North Dakota and NORC Rural Health Reform Policy Research Center

Current Projects

  • Comparisons of Rural Definitions
    This project will lead to the creation of a mega rural and frontier website. This website will emphasize the use of various rural definitions and datasets for health care policy, policy analysis, and research.
    Topic: Frontier health
  • Cost of Running a Rural Ambulance Service
    This study will address the cost of running ambulance services in rural areas by organizational structure/source of funding, the factors contributing to differences in costs, and factors contributing to differences in financial viability.
    Topics: Emergency medical services (EMS), Healthcare financing
  • Critical Review and Analysis Regarding PCSAs, HPSA Rational Service Areas, and Other: Geographic Alternatives for Creating Useful Primary Care Service Areas
    The purpose of this proposed project is to review Dartmouth’s Primary Care Service Areas (PCSAs), other Rational Service Area (RSA) methodologies, and alternative methodologies related to their strengths, weaknesses, and spatial analytic criteria regarding their ability to serve in the process of developing useful primary care service areas. The project will include normative service areas where in a primary care service area should exist (potential service area) but does not (e.g., large area/population with no providers that could support them).
    Topics: Physicians, Workforce
  • Exploring Global Budgets as a New Reimbursement Model for Low-Volume Critical Access Hospitals
    Given the complexity of the Global Budget reimbursement model, we are interested to learn if there are aspects of the model that can be applied to consolidate reimbursement across rural and frontier health care settings, particularly for CAHs with low-volume (e.g., < 5 acute patients as a daily census).
    Topics: Critical Access Hospitals and Rural Hospital Flexibility Program, Healthcare financing, Hospitals and clinics
  • Implications of Rural Ambulance Service Closures
    The purpose of this project is to examine closed ambulance services and those ambulance services adjacent to the closed units. The ambulance services adjacent to those which closed will be examined for service area, workload, and staffing for one year prior to and one year after the adjacent service closure.
    Topics: Allied health professionals, Emergency medical services (EMS), Frontier health, Health disparities, Health services, Workforce
  • Rural End-of-Life Care: An Analysis of Rural Medicare Beneficiaries’ Health Care Costs, Utilization, and Patient-Centered Decisions
    This research examines the costs and types of care that rural Medicare beneficiaries use during their last six months of life. In addition, to learn how patient-centered decisions are made regarding health care transitions at the end-of-life, interview were conducted with rural providers and families.
    Topics: Aging, Long term care, Medicare
  • Rural Hospice Surveys Regarding Family Members & Health Workforce
    This project’s two parts survey both hospice users’ family members and hospice CEOs regarding their health workforce staffing and shortages. The family member survey involves a sample of hospices from a geographically disperse group of states and the CEO survey involves a national random sample of hospice CEOs.
    Topics: Hospice and palliative care, Workforce
  • Utilization of Hospital Care for Rural Medicare Beneficiaries
    This project examines where rural and frontier Medicare beneficiaries access hospital care. Specifically, it explores the different types of inpatient care sought in local rural communities and at tertiary providers. Beneficiary patterns of care by condition, location type and other factors will be examined. The study will also focus on the bypassing behavior of rural residents when being hospitalized. Analysis sensitivity analyses are being performed regarding small travel time differences per alternative hospitals.
    Topics: Frontier health, Hospitals and clinics, Medicare