Li-Wu Chen, PhD

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

Phone: 402.559.7113
E-mail: liwuchen@unmc.edu

RUPRI
University of Nebraska (RUPRI)

Current Projects

Examining Recent Trends and Variation in Ambulatory Care Sensitive Conditions-related Hospital Expenditures of Rural Americans with Different Health Insurance Coverage and Status
Research center: Rural Policy Research Institute (RUPRI) Center for Rural Health Policy Analysis
Funder: Office of Rural Health Policy (ORHP)
Topics: Chronic diseases and conditions, Health care financing, Health insurance and the uninsured, Health services
This study documents the national time-trend and regional variation of rural Ambulatory Care Sensitive Conditions (ACSC)-related hospital expenditures by patient insurance coverage/status. The study will also compare the pattern of difference in the ACSC-related expenditures of rural patients with different insurance coverage/status by patient demographic and economic characteristics as well as hospital characteristics.

Examining the Applicability of the AHRQ's Inpatient Quality Indicators to Rural Hospitals and the Implications of the Relationship Between the Indicators and Financial Measures for Medicare Payment Policies
Research center: Rural Policy Research Institute (RUPRI) Center for Rural Health Policy Analysis
Funder: Office of Rural Health Policy (ORHP)
Topics: Health care financing, Health policy, Hospitals and clinics, Quality
This study will investigate how the Agency for Healthcare Research and Quality's inpatient quality indicators can be applied to rural hospitals and will explore the application of those indicators in answering relevant policy questions.

Completed Projects

Discrepancies of Financial Data between Medicare Cost Report and Hospital Audited Financial Statement and Its Implication for Measuring Financial Impact of Payment Policy on Rural Hospitals, Lead researcher
Research center: Rural Policy Research Institute (RUPRI) Center for Rural Health Policy Analysis
Funder: Office of Rural Health Policy (ORHP)
Topics: Health care financing, Health policy, Hospitals and clinics

Examining the Magnitudes, Geographic Variations, and Determinants Of Expenditures Due to Ambulatory Care Sensitive Conditions in Rural Hospitals, Lead researcher
Research center: Rural Policy Research Institute (RUPRI) Center for Rural Health Policy Analysis
Funder: Office of Rural Health Policy (ORHP)
Topics: Chronic diseases and conditions, Health care financing, Hospitals and clinics
This project will document the magnitude of and variation in ambulatory care sensitive condition (ACSC) expenditures of rural hospitals and explore the relationships between rural hospital ACSC expenditure and its key determinants in the areas of population demand, health care system supply, and provider practice style.

Publications

• Analysis of the Agreement of Financial Data between the Medicare Cost Report and the Audited Hospital Financial Statement
  Author(s): Li-Wu Chen, Julie Stoner, Catherine Makhanu, Kathy Minikus, Keith J. Mueller
  Research center: Rural Policy Research Institute (RUPRI) Center for Rural Health Policy Analysis
  Topics: Health care financing, Hospitals and clinics, Medicare
  Report Number: Rural Policy Brief Vol. 9, No. 4 (PB2004-4 )
  Date: 05 / 2004
  Very few studies have thoroughly examined the discrepancies between the Medicare Cost Report (MCR) and the audited hospital financial statement (FS), and none have been conducted for rural hospitals. Findings from this study which focused on the MCR and FS for rural hospitals suggest that relying on a single source of financial data such as the MCR to assess the financial performance of rural hospitals may be inappropriate.
• Assessing the Financial Effect of Medicare Payment on Rural Hospitals: Does the Source of Data Change the Results?
  Author(s): Li-Wu Chen, Susan Puumala, Keith J. Mueller, Liyan Xu, Kathy Minikus, Catherine Makhanu
  Research center: Rural Policy Research Institute (RUPRI) Center for Rural Health Policy Analysis
  Topics: Health care financing, Hospitals and clinics, Medicare
  Report Number: Rural Policy Brief Vol. 10, No. 3 (PB2005-3 )
  Date: 11 / 2005
  Explores how predictions of changes in hospital financial performance as a result of change in Medicare payment differ when comparing results using data from the Medicare Cost Report (MCR) to results using data from the audited hospital financial statement (FS). Results indicate that when policy analysts and policymakers examine the effect of payment policies on hospitals' financial performance (e.g., total margin) using the best available national data (the MCR) rather than FS data, the results are likely to be valid, despite previously reported discrepancies in the financial information between the two data sources Using statistical analysis of MCR data as a basis for decisions is, therefore, valid for hospitals as a whole. However, using MCR data to directly track the financial performance of individual hospitals may not be valid. This analysis does not, therefore, support using only MCR data for particular hospitals when FS data are available. In those situations, the findings would support using both data sources because of the potential disagreements between the financial data in the MCR and the FS.
• Electronic Health Records Adoption: Rural Providers' Decision-Making Process (Policy Brief)
  Author(s): Li-Wu Chen, Anne Skinner
  Research center: Rural Policy Research Institute (RUPRI) Center for Rural Health Policy Analysis
  Topics: Health information technology, Hospitals and clinics
  Report Number: 2008-4
  Date: 10 / 2008
  This brief reports findings of a study that examined the decision-making process that small rural physician clinics and hospitals use as they investigate and select an electronic health record (EHR) system. Policy makers can use the study findings to understand the challenges that rural health care providers may face in the process of adopting EHRs and to develop incentives that promote the use of health information technology in rural America.
• National Rural Hospital Charges Due to Ambulatory Care Sensitive Conditions
  Author(s): Li-Wu Chen, Wanqing Zhang, Junfeng Sun, Keith J. Mueller
  Research center: Rural Policy Research Institute (RUPRI) Center for Rural Health Policy Analysis
  Topics: Chronic diseases and conditions, Health care financing, Health policy, Hospitals and clinics
  Report Number: Policy Brief No. PB2007-4
  Date: 12 / 2007
  Documents the national magnitude of charges associated with hospitalizations due to ambulatory care sensitive conditions in rural hospitals.
• Regional Variation in Rural Hospital Charges Due to Ambulatory Care Sensitive Conditions
  Author(s): Li-Wu Chen, Wanqing Zhang, Junfeng Sun, Keith J. Mueller
  Research center: Rural Policy Research Institute (RUPRI) Center for Rural Health Policy Analysis
  Topics: Chronic diseases and conditions, Health care financing, Health policy, Hospitals and clinics
  Report Number: Policy Brief No. PB2007-5
  Date: 12 / 2007
  Estimates and documents the regional magnitude of charges associated with hospitalizations due to ambulatory care sensitive conditions in rural hospitals.