Gary Hart, PhD

Director, North Dakota and NORC Rural Health Reform Policy Research Center

Phone: 701.777.3848
Fax: 701.777.6779
Email: gary.hart@med.und.edu

Center for Rural Health
University of North Dakota
School of Medicine and Health Sciences
1301 N. Columbia Road, Stop 9037
Suite E231 (Office #252)
Grand Forks, ND 58202


Current Projects - (5)

  • Comparisons of Rural Definitions
    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.
    Research center: North Dakota and NORC Rural Health Reform Policy Research Center
    Topic: Frontier health
  • Critical Review and Analysis Regarding PCSAs, HPSA Rational Service Areas, and Other: Geographic Alternatives for Creating Useful Primary Care Service Areas
    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).
    Research center: North Dakota and NORC Rural Health Reform Policy Research Center
    Topics: Physicians, Workforce
  • Exploring Global Budgets as a New Reimbursement Model for Low-Volume Critical Access Hospitals
    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).
    Research center: North Dakota and NORC Rural Health Reform Policy Research Center
    Topics: Critical Access Hospitals and Rural Hospital Flexibility Program, Healthcare financing, Hospitals and clinics
  • Rural Hospice Surveys Regarding Family Members & Health Workforce
    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.
    Research center: North Dakota and NORC Rural Health Reform Policy Research Center
    Topics: Hospice and palliative care, Workforce
  • Utilization of Hospital Care for Rural Medicare Beneficiaries
    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.
    Research center: North Dakota and NORC Rural Health Reform Policy Research Center
    Topics: Frontier health, Hospitals and clinics, Medicare

Completed Projects - (18)

  • Access to Physician Care for the Rural Medicare Elderly
    This study described where Medicare beneficiaries in five states obtain their health care, how far they travel for that care, and the mix of physician specialties from which they obtain ambulatory care. Special attention was paid to beneficiaries who have dual Medicare-Medicaid status, who reside in poorer income areas, and who live in designated Health Professional Shortage Areas.
    Research center: WWAMI Rural Health Research Center
    Topics: Aging, Chronic diseases and conditions, Health services, Medicare, Physicians, Poverty
  • Ambulatory Care and the Rural Elderly
    Research center: WWAMI Rural Health Research Center
    Topics: Aging, Chronic diseases and conditions, Health services
  • Chartbook of Family Practice Graduate Medical Education Programs in Rural America
    Little is known about the volume, location, and types of rural training for family physicians. This project will produce a chartbook that makes previously unreported information about family physician residency directors more fully available to medical educators and other policymakers.
    Research center: WWAMI Rural Health Research Center
    Topics: Physicians, Workforce
  • Evaluation of Washington State Shortage Designations
    Research center: WWAMI Rural Health Research Center
    Topic: Workforce
  • Examination of Trends in Rural and Urban Health: Establishing a Baseline for Health Reform
    The purpose of this project is to update and supplement the seminal Health, United States, 2001: Urban and Rural Health Chartbook. Resulting information can not only be compared to the 2001 Chartbook but provides a baseline from which to measure future change related to the Accountable Care Act implementation. Where appropriate additional charts are included wherein rural areas are subdivided by type.
    Research center: North Dakota and NORC Rural Health Reform Policy Research Center
    Topics: Health disparities, Health policy, Health services, Public health
  • Frontier and Rural Definition Development and Dissemination Project
    The Frontier and Remote (FAR) codes are a new geographic definition that delineates frontier/remote areas in the U.S.
    Research center: North Dakota and NORC Rural Health Reform Policy Research Center
    Topic: Frontier health
  • Medicare Bonus Payments for Physician Care in Health Professional Shortage Areas
    Research center: WWAMI Rural Health Research Center
    Topics: Healthcare financing, Medicare, Physicians
  • National Rural General Surgeon Project
    Research center: WWAMI Rural Health Research Center
    Topics: Health services, Physicians, Workforce
  • National Rural Hospital Flexibility Program Tracking Project
    Research center: WWAMI Rural Health Research Center
    Topic: Critical Access Hospitals and Rural Hospital Flexibility Program
  • National Study of Rural-Urban Differences in Use of Home Oxygen for Chronic Obstructive Lung Disease: Are Rural Medicare Beneficiaries Disadvantaged?
    To understand disparities in care among rural and urban Medicare beneficiaries, data from Medicare's Durable Medical Equipment (DME) files were used to assess rural/urban variation in the home use of supplemental oxygen.
    Research center: WWAMI Rural Health Research Center
    Topics: Chronic diseases and conditions, Medicare
  • Perspectives of Rural Hospice Directors
    Rural hospice care, as it is currently configured, is under pressure by a variety of factors (e.g., policy and regulation, economic and financial, and organizational and structural) which are reviewed in this document. However, a central core element of rural hospice remains the strong sense of community that is embodied in the system (i.e., typically a small non-profit arrangement) and design (i.e., a delivery system reliant on community connections and personal relationships) of care. This policy brief is the result of a national phone survey of rural hospice directors or key staff in 47 states. Fifty-three directors or key staff members were interviewed during a three-month period in 2013.
    Research center: North Dakota and NORC Rural Health Reform Policy Research Center
    Topics: Aging, Health policy, Health services, Quality, Telehealth
  • Rural Health Center Expansion and Recruitment Survey
    This collaborative project between WWAMI and the South Carolina Rural Health Research Centers examined and described the current staffing needs of rural health centers (HC), ascertained the staffing, recruitment, and retention issues that HC CEOs regard as most critical; distinguished how issues differ between CEOs contemplating development of expansion sites versus those who are not; and described how these findings correlate with the literature and current national supply projections for the categories of health professions needed by the HCs.
    Research centers: South Carolina Rural Health Research Center, WWAMI Rural Health Research Center
    Topics: Federally Qualified Health Centers (FQHCs), Rural Health Clinics (RHCs), Workforce
  • Rural Population Hospice Care
    Relatively little is known about rural hospice care. The objectives of this project are to review and describe what is already known about rural hospices and to perform initial quantitative analyses on available data to describe the: number of rural hospices and their use patterns (e.g., length of stay and utilization rates), rural residents to urban hospice utilization, and rural versus urban resident hospice utilization rates. For this project, rural is be subdivided into categories such as large rural, small rural, isolated small rural, and frontier. To supplement this information, qualitative information was obtained and integrated into the findings report.
    Research center: North Dakota and NORC Rural Health Reform Policy Research Center
    Topics: Aging, Health services, Quality
  • Rural-Urban Commuting Area (RUCA) Development Project: Demographic Description and Frontier Enhancement
    This project augments the initial RUCA work by producing and describing the base 1998 demography of the RUCA code areas, creating quality state maps of the RUCA codes, and making this information and the codes easily available on the Web.
    Research center: WWAMI Rural Health Research Center
    Topics: Defining rural, Frontier health
  • State Rural Health Workforce Monograph
    Research center: WWAMI Rural Health Research Center
    Topics: Physicians, Workforce
  • The Rural/Urban Practice Location Patterns of Women Medical School Graduates
    While women are becoming an increasingly large percentage of the graduates of medical schools, they are much less likely to locate their practices in rural towns. This study involved a survey including questions about where the residents preferred to locate and how much they thought they would be practicing in the future.
    Research center: WWAMI Rural Health Research Center
    Topics: Physicians, Women, Workforce
  • Use and Performance Variations in Rural Emergency Departments: Implications for Improving Care Quality and Reducing Costs
    This project describes rural usage of rural emergency departments (EDs). It will examine the conditions that are treated in these EDs and describe those that are more and less appropriate for ED use. Rural ED use is described by community characteristics including rural level. The findings provide a baseline from which to measure the future influence of the Accountable Care Act implementation on the usage of rural EDs and the appropriateness and cost efficiency of changes.
    Research center: North Dakota and NORC Rural Health Reform Policy Research Center
    Topics: Emergency medical services (EMS), Quality
  • Validation of Commuting Area Designations for the Elderly
    Research center: WWAMI Rural Health Research Center
    Topics: Aging, Defining rural

Publications - (58)