Andrea Radford, DrPH


Completed Projects - (3)

Rural Health Clinics: Medicare & Medicaid Profile
This study builds on our work with the 2009 RHC Medicare claims. This project will result in the development of a longitudinal data collection/tracking mechanism of key RHC Medicare claims data and cost report elements (provider-based cost reports only at this point in time). RHC Medicaid data for a sample of states will be requested and analyzed to determine utilization patterns and identification of potential quality metrics.
Research center: North Carolina Rural Health Research and Policy Analysis Center
Topics: Medicare, Rural Health Clinics (RHCs)
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.
Research centers: NORC Walsh Center for Rural Health Analysis, North Carolina Rural Health Research and Policy Analysis Center
Topics: Hospitals and clinics, Pharmacy and prescription drugs
Use of Rural Health Clinics by Medicare Beneficiaries
Determination of Medicare beneficiaries utilization of available RHCs and development of a descriptive profile of Medicare beneficiaries who utilize RHCs including both geographic and diagnostic elements and a comparison to Medicare beneficiaries who utilize FQHCs.
Research center: North Carolina Rural Health Research and Policy Analysis Center
Topics: Medicare, Rural Health Clinics (RHCs)

Publications - (13)

  • Effect of Medicare Part D Plan Switching and Formulary Changes on Sole Community Pharmacies and the Patients They Serve
    North Carolina Rural Health Research and Policy Analysis Center, RUPRI Center for Rural Health Policy Analysis
    Date: 03/2010
    Presents findings from a 2008 survey of 401 pharmacist-owners of sole community independent pharmacies.
  • The Experience of Rural Independent Pharmacies With Medicare Part D: Reports From the Field
    North Carolina Rural Health Research and Policy Analysis Center, RUPRI Center for Rural Health Policy Analysis
    Date: 2007
    Describes first-hand reports from rural pharmacist-owners about their experiences with Medicare Part D plans in the first 7 months of 2006 in order to gain a more thorough understanding of the challenges faced by rural independent pharmacies as a result of program implementation.
  • The Key Role of Sole Community Pharmacists in Their Local Healthcare Delivery Systems
    North Carolina Rural Health Research and Policy Analysis Center
    Date: 03/2009
    This findings brief presents findings from a 2008 survey of 401 community pharmacists that are the only retail provider in their community to document their extended relationships with other health care providers and the additional health care services these pharmacists provide to their patients. Pharmacist-owners in independent pharmacies located at least 10 miles from the next closest retail pharmacy were interviewed to determine the presence in their community of other types of health care organizations that require pharmaceutical support(such as hospitals, long-term care facilities, hospice providers, home health agencies and community health centers), their level of involvement with those facilities, and the types of clinical services (other than dispensing and counseling) the pharmacists offered to their own patients.
  • One Year In: Sole Community Rural Independent Pharmacies and Medicare Part D (Final Report)
    North Carolina Rural Health Research and Policy Analysis Center, RUPRI Center for Rural Health Policy Analysis
    Date: 09/2007
    Describes the experiences of 51 rural independently-owned pharmacies that are the sole providers of pharmacy services in their community one year after implementation of the Medicare Part D prescription drug benefit. A findings brief is also available. Funded by the Office of Rural Health Policy: Cooperative Agreement for Rapid Response to Issue-Specific Rural Research
  • One Year In: Sole Community Rural Independent Pharmacies and Medicare Part D (Findings Brief)
    North Carolina Rural Health Research and Policy Analysis Center, RUPRI Center for Rural Health Policy Analysis
    Date: 10/2007
    Describes the experiences of 51 rural independently-owned pharmacies that are the sole providers of pharmacy services in their community one year after implementation of the Medicare Part D prescription drug benefit. A final report is also available. Funded by the Office of Rural Health Policy: Cooperative Agreement for Rapid Response to Issue-Specific Rural Research
  • Profile of Rural Health Clinics: Clinic & Medicare Patient Characteristics
    North Carolina Rural Health Research and Policy Analysis Center
    Date: 03/2013
    Presents a summary of the geographic distribution and clinic-level characteristics of rural health clinics, as well as an overview of the Medicare beneficiaries they served.
  • Profile of Rural Health Clinics: Medicare Payments & Common Diagnoses: Review of 2009 Medicare Outpatient Claims Data
    North Carolina Rural Health Research and Policy Analysis Center
    Date: 12/2012
    Using data extracted from 2009 Medicare outpatient provider claims, this brief presents a summary profile of Medicare billing and reimbursement activity for independent and provider-based RHCs.
  • Profile of Sole Community Pharmacists' Prescription Sales and Overall Financial Position
    Rapid Response to Requests for Rural Data Analysis
    Date: 08/2009
    Sole community independent pharmacists provide essential services to residents of small towns and isolated communities. In an effort to document the role sole community pharmacies play in their local health care system and to monitor their financial and operational status we conducted a survey in 2008 of 401 community pharmacists that owned the only retail outlet in their community. Pharmacist-owners in independent pharmacies located at least 10 miles from the next closest retail pharmacy were interviewed to determine their reliance on prescription sales and to understand their store's current financial position.
  • Rural Hospitals' Experience with the 340B Drug Pricing Program
    NORC Walsh Center for Rural Health Analysis, North Carolina Rural Health Research and Policy Analysis Center
    Date: 09/2007
    Policy brief describing the results of surveys of rural hospitals participating in the 340B drug pricing program and of rural eligible but non-participating hospitals. Includes information on factors affecting participation in the program and the benefits and challenges of participation.
  • Safety Net Clinics Serving the Elderly in Rural Areas: Rural Health Clinic Patients Compared to Federally Qualified Health Center Patients
    Policy Brief
    North Carolina Rural Health Research and Policy Analysis Center
    Date: 05/2014

    Uses data extracted from 2009 Medicare outpatient provider claims to look at the location of clinics, the number of beneficiaries served, and the number of and cost per claim for each type of rural safety net clinic. We further examined characteristics of Medicare beneficiaries comparing their age, the health problems for which they sought care, and the distance they travelled to obtain care. Because Rural Health Centers (RHCs) and Federally Qualified Health Centers (FQHCs) are similar in mission but may be different in practice, understanding their respective Medicare patient profiles is important. This findings brief is the third and final in a series on RHCs which draws on a large, national dataset that includes claims data on the approximately 90% of RHCs that billed Medicare in 2009.

  • States' Use of Cost-Based Reimbursement for Medicaid Services at Critical Access Hospitals
    North Carolina Rural Health Research and Policy Analysis Center
    Date: 04/2010
    Critical Access Hospitals (CAH) are reimbursed by Medicare at 101% of allowable cost for both inpatient and outpatient services. State Medicaid agencies however are not required to reimburse CAHs on a cost-basis and have flexibility in determining how CAHs are paid for providing services to Medicaid enrollees. This brief documents which states utilize a cost-based reimbursement methodology for Medicaid.
  • Why Use Swing Beds? Conversations with Hospital Administrators and Staff (Findings Brief)
    North Carolina Rural Health Research and Policy Analysis Center
    Date: 04/2012
    In this study we interview hospital administrators and staff about the use of swing beds. Topics include the role of swing beds in patient care, swing bed volume and financial considerations, swing beds in the context of all community post-acute skilled care and swing beds as a benefit for community residents.
  • Workforce Issues Among Sole Community Pharmacies
    North Carolina Rural Health Research and Policy Analysis Center, RUPRI Center for Rural Health Policy Analysis
    Date: 07/2009
    Pharmacy services are delivered through a sole community pharmacy in over 1000 small rural communities nationwide. This brief presents the findings from 401 telephone interviews of sole community pharmacist-owners nationwide about their current staffing and future plans. Thirty-three percent of those interviewed have one or fewer pharmacist FTEs on staff. Thirty percent of those interviewed would like to retire in five years or fewer, and most would like to sell their pharmacies upon retirement. This brief explores the shared experiences of sole community pharmacist-owners regarding the challenges facing the pharmacy workforce in their communities and their concerns about their pharmacy's future.