Rural Health Research Gateway

Health policy

Publications

Alphabetical list. You can also view by publication date.

  • 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.
  • Changing Rural Populations and Impact on Public Policy
    Author(s): Keith Mueller, Michael D. Shambaugh-Miller
    Research center: Rural Policy Research Institute (RUPRI) Center for Rural Health Policy Analysis
    Topics: Health policy, Rural statistics and demographics
    Date: 10 / 2002
    Population movement in rural areas and health policy issues
  • Comments on the June 2001 Report of the Medicare Payment Advisory Commission: Medicare in Rural America
    Author(s): Andrew Coburn, Charles Fluharty, J. Patrick Hart, A. Clinton MacKinney, Timothy McBride, Keith Mueller, Rebecca Slifkin
    Research center: Rural Policy Research Institute (RUPRI) Center for Rural Health Policy Analysis
    Topics: Health policy, Medicare
    Date: 09 / 2001
    Comments on and critiques the findings in MedPAC's Medicare in Rural America. The authors believe that while the MedPAC report helps set a framework for analysis, it is not a definitive treatise on the role of Medicare in rural health. Among its findings: most of MedPAC's recommendations would have positive impacts on health care for rural beneficiaries, others would do no harm, others could be strengthened, and a few, particularly those relating to access to services, "suffer from disparities and weaknesses." Report produced by the RUPRI Rural Health Panel.
  • Emergency Medical Services and the Federal Government's Evolving Role: What Rural and Frontier Emergency Medical Services Advocates Should Know
    Author(s): P. Daniel Patterson
    Topics: Emergency medical services (EMS), Frontier health, Health policy
    Citation: Journal of Rural Health, 22(2), 97-101
    Date: 2006
    Examines the debate around recent recommendations for an expanded federal role in supporting Emergency Medical Services (EMS). If federal expansion were to occur, the author recommends that responsibility for EMS be placed in the Department of Health and Human Services.
  • Essential Research Issues in Rural Health: The State Rural Health Directors' Perspective
    Author(s): Michael J. O'Grady, Curt D. Mueller, Gail R. Wilensky
    Research center: Walsh Center for Rural Health Analysis
    Topic: Health policy
    Report Number: Policy Analysis Brief W Series, Vol. 5 No. 1
    Date: 03 / 2002
    Policy brief describes the key issues confronting state rural health directors. Five issues were repeatedly raised by directors from a wide variety of states: workforce, telemedicine, emergency medical services, mental health, and lack of local data.
  • 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.
  • How State Rural Health Directors Obtain Policy-Relevant Research Information
    Author(s): Michael J. O'Grady, Curt D. Mueller, Gail R. Wilensky
    Research center: Walsh Center for Rural Health Analysis
    Topic: Health policy
    Report Number: Policy Analysis Brief W Series, Vol. 5 No. 2
    Date: 03 / 2002
    Policy brief summarizes how information pertinent to rural health policy activities of the state offices is obtained. The primary sources of policy-relevant information identified by directors are: the Internet, information sharing with others, and strategic partnerships with organizations outside the traditional health policy arena. The study also found that the organizational location of the state's office of rural health may affect the level of resources available for information gathering. The brief identifies steps to ensure that needed information can be accessed in the future: 1) state offices should have and maintain adequate resources to ensure ready access to electronic forms of information; 2) state offices should continue to share information on sources of health policy research; and 3) study further the implications of organizational form of state offices on resources available for getting needed information.
  • Impact of National Policy on Access to Health Care: The Rural Perspective
    Author(s): Keith Mueller
    Research center: Rural Policy Research Institute (RUPRI) Center for Rural Health Policy Analysis
    Topics: Health policy, Health services
    Date: 10 / 2002
    Current state of financial and geographic access to health care in the U.S. and federal policy
  • 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.
  • 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.
  • Redesigning Medicare: Considerations for Rural Beneficiaries and Health Systems
    Author(s): Andrew F. Coburn, Charles W. Fluharty, A. Clinton MacKinney, Timothy D. McBride, Keith J. Mueller, Rebecca T. Slifkin, Mary K. Wakefield
    Research center: Rural Policy Research Institute (RUPRI) Center for Rural Health Policy Analysis
    Topics: Health policy, Medicare
    Report Number: Special Monograph
    Date: 02 / 2001
    Provides a framework to help shape proposals to redesign Medicare to the benefit of rural beneficiaries and providers. Chapters focus on equity, quality, choice, access, and cost. Each chapter outlines the current situation, analyzes the implications of various approaches to changing the program, and makes recommendations for developing a Medicare program of greatest benefit to rural residents. Report produced by the RUPRI Rural Health Panel.
  • Redesigning the Medicare Program: An Opportunity to Improve Rural Health Care Systems?
    Author(s): Andrew F. Coburn, Charles W. Fluharty, J. Patrick Hart, A. Clinton MacKinney, Timothy D. McBride, Keith J. Mueller, Rebecca T. Slifkin, Mary K. Wakefield
    Research center: Rural Policy Research Institute (RUPRI) Center for Rural Health Policy Analysis
    Topics: Health policy, Medicare
    Date: 08 / 2000
    With this paper, the RUPRI Rural Health Panel is presenting a well-defined framework for what should be included in any discussion of Medicare policies.
  • 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.
  • Rural Assessment of Leading Proposals to Redesign the Medicare Program
    Author(s): Andrew F. Coburn, Charles W. Fluharty, J. Patrick Hart, A. Clinton MacKinney, Timothy D. McBride, Keith J. Mueller, Rebecca T. Slifkin, Mary K. Wakefield
    Research center: Rural Policy Research Institute (RUPRI) Center for Rural Health Policy Analysis
    Topics: Health policy, Medicare
    Date: 05 / 2000
    This Policy Paper provides a critique of two proposals to redesign the Medicare program: the "Medicare Preservation and Improvement Act of 1999" (S. 1895, introduced by Senator Breaux and others) and "The President's Plan to Modernize and Strengthen Medicare for the 21st Century." Rural implications of the proposals are discussed, specifically how they affect rural Medicare beneficiaries and rural providers of health care services. Report produced by the RUPRI Rural Health Panel.
  • Rural Definitions for Health Policy and Research
    Author(s): L. Gary Hart, Eric H. Larson, Denise M. Lishner
    Research center: WWAMI Rural Health Research Center
    Topics: Defining rural, Health policy
    Citation: American Journal of Public Health, 95(7), 1149-1155
    Date: 07 / 2005
    Defining "rural" for health policy and research purposes requires researchers and policy analysts to specify which aspects of rurality are most relevant to the topic at hand and then select an appropriate definition. Rural and urban taxonomies often do not discuss important demographic, cultural, and economic differences across rural places-differences that have major implications for policy and research. Factors such as geographic scale and region also must be considered. Several useful rural taxonomies are discussed and compared in this article. Careful attention to the definition of "rural" is required for effectively targeting policy and research aimed at improving the health of rural Americans.
  • Rural Health Research in Progress in the Rural Health Research Centers Program, 10th Edition
    Author(s): Karen B. Pearson (Ed.)
    Research center: Maine Rural Health Research Center
    Topic: Health policy
    Citation: Portland, ME: University of Southern Maine, Edmund S. Muskie School of Public Service, Institute for Health Policy, Maine Rural Health Research Center
    Date: 02 / 2006
    Annual monograph providing policymakers with a concise source of rural health services research currently underway in the Rural Health Research Centers funded by the Office of Rural Health Policy. Provides a context for legislation current and proposed that affects rural health services and populations. A summary report booklet is provided to the federal Office of Rural Health Policy prior to the full printing of the monograph. The summary booklet is also distributed to members of the Senate Rural Caucus and the House Rural Health Care Coalition.
  • Rural Health Research In Progress in the Rural Health Research Centers Program, 7th edition
    Research center: Maine Rural Health Research Center
    Topic: Health policy
    Date: 03 / 2003
    Annual monograph providing policymakers with a concise source of rural health services research currently underway in the Rural Health Research Centers funded by the Office of Rural Health Policy. Provides a context for legislation current and proposed that affects rural health services and populations. A summary report booklet is provided to the federal Office of Rural Health Policy prior to the full printing of the monograph. The summary booklet is also distributed to members of the Senate Rural Caucus and the House Rural Health Care Coalition.
  • Rural Health Research in Progress in the Rural Health Research Centers Program, 8th Edition
    Research center: Maine Rural Health Research Center
    Topic: Health policy
    Date: 02 / 2004
    Annual monograph providing policymakers with a concise source of rural health services research currently underway in the Rural Health Research Centers funded by the Office of Rural Health Policy. Provides a context for legislation current and proposed that affects rural health services and populations. A summary report booklet is provided to the federal Office of Rural Health Policy prior to the full printing of the monograph. The summary booklet is also distributed to members of the Senate Rural Caucus and the House Rural Health Care Coalition.
  • Rural Health Research in Progress in the Rural Health Research Centers Program, 9th Edition
    Research center: Maine Rural Health Research Center
    Topic: Health policy
    Date: 02 / 2005
    Annual monograph providing policymakers with a concise source of rural health services research currently underway in the Rural Health Research Centers funded by the Office of Rural Health Policy. Provides a context for legislation current and proposed that affects rural health services and populations. A summary report booklet is provided to the federal Office of Rural Health Policy prior to the full printing of the monograph. The summary booklet is also distributed to members of the Senate Rural Caucus and the House Rural Health Care Coalition.
  • Rural Implications of the Medicare, Medicaid, and SCHIP Benefits Improvement and Protection Act of 2000
    Author(s): Keith J. Mueller
    Research center: Rural Policy Research Institute (RUPRI) Center for Rural Health Policy Analysis
    Topics: Health policy, Legislation and regulation, Medicaid and S-CHIP, Medicare
    Date: 01 / 2001
    Covers rural health policy, SCHIP Benefit Improvement Plan, and legislation.
  • Rural Implications of the Medicare, Medicaid, and SCHIP Benefits Improvement and Protection Act of 2000: Concerns, Legislation, and Next Steps
    Research center: Rural Policy Research Institute (RUPRI) Center for Rural Health Policy Analysis
    Topics: Health policy, Legislation and regulation, Medicaid and S-CHIP, Medicare
    Date: 01 / 2001
    Overview of the Medicare, Medicaid, and SCHIP Benefits Improvement and Protection Act of 2000 (BIPA) as it impacts rural health.
  • Understanding the Impacts of the Medicare Modernization Act: Concerns of Congressional Staff
    Author(s): Keith J. Mueller, Andrew F. Coburn, A. Clinton MacKinney, Timothy D. McBride, Rebecca T. Slifkin, Mary K. Wakefield
    Research centers: Maine Rural Health Research Center, Rural Policy Research Institute (RUPRI) Center for Rural Health Policy Analysis, Upper Midwest Rural Health Research Center
    Topics: Health policy, Legislation and regulation, Medicare, Pharmacy and prescription drugs
    Citation: Journal of Rural Health, 21(3), 194-197
    Date: 2005
    The most efficient mechanism for research to affect policy is to provide policy makers with information on issues about which they have voiced concern. The Rural Policy Research Institute's Health Panel conducted 2 focus groups with 16 congressional staff in September 2004 to identify a set of researchable questions concerning the impact of the MMA on rural health care. This paper presents research questions in the following areas that congressional staff identified as having the highest priority: access to health plans and pharmacy services, beneficiary outreach and enrollment, technology capacity, provider payment policy, and demonstration projects.
  • 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.

This web site includes content provided by and adapted from the Maine Rural Health Research Center, University of Southern Maine under a Cooperative Agreement with the University of North Dakota.