H. Ann Howard, BA

North Carolina Rural Health Research and Policy Analysis Center

Email: ann_howard@unc.edu

University of North Carolina - Chapel Hill
Cecil G. Sheps Center for Health Services Research
CB# 7590
Chapel Hill, NC 27599


Publications - (15)

  • The 21st Century Rural Hospital: A Chart Book
    Chartbook
    North Carolina Rural Health Research and Policy Analysis Center
    Date: 03/2015
    This chartbook presents a broad profile of rural hospitals and includes information on location, who they serve, services they provide, how they ensure outpatient services for their communities, other community benefits they provide, and financial performance. Each page includes charts comparing rural hospitals to each other and to urban hospitals.
  • At-Risk Hospitals: The Role of Critical Access Hospital Status in Mitigating the Effects of New Prospective Payment Systems Under Medicare
    North Carolina Rural Health Research and Policy Analysis Center
    Date: 02/2000
    This report examines not-for-profit hospitals that potentially qualify as critical access hospitals and identifies facilities at risk as a result of Medicare's prospective payment systems to non-acute care settings.
  • Cesarean Section Patterns In Rural Hospitals
    North Carolina Rural Health Research and Policy Analysis Center
    Date: 11/2004
    This paper examines childbirth delivery patterns in rural hospitals and compares the cesarean section rate in rural hospitals to that in urban hospitals.
  • Cesarean Section Rates in Rural Hospitals
    North Carolina Rural Health Research and Policy Analysis Center
    Date: 03/2005
    This findings brief examines childbirth delivery patterns in rural hospitals and compares the C-section rate in rural hospitals to that in urban hospitals using the Nationwide Inpatient Sample.
  • A Comparison of Rural Hospitals with Special Medicare Payment Provisions to Urban and Rural Hospitals Paid Under Prospective Payment (Final Report)
    North Carolina Rural Health Research and Policy Analysis Center
    Date: 08/2010
    This final report compares the financial performance and condition of rural hospitals with special Medicare payment provisions to urban and rural hospitals paid under prospective payment (UPPS and R-PPS hospitals, respectively). Nine ratios from the three most common categories of ratios used in financial statement analysis (profitability, liquidity, and capital structure) as well as four other ratios that are commonly used to evaluate rural hospital financial performance are assessed.
  • The Financial Importance of Medicare Post-Acute and Hospice Care to Rural Hospitals
    Policy Brief
    North Carolina Rural Health Research and Policy Analysis Center
    Date: 07/2017
    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.
  • Geographic Variation in the 2016 Profitability of Urban and Rural Hospitals
    Policy Brief
    North Carolina Rural Health Research and Policy Analysis Center
    Date: 03/2018
    This study describes the geographic variation in 2016 profitability of critical access hospitals (CAHs), other rural hospitals (Medicare Dependent Hospitals, Sole Community Hospitals, and rural Prospective Payment System (PPS) hospitals denoted as “ORH”), and urban PPS hospitals by census region, census division, and state.
  • Geographic Variation in Uncompensated Care Between Rural and Urban Hospitals
    Policy Brief
    North Carolina Rural Health Research and Policy Analysis Center
    Date: 06/2018
    The purpose of this brief is to compare uncompensated care in rural and urban hospitals and to describe how it varies across regions of the country.
  • Role of CAH Status in Mitigating the Effects of New Prospective Payment Systems Under Medicare
    North Carolina Rural Health Research and Policy Analysis Center
    Date: 01/2000
    This findings brief examines rural hospitals that potentially qualify as critical access hospitals and identifies facilities at substantial financial risk as a result of Medicare’s expansion of prospective payment systems to non-acute settings.
  • Rural Hospital Area Wages and the PPS Wage Index: 1900-1997
    North Carolina Rural Health Research and Policy Analysis Center
    Date: 10/2000
    This paper examines the hospital wage index used by the Health Care Financing Administration and its effects on rural hospitals.
  • Rural Hospital Mergers from 2005 through 2016
    Policy Brief
    North Carolina Rural Health Research and Policy Analysis Center
    Date: 08/2018
    This brief describes the number and geographic distribution of rural hospital mergers from 2005-2016.
  • Rural Hospital Wages and the Area Wage Index: 1990-1997
    North Carolina Rural Health Research and Policy Analysis Center
    Date: 01/2001
    This findings brief examines whether incremental changes to the hospital wage index have made it more equitable across regions and how these changes have impacted rural hospitals.
  • Rural-Urban Differences in Nursing Home and Skilled Nursing Supply
    North Carolina Rural Health Research and Policy Analysis Center
    Date: 02/2003
    This paper examines characteristics of nursing facilities and the supply of certified skilled nursing beds as the new PPS is being phased in, with particular reference to differences between urban and rural settings.
  • Trends in Skilled Nursing and Swing-bed Use in Rural Areas, 1996-2003
    North Carolina Rural Health Research and Policy Analysis Center
    Date: 12/2005
    This paper examines trends in the delivery of skilled nursing facility (SNF) services in rural areas during a time of dramatic change in Medicare payments for acute and post-acute care. It focuses on the role of rural hospitals in providing SNF services as they respond to the new reimbursement environment.
  • Trends over Time in the Provision of Skilled Nursing Care in Critical Access Hospitals
    North Carolina Rural Health Research and Policy Analysis Center
    Date: 02/2006
    This findings brief examines trends in the delivery of skilled nursing facility services in both hospital-based units and swing beds during a period of dramatic change in Medicare payments for post-acute care, focusing on critical access hospitals.