North Carolina Rural Health Research and Policy Analysis Center

Research Products & Journal Articles

Browse the full list of research publications from this Rural Health Research Center.

Products – Freely accessible products include policy briefs, fact sheets, full reports, chartbooks, and interactive data websites.

Journal Articles – Articles in peer-reviewed journals may require a subscription or affiliation with a subscribing library. For these publications, Gateway lists the article citation, a brief summary, a link to additional information and access to the full-text of the article, if available.









  • Best Practices for Health Insurance Marketplace Outreach and Enrollment in Rural Areas
    Fact Sheet
    Date: 12/2014
    Research suggests enrollment rates for those in rural areas was less than urban areas during the first Health Insurance Marketplace enrollment period. Interviews of navigators, health centers, and others in rural counties with high enrollment rates were conducted to uncover best practices for marketing, outreach/education, in-reach, and enrollment.
  • Rural-Urban Differences in Continuity of Care Among Medicare Beneficiaries
    Policy Brief
    Date: 12/2014
    In response to the ACA and other reforms in the healthcare market, new care models are being tested and implemented. To addresses concerns that healthcare in rural areas may be more fractured and thus a difficult place for the models to succeed, we measured continuity of care using detailed data on a sample of Medicare beneficiaries from 2000-2009.
  • Geographic Variation in Plan Uptake in the Federally Facilitated Marketplace
    Policy Brief
    Date: 10/2014
    This brief combines the data on plan selection in the federally facilitated marketplaces with estimates of those likely to qualify for the marketplace to calculate the percentage of potential eligible individuals who chose a health insurance plan (the uptake rate). It contains a heat map showing the variation in uptake rates across the country.
  • Rural Hospital Mergers and Acquisitions: Who Is Being Acquired and What Happens Afterward?
    Policy Brief
    Date: 08/2014
    A brief from the North Carolina Rural Health Research and Policy Analysis Center examines the implications of mergers and acquisitions for small rural hospitals. The brief addresses the characteristics of rural hospitals that merged and the changes in hospital financial performance, staffing, or services following a merger.
  • How Does Medicaid Expansion Affect Insurance Coverage of Rural Populations?
    Policy Brief
    Date: 07/2014
    This brief examines how states' decisions on Medicaid expansion are impacting rural areas in the United States. Population estimates, current state expansion status, and state-level insurance estimates were used to answer two main questions—how is expansion affecting rural populations and how would it differ if every state were to expand Medicaid.
  • Safety Net Clinics Serving the Elderly in Rural Areas: Rural Health Clinic Patients Compared to Federally Qualified Health Center Patients
    Policy Brief
    Date: 05/2014
    This brief, the third and final in a series on rural health centers (RHC), uses data from 2009 Medicare outpatient provider claims to look at clinic locations, number of beneficiaries served, and number of/cost per claim for each type of rural safety net clinic, as well as beneficiaries' ages, health problems, and distance traveled for care.
  • Discharge to Swing Bed or Skilled Nursing Facility: Who Goes Where?
    Policy Brief
    Date: 02/2014
    This brief examines health conditions of patients discharged from rural prospective payment system (PPS) hospitals and critical access hospitals (CAHs) to swing beds and skilled nursing facilities (SNFs).