2017 Rural Health Research Products

  • Rural-Urban Variations in Medicare Live Discharge Patterns from Hospice, 2012-2013
    Policy Brief
    Rapid Response to Requests for Rural Data Analysis
    This brief 1) provides an overview of the geographic distribution of “freestanding” (i.e., rather than those co-located in a hospital, home health agency, or skilled nursing facility) rural and urban hospices and, 2) explores live discharge rates for hospices operating in rural versus urban areas.
  • Regulating Network Adequacy for Rural Populations: Perspectives of Five States
    Policy Brief
    University of Minnesota Rural Health Research Center
    The purpose of this study was to examine how five geographically-diverse states with significant rural populations define "network adequacy" and the degree to which they consider rural issues when regulating networks.
  • Improving Rural Oral Health: Six States’ Response to the United States Department of Health and Human Services Oral Health Strategic Framework
    Policy Brief
    South Carolina Rural Health Research Center
    The U.S. Public Health Service Oral Health Coordinating Committee published the Oral Health Strategic Framework 2014-2017. The framework includes 5 goals for advancing oral health in America. We explore how 6 states have responded to the Strategic Framework; specifically, how they address oral health inter-professional practice, and access to care.
  • Chartbook: Trends in Rural Children’s Oral Health and Access to Care
    Chartbook
    South Carolina Rural Health Research Center
    Assessing progress at improving children’s oral health requires examining trends to see whether rural disparities, if present, are being reduced. Our report uses data from the National Survey of Children’s Health (2003, 2007, and 2011- 2012) to assess progress in access to oral health care, and perceived status of teeth among rural children.
  • Regional Differences in Rural and Urban Mortality Trends
    Policy Brief
    North Carolina Rural Health Research and Policy Analysis Center
    This brief explores the differences in mortality rates over time by (1) urban and rural location, (2) census division, and (3) urban and rural location within each census division.
  • Home is Where the Heart Is: Insights on the Coordination and Delivery of Home Health Services in Rural America
    Policy Brief
    North Dakota and NORC Rural Health Reform Policy Research Center
    Access to home health in rural areas is an important public policy concern, particularly with the growing number of older adults residing in rural America. This qualitative study seeks to better understand how home health services are provided in rural areas, and identifies facilitators and barriers to providing care.
  • Improving Access to High Quality Sepsis Care in a South Dakota Emergency Telemedicine Network
    Policy Brief
    Rural Telehealth Research Center
    This brief describes an implementation initiative designed to increase use of emergency department-based telemedicine consultation for patients with severe sepsis or septic shock. This initiative is the first step of an analysis to estimate the effect of telemedicine on sepsis care and outcomes.
  • Transitions in Care Among Rural Residents with Congestive Heart Failure, Acute Myocardial Infarction, and Pneumonia
    Report
    South Carolina Rural Health Research Center
    Rural and urban hospitals vary with regard to the levels of care they are able to provide, requiring that a subset of patients be transferred from the first point of encounter to a second facility. The degree to which inter-hospital transfers occur, and the outcomes for transfer patients, have not been studied across rural and urban institutions.
  • Rural-Urban Differences in Medicare Service Use in the Last Six Months of Life
    Report
    South Carolina Rural Health Research Center
    This brief focuses on the current status of healthcare use during the last six months of life among Medicare beneficiaries. We used data from a sample of Medicare beneficiary claims to assess whether service utilization differed between rural and urban decedents and across decedents of different race/ethnicity categories.
  • Differences in Medicare Service Use in the Last Six Months of Life among Rural and Urban Dual – Eligible Beneficiaries
    Report
    South Carolina Rural Health Research Center
    In this brief, we compare rural and urban dual-eligible beneficiaries to Medicare-only beneficiaries in their service utilization in the last six months of life. Within rural beneficiaries, we further explore differences associated with race/ethnicity.
  • Rural/Urban Analysis on Individual Insurance Market Topics
    Fact Sheet
    RUPRI Center for Rural Health Policy Analysis
    Some special challenges face the development and sustainability of marketplace plans in rural areas. This data release provides some additional detail on some important topics, with particular importance to rural people, places, and providers.
  • Medicare Advantage Enrollment Update 2017
    Policy Brief
    RUPRI Center for Rural Health Policy Analysis
    Reports on the percentage of rural Medicare beneficiaries enrolled in Medicare Advantage (MA) plans and other prepaid enrollment plans. Compares national and rural MA enrollment, and variability by state.
  • Use of the Emergency Department for Mental Health and Substance Abuse among Women
    Fact Sheet
    North Dakota and NORC Rural Health Reform Policy Research Center
    This study identifies trends among women in rural and urban communities who utilize the emergency department for mental health and substance abuse. The information can be used to help communities provide more relevant, appropriate, and less costly care.
  • Knowledge of Health Insurance Concepts and the Affordable Care Act among Rural Residents
    Policy Brief
    Maine Rural Health Research Center
    Health insurance literacy is central to identifying eligibility for coverage and subsidies, choosing a plan, and using optimal healthcare services. This study examined rural-urban differences in knowledge and/or use of the Affordable Care Act Marketplaces; subsidies; the health insurance mandate; and health insurance terms and concepts.
  • The Financial Importance of Medicare Post-Acute and Hospice Care to Rural Hospitals
    Policy Brief
    North Carolina Rural Health Research and Policy Analysis Center
    This brief describes Medicare post-acute and hospice care provided by hospitals in rural areas by characterizing the variation in the number of rural hospitals that provide PAC and hospice care, the average amount of Medicare revenue rural hospitals receive for these services, and the financial importance of PAC and hospice care to rural hospitals.
  • After Hospital Closure: Pursuing High Performance Rural Health Systems without Inpatient Care
    RUPRI Center for Rural Health Policy Analysis
    A new paper describing opportunities for rural communities to develop a high performance rural health system after hospital closure, including three case studies that describe real-world transitions from hospital-based locus of care to new models of care delivery in rural places.
  • Rural and Urban Utilization of the Emergency Department for Mental Health and Substance Abuse
    Policy Brief
    North Dakota and NORC Rural Health Reform Policy Research Center
    Utilizes data from the Healthcare Cost and Utilization Project’s (HCUP’s) State Emergency Department Databases (SEDD) for seven states. Researchers explore, and describe in this brief, the use of the Emergency Department for mental health and substance abuse among Urban, Large Rural, Small Rural, and Isolated Small Rural residents.
  • CMS Hospital Quality Star Rating: For 762 Rural Hospitals, No Stars is the Problem
    Policy Brief
    Rapid Response to Requests for Rural Data Analysis
    The purpose of this brief is to look more closely at the characteristics of rural hospitals with and without CMS Hospital Quality Star Ratings to help inform ongoing discussions about the usefulness of the quality star rating for comparing hospital quality and possible ways to improve the star rating initiative.
  • Rural Health Snapshot (2017)
    Rapid Response to Requests for Rural Data Analysis
    The Rural Health Snapshot (2017) updates the 2010 Rural Health Snapshot. The document is a data sheet that compares a selection of health and healthcare access indicators for populations in rural and urban areas.
  • Medical Barriers to Nursing Home Care for Rural Residents
    Policy Brief
    University of Minnesota Rural Health Research Center
    This policy brief describes barriers rural residents with complex medical care needs may face when seeking placement in a nursing home and identifies potential policy strategies to overcome them.
  • Changes in the Supply of Physicians with a DEA DATA Waiver to Prescribe Buprenorphine for Opioid Use Disorder
    Policy Brief
    WWAMI Rural Health Research Center
    This project mapped the location of physicians with a DEA DATA 2000 waiver to prescribe buprenorphine for opioid use disorder in July 2012 and April 2016. The number of counties without a waivered physician and the ratio of waivered physicians per 100,000 population is reported by the rural/urban status of the county.
  • Identifying Adverse Drug Events in Rural Hospitals: An Eight-State Study
    Policy Brief
    University of Minnesota Rural Health Research Center
    Analyzes the prevalence of Adverse Drug Events (ADEs) in rural hospitals, including both CAHs and rural PPS hospitals, related to four categories of drugs: steroids, antibiotics, opiates / narcotics, and anticoagulants in 2013 for eight states. It also examines whether or not these hospitals' ADE rates varied based on hospital characteristics.
  • Resources to Reduce Adverse Drug Events in Rural Hospitals
    Policy Brief
    University of Minnesota Rural Health Research Center
    This policy brief provides resources that could be used to decrease Adverse Drug Events (ADEs) in rural hospitals.
  • Issues Confronting Rural Pharmacies after a Decade of Medicare Part D
    Policy Brief
    RUPRI Center for Rural Health Policy Analysis
    This brief reports on a survey of very rural independent pharmacies designed to assess threats to their sustainability. Major, immediate issues included delays in updates to maximum allowable costs (MACS), charges for remuneration fees, competition from mail order pharmacies; and, status as a “non-preferred pharmacy” for Medicare Part D plans.
  • Closure of Hospital Obstetric Services Disproportionately Affects Less-Populated Counties
    Policy Brief
    University of Minnesota Rural Health Research Center
    This policy brief describes the scope of obstetric unit and hospital closures resulting in loss of obstetric services in rural U.S. counties from 2004 to 2014.
  • State Variability in Access to Hospital-Based Obstetric Services in Rural US Counties
    Policy Brief
    University of Minnesota Rural Health Research Center
    This policy brief describes state-level variations in 1) the availability of hospital-based obstetric services, and 2) the scope of obstetric unit and hospital closures resulting in the loss of obstetric services in rural U.S. counties from 2004 to 2014.
  • Rural Opioid Abuse Prevention and Treatment Strategies: The Experience in Four States
    Policy Brief
    Maine Rural Health Research Center
    Little is known about what states with large rural populations are doing to combat opioid use disorders (OUD) in rural communities. This qualitative study identified rural challenges to the provision of OUD prevention, treatment, and recovery services and explored promising strategies to tackle the opioid crisis in rural communities.
  • Telepharmacy Rules and Statutes: A 50-State Survey
    Policy Brief
    RUPRI Center for Rural Health Policy Analysis
    This is summary analysis reviews administrative rules and legislative statutes governing the practice of telepharmacy in all 50 states. Telepharmacy is specifically authorized in 23 states and 16 states have no rules or legislation authorizing telepharmacy. Other states have pilot programs or waivers that would enable telepharmacy.
  • 2016 Rural Enrollment in Health Insurance Marketplaces, by State
    Policy Brief
    RUPRI Center for Rural Health Policy Analysis
    Cumulative county-level enrollment rates in Health Insurance Marketplaces (HIMs) in metropolitan and non-metropolitan areas of each state, defined as the percentage of “potential market” participants selecting plans, are presented as of March 2016. States are separated by Medicaid expansion status.
  • Changing Rural and Urban Enrollment in State Medicaid Programs
    Policy Brief
    RUPRI Center for Rural Health Policy Analysis
    Medicaid enrollment growth in 36 states is analyzed by rural and expansion status, pre- and post-ACA. Enrollment growth was larger in expansion states but did take place in most states, with significant state-level variation in both groups. Metropolitan areas generally had higher growth than micropolitan and rural areas.
  • Trends in Rural Children’s Health and Access to Care
    Chartbook
    South Carolina Rural Health Research Center
    The past ten years have seen positive trends in the availability of health insurance coverage for children. This project examines data from three iterations of the National Survey of Children’s Health to see if rural children have benefitted equally from any improvements in health insurance, healthcare use, and health status.
  • The Role of Public versus Private Health Insurance in Ensuring Health Care Access & Affordability for Low-Income Rural Children
    Policy Brief
    Maine Rural Health Research Center
    Medicaid and CHIP have played a critical role in ensuring access to health coverage among children –particularly rural children. This study examines rural-urban differences in children’s access to care, and their families’ perceived affordability of that care among those enrolled in Medicaid or CHIP, and those with private insurance plans.