Critical Access Hospitals and Rural Hospital Flexibility Program
Completed Projects
Alternatives to the 96-Hour Rule for Critical Access Hospitals
Research center:
Walsh Center for Rural Health Analysis
Funder:
Health Care Financing Administration (HCFA)
Topic:
Critical Access Hospitals and Rural Hospital Flexibility Program
Analysis of 2004-2005 State Flex Grant Plans
Research centers:
Maine Rural Health Research Center,
Minnesota Rural Health Research Center
Funder:
Office of Rural Health Policy (ORHP)
Topics:
Critical Access Hospitals and Rural Hospital Flexibility Program,
Emergency medical services (EMS),
Networking and collaboration,
Quality
This project will analyze state Flex grant applications and related budget and work plan revisions focusing on state activities in the core Flex program areas of networks, quality improvement, and EMS.
Analysis of Critical Access Hospital Inpatient Hospitalizations and Transfers from CAHs to Other Acute and Post-Acute Care Settings Using State Inpatient Databases
Research center:
Minnesota Rural Health Research Center
Funder:
Office of Rural Health Policy (ORHP)
Topics:
Critical Access Hospitals and Rural Hospital Flexibility Program,
Quality,
Technology
The purpose of this project is to analyze Critical Access Hospital (CAH) inpatient hospitalizations and transfers from CAHs in order to help inform the development of quality indicators for CAHs, especially quality indicators focused on the transfer process.
Analyzing the Relationship Among Critical Access Hospital Financial Status, Organizational Linkages, and Scope of Services
Research center:
Minnesota Rural Health Research Center
Funder:
Office of Rural Health Policy (ORHP)
Topics:
Critical Access Hospitals and Rural Hospital Flexibility Program,
Health care financing,
Health services,
Networking and collaboration
This project will systematically analyze the relationships among pre- and post-conversion Critical Access Hospital (CAH) financial performance, the organizational linkages in which the hospital participates (e.g., health care systems and/or networks), and the scope of services (i.e., the number and type of services) provided.
Community Impact Assessment
Research centers:
Maine Rural Health Research Center,
North Carolina Rural Health Research and Policy Analysis Center
Funder:
Office of Rural Health Policy (ORHP)
Topics:
Critical Access Hospitals and Rural Hospital Flexibility Program,
Networking and collaboration
This project will evaluate the impact of the Flex program on local communities. Activities will focus on identifying the ways in which the program could have a measurable effect, as well as the ways in which Flex program coordinators intended to affect community health. A briefing paper that integrates information on scope of services, networking, and quality will be produced. Additionally, case studies will be conducted in six CAH communities.
Critical Access Hospital Access To and Use of Capital
Research center:
Minnesota Rural Health Research Center
Funder:
Office of Rural Health Policy (ORHP)
Topics:
Capital funding,
Critical Access Hospitals and Rural Hospital Flexibility Program
This project will describe the capital needs of CAHs and their experiences in accessing and using capital, based on data from an e-mail survey of State Flex Coordinators, the TASC listserve, telephone contacts with Flex Coordinators in key states, and Medicare Cost Reports.
Critical Access Hospital Participation in the Hospital Quality Alliance and Initial Quality Measure Results
Research center:
Minnesota Rural Health Research Center
Funder:
Office of Rural Health Policy (ORHP)
Topics:
Critical Access Hospitals and Rural Hospital Flexibility Program,
Quality
This project examined the participation of Critical Access Hospitals (CAHs) in public reporting of quality measures in the Centers for Medicare and Medicaid Services Hospital Compare database. It presented the initial Hospital Compare results for CAHs and comparisons with other groups of hospitals on quality measures for three conditions: acute myocardial infarction (heart attack), heart failure and pneumonia.
Developing a Quality Performance Measurement System for Critical Access Hospitals
Research center:
Minnesota Rural Health Research Center
Funder:
Office of Rural Health Policy (ORHP)
Topics:
Critical Access Hospitals and Rural Hospital Flexibility Program,
Quality
This project continues to support activities related to quality performance measurement relevant for Critical Access Hospitals. By the end of 2005, the technical expert panel had reviewed the findings of the initial field test of the small rural hospital quality measure set and made recommendations for revisions.
Development of State Flex Program Logic Models and Related Toolkit
Research center:
Maine Rural Health Research Center
Funder:
Office of Rural Health Policy (ORHP)
Topic:
Critical Access Hospitals and Rural Hospital Flexibility Program
Evaluating the Financial Impact of Critical Access Hospital Conversion Over Time
Research center:
Minnesota Rural Health Research Center
Funder:
Office of Rural Health Policy (ORHP)
Topics:
Critical Access Hospitals and Rural Hospital Flexibility Program,
Health care financing
Using Medicare cost report data, this project will analyze changes in several key financial and organizational indicators that may be affected by CAH conversion, and produce annual reports describing the financial status of CAHs.
Evaluation of New Hampshire's Rural Hospital Flexibility Program
Research center:
Maine Rural Health Research Center
Funder:
Bureau of Rural Health & Primary Care, Office of Community & Public Health, NH DHHS
Topic:
Critical Access Hospitals and Rural Hospital Flexibility Program
Evaluation of the New Hampshire Rural Hospital Flexibility Program (NH Flex Program) will focus on the experience of the hospitals that have converted to Critical Access Hospital (CAH) status, the assistance provided to the remaining hospitals that are eligible for conversion, and the satisfaction of the staff of the hospitals and related community organizations with the support and assistance provided to them.
Evaluation of the Medicare Rural Hospital Flexibility Program
Research center:
North Carolina Rural Health Research and Policy Analysis Center
Funder:
Office of Rural Health Policy (ORHP)
Topic:
Critical Access Hospitals and Rural Hospital Flexibility Program
Evaluation of the Rural Hospital Flexibility Act and the Critical Access Hospital Program
Research center:
North Carolina Rural Health Research and Policy Analysis Center
Funder:
Office of Rural Health Policy (ORHP)
Topic:
Critical Access Hospitals and Rural Hospital Flexibility Program
Financial Performance of Critical Access Hospitals, Pre- and Post-Conversion
Research center:
North Carolina Rural Health Research and Policy Analysis Center
Funder:
Office of Rural Health Policy (ORHP)
Topics:
Critical Access Hospitals and Rural Hospital Flexibility Program,
Health care financing,
Medicare Prospective Payment System (PPS)
Making use of the financial indicators developed by project staff, the focus of this project is a longitudinal analysis of the dimensions and indicators of financial performance. Descriptive analyses are used to capture changes in all dimensions of financial performance pre- and post-conversion.
Impact of CAH Conversion on Hospital Costs and Mix of Services
Research center:
Walsh Center for Rural Health Analysis
Funder:
Office of Rural Health Policy (ORHP)
Topics:
Critical Access Hospitals and Rural Hospital Flexibility Program,
Health care financing,
Health services
This study examined Medicare Cost Report and claims data for hospitals before and after CAH conversion in order to better understand changes in hospital costs associated with CAH conversion, factors associated with any cost growth, and changes in the mix of services provided by the facility.
Mental Health Encounters in Critical Access Hospital Emergency Rooms: A National Survey
Research center:
Maine Rural Health Research Center
Funder:
Office of Rural Health Policy (ORHP)
Topics:
Critical Access Hospitals and Rural Hospital Flexibility Program,
Emergency medical services (EMS),
Mental health
This project will survey Emergency Room (ER) managers in a nationally representative sample of Critical Access Hospitals (CAHs) to determine the proportion of ER encounters involving mental health pathology, types of mental health problems most commonly seen in these encounters, and resources available to CAHs to address the problems encountered.
National Rural Hospital Flexibility Program Review
Research center:
North Carolina Rural Health Research and Policy Analysis Center
Funder:
Office of Rural Health Policy (ORHP)
Topic:
Critical Access Hospitals and Rural Hospital Flexibility Program
National Rural Hospital Flexibility Program Tracking Project
Research center:
WWAMI Rural Health Research Center
Funder:
Office of Rural Health Policy (ORHP)
Topic:
Critical Access Hospitals and Rural Hospital Flexibility Program
National Rural Hospital Flexibility Program Tracking Project Dissemination
Research center:
Rural Policy Research Institute (RUPRI) Center for Rural Health Policy Analysis
Funder:
Office of Rural Health Policy (ORHP)
Topic:
Critical Access Hospitals and Rural Hospital Flexibility Program
National Rural Hospital Flexibility Program Tracking Project: Analysis of CAH Quality Improvement (QI) Strategies
Research center:
Minnesota Rural Health Research Center
Funder:
Office of Rural Health Policy (ORHP)
Topics:
Critical Access Hospitals and Rural Hospital Flexibility Program,
Quality
National Rural Hospital Flexibility Program Tracking Project: Analysis of Network Development Strategies and CAH Performance
Research center:
Minnesota Rural Health Research Center
Funder:
Office of Rural Health Policy (ORHP)
Topics:
Capital funding,
Critical Access Hospitals and Rural Hospital Flexibility Program,
Networking and collaboration
National Rural Hospital Flexibility Program Tracking Project: Analysis of the Financial Impact of Conversion on Critical Access Hospitals (CAHs) and the Medicare Program
Research center:
Minnesota Rural Health Research Center
Funder:
Office of Rural Health Policy (ORHP)
Topics:
Critical Access Hospitals and Rural Hospital Flexibility Program,
Health care financing
National Rural Hospital Flexibility Program Tracking Project: Emergency Medical Services
Research center:
Walsh Center for Rural Health Analysis
Funder:
Office of Rural Health Policy (ORHP)
Topics:
Critical Access Hospitals and Rural Hospital Flexibility Program,
Emergency medical services (EMS),
Networking and collaboration
National Rural Hospital Flexibility Program Tracking Project: Perceptions of Community Physicians
Research center:
Walsh Center for Rural Health Analysis
Funder:
Office of Rural Health Policy (ORHP)
Topics:
Critical Access Hospitals and Rural Hospital Flexibility Program,
Physicians
National Rural Hospital Flexibility Program Tracking Project: Tracking State Policy and Program Development
Research center:
Maine Rural Health Research Center
Funder:
Office of Rural Health Policy (ORHP)
Topic:
Critical Access Hospitals and Rural Hospital Flexibility Program
National Rural Hospital Flexiblity Program Tracking Project: Analysis of Hospital Conversion and Network Development Strategies
Research center:
Minnesota Rural Health Research Center
Funder:
Office of Rural Health Policy (ORHP)
Topics:
Critical Access Hospitals and Rural Hospital Flexibility Program,
Networking and collaboration
Patient Bypass Behavior and Critical Access Hospitals: Implications for Patient Retention
Research center:
ORHP-funded Individual Grantees
Funder:
Office of Rural Health Policy (ORHP)
Topics:
Critical Access Hospitals and Rural Hospital Flexibility Program,
Health services
This project drew on a survey of patients sampled from the service areas of 25 Critical Access Hospitals (CAHs) from different regions of the country. The purpose of this project is to identify policy and programmatic issues related to bypass, specifically targeting CAHs in order to offer evidence and guidance to policymakers, CAH administrators, and planners on the location of healthcare resources, factors that affect patient actions for planning programs, and the adjustment of policies in order to retain patients locally.
Quality and Financial Status of Critical Access Hospitals: A Preliminary Analysis
Research centers:
Minnesota Rural Health Research Center ,
North Carolina Rural Health Research and Policy Analysis Center
Funder:
Office of Rural Health Policy (ORHP)
Topics:
Critical Access Hospitals and Rural Hospital Flexibility Program,
Health care financing,
Quality
The purpose of this project is to continue to investigate the relationship between CAH financial performance and quality of care. UMN and UNC will jointly develop hypotheses related to the finance-quality link and statistical models suitable for testing hypotheses.
Role of Intensive Care Units in Critical Access Hospitals
Research center:
North Carolina Rural Health Research and Policy Analysis Center
Funder:
Office of Rural Health Policy (ORHP)
Topics:
Critical Access Hospitals and Rural Hospital Flexibility Program,
Health services
This project will examine the role that intensive care units (ICUs) play in Critical Access Hospitals (CAHs). The number and geographic distribution of CAH with ICUs will be described, and types of services provided in these units discussed.
Special Study of EMS Issues
Research centers:
Maine Rural Health Research Center,
North Carolina Rural Health Research and Policy Analysis Center
Funder:
Office of Rural Health Policy (ORHP)
Topics:
Critical Access Hospitals and Rural Hospital Flexibility Program,
Emergency medical services (EMS),
Networking and collaboration
This study will focus on state, community, and hospital level initiatives designed to build the infrastructure to support EMS service capacity and encourage the integration of these services into the rural healthcare infrastructure in the areas of quality improvement, financing, staffing, medical control, and networking and integration.
State Flex Program Quality Improvement Activities
Research center:
Maine Rural Health Research Center
Funder:
Office of Rural Health Policy (ORHP)
Topics:
Critical Access Hospitals and Rural Hospital Flexibility Program,
Quality
Using Program Logic Models to Monitor the Performance of State Flex Programs
Research center:
Maine Rural Health Research Center
Funder:
Office of Rural Health Policy (ORHP)
Topic:
Critical Access Hospitals and Rural Hospital Flexibility Program
This project will use a program logic model approach to track state program activities and develop tools that allow states to systematically monitor and manage their accomplishments in the context of Flex Program goals.
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