Randy Randolph, MRP

North Carolina Rural Health Research and Policy Analysis Center

Phone: 919.966.7113
Fax: 919.966.5764
E-mail: randy_randolph@unc.edu

Rural Health Research and Policy Analysis Center
University of North Carolina - Chapel Hill
725 Airport Road CB 7590
Chapel Hill, NC 27599-7290

Completed Projects

Impacts of Multiple Race Reporting, Lead researcher
Research center: North Carolina Rural Health Research and Policy Analysis Center
Funder: Office of Rural Health Policy (ORHP)
Topics: Health policy, Minority health

Publications

• 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.
• Effect of Rural Hospital Closures on Community Economic Health
  Author(s): George M. Holmes, Rebecca T. Slifkin, Randy K. Randolph, Stephanie Poley
  Research center: North Carolina Rural Health Research and Policy Analysis Center
  Topics: Economic development, Hospitals and clinics
  Citation: Health Services Research, 41(2), 467-485
  Date: 2006
  Describes the effect of hospital closure on the local economy, based on a study of county level economic data for 1990–2000 in rural counties experiencing a hospital closure.
• How Might the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 Affect the Financial Viability of Rural Pharmacies? An Analysis of Pre-Implementation Prescription Volume and Payment Sources in Rural and Urban Areas
  Author(s): Erin P. Fraher, Rebecca T. Slifkin, Laura Smith, Randy Randolph, Matthew Rudolf, George M. Holmes
  Research center: North Carolina Rural Health Research and Policy Analysis Center
  Topics: Health care financing, Health policy, Medicare Part D, Pharmacy and prescription drugs
  Citation: Journal of Rural Health, 21(2), 114-121
  Date: 2005
  Presents descriptive information on mail-order prescriptions, volume, and payer type of retail prescriptions in rural vs. urban areas. Together, these data provide a baseline for evaluating how implementation of the MMA may affect the financial viability of rural independent pharmacies. The authors found that the volume of mail-order prescriptions is small. Rural providers prescribed fewer retail and mail-order prescriptions per person, but more units per person. Rural areas have a higher percentage of prescriptions paid for by cash (18% vs. 13%) and Medicaid (16% vs. 10%) and a lower percentage of third-party payers than urban areas. Significant variation in volume and payer type exists between states. The authors conclude that rural, independent pharmacies may be negatively affected by MMA implementation as business shifts from cash to third-party reimbursement. The high degree of variation between states also has potentially important implications for the implementation of Prescription Drug Plan regions under MMA.
• Impact Of The Medicaid Budgetary Crisis On Rural Communities
  Author(s): Pam Silberman, Matthew Rudolf, Cammie D'Alpe, Randy Randolph, Rebecca Slifkin
  Research center: North Carolina Rural Health Research and Policy Analysis Center
  Topic: Medicaid and S-CHIP
  Report Number: Working Paper No. 77
  Date: 08 / 2003
  Provides an overview of the Medicaid program and options states have to reduce program costs. Steps states have proposed or taken to reduce Medicaid costs and the potential impact of these changes on rural areas are discussed. The potential impact on rural communities of federal proposals to redesign Medicaid is assessed.
• Impacts of Multiple Race Reporting on Rural Health Policy and Data Analysis
  Author(s): Randy Randolph, Rebecca Slifkin, Lynn Whitener, Anna Wulfsberg
  Research center: North Carolina Rural Health Research and Policy Analysis Center
  Topics: Health policy, Minority health
  Report Number: Working Paper No. 73
  Date: 05 / 2002
  Examines some of the impacts to rural health analysis of new federal policy that allows people to choose one or more race categories when classifying themselves. Implementation of the new policy in the 2000 Census yields 63 possible combinations of race classification. Report also presents data on the number of persons choosing more than one race, discusses ways that analysts can handle the issues surrounding multiple race data, and compares several methods for bridging the change from the old single-race system to the new multiple-race system. Among its findings: rural Americans were less inclined to identify themselves as more than one race than were urban Americans; rural western residents were the only ones more inclined to choose multiple races than the rural average; and rural residents of Hawaii, Alaska, and Oklahoma were the most likely to identify with multiple races while those of Mississippi, Pennsylvania, and South Carolina were the least likely to do so.
• Rural Populations and Health Care Providers: A Map Book
  Author(s): Randy Randolph, Katherine Gaul, Rebecca Slifkin
  Research center: North Carolina Rural Health Research and Policy Analysis Center
  Topics: Rural statistics and demographics, Workforce
  Date: 09 / 2002
  Uses 2000 Census data to reassess and provide a visual picture of where rural people live, how the racial and ethnic nature of rural populations is changing, and whether the distribution of health care providers matches the population distribution.
• 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.