University of Minnesota Rural Health Research Center

Completed Projects

Listed by project completion date. You can also view these projects alphabetically.



  • Identifying Adverse Drug Events and Improving Patient Safety in Rural Hospitals
    This study identifies rates of adverse drug events (ADEs) and opportunities to improve patient safety in Critical Access Hospitals (CAHs) and non‐CAH rural hospitals.
    Topics: Critical Access Hospitals, Hospitals and clinics, Pharmacy and prescription drugs, Quality
  • Obstetric Unit and Hospital Closures and Maternal and Infant Health in Rural Communities
    This project will examine the relationship between closure of an obstetric unit or hospital and maternity care and outcomes of childbirth in rural US counties including prenatal care, distance to delivery hospital, out-of-hospital birth, and infant health outcomes.
    Topics: Children and adolescents, Health services, Hospitals and clinics, Women
  • Paving the Way: Addressing Transportation as a Social Determinant of Health for Rural Residents
    This project will use a mixed-methods design to examine ways in which transportation operates as a social determinant of health for vulnerable rural residents, and to identify exemplar transportation programs that are successfully improving health and well-being of those residents.
    Topics: Aging, Health services, Networking and collaboration, Transportation
  • Rural Implications of Quality-Based Physician Payment Reform
    The purpose of this project is to assess existing national data about the quality of care provided by rural physicians, and to determine what additional information will be needed as CMS moves towards inclusion of all physicians in payment reforms based on quality.
    Topics: Physicians, Quality
  • Skilled Nursing Facility Care for Rural Residents with Complex Care Needs
    This project will examine barriers to skilled nursing facility placement for rural residents with complex care needs, including obesity, dementia, and behavioral health problems, and explore potential implications for access to and quality of care.
    Topics: Health services, Hospitals and clinics, Long-term care
  • What Constitutes An Adequate Provider Network For Rural Health Populations?
    The purpose of this study is to develop norms/standards for provider network adequacy for rural populations (which may vary across different rural environments) that will be useful to consumers, providers, and policymakers in the decisions they face with respect to health plan choices, participation, and policies.
    Topic: Private health insurance


  • Quality Measures and Sociodemographic Risk Factors: The Rural Environmental Context
    For three acute care conditions/diagnoses (potential examples include diabetes, congestive heart failure, COPD), this study will (1) identify the key socio-demographic variables that may affect quality adjustment for rural populations/providers; (2) identify data sources/strategies available for the above variables; and (3) identify the quality measures (e.g. readmission rates) that should be adjusted for socio-demographic variables for rural populations/providers and estimate the potential impact of those adjustments on quality measurement.
    Topics: Diabetes, Quality, Rural statistics and demographics
  • Relationship Between Service Utilization and Costs for High Cost Rural Medicare Patients
    This project will 1) assess the relationship between service utilization patterns and costs for rural Medicare beneficiaries across the rural continuum, and 2) examine the relationships between rural beneficiaries' service utilization and market structure.
    Topic: Medicare
  • Rural Hospital Obstetric Workforce, Procedure Utilization, and Quality of Care
    This study examines the relationships between key aspects of the obstetric workforce in rural hospitals and procedure intensity and quality of maternity care in those hospitals.
    Topics: Maternal health, Quality, Women, Workforce
  • Rural-Urban Differences in Insurer Participation, Premiums, Health Plan Provider Networks in Federal and State Marketplaces
    This two-year project will: 1) measure rural-urban differences in the size, scope, and composition of provider networks affiliated with Marketplace plans; 2) analyze the relationships between provider network size and composition, other benefit design attributes, geographic rating area designations, and premiums; and 3) examine how rural and urban Marketplace-based plan enrollment is affected by plan availability and provider network size and scope.
    Topic: Private health insurance



  • High Quality Rural Hospitals and Post-Acute Care Providers
    This project will use several large longitudinal national databases to model alternative ways of identifying high quality rural hospitals, analyze factors related to quality in rural hospitals, and examine the relationship between the quality of care provided by rural hospitals and the quality of care provided by nursing homes and home health agencies within rural communities.
    Topics: Hospitals and clinics, Post-acute care, Quality
  • Observation Care Services in Rural Hospitals: Reimbursement and Quality Implications
    This project will describe the nature and scope of observation care services provided by rural hospitals and discuss policy relevant issues for Medicare beneficiaries and providers. Study findings will provide the first assessment of rural observation care services and identify policy options to minimize the potential for unintended consequences of Medicare policies related to observation care services.
    Topics: Hospitals and clinics, Medicare, Quality
  • Obstetric Care Practice Models and Quality in Rural Hospitals
    The project will examine current obstetric practice models in rural hospitals and assess the prospects for implementation of new policy recommendations for reducing primary cesarean rates and non-medically indicated inductions of labor in rural hospitals.
    Topics: Maternal health, Quality
  • Quality Implications of Transferring Emergency Department Patients from Rural Hospitals
    This project will use Medicare inpatient and Emergency Department claims data to 1.) compare patients who are transferred directly from rural hospital Emergency Departments to larger hospitals with those who are admitted as inpatients to rural hospitals in terms of diagnoses, comorbidities, demographics, and the care received and 2.) analyze how the inclusion or exclusion of transferred emergency patients affects risk-adjusted mortality rates for transferring and receiving hospitals.
    Topics: Emergency medical services and trauma, Quality


  • Has the Medicare Part D Program Improved Medication Access and the Health Status of Rural Beneficiaries?
    This project will use Medicare Current Beneficiary Survey data to assess the impact of the Medicare Part D Program on medication access and the health status of rural Medicare beneficiaries.
    Topics: Medicare Advantage (MA), Medicare Part D, Pharmacy and prescription drugs
  • Progress Toward Meaningful Use of Health Information Technology Among Rural Physician Practices
    This project will assess progress toward the meaningful use of health information technology among rural physician practices, using several sources of data. This empirical analysis will be supplemented by a qualitative assessment of rural physician practices' experiences with the meaningful use of health IT, working with two quality improvement organizations (QIOs)/Regional Extension Centers (RECs).
    Topics: Health information technology, Physicians
  • Quality of Obstetric Care and Perinatal Safety in Rural Hospitals
    The project will use both national and state-level hospital discharge data to examine obstetric care quality and perinatal safety in rural U.S. hospitals, with an in-depth focus on rural hospitals in a nationally representative group of eight states across all four U.S. Census regions.
    Topics: Critical Access Hospitals, Maternal health, Women


  • Measuring Quality Performance in CAHs
    The purpose of the project is to update our previous analyses of Critical Access Hospital (CAH) participation in Hospital Compare, analyze trends over time, and explore additional sources of quality data for CAHs.
    Topics: Critical Access Hospitals, Quality


  • Quality and Financial Status of Critical Access Hospitals: A Preliminary Analysis
    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.
    Topics: Critical Access Hospitals, Healthcare financing, Quality, Rural Hospital Flexibility Program
  • Rural Hospital Flexibility Performance Monitoring Project- Grant Years 2003-2008
    Under contract with the federal Office of Rural Health Policy, the Rural Health Research Centers at the Universities of Minnesota, North Carolina, and Southern Maine are cooperatively conducting a performance monitoring project for the Medicare Rural Hospital Flexibility Program (Flex Program). The monitoring project will assess the impact of the Flex Program on rural hospitals and communities and the role of states in achieving overall program objectives, including improving access to and the quality of health care services; improving the financial performance of Critical Access Hospitals; and engaging rural communities in health care system development.
    Topics: Critical Access Hospitals, Rural Hospital Flexibility Program



  • Analysis of 2004-2005 State Flex Grant Plans
    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.
    Topics: Emergency medical services and trauma, Networking and collaboration, Quality, Rural Hospital Flexibility Program


  • Critical Access Hospital Access To and Use of Capital
    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.
    Topics: Critical Access Hospitals, Rural Hospital Flexibility Program
  • Evaluating the Financial Impact of Critical Access Hospital Conversion Over Time
    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.
    Topics: Critical Access Hospitals, Healthcare financing, Rural Hospital Flexibility Program