North Carolina Rural Health Research and Policy Analysis Center

Current Projects

• Alternative Methods for Defining Rural Hospital Service Area Market
  Options for describing the population served by a rural hospital are limited; geopolitical areas such as counties are convenient, but ZIP-based methods may be more accurate. In this project, we will consider multiple options that tradeoff ease, accuracy, ability to capture trends, and availability.
  Topics: Hospitals and clinics, Medicare
  
• Developing a Post-COVID Financial Distress Index
  This project will update and improve the North Carolina Rural Health Research Program's Financial Distress Index, which uses historical data about hospital financial performance, government reimbursement, organizational characteristics, and market characteristics to predict the current risk of financial distress.
  Topics: Hospitals and clinics, Medicare
  
• Long-term Implications of Declining Inpatient Revenue on Bed Surge Capacity and Emergency Preparedness
  Inpatient use and key health care services offered at rural hospitals have declined over the past decade. Has the quest for efficiency in hospitals led to a dangerously low surge capacity and ability to effectively handle public health emergencies?
  Topics: Hospitals and clinics, Medicare
  
• Low Volume Hospitals
  This analysis will compare rural low volume hospitals (LVHs) to non-LVH characteristics and estimate the financial impact of eliminating the LVH program and reverting to the original (2005) LVH classification and payment adjustment.
  Topics: Hospitals and clinics, Medicare
  
• Medicare Advantage and Financial, Hospital, and Community Characteristics of Rural Hospitals
  This project will compare financial, hospital, and community differences among rural hospitals located in areas with lower versus higher rates of Medicare Advantage penetration.
  Topics: Hospitals and clinics, Medicare, Medicare Advantage (MA)
  
• Medicare Disproportionate Share Hospital and Uncompensated Care Payments Since the ACA
  This project will compare disproportionate share hospital payments and uncompensated care payments to rural and urban hospitals for the years 2013-2022.
  Topics: Medicare, Medicare Prospective Payment System (PPS)
  
• Rural-Urban Differences in Medicaid Utilization
  Nationwide, approximately 1 in 4 rural residents are insured by Medicaid, yet we lack basic understanding of rural-urban differences in Medicaid utilization.
  Topics: Medicaid and CHIP, Minority health