University of Minnesota Rural Health Research Center

Products

Listed by publication date. You can also view these publications alphabetically.

For a complete list of publications from the Center, which may include older publications and publications funded by other sources, please see the Center's website.

2017

  • Rural Transportation: Challenges and Opportunities
    Policy Brief
    University of Minnesota Rural Health Research Center
    Date: 11/2017
    This policy brief uses survey data from 113 key informants across all 50 states to describe challenges and opportunities related to rural transportation.
  • Regulating Network Adequacy for Rural Populations: Perspectives of Five States
    Policy Brief
    University of Minnesota Rural Health Research Center
    Date: 08/2017
    The purpose of this study was to examine how five geographically-diverse states with significant rural populations define "network adequacy" and the degree to which they consider rural issues when regulating networks.
  • Identifying Adverse Drug Events in Rural Hospitals: An Eight-State Study
    Policy Brief
    University of Minnesota Rural Health Research Center
    Date: 05/2017
    Analyzes the prevalence of Adverse Drug Events (ADEs) in rural hospitals, including both CAHs and rural PPS hospitals, related to four categories of drugs: steroids, antibiotics, opiates / narcotics, and anticoagulants in 2013 for eight states. It also examines whether or not these hospitals' ADE rates varied based on hospital characteristics.
  • Medical Barriers to Nursing Home Care for Rural Residents
    Policy Brief
    University of Minnesota Rural Health Research Center
    Date: 05/2017
    This policy brief describes barriers rural residents with complex medical care needs may face when seeking placement in a nursing home and identifies potential policy strategies to overcome them.
  • Resources to Reduce Adverse Drug Events in Rural Hospitals
    Policy Brief
    University of Minnesota Rural Health Research Center
    Date: 05/2017
    This policy brief provides resources that could be used to decrease Adverse Drug Events (ADEs) in rural hospitals.
  • Closure of Hospital Obstetric Services Disproportionately Affects Less-Populated Counties
    Policy Brief
    University of Minnesota Rural Health Research Center
    Date: 04/2017
    This policy brief describes the scope of obstetric unit and hospital closures resulting in loss of obstetric services in rural U.S. counties from 2004 to 2014.
  • State Variability in Access to Hospital-Based Obstetric Services in Rural US Counties
    Policy Brief
    University of Minnesota Rural Health Research Center
    Date: 04/2017
    This policy brief describes state-level variations in 1) the availability of hospital-based obstetric services, and 2) the scope of obstetric unit and hospital closures resulting in the loss of obstetric services in rural U.S. counties from 2004 to 2014.

2016

  • Rural-Urban Differences in Insurer Participation for Marketplace-Based Coverage
    Policy Brief
    University of Minnesota Rural Health Research Center
    Date: 08/2016
    This policy brief examines the differences between rural and urban counties in terms of the number and composition of insurers in Federally-Facilitated Marketplaces.
  • Quality Measures and Sociodemographic Risk Factors: The Rural Context
    Policy Brief
    University of Minnesota Rural Health Research Center
    Date: 05/2016
    This policy brief aims to inform discussions concerning whether or not to adjust provider quality measures for differences in patient characteristics by examining how rurality and key sociodemographic variables might affect quality-of-care outcomes.
  • State Variations in the Rural Obstetric Workforce
    Policy Brief
    University of Minnesota Rural Health Research Center
    Date: 05/2016
    Many types of staff are necessary to successfully run an obstetrics unit. Rural hospitals face unique staffing challenges. This policy brief describes the obstetric workforce in rural hospitals by state for nine states: Colorado, Iowa, Kentucky, New York, North Carolina, Oregon, Vermont, Washington, and Wisconsin.
  • Medicare Costs and Utilization Among Beneficiaries in Rural Areas
    Policy Brief
    University of Minnesota Rural Health Research Center
    Date: 03/2016
    This study assesses the relationship between service utilization patterns and costs for rural Medicare beneficiaries across the rural continuum. It also examines the relationships between rural beneficiaries’ service utilization and healthcare delivery market structure and evaluates strategies and policies to address high costs in rural areas.

2015

  • Rural Hospital and Physician Participation in Private Sector Quality Initiatives
    Policy Brief
    University of Minnesota Rural Health Research Center
    Date: 10/2015
    This project examined private sector quality reporting and quality improvement initiatives being implemented by dominant insurers in states with significant rural populations. The policy brief profiles 12 initiatives, half focused on physician quality improvement and half focused on hospital quality improvement.
  • Which Rural and Urban Hospitals Have Received Readmission Penalties Over Time?
    Policy Brief
    University of Minnesota Rural Health Research Center
    Date: 10/2015
    The Hospital Readmissions Reduction Program reduces Medicare payments for hospitals with excess rates of patient readmissions for certain conditions. It assesses rural/urban differences in the proportion of hospitals penalized under the program over time and whether condition-specific hospital readmission rates differ for rural/urban hospitals.
  • Differences in Part D Plans Offered to Rural and Urban Medicare Beneficiaries
    Policy Brief
    University of Minnesota Rural Health Research Center
    Date: 07/2015
    This brief analyzes how the plan options available to rural and urban beneficiaries differ in terms of premiums, deductibles, and copayments, as well as differences in plan options within rural areas.
  • Rural and Urban Differences in Choice of and Satisfaction with Medicare Part D Plans
    Policy Brief
    University of Minnesota Rural Health Research Center
    Date: 07/2015
    This brief examines whether rural Medicare beneficiaries are satisfied with their Medicare Part D drug plans and whether there is a difference in beneficiary satisfaction and plan selection experience by rurality.
  • Rural Women Delivering Babies in Non-Local Hospitals: Differences by Rurality and Insurance Status
    Policy Brief
    University of Minnesota Rural Health Research Center
    Date: 06/2015
    This policy brief describes the extent to which rural pregnant women give birth in non-local hospitals and analyzes current patterns of non-local delivery by rural women's health insurance status and residential rurality.
  • Nurse Staffing Levels and Quality of Care in Rural Nursing Homes
    Policy Brief
    University of Minnesota Rural Health Research Center
    Date: 01/2015
    This study’s purpose was to examine the relationship between nurse staffing levels and care quality in rural nursing homes and to assess potential differences between hospital-based and freestanding rural nursing homes.

2014

  • The Obstetric Care Workforce in Critical Access Hospitals (CAHs) and Rural Non-CAHs
    Policy Brief
    University of Minnesota Rural Health Research Center
    Date: 11/2014
    This brief details rural hospital obstetric staffing patterns in nine states by critical access hospital status. The purpose was to examine obstetric practice models in rural hospitals, providing information to rural hospitals with obstetric care units regarding workforce and informing policymakers about the context in which the hospitals operate.
  • Successful Health Insurance Outreach, Education, and Enrollment Strategies for Rural Hospitals
    Policy Brief
    University of Minnesota Rural Health Research Center
    Date: 11/2014
    This brief offers best practices for hospitals to use in health insurance outreach/enrollment based on interviews with administrators, staff, and community reps at 11 rural hospitals. It also discusses certified application counselors and the importance of collaborative community partnerships in conducting insurance enrollment outreach/education.
  • Does Rurality Affect Observation Care Services Use in CAHs for Medicare Beneficiaries?
    Policy Brief
    University of Minnesota Rural Health Research Center
    Date: 10/2014
    This brief describes the use of observation services across levels of rurality by Medicare beneficiaries in critical access hospitals, the demographics and health status of patients receiving these services, and the characteristics of their observation stays.
  • Observation Care Services for Medicare Beneficiaries in Rural Hospitals: Policy Issues and Stakeholder Perspectives
    Policy Brief
    University of Minnesota Rural Health Research Center
    Date: 10/2014
    This brief describes the findings of a qualitative study aimed at gaining a greater understanding of the rural policy context surrounding the use of observation care services by Medicare beneficiaries from 2010 to 2013.
  • Which Medicare Patients Are Transferred from Rural Emergency Departments?
    Policy Brief
    University of Minnesota Rural Health Research Center
    Date: 06/2014
    A brief from the University of Minnesota Rural Health Research Center analyzes transfers of Medicare beneficiaries who received emergency care in a critical access hospitals or rural hospitals and were transferred to other hospitals for care.

2013

2007

  • State Initiatives Funded by the Medicare Rural Hospital Flexibility Grant Program
    Maine Rural Health Research Center, North Carolina Rural Health Research and Policy Analysis Center, University of Minnesota Rural Health Research Center
    Date: 10/2007
    This report explores activities funded by the Medicare Rural Hospital Flexibility Program (Flex Program) to strengthen the rural healthcare infrastructure and discusses which activities were considered most successful by state Flex coordinators.
  • Critical Access Hospital Year 2 Hospital Compare Participation and Quality Measure Results
    Policy Brief
    University of Minnesota Rural Health Research Center
    Date: 05/2007
    This policy brief examines the second-year participation and quality measure results for critical access hospitals in the Centers for Medicare and Medicaid Services Hospital Compare public reporting database.
  • Critical Access Hospital Year 2 Hospital Compare Participation and Quality Measure Results: Briefing Paper
    University of Minnesota Rural Health Research Center
    Date: 04/2007
    This brief examines the second-year participation and quality measure results for critical access hospitals in the Centers for Medicare and Medicaid Services Hospital Compare public reporting database for hospital quality measures.
  • The State Flex Program at 10 Years: Strengthening Critical Access Hospitals and Rural Communities
    Policy Brief
    Maine Rural Health Research Center, North Carolina Rural Health Research and Policy Analysis Center, University of Minnesota Rural Health Research Center
    Date: 04/2007
    To understand the priorities/accomplishments of state Flex Grant Programs, the Flex Monitoring Team asked Flex coordinators to identify and discuss their states' three most successful initiatives in the last two years. Interviews were conducted with Flex coordinators and State Office of Rural Health staff in 45 states.
  • Rural Hospital Emergency Department Quality Measures: Aggregate Data Report
    University of Minnesota Rural Health Research Center
    Date: 03/2007
    This report shares findings from a project testing emergency department (ED) quality measures in critical access hospitals in Washington state. The quality measures focused on patients presenting to the ED with chest pain/acute myocardial infarction or trauma and patients seen in the ED who were transferred to another hospital for care.
  • The Community Impact of Critical Access Hospitals
    Maine Rural Health Research Center, North Carolina Rural Health Research and Policy Analysis Center, University of Minnesota Rural Health Research Center
    Date: 02/2007
    This policy brief discusses the findings of a project to understand the community involvement and impact of critical access hospitals and the Medicare Rural Hospital Flexibility Program (Flex Program).
  • Exploring the Community Impact of Critical Access Hospitals
    Maine Rural Health Research Center, North Carolina Rural Health Research and Policy Analysis Center, University of Minnesota Rural Health Research Center
    Date: 01/2007
    This paper reports on a series of site visits to six diverse rural communities and critical access hospitals to assess the experiences and impact of these hospitals in responding to their community's health infrastructure needs.

2006

  • The Current Status of Health Information Technology Use in CAHs
    University of Minnesota Rural Health Research Center
    Date: 05/2006
    The purpose of this briefing paper is to assess the current status of health information technology use in critical access hospitals nationally.
  • A Review of State Flex Program Plans, 2004-2005
    Maine Rural Health Research Center, University of Minnesota Rural Health Research Center
    Date: 03/2006
    This paper examines the objectives and project activities proposed by states in their Medicare Rural Hospital Flexibility Program (Flex Program) grant applications for Fiscal Year 2004 to strengthen the rural healthcare infrastructure in their states. It highlights recent trends in state Flex Program planning, development, and implementation.
  • CAH Participation in Hospital Compare and Initial Results
    University of Minnesota Rural Health Research Center
    Date: 02/2006
    This paper examines 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 presents the initial results for CAHs and comparisons with other hospital groups on quality measures for various conditions.

2005

  • Is Large Really Beautiful? Physician Practice in Small versus Large Scale Communities
    University of Minnesota Rural Health Research Center
    Date: 09/2005
    This paper examines the effect of community size on how physicians view their practices as reported by respondents to two waves (1996-97 and 1998-99) of a national sample survey conducted as part of the Community Tracking Study. Results suggest that bigger is not necessarily better when it comes to physicians' perceptions of their practices.
  • Availability and Use of Capital by Critical Access Hospitals
    University of Minnesota Rural Health Research Center
    Date: 03/2005
    This paper examines the experiences of critical access hospitals (CAHs) in meeting their capital needs. It focuses on their efforts to obtain capital, the capital sources tapped through these efforts and how CAHs have used the capital they have been able to obtain over the last few years and assesses their current capital needs.

2004

2003

  • Grantee Sustainability in the Rural Health Outreach Grant Program
    University of Minnesota Rural Health Research Center
    Date: 12/2003
    This paper describes a study of the post-grant experiences of 99 Rural Health Outreach Grant recipients and focuses on the extent to which programs were able to maintain or expand services after their grants ended and characteristics that helped programs succeed in the post-grant period.
  • Are There Geographic Disparities in Out-of-Pocket Spending by Medicare Beneficiaries?
    University of Minnesota Rural Health Research Center
    Date: 10/2003
    This paper describes a study comparing out-of-pocket spending among rural and urban Medicare recipients. It includes data on differences based on supplemental insurance coverage.
  • The Response of Local Health Care Systems in the Rural Midwest to a Growing Latino Population
    University of Minnesota Rural Health Research Center
    Date: 08/2003
    This paper reports on the case studies of rural communities in Iowa, Kansas, and Nebraska, documenting successful strategies that could be adopted by other communities facing challenges to their rural healthcare system in meeting the needs of a growing Latino population.
  • Rural Health Networks: Evolving Organizational Forms and Functions
    University of Minnesota Rural Health Research Center
    Date: 06/2003
    This report discusses results of a survey of rural health networks. It includes information about the location, membership, relationships, governance, management, process, and products of rural health networks.
  • Environmental Context of Patient Safety and Medical Errors
    University of Minnesota Rural Health Research Center
    Date: 03/2003
    This paper explores the environmental context of patient safety/medical errors with specific interest in rural areas. It reviews patient safety/medical error literature, identifies features of rural healthcare organizations and their environment relating to patient safety issues/medical errors, and discusses error reduction/prevention strategies.
  • Rural Hospitals: New Millennium and New Challenges
    University of Minnesota Rural Health Research Center
    Date: 02/2003
    This report discusses the changes in rural hospitals that took place in the decade of the 1990s and discusses some of the challenges that face rural hospitals in 2003. It includes discussion of rural hospitals' organizational structures, health service provision, payment/reimbursement, and financial performance.
  • The Financial Effects of Critical Access Hospital Conversion
    University of Minnesota Rural Health Research Center
    Date: 01/2003
    This paper describes how the first wave of conversions to critical access hospital status affected rural hospitals’ financial performances and organizational structures.
  • Rate of Return on Capital Investments at Small Rural Hospitals
    University of Minnesota Rural Health Research Center
    Date: 01/2003
    This paper examines whether the aging of rural facilities is due to a lower rate of return on capital investment at these hospitals. This paper also investigates whether membership in a hospital system improves access to capital and results in the updating of buildings and equipment.

2002

  • Implementing Quality Assessment and Performance Improvement Systems in Rural Health Clinics: Clinic and State Agency Responses
    University of Minnesota Rural Health Research Center
    Date: 08/2002
    This paper assesses the potential of a diverse set of rural health clinics (RHCs) to comply with the quality assessment and performance improvement program (QAPI) requirements and the capacity of state agencies to provide RHCs with technical assistance in their QAPI implementation.
  • Use of the Hospice Benefit by Rural Medicare Beneficiaries
    University of Minnesota Rural Health Research Center
    Date: 08/2002
    This publication identifies urban-rural differences in hospice use in rural service areas.
  • Rural Hospital Access to Capital: Issues and Recommendations
    University of Minnesota Rural Health Research Center
    Date: 07/2002
    This paper identifies programs that have assisted/could assist rural hospitals in meeting capital needs; assesses whether rural hospital borrowers have difficulty in meeting capital needs under existing grant, loan, and mortgage insurance programs; and discusses potential options for improving access to capital for rural hospitals.
  • Financial Incentives for Rural Hospitals to Expand the Scope of Their Services
    University of Minnesota Rural Health Research Center
    Date: 06/2002
    This paper examines the financial incentives that rural hospitals have to conduct surgery and treat more complex medical conditions. The objective is to evaluate whether rural hospitals that offer broader services are more profitable than hospitals with limited inpatient services.
  • Understanding Rural Hospital Bypass Behavior
    University of Minnesota Rural Health Research Center
    Date: 06/2002
    This study provides a descriptive analysis of rural hospital bypass behavior. It focuses on the extent to which patients admitted from rural areas are bypassing local facilities and whether there are changes in bypass patterns over time.
  • Access to Emergency Medical Services in Rural Areas: The Supporting Role of State EMS Agencies
    University of Minnesota Rural Health Research Center
    Date: 02/2002
    This paper reports on a survey of state emergency medical services (EMS) directors about access to rural EMS; programs/initiatives by state EMS agencies to target rural/volunteer EMS providers; integration initiatives by rural EMS providers; issues in medical direction for rural EMS; and anticipated effects of the new Medicare fee schedule.

2001

2000

  • Influence of Rural Residence on the Use of Preventative Health Care Services
    University of Minnesota Rural Health Research Center
    Date: 11/2000
    This paper details a study of the utilization of specific preventive healthcare services by rural women and men to assess the impact of rural residence, the availability of healthcare providers and technology, demographic factors, and health insurance status on the likelihood of obtaining several preventive healthcare services.
  • Financial Viability of Rural Hospitals in a Post-BBA Environment
    University of Minnesota Rural Health Research Center
    Date: 10/2000
    This paper evaluates the financial viability of rural hospitals under the Balanced Budget Act of 1997 and the Balanced Budget Refinement Act of 1999 Medicare payment policies. It estimates the number of hospitals that will become critical access hospitals and the number of beds at each hospital.
  • Why do Rural Primary-Care Physicians Sell Their Practices?
    University of Minnesota Rural Health Research Center
    Date: 06/2000
    This study evaluates why rural primary care physicians sell their practices. It examines the factors that led independent physicians to sell their practices to either non-local buyers, local hospitals, or local physicians.
  • Strategic Choices of Rural Health Networks: Implications for Goals and Performance Measurement
    University of Minnesota Rural Health Research Center
    Date: 01/2000
    The purpose of this study is to obtain a greater understanding of rural health networks by classifying them according to their functions and purposes. Examples of performance measures that might be used for the different network types are given.