Health policy

Publications

Alphabetical list. You can also view by publication date.

• Arguing for Rural Health in Medicare: A Progressive Rhetoric for Rural America
  Date: 09 / 2002
  Author(s): Thomas Ricketts
  Research center: North Carolina Rural Health Research and Policy Analysis Center
  Topics: Health policy, Medicare
  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
  Date: 10 / 2002
  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
  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
  Date: 09 / 2001
  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
  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.
• Cost of Inaction to Rural Communities: The Urgent Need for Health Care Reform Leake County, Mississippi
  Date: 08 / 2009
  Author(s): Kelly Shaw-Sutherland, Anh Nguyen, Keith Mueller
  Research center: Rural Policy Research Institute (RUPRI) Center for Rural Health Policy Analysis
  Topics: Health insurance and the uninsured, Health policy, Health services
  Report Number: 2009-9
  The U.S. health care crisis is especially strong in rural communities. The experience of Leake County, a rural Mississippi county, embodies these problems.
• Cost of Inaction to Rural Communities: The Urgent Need for Health Care Reform Nemaha County, Nebraska
  Date: 08 / 2009
  Author(s): Anh Nguyen, Kelly Shaw-Sutherland, Keith Mueller
  Research center: Rural Policy Research Institute (RUPRI) Center for Rural Health Policy Analysis
  Topics: Health insurance and the uninsured, Health policy, Health services
  Report Number: 2009-11
  The U.S. health care crisis is especially strong in rural communities. The experience of Nemaha County, a small county located in southeastern Nebraska, illustrates the reach of these problems into counties that are somewhat stable during times of economic turbulence.
• Cost of Inaction to Rural Communities: The Urgent Need for Health Care Reform Walthall County, Mississippi
  Date: 08 / 2009
  Author(s): Anh Nguyen, Kelly Shaw-Sutherland, Keith Mueller
  Research center: Rural Policy Research Institute (RUPRI) Center for Rural Health Policy Analysis
  Topics: Health insurance and the uninsured, Health policy, Health services
  Report Number: 2009-10
  The U.S. health care crisis is especially strong in rural communities. The experience of Walthall County, a small county located in southwestern Mississippi, exemplifies these problems.
• Emergency Medical Services and the Federal Government's Evolving Role: What Rural and Frontier Emergency Medical Services Advocates Should Know
  Date: 2006
  Author(s): P. Daniel Patterson
  Topics: Emergency medical services (EMS), Frontier health, Health policy
  Citation: Journal of Rural Health, 22(2), 97-101
  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
  Date: 03 / 2002
  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
  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.
• Health Insurance Profile Indicates Need for Reform in Rural Areas (Policy Brief)
  Date: 07 / 2009
  Author(s): Jennifer Lenardson, Erika Ziller, Andrew Coburn, Nathaniel Anderson
  Research center: Maine Rural Health Research Center
  Topics: Health insurance and the uninsured, Health policy
  Rural residents-particularly in the most remote rural communities-are in greater need of health reform, as demonstrated by an uninsured rate higher than that of urban residents. The rural-urban disparity in coverage is driven by higher uninsured rates among rural adults, a group that should be part of any strategic effort to improve coverage. This brief provides information on the health insurance status of rural Americans, summarized from a more detailed chartbook. Analyses are based on the 2004-05 Medical Expenditure Panel Survey.
• 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
  Date: 2005
  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
  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
  Date: 03 / 2002
  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
  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
  Date: 10 / 2002
  Author(s): Keith Mueller
  Research center: Rural Policy Research Institute (RUPRI) Center for Rural Health Policy Analysis
  Topics: Health policy, Health services
  Current state of financial and geographic access to health care in the U.S. and federal policy
• Impact of the Recession on Rural America: Rising Unemployment Leading to More Uninsured in 2009
  Date: 06 / 2009
  Author(s): Timothy McBride, Leah Kemper
  Research center: Rural Policy Research Institute (RUPRI) Center for Rural Health Policy Analysis
  Topics: Health insurance and the uninsured, Health policy
  Report Number: 2009-6
  The 2008-09 recession has impacted the United States in many profound ways, but perhaps most dramatically through increased unemployment. Job loss for many means loss of employer-sponsored health insurance or ability to purchase individual insurance. Some individuals can obtain coverage through Medicaid or private health insurance, but many remain uninsured. This brief presents the results of state and county analysis of unemployment rates nationally in urban and rural (non-metropolitan) areas over the period 2007-February 2009 and discusses the impact of rising unemployment on uninsurance in rural areas.
• Impacts of Multiple Race Reporting on Rural Health Policy and Data Analysis
  Date: 05 / 2002
  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
  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
  Date: 12 / 2007
  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
  Documents the national magnitude of charges associated with hospitalizations due to ambulatory care sensitive conditions in rural hospitals.
• Persistent Primary Care Health Professional Shortage Areas (HPSAs) and Health Care Access in Rural America (Policy Brief)
  Date: 09 / 2009
  Author(s): Mark P. Doescher, Meredith A. Fordyce, Susan M. Skillman, J. Elizabeth Jackson, Roger A. Rosenblatt
  Research center: WWAMI Rural Health Research Center
  Topics: Health policy, Health services
  Resources are needed to increase and sustain the number of primary care providers and reduce financial barriers to care in all rural primary care HPSAs.
• Private Health Insurance in Rural Areas: Challenges and Reform Options (Policy Brief)
  Date: 04 / 2009
  Author(s): Erika Ziller, Andrew Coburn
  Research center: Maine Rural Health Research Center
  Topics: Health insurance and the uninsured, Health policy
  Rural residents are less likely than their urban counterparts to have private health insurance coverage. This difference is driven by the unique characteristics of rural places that make it challenging to create and sustain viable private insurance pools, including the predominance of small businesses and self employed, part time, and low wage workers. This brief discusses the challenges of expanding private coverage in rural areas, and describes policy options to address them.
• Profile of Rural Health Insurance Coverage: A Chartbook
  Date: 06 / 2009
  Author(s): Jennifer D. Lenardson, Erika C. Ziller, Andrew F. Coburn, Nathaniel J. Anderson
  Research center: Maine Rural Health Research Center
  Topics: Health insurance and the uninsured, Health policy
  As the nation considers whether and how to reform the healthcare system, it is important to consider differences in health insurance coverage for those living in rural and urban areas. Analyses of persons under age 65 from the 2004-05 Medical Expenditure Panel Survey reveal a greater proportion of rural residents than urban residents who are uninsured or covered through public sources, especially among those living in remote areas. Rural adults are at high risk of being uninsured compared to rural children. Uninsured rates are highest among adults over age 50 in the most remote rural places. Compared to urban adults, rural adults are less likely to be in employment situations where private coverage is offered.
• Redesigning Medicare: Considerations for Rural Beneficiaries and Health Systems
  Date: 02 / 2001
  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
  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?
  Date: 08 / 2000
  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
  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
  Date: 12 / 2007
  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
  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
  Date: 05 / 2000
  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
  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
  Date: 07 / 2005
  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
  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
  Date: 02 / 2006
  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
  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
  Date: 03 / 2003
  Research center: Maine Rural Health Research Center
  Topic: Health policy
  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
  Date: 02 / 2004
  Research center: Maine Rural Health Research Center
  Topic: Health policy
  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
  Date: 02 / 2005
  Research center: Maine Rural Health Research Center
  Topic: Health policy
  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
  Date: 01 / 2001
  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
  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
  Date: 01 / 2001
  Research center: Rural Policy Research Institute (RUPRI) Center for Rural Health Policy Analysis
  Topics: Health policy, Legislation and regulation, Medicaid and S-CHIP, Medicare
  Overview of the Medicare, Medicaid, and SCHIP Benefits Improvement and Protection Act of 2000 (BIPA) as it impacts rural health.
• Rural Issues Related to Comparative Effectiveness Research and Dissemination (Policy Brief)
  Date: 06 / 2009
  Author(s): Ira Moscovice, Michelle Casey
  Research center: Upper Midwest Rural Health Research Center
  Topics: Health policy, Rural statistics and demographics
  Comparative effectiveness research, which compares the costs and benefits of different treatments for specific diseases or conditions, has the potential to improve the quality and reduce the costs of health care. This brief describes strategies for expanding clinical research in rural environments; implementing practice guidelines in rural settings; and improving access to current evidence-based information for rural health professionals and patients.
• Rural-Urban Comparison of a Building Blocks Approach to Covering the Uninsured (Policy Brief)
  Date: 06 / 2009
  Author(s): Timothy McBride
  Research center: Rural Policy Research Institute (RUPRI) Center for Rural Health Policy Analysis
  Topics: Health insurance and the uninsured, Health policy
  Report Number: 2009-5
  A range of proposals are now being considered to reform the health care system, specifically to provide access to health insurance coverage for the uninsured. Proposals include a range of public-private approaches, typically called "building blocks" approaches, which build upon our current system of health insurance to provide access to health insurance for all Americans. This brief uses a RUPRI health insurance model to compare the effects of a building blocks approach on health insurance coverage and health spending, focusing on the geographic differences (by metropolitan and non-metropolitan) of this approach.
• Understanding the Impacts of the Medicare Modernization Act: Concerns of Congressional Staff
  Date: 2005
  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
  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
  Date: 01 / 2005
  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
  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.