Health policy

Completed Projects

Analytic Capacity to Respond to Changes in Medicare and Medicaid, Data Assistance to Policy Staff at the Federal Office of Rural Health Policy, and Production of Short Policy Briefs
Research center: North Carolina Rural Health Research and Policy Analysis Center
Funder: Office of Rural Health Policy (ORHP)
Topics: Health policy, Legislation and regulation, Medicaid and S-CHIP, Medicare
This project will produce short policy briefs on a variety of topics related to proposed and enacted changes in Medicare and Medicaid, as requested by policy staff at the federal Office of Rural Health Policy.

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

Comments on Regulatory and Contractor Reform Legislation
Research center: Rural Policy Research Institute (RUPRI) Center for Rural Health Policy Analysis
Funder: Office of Rural Health Policy (ORHP)
Topics: Health policy, Legislation and regulation, Medicare

Community Health Worker Certification Process in Texas: Implications for Practice and Policy
Research center: Southwest Rural Health Research Center
Funder: Office of Rural Health Policy (ORHP)
Topics: Health policy, Hispanics, Legislation and regulation, Workforce

Cost of Ambulance Transports for Low-Volume Providers in Rural Areas and Its Implications for Medicare Reimbursement Policy
Research center: Walsh Center for Rural Health Analysis
Funder: Office of Rural Health Policy (ORHP)
Topics: Emergency medical services (EMS), Health care financing, Health policy, Medicare

Database for Rural Health Research in Progress
Research center: Maine Rural Health Research Center
Funder: Office of Rural Health Policy (ORHP)
Topic: Health policy
This searchable database of current rural health services research and policy analysis includes all ORHP-funded studies as well as research funded by other federal agencies, major private foundations and other sources.

Declining Access to Hospital-based Obstetric Services in Rural Areas: Causes and Impact
Research center: Walsh Center for Rural Health Analysis
Funder: Office of Rural Health Policy (ORHP)
Topics: Health policy, Hospitals and clinics, Legislation and regulation, Maternal and child health, Women
This study examines the declining availability of hospital-based obstetric services in rural areas from the mid-1980s to the early 2000s. It examines potential causes for this trend and explores the effects of medical malpractice reforms.

Developing and Using a Classification Schema to Identify Sentinel Communities in the U.S.
Research center: Rural Policy Research Institute (RUPRI) Center for Rural Health Policy Analysis
Funder: Office of Rural Health Policy (ORHP)
Topic: Health policy
This project will enable rural researchers to track the effect of current policies on rural communities, anticipate the effect of proposed policies, and demonstrate policy effects that link one sector to another.

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
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

Establishing a Fair Payment for Rural Physicians
Research center: Rural Policy Research Institute (RUPRI) Center for Rural Health Policy Analysis
Funder: Office of Rural Health Policy (ORHP)
Topics: Health policy, Physicians, Workforce
This project will analyze differences in physician payment as a function of practice location and simulate policy choices that change the current payment formula.

Expanding Rural Health Insurance Coverage: How Do Insurance Reform Strategies Stack Up?
Research centers: Maine Rural Health Research Center, Rural Policy Research Institute (RUPRI) Center for Rural Health Policy Analysis
Funder: Office of Rural Health Policy (ORHP)
Topics: Health insurance and the uninsured, Health policy
This purpose of this study is to inform policymakers about the current state of health insurance coverage in rural America, and to assess how specific reform strategies may differentially affect rural residents. Using a combination of analytic strategies, we will provide policymakers and rural health advocates with the necessary tools to develop reform strategies that meet the needs of rural residents.

Impact of The Medicaid Budget Crisis on Rural Communities: A 50-State Survey
Research center: North Carolina Rural Health Research and Policy Analysis Center
Funder: Office of Rural Health Policy (ORHP)
Topics: Health policy, Medicaid and S-CHIP
The impact of the Medicaid budgetary crisis on rural communities across the US will be assessed through a 50-state survey of state Medicaid agencies, state Offices of Rural Health and state rural health associations.

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

Implementation of the Medicare Prescription Drug Benefit: What is Available to Rural Beneficiaries?
Research center: Rural Policy Research Institute (RUPRI) Center for Rural Health Policy Analysis
Funder: Office of Rural Health Policy (ORHP)
Topics: Health policy, Legislation and regulation, Medicare Part D
This study will focus on the impact of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 on rural beneficiaries, based on actual prescription drug plan contracts, comparing the impact of the legislation on rural beneficiaries to their urban counterparts.

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
Research center: North Carolina Rural Health Research and Policy Analysis Center
Funder: Office of Rural Health Policy (ORHP)
Topics: Health policy, Technology, Workforce

J-1 Visa Project
Research center: Rural Policy Research Institute (RUPRI) Center for Rural Health Policy Analysis
Funder: Office of Rural Health Policy (ORHP)
Topics: Health policy, International Medical Graduates (IMGs), J-1 Visa Waiver, Workforce

Medicaid Budget Cuts and Long-Term Care Supplement
Research center: Southwest Rural Health Research Center
Funder: Office of Rural Health Policy (ORHP)
Topics: Aging, Disabilities, Health policy, Long term care, Medicaid and S-CHIP
Data on each state will be collected identifying all the changes made to their Medicaid program in the area of long-term care or related services to the frail elderly and disabled, and a policy paper addressing the impact of Medicaid cuts on long term care services, particularly among the elderly in rural areas, will be produced.

Medicare Modernization Act: Reality for Rural Beneficiaries and Providers
Research center: Rural Policy Research Institute (RUPRI) Center for Rural Health Policy Analysis
Funder: Office of Rural Health Policy (ORHP)
Topics: Health policy, Medicare Advantage (MA), Medicare Part D
This project will focus on two areas of new activity in Medicare—beneficiary participation in Medicare Advantage (MA) plans and prescription drug plans and implementation of the new Part D benefit through private health plans. We will describe enrollment into specific types of MA prescription drug plans and other prescription drug plans, and analyze differences across regions, states, and types of counties. We will also examine the impact of the transfer to Part D coverage on rural dual eligibles and their local pharmacies.

Medicare Payment for Post-Acute Care Transfers
Research center: Walsh Center for Rural Health Analysis
Funder: Office of Rural Health Policy (ORHP)
Topics: Health care financing, Health policy, Hospitals and clinics

Medicare Reform: Rural Considerations
Research center: Rural Policy Research Institute (RUPRI) Center for Rural Health Policy Analysis
Funder: Office of Rural Health Policy (ORHP)
Topics: Health policy, Medicare Prospective Payment System (PPS), Medicare Wage Index

Mental Health Services: The Effect of Variations in State Policies
Research center: Southwest Rural Health Research Center
Funder: Office of Rural Health Policy (ORHP)
Topics: Health policy, Health services, Mental health
This study will identify variations in state licensure and payment or coverage polices and examine the effect of these variations on the availability of mental health services in rural areas.

Options for Structuring Disproportionate Share (DSH) Payments to Account for Uncompensated Care: Impact on Rural Hospitals
Research center: Walsh Center for Rural Health Analysis
Funder: Office of Rural Health Policy (ORHP)
Topics: Health care financing, Health policy, Hospitals and clinics
This study will identify options for development of an equitable DSH payment adjustment that accounts for hospital uncompensated care costs and determine the financial impact of each of these proposals on rural hospitals, using simulations with data from Washington, West Virginia, Texas, and Iowa.

Rapid and Flexible Analysis of Data from Centers for Medicare and Medicaid Services
Research center: North Carolina Rural Health Research and Policy Analysis Center
Funder: Office of Rural Health Policy (ORHP)
Topics: Health policy, Medicare, Rural statistics and demographics
Project staff will provide rapid and flexible analysis of CMS data in response to requests from ORHP staff. Work will be ongoing throughout the contract year, with the design of individual products determined in response to ORHP staff needs.

Rural Dimensions of Medicare Payment Policies
Research center: Walsh Center for Rural Health Analysis
Funder: Office of Rural Health Policy (ORHP)
Topics: Health policy, Medicare

Rural-Urban Physician Payment Differences Across the Nation: Methodological Changes
Research center: Rural Policy Research Institute (RUPRI) Center for Rural Health Policy Analysis
Funder: Office of Rural Health Policy (ORHP)
Topics: Health policy, Medicare, Physicians, Workforce
This project will simulate the effects of changes to the methodologies used to calculate the three geographic practice cost indices (GPCIs) currently used to adjust physician payment across the 89 Medicare payment areas in the U.S. and territories. Changes to the payment formula will be analyzed to determine potential impact on payment across areas and revenues for rural physician practices.

Tribal Long-Term Care: Barriers to Best Practices in Policy and Programming for a National Sample of Rural Tribes
Research center: ORHP-funded Individual Grantees
Funder: Office of Rural Health Policy (ORHP)
Topics: Aging, American Indians and Alaska Natives, Health policy, Long term care, Minority health
This project will examine barriers experienced by rural American Indian and Alaska Native (AI/AN) tribes in developing long term care policy and service provision, identify tribes which exemplify best practices in the area of long term care policy, and document what other tribes would need to know to develop successful long term care programs (i.e., lessons learned).