rural America. The ultimate goal of the study will be to improve our measures of access by identifying the extent to which border resources can be considered in indices of access.

Development of a New Methodology for Dental Health Professional Shortage Area Designation, Lead researcher
Research center: North Carolina Rural Health Research and Policy Analysis Center
Funders: Health Research Services Administration (HRSA), National Center for Health Workforce Analysis
Topics: Dental health, Workforce
This project will develop a methodology for designating dental health professional shortage areas within the United States.

Evaluating Need for Assistance Criteria and Weighting of Overall Criteria in the Requirements of Funding New Start and Grant Applications for Health Centers, Lead researcher
Research center: North Carolina Rural Health Research and Policy Analysis Center
Funder: Bureau of Primary Health Care (BPHC)
Topics: Federally Qualified Health Centers (FQHCs), Health policy
This project extends and enhances work done previously for the Bureau by examining the current and proposed changes to the Need for Assistance (NFA) criteria. Data submitted by applicants for assistance through the Bureau were examined, then the effects of optional weighting and scaling of the data for the development of scores that allow for ranking and comparison of applications were tested. A revised NFA form was developed and adopted by the Bureau of Primary Health Care, HRSA.

Information Technology Engineering Support for Health Resources and Services Administration Data Systems/Geospatial Data Warehouse, GIS Technologies, GEMS Support and General Office of Information Technology Systems Support, Lead researcher
Research center: North Carolina Rural Health Research and Policy Analysis Center
Funder: Office of Rural Health Policy (ORHP)
Topics: Health policy, Technology, Workforce

Rural Informal Safety Net: The Development of a Research and Evaluation Design and a Preliminary Assessment
Research center: North Carolina Rural Health Research and Policy Analysis Center
Funder: Office of Rural Health Policy (ORHP)
Topics: Health insurance and the uninsured, Health services

Southeast Regional Center for Health Workforce Studies, Lead researcher
Research center: North Carolina Rural Health Research and Policy Analysis Center
Funder: Bureau of Health Professions
Topics: Allied health professionals, Dental health, Nurses, Pharmacy and prescription drugs, Physicians, Workforce
The Center conducts research and analysis with the goal of improving access to an appropriate and effective health workforce in the Southeast and North Carolina. The Center draws on the resources of the Chapel Hill Campus with its five health professions schools as well as the 16-campus University of North Carolina system to respond to the information and analysis needs of health workforce policymakers in the state, the region, and the nation. The Center also collects and maintains data describing the need for and supply of health professionals, and makes these data available for research and policy analysis purposes.

Publications

• Analysis of Medicare's Incentive Payment Program for Physicians in Health Professional Shortage Areas
  Author(s): Leighton Chan, L. Gary Hart, Thomas C. Ricketts III, Shelli K. Beaver
  Research center: WWAMI Rural Health Research Center
  Topics: Medicare, Physicians
  Citation: Journal of Rural Health, 20(2), 109-117
  Date: 2004
  The Medicare Incentive Payment (MIP) program provides a 10 percent bonus payment to physicians who treat patients in Health Professional Shortage Areas (HPSAs). This paper examines the experience of five states (Alaska, Idaho, North Carolina, South Carolina, and Washington) with the Medicare Incentive Payment (MIP) program. This study determines the program's expenditures, utilizations, and which types of physicians received payments. Results show that physicians eligible for the bonus payments often did not claim them, and physicians who likely did not work in approved HPSA sites, claimed the bonus payments and received them.
• Arguing for Rural Health in Medicare: A Progressive Rhetoric for Rural America
  Author(s): Thomas Ricketts
  Research center: North Carolina Rural Health Research and Policy Analysis Center
  Topics: Health policy, Medicare
  Date: 09 / 2002
  Examines how rural health policy is treated in the broader field of public policy, discusses the role of advocacy in developing rural health policy, and suggests ways to make that advocacy more effective. Specifically, the report explores the types of claims that rural advocates make, focusing in the context of Medicare policy, and determines to what extent those claims reflect a central them of fairness and inclusiveness in national polices versus claims that benefit special interests.
• Fewer Hospitals Close in the 1990s: Rural Hospitals Mirror This Trend
  Author(s): Stephanie T. Poley, Thomas C. Ricketts
  Research center: North Carolina Rural Health Research and Policy Analysis Center
  Topic: Hospitals and clinics
  Date: 10 / 2001
  Summarizes a study of the number and rate of hospital closures in rural areas during the 1990s. Includes graphs and a map.
• How Adults' Access to Outpatient Physician Services Relates to the Local Supply of Primary Care Physicians in the Rural Southeast
  Author(s): Donald E. Pathman, Thomas C. Ricketts, Thomas R. Konrad
  Research center: North Carolina Rural Health Research and Policy Analysis Center
  Topics: Health services, Physicians
  Citation: Health Services Research, 41(1), 79-102
  Date: 2006
  For adults as a whole in the rural South and for the elderly there, low local primary care physician densities are associated with travel inconvenience but not convincingly with other aspects of access to outpatient care. Access for those insured under Medicaid and the uninsured, however, is in more ways sensitive to local physician densities.
• Race and Place: Urban-Rural Differences in Health for Racial and Ethnic Minorities
  Author(s): Rebecca T. Slifkin, Laurie J. Goldsmith, Thomas C. Ricketts,
  Research center: North Carolina Rural Health Research and Policy Analysis Center
  Topics: AIDS and HIV, Chronic diseases and conditions, Health disparities, Health promotion and disease prevention, Minority health
  Date: 03 / 2000
  This findings brief investigates urban-rural disparities for racial and ethnic minorities in six health areas: infant mortality, cancer screening and management, cardiovascular disease, diabetes, HIV infection, and child and adult immunizations.
• Urban-Rural Flows of Physicians
  Author(s): Thomas C. Ricketts, Randy Randolph
  Research center: North Carolina Rural Health Research and Policy Analysis Center
  Topics: Physicians, Workforce
  Citation: Journal of Rural Health, 23(4), 277–285
  Date: 2007
  Reports findings from a study to determine whether there was a significant flow of physicians from urban to rural areas in recent years when the overall supply of physicians has been considered in balance with needs.
• Workforce Issues in Rural Areas: A Focus on Policy Equity
  Author(s): Thomas C. Ricketts
  Research center: North Carolina Rural Health Research and Policy Analysis Center
  Topics: Health policy, Nurses, Pharmacy and prescription drugs, Physicians, Workforce
  Citation: American Journal of Public Health, 95(1), 42-48
  Date: 01 / 2005
  Reviews the geographic distribution of 6 classes of health professionals: physicians, nurses, dentists, pharmacists, mental health professionals, and public health professionals. Describes the government and private policies and programs intended to affect the geographic distribution of these health professionals.