NORC Walsh Center for Rural Health Analysis

Completed Projects

Alphabetical list. You can also view by project completion date.

• Achieving Equity in Disproportionate Share Payments to Rural Hospitals: An Examination of MedPAC's Revised Disproportionate Share Formula
  Topics: Healthcare financing, Hospitals and clinics, Legislation and regulation
  
• 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 (EMS) 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
  
• Burdens of HIPAA on Rural Hospitals
  Topics: Hospitals and clinics, Legislation and regulation
  
• Capital Needs of Small Rural Hospitals
  Topic: Hospitals and clinics
  
• Cash Flow of Small Rural Hospitals: The Impact of the Medicare Outpatient Prospective Payment System
  Topics: Healthcare financing, Hospitals and clinics, Medicare Prospective Payment System (PPS)
  
• Comparison of Coding and Billing Practices Among Selected Small Rural and Urban Hospital Outpatient Departments
  Topics: Hospitals and clinics, Medicare Prospective Payment System (PPS)
  
• Cost of Ambulance Transports for Low-Volume Providers in Rural Areas and Its Implications for Medicare Reimbursement Policy
  Topics: Emergency medical services (EMS) and trauma, Healthcare financing, Medicare
  
• Counting Rural Health Care Facilities: A Moving Target?
  Topics: Home health, Hospitals and clinics, Medicare, Medicare Prospective Payment System (PPS)
  
• 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
  
• Determinants of Quality of Care in Rural Communities: How Does The Health Care Infrastructure Affect Quality of Care in Rural America?
  Topics: Health services, Quality, Workforce
  
• Do We Need a Rural Payment Differential Under the Medicare Ambulance Fee Schedule?
  Topics: Emergency medical services (EMS) and trauma, Healthcare financing, Medicare
  
• Effective Strategies for Achieving HIPAA Compliance Among Rural Hospitals
  Topics: Hospitals and clinics, Legislation and regulation
  
• 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 (EMS) and trauma, Healthcare financing, Physicians
  
• Financial Impact of Outpatient Payment Reform on Rural Hospitals
  Topics: Healthcare financing, Hospitals and clinics, Medicare Prospective Payment System (PPS)
  
• 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
  
• Home Care in Rural America
  Topics: Home health, Medicare, Medicare Prospective Payment System (PPS)
  
• 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 (CAHs), Health services, Healthcare financing
  
• 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)
  
• Impact of the Proposed Medicare Prospective Payment Reforms on Rural Hospitals in Selected States
  Topics: Healthcare financing, Hospitals and clinics, Medicare Prospective Payment System (PPS)
  
• 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
  
• Involvement of State Offices of Rural Health in Emergency Preparedness Activities
  This project will follow-up with the state offices of rural health (SORH) to identify their current involvement with preparedness in rural areas, particularly in the use of funds earmarked to bioterrorism preparedness.
  Topic: Emergency preparedness and response
  
• 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
  
• Medicare Payment for Post-Acute Care Transfers
  Topics: Healthcare financing, Hospitals and clinics, Post-acute care
  
• National Rural Hospital Flexibility Program Tracking Project: Emergency Medical Services
  Topics: Critical Access Hospitals (CAHs), Emergency medical services (EMS) and trauma, Networking and collaboration, Rural Hospital Flexibility Program
  
• National Rural Hospital Flexibility Program Tracking Project: Perceptions of Community Physicians
  Topics: Critical Access Hospitals (CAHs), Physicians, Rural Hospital Flexibility Program
  
• Options for Structuring Disproportionate Share (DSH) Payments to Account for Uncompensated Care: Impact on Rural Hospitals
  This study will identify options for development of an equitable DSH payment adjustment that accounts for hospital uncompensated care costs and determine the financial impact of each of these proposals on rural hospitals, using simulations with data from Washington, West Virginia, Texas, and Iowa.
  Topics: Healthcare financing, Hospitals and clinics
  
• 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
  
• 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
  
• Public Health System Performance Measurement: Are Standards Applicable to Rural Communities?
  This project aims to increase understanding of how public health governance affects the structure of public health services, and how this in turn influences the strategies adopted for meeting community public health needs in rural areas.
  Topics: Legislation and regulation, Public health
  
• 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 (CAHs), Health information technology, Hospitals and clinics, Quality
  
• 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 prospective payment system (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)
  
• Recent History of Federal Funding for EMS in the United States
  Topics: Emergency medical services (EMS) and trauma, Health services, Healthcare financing
  
• 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
  
• Rural Dimensions of Medicare Payment Policies
  This project examines major Medicare fee-for-service payment policies from the rural perspective.
  Topics: Medicare, Post-acute care
  
• 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
  
• Rural Perspective on Restructuring Medicare
  Topics: Medicare, Pharmacy and prescription drugs
  
• Stay or Leave: Evidence from a Cohort of Young Rural Physicians
  This project aims to improve understanding of the dynamics of physician practice location decision making by examining and analyzing changes in practice locations for a sample of rural physicians.
  Topics: Physicians, Workforce
  
• Understanding the Roles of the Rural Hospital in Responding to Bioterrorist Attacks and Other Emergencies
  Topics: Emergency preparedness and response, 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
  
• Volunteer Labor and the Organizational Structure of Rural Emergency Medical Services (EMS) Providers
  Topics: Emergency medical services (EMS) and trauma, Workforce
  
• What is Causing the Increase in Rural Hospital Costs?
  Topics: Healthcare financing, Hospitals and clinics