Craig Holden

• Current Projects - (8)
• Completed Projects - (4)
• Publications - (2)

---

Current Projects - (8)

• A Closer Examination of Rural Hospital Bypass
  This project will estimate the rural hospital bypass rate using all-payer claims data for a set of states and compare patients based on the inpatient treatments and procedures received relative to those routinely provided by rural facilities.
  Research center: ETSU/NORC Rural Health Research Center
  Topics: Critical Access Hospitals (CAHs), Health reform, Health services, Healthcare access, Hospitals and clinics, Medicaid and CHIP, Medicare, Medicare Advantage (MA), Private health insurance, Uninsured and underinsured
  
• Comparing Care-Seeking Patterns Among Rural Medicare Fee-for-Service and Medicare Advantage Beneficiaries
  This study uses national Medicare claims and encounter data to compare how often rural traditional Medicare and Medicare Advantage beneficiaries bypass their nearest hospital or primary care provider, how far they travel, and how these care-seeking patterns vary by plan type and region.
  Research center: ETSU/NORC Rural Health Research Center
  Topics: Aging, Critical Access Hospitals (CAHs), Health services, Healthcare access, Healthcare financing, Hospitals and clinics, Medicare, Medicare Advantage (MA), Quality, Rural statistics and demographics
  
• Examining Post-Acute Care Utilization and Outcomes for Rural Medicare FFS and Medicare Advantage Beneficiaries
  This study will describe differences in post-acute care utilization and post-discharge outcomes between rural Medicare Fee-for-Service beneficiaries and rural Medicare Advantage beneficiaries overall, by region of the country, and levels of rurality.
  Research center: ETSU/NORC Rural Health Research Center
  Topics: Care management, Critical Access Hospitals (CAHs), Healthcare access, Home health, Medicare, Medicare Advantage (MA), Post-acute care
  
• Examining Rural Population Characteristics and Access to Care: A Study of Health Professional Shortage Areas (HPSAs) and Medically Underserved Areas (MUAs)
  This project examined Health Professional Shortage Areas (HPSAs) and Medically Underserved Areas (MUAs), analyzing geographic disparities in provider shortages across rural and urban settings. Findings highlight variations in access to primary care, mental health, and dental services, informing federal programs that allocate resources to improve health care access.
  Research center: ETSU/NORC Rural Health Research Center
  Topics: Healthcare access, Mental and behavioral health, Oral health, Workforce
  
• Exploring Rural and Urban Medicare Beneficiaries' Use of Home Health Services
  This study maps the geographic distribution of home health services provided to Medicare fee-for-service (FFS) and Medicare Advantage (MA) beneficiaries and assesses how these patterns align with Medicare-approved home health agencies' service areas.
  Research center: ETSU/NORC Rural Health Research Center
  Topics: Aging, Chronic diseases and conditions, Home health, Medicare, Medicare Advantage (MA), Post-acute care
  
• Rural and Urban Sepsis Outcomes as a Measure of Health Care Quality: A Nationwide Comparative Analysis Using HCUP Data
  This study examines differences in sepsis prevalence, outcomes, costs, and treatment between rural and urban hospitals using the HCUP Nationwide Readmissions Database. It aims to inform policies related to access to timely, high-quality sepsis care and identify strategies to enhance healthcare outcomes across diverse hospital settings.
  Research center: ETSU/NORC Rural Health Research Center
  Topics: Care management, Critical Access Hospitals (CAHs), Emergency medical services (EMS) and trauma, Healthcare access, Hospitals and clinics, Medicaid and CHIP, Medicare, Medicare Advantage (MA), Private health insurance, Quality, Social determinants of health
  
• Rural/Urban Differences in Forgoing Health Care During the COVID-19 Pandemic
  Several surveys conducted during the COVID-19 pandemic showed that adults delayed or skipped healthcare services during the initial months of the COVID-19 pandemic. This study examines changes in healthcare utilization for primary and preventative care among rural and urban Medicare fee-for-service enrollees since the COVID-19 pandemic.
  Research center: ETSU/NORC Rural Health Research Center
  Topics: Aging, Care management, Chronic diseases and conditions, Coronavirus Disease 2019 (COVID-19), Diabetes, Health promotion and disease prevention, Health services, Medicare, Mental and behavioral health, Telehealth
  
• Utilization of Medicare Care Management Codes
  This study assesses the adoption of Medicare care management billing codes among rural and urban providers and the extent to which rural Medicare beneficiaries access these services. Using 2024 Medicare fee-for-service claims and provider data, this study will analyze trends in provider participation and utilization by service type, region, and rurality.
  Research center: ETSU/NORC Rural Health Research Center
  Topics: Care management, Federally Qualified Health Centers (FQHCs), Health services, Medicare, Rural Health Clinics (RHCs), Social determinants of health
  

---

Completed Projects - (4)

• Examining Differences in Rural and Urban Medicare FFS Beneficiaries' Emergency Department Use Pre-COVID-19 and During COVID-19
  This study described and compared the differences in the utilization of emergency department (ED) services among rural and urban Medicare Fee-For-Service (FFS) enrollees during 2018-2021. Researchers identified factors associated with differences in ED use, including shifts in volume, primary diagnoses, and admission source, before and since the COVID-19 public health emergency in rural and urban areas.
  Research center: ETSU/NORC Rural Health Research Center
  Topics: Coronavirus Disease 2019 (COVID-19), Critical Access Hospitals (CAHs), Emergency medical services (EMS) and trauma, Healthcare access, Hospitals and clinics, Medicare, Social determinants of health
  
• Hierarchical Condition Category (HCC) Risk Scores: Designed to Predict Future Cost and Health Care Resource Use – Do They Also Accurately Reflect Differences in Health Status between Rural and Urban Beneficiaries?
  This CMS Hierarchical Condition Category (CMS-HCC) risk score study investigated differences in underlying health between rural and urban populations using recent data and analyze which factors drive observed differences.
  Research center: ETSU/NORC Rural Health Research Center
  Topics: Health services, Healthcare access, Hospitals and clinics, Medicaid and CHIP, Medicare, Medicare Advantage (MA)
  
• Inpatient Treatment Costs Associated with Substance Use Disorders
  The purposes of this project were to examine the costs and characteristics of inpatient stays associated with substance use disorders and to examine whether there are systematic differences in these stays and costs for persons residing in rural areas compared to urban areas.
  Research center: ETSU/NORC Rural Health Research Center
  Topics: Healthcare access, Healthcare financing, Mental and behavioral health, Substance use and treatment
  
• Rural-Urban Analysis of Persistent Health Professional Shortage Areas
  The study described rural-urban differences in persistent Health Professional Shortage Area designations for primary care, mental health, and dental care between 2010 and 2020.
  Research center: ETSU/NORC Rural Health Research Center
  Topics: Healthcare access, Mental and behavioral health, Oral health, Workforce
  

---

Publications - (2)