Current Projects from All Research Centers

Projects in progress, with research still being conducted, listed by the date funded by the Federal Office of Rural Health Policy (FORHP):

Projects Funded April 2017 - (1)

Projects Funded September 2016 - (24)

Projects Funded September 2015 - (13)

  • Assessing the Impact of Medicaid Policy Changes
    RUPRI Center for Rural Health Policy Analysis
     Goals of this project include: 1) clearly articulating the rural considerations in Medicare reform by synthesizing information on the impact of Medicare on rural people, places, and providers; 2) assessing the impact of specific proposals to reform Medicare; and 3) analyzing the effects of market-based reform on rural populations, focusing on specific provisions of Medicare reform proposals.
  • Characteristics and Utilization Patterns of Rural Medicaid Recipients
    South Carolina Rural Health Research Center
     This study will use the Medicaid Analytic Extract file to examine the characteristics of persons enrolled in Medicaid by type of eligibility. The study will also examine overall utilization and total payments for this utilization. All estimates will be subset by rurality and region.
  • Cost of Running a Rural Ambulance Service
    North Dakota and NORC Rural Health Reform Policy Research Center
     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.
  • For Amber "Waives" of Grain: The Impact of Medicaid Managed Care Waiver Programs on Care Choices in Rural America
    South Carolina Rural Health Research Center
     This project will use a combination of systematic review of waiver content and structured interviews with key informants to assess the potential for rural disparities in access to care for Medicaid enrollees.
  • Implications of Rural Ambulance Service Closures
    North Dakota and NORC Rural Health Reform Policy Research Center
     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.
  • Potential Impact of ESRD Payment Reform on Rural Dialysis Patients
    South Carolina Rural Health Research Center
     This study will estimate the potential implications of rural dialysis facility loss for rural patients. Specifically, we will identify low-volume dialysis facilities in rural areas, profile the patients they serve, and estimate the additional travel burden that these patients would experience if facilities close.
  • Rural Demography and Aging: The LTSS Imperative in Rural America
    Maine Rural Health Research Center
     The proposed project aims to create a current, broad-ranging, detailed profile of health care/LTSS needs and use patterns among rural and urban older adults through a literature review and analysis of data sets including the American Community Survey, the Area Health Resource File, and the Medicare Current Beneficiary Survey.
  • Rural Health Clinic Financial Performance and Productivity
    Maine Rural Health Research Center
     This study will use Medicare cost reports for independent and provider-based clinics to provide a detailed national picture of the financial and operational performance of RHCs and describe variations in performance related to revenue, costs, staffing, payer mix, productivity levels, and hours of operation across independent and provider-based clinics. The project will also develop measures that can be used to benchmark RHC performance over time.
  • Social Determinants of Health Among Minority Populations in Rural America
    South Carolina Rural Health Research Center
     This project will compile information from the U.S. Census, the Area Health Resource File, and the Robert Wood Johnson Foundation County Rankings data set into a comprehensive summary of key social determinants of health among rural populations: demographic characteristics, economic characteristics, health facility availability, and selected health outcomes.
  • The Financial and Community Experience of Sole Community Hospitals in Comparison to Other Rural Hospitals
    North Carolina Rural Health Research and Policy Analysis Center
     This research will investigate the financial and community experience of SCHs in comparison with other rural hospitals. The availability of alternative facilities, and the socioeconomic and demographic characteristics of SCH service areas will be compared to other rural hospital service areas.
  • Understanding Rural-Urban Mortality Differences
    Maine Rural Health Research Center
     This study will address rural-urban mortality gaps in our understanding of rural mortality disparities using the 1985-2009 National Health Interview Survey (NHIS), linked to national death certificate data, to explore the individual-level characteristics and health behaviors of rural and urban adults and their association with mortality.
  • Use of Home Health Services among High Risk Rural Medicare Patients: Patient, Service, and Community Factors Associated with Outcomes of Care
    WWAMI Rural Health Research Center
     This study will examine outcomes of care for rural Medicare patients who were discharged from hospitals and admitted to home health care for post-acute services. Outcomes will include emergent care use and re-hospitalization during the home health admission and community discharge.
  • Use of Telehealth Services Among Rural Medicaid Enrollees: A Baseline Inventory
    Rural Telehealth Research Center
     Uses data from the Medicaid Analytic Extract (MAX) for 2011 to create a 50-state, baseline inventory of telehealth services provided to Medicaid enrollees in rural and urban settings. Provides important information on the feasibility of using MAX data to study the effects of Medicaid telehealth policies.

Projects Funded September 2014 - (7)

  • Comparisons of Rural Definitions
    North Dakota and NORC Rural Health Reform Policy Research Center
     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.
  • Critical Review and Analysis Regarding PCSAs, HPSA Rational Service Areas, and Other: Geographic Alternatives for Creating Useful Primary Care Service Areas
    North Dakota and NORC Rural Health Reform Policy Research Center
     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).
  • Exploring Global Budgets as a New Reimbursement Model for Low-Volume Critical Access Hospitals
    North Dakota and NORC Rural Health Reform Policy Research Center
     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).
  • How Do Costs for Rural Medicare Beneficiaries Using Swing Beds Compare to Those Using Skilled Nursing Facilities?
    North Carolina Rural Health Research and Policy Analysis Center
     This study will estimate and compare total Medicare expenditures for episodes of care that include post-acute stays in either swing beds or skilled nursing facilities (SNFs). Results will inform federal and state agencies, rural providers and communities as to how post-acute care in swing bed versus a SNF affects the trajectory of costs and utilization for rural Medicare beneficiaries.
  • Rural Implications of Quality-Based Physician Payment Reform
    University of Minnesota Rural Health Research Center
     The purpose of this project is to assess existing national data about the quality of care provided by rural physicians, and to determine what additional information will be needed as CMS moves towards inclusion of all physicians in payment reforms based on quality.
  • What Impact Will Unified GME Accreditation Have on Rural-focused Physician Residencies
    WWAMI Rural Health Research Center
     The impending unification of allopathic and osteopathic graduate medical education (GME) under a single accreditation system has uncertain implications for small and rural-focused residency programs. This proposed study aims to (1) quantify the rural practice outcomes of residencies in rurally-relevant specialties such as pediatrics, internal medicine, obstetrics/gynecology, emergency medicine, surgery, anesthesia, and psychiatry, and (2) interview key stakeholders to identify anticipated challenges of the accreditation merger and potential policies to strengthen vulnerable rural-focused residencies during the transition.
  • What Makes Physician Assistant Programs Successful at Training Rural PAs?
    WWAMI Rural Health Research Center
     A current WWAMI RHRC study has identified the physician assistant (PA ) training programs that have reduced high numbers and high proportions of graduates working in rural areas. The proposed study will extend that work through a physician assistant program survey, identifying key characteristics, admission, and training strategies, and missions of successful rural programs.

Projects Funded September 2013 - (3)

  • Rural End-of-Life Care: An Analysis of Rural Medicare Beneficiaries’ Health Care Costs, Utilization, and Patient-Centered Decisions
    North Dakota and NORC Rural Health Reform Policy Research Center
     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.
  • Rural Hospice Surveys Regarding Family Members & Health Workforce
    North Dakota and NORC Rural Health Reform Policy Research Center
     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.
  • Utilization of Hospital Care for Rural Medicare Beneficiaries
    North Dakota and NORC Rural Health Reform Policy Research Center
     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.

Projects Funded September 2012 - (2)

Projects Funded September 2009 - (1)