NORC Walsh Center for Rural Health Analysis

Completed Projects

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


  • Effect of Travel Distances on Access to Obstetric Care and Birth Outcomes in Rural Communities
    This study will assess whether the availability of obstetric providers in rural areas is sufficient to meet the need for obstetric care by measuring the distance patients must travel to obtain prenatal care and delivery and by examining health outcomes related to labor and delivery.
    Topics: Maternal health, Physicians, Women
  • Exploring the Black Box: Design and Implementation Issues of P4P for Rural Physicians
    Information about how pay-for-performance (P4P) payment systems work in ambulatory care settings, and in particular, how rural physicians might be affected, is scarce. This study employs qualitative research methods to explore the design and implementation of P4P systems and to investigate effects of P4P on rural physicians in a variety of settings.
    Topics: Emergency medical services and trauma, Healthcare financing, Physicians
  • Outpatient Payment Policy Under Medicare: Recent Policy Developments from the Rural Perspective
    This study was designed to examine outpatient payment options for rural hospitals, the advantages and disadvantages of each, and their potential impact on hospital revenue and rural access to health services.
    Topics: Healthcare financing, Hospitals and clinics
  • Use of Emergency Departments and Inpatient Care for Conditions Related to Poor Oral Health Care
    This study combines patient-level data from emergency departments and inpatient hospitals from selected states with data on dental HPSA designation, Medicaid dental coverage, and area population characteristics to document the extent to which ED and inpatient settings are used to treat problems related to poor oral health care, the charges for such care, and variations in the use of such services by characteristics of the patient and the area.
    Topics: Health services, Oral health



  • Advantages and Disadvantages of Hospital-Based Emergency Medical Services in Rural Areas
    This project sought to clarify issues surrounding hospital decisions to acquire and maintain ownership of community ambulance services.
    Topics: Emergency medical services and trauma, Hospitals and clinics
  • Augmenting Efforts for a Tool to Predict Post-Event Rural Population Surge
    The Walsh Center is developing a tool to predict post-event rural population surge following public health emergencies, with funding originating from CDC. To enhance predictive accuracy of this tool and to more generally inform rural preparedness efforts, this project will gather information using key informant and survey methodologies.
    Topic: Emergency preparedness and response
  • Financing Rural Public Health Activities in Chronic Disease Prevention and Health Promotion
    This project describes the federal-state funding streams for selected local public health activities in the area of chronic disease prevention and health promotion, and assesses potential barriers to program implementation in less populated, local areas of a state.
    Topics: Chronic diseases and conditions, Health promotion and disease prevention, Healthcare financing, Public health
  • Impact of CAH Conversion on Hospital Costs and Mix of Services
    This study examined Medicare Cost Report and claims data for hospitals before and after CAH conversion in order to better understand changes in hospital costs associated with CAH conversion, factors associated with any cost growth, and changes in the mix of services provided by the facility.
    Topics: Critical Access Hospitals, Health services, Healthcare financing
  • Quality Improvement Organizations' Contributions to Rural Hospital Performance
    This qualitative study is designed to gather information on best-practices in Quality Improvement Organization (QIO)-rural hospital partnerships. Specifically, this study will identify successful and replicable examples in which QIOs have worked with rural and critical access hospitals to improve processes of care, implement health information technology and promote organizational safety culture.
    Topics: Critical Access Hospitals, Health information technology, Hospitals and clinics, Quality
  • Rural Dimensions of Medicare Payment Policies
    Topics: Medicare, Post-acute care


  • Investments in Health Information Technology by Rural Hospitals
    This study involved a national survey of rural hospitals conducted in late spring 2006 to gather data about readiness to adopt health IT, current use of different technologies, perceptions about the benefits and barriers to health IT adoption, future implementation plans, use of Federal programs designed to facilitate IT adoption, and interest in various health IT policy options.
    Topics: Health information technology, Hospitals and clinics
  • Rapid Response: Elimination of Bad Debt Payments to Rural PPS Hospitals
    The purpose of this project is to examine: (1) the extent to which elimination of Medicare Bad Debt payments will reduce reimbursement to rural PPS hospitals and (2) how rural hospitals would respond to this reduction in reimbursement.
    Topics: Healthcare financing, Hospitals and clinics, Medicare Prospective Payment System (PPS)
  • Rural Hospital Participation in the 340B Drug Discount Program
    The 340B drug discount program enables certain types of safety net organizations to obtain deeply discounted medications, at prices below the 'best price' typically offered to Medicaid agencies. This study used telephone interviews and mail surveys to explore the experiences that rural hospitals have had in seeking 340B eligibility status.
    Topics: Hospitals and clinics, Pharmacy and prescription drugs


  • Declining Access to Hospital-based Obstetric Services in Rural Areas: Causes and Impact
    This study examines the declining availability of hospital-based obstetric services in rural areas from the mid-1980s to the early 2000s. It examines potential causes for this trend and explores the effects of medical malpractice reforms.
    Topics: Hospitals and clinics, Legislation and regulation, Maternal health, Women
  • Roadmap for the Adoption of Health Information Technology in Rural Communities
    This project developed a resource document intended to help rural health care providers of all types as they think about whether an investment in health information technology makes sense for them and work through various implementation issues. The document was distributed at the September 2006 conference entitled "Health Information Technology: A Rural Provider's Roadmap to Quality," sponsored by ORHP.
    Topics: Health information technology, Health services


  • Impact of the Home Health PPS on Access in Rural America
    This study is designed to help policymakers understand whether patterns of home care use in rural communities have been affected by the PPS. Analyses will provide information on the characteristics of the patients served, the number and mix of services rendered, and quality of care.
    Topics: Home health, Medicare Prospective Payment System (PPS)
  • Medicare Beneficiary Outcomes in Rural and Urban Home Health Agencies
    This study will compare the performance of rural and urban home care agencies, and identify agency characteristics that contribute to better patient care outcomes.
    Topics: Home health, Medicare Prospective Payment System (PPS), Quality
  • Post-Acute Care: A Rural and Urban Comparison
    This multi-phase analysis examines whether discharge patterns for and use of post-acute care services by rural and urban hospitalized Medicare beneficiaries differ and, if they do, what are the sources of these different patterns.
    Topics: Home health, Long-term care, Medicare, Post-acute care