Ira Moscovice, PhD

Director, University of Minnesota Rural Health Research Center

Phone: 612.624.8618
Fax: 612.624.2196
Email: mosco001@umn.edu

Rural Health Research Center
University of Minnesota
Division of Health Policy and Management
420 Delaware Street SE, MMC 729
Minneapolis, MN 55455


Current Projects - (3)

  • Access and Quality of Care for Rural Patients with Chronic Obstructive Pulmonary Disease
    Although rates of chronic obstructive pulmonary disease (COPD) are substantially higher in rural areas, there has been limited research on healthcare access and quality issues for individuals with COPD who live in rural communities. This project aims to improve the accessibility and quality of care for rural COPD patients.
    Research center: University of Minnesota Rural Health Research Center
    Topics: Chronic diseases and conditions, Quality
  • Measuring the Quality of Swing-Bed Care in Critical Access Hospitals
    This project will identify quality measures to be used by Critical Access Hospitals to assess the quality of care provided to their swing-bed patients, and recommend appropriate uses of the measures.
    Research center: University of Minnesota Rural Health Research Center
    Topics: Hospitals and clinics, Quality
  • Rural Implications of Quality-Based Physician Payment Reform
    The purpose of this project is to assess existing national data about the quality of care provided by rural physicians, and to determine what additional information will be needed as CMS moves towards inclusion of all physicians in payment reforms based on quality.
    Research center: University of Minnesota Rural Health Research Center
    Topics: Physicians, Quality

Completed Projects - (45)

  • Affordable Care Act Outreach and Enrollment: Case Studies of Rural Hospitals in Four States
    The purpose of this project is to identify best practices used by rural hospitals to educate uninsured rural patients and consumers about available health insurance coverage options and to assist them in enrolling in a Qualified Health Plan or Medicaid.
    Research center: University of Minnesota Rural Health Research Center
    Topics: Health insurance and the uninsured, Hospitals and clinics, Medicaid and S-CHIP
  • Analysis of Critical Access Hospital Inpatient Hospitalizations and Transfers from CAHs to Other Acute and Post-Acute Care Settings Using State Inpatient Databases
    The purpose of this project is to analyze Critical Access Hospital (CAH) inpatient hospitalizations and transfers from CAHs in order to help inform the development of quality indicators for CAHs, especially quality indicators focused on the transfer process.
    Research center: University of Minnesota Rural Health Research Center
    Topics: Critical Access Hospitals and Rural Hospital Flexibility Program, Quality, Technology
  • Analyzing the Relationship Among Critical Access Hospital Financial Status, Organizational Linkages, and Scope of Services
    This project will systematically analyze the relationships among pre- and post-conversion Critical Access Hospital (CAH) financial performance, the organizational linkages in which the hospital participates (e.g., health care systems and/or networks), and the scope of services (i.e., the number and type of services) provided.
    Research center: University of Minnesota Rural Health Research Center
    Topics: Critical Access Hospitals and Rural Hospital Flexibility Program, Health services, Healthcare financing, Networking and collaboration
  • Are Part D Plans Meeting the Needs of Rural Medicare Beneficiaries?
    The purpose of this project is to assess whether the Medicare Part D prescription drug plans available in rural counties are sufficient to meet the needs of rural Medicare beneficiaries.
    Research center: University of Minnesota Rural Health Research Center
    Topics: Medicare, Medicare Part D, Pharmacy and prescription drugs
  • Assessing Pent-Up Demand for Rural Medicare Beneficiaries
    The purpose of this project is to estimate the amount of pent-up demand of rural Medicare beneficiaries who enter risk plans.
    Research center: University of Minnesota Rural Health Research Center
    Topic: Medicare
  • Assessing the Rural Relevance of Hospital Outpatient Quality Measures
    The purpose of this project is to: 1) determine the diagnoses that are most commonly treated and the procedures most commonly performed in rural hospital outpatient settings; and 2) to evaluate the rural relevance of the proposed new CMS outpatient quality measures and other potential outpatient quality measures.
    Research center: Upper Midwest Rural Health Research Center
    Topics: Hospitals and clinics, Quality
  • Beyond Simple Ranking: Identifying and Empirically Testing Alternative Approaches for Recognizing Quality in Rural Hospitals
    The purpose of this project is to explore several alternative methods for assessing the relative quality of hospitals using data from the Hospital Quality Incentive Demonstration Project and Hospital Compare.
    Research center: Upper Midwest Rural Health Research Center
    Topics: Hospitals and clinics, Quality
  • Critical Access Hospital Participation in the Hospital Quality Alliance and Initial Quality Measure Results
    This project examined the participation of Critical Access Hospitals (CAHs) in public reporting of quality measures in the Centers for Medicare and Medicaid Services Hospital Compare database. It presented the initial Hospital Compare results for CAHs and comparisons with other groups of hospitals on quality measures for three conditions: acute myocardial infarction (heart attack), heart failure and pneumonia.
    Research center: University of Minnesota Rural Health Research Center
    Topics: Critical Access Hospitals and Rural Hospital Flexibility Program, Quality
  • Critical Access Hospital Readiness for CMS Value-Based Purchasing
    The purpose of this project will be to assess Critical Access Hospital readiness for participation in a Value-based Purchasing program similar to that proposed by CMS for Prospective Payment System hospitals.
    Research center: Upper Midwest Rural Health Research Center
    Topics: Critical Access Hospitals and Rural Hospital Flexibility Program, Healthcare financing, Quality
  • Developing a Quality Performance Measurement System for Critical Access Hospitals
    This project continues to support activities related to quality performance measurement relevant for Critical Access Hospitals. By the end of 2005, the technical expert panel had reviewed the findings of the initial field test of the small rural hospital quality measure set and made recommendations for revisions.
    Research center: University of Minnesota Rural Health Research Center
    Topics: Critical Access Hospitals and Rural Hospital Flexibility Program, Quality
  • Developing Quality Measures and Communication Strategies for Rural Patient Transfers
    The purpose of this project is to quantify the complexity of the coordination of patient care in rural health care systems and to expand our work on developing quality measures for rural patients whose care is transferred between providers.
    Research center: Upper Midwest Rural Health Research Center
    Topic: Quality
  • Developing Relevant Quality Indicators for Rural Hospitals
    Research center: University of Minnesota Rural Health Research Center
    Topics: Hospitals and clinics, Quality
  • Effect of Type and Timeliness of Post-Acute Care on Preventable Hospital Readmissions for Rural Medicare Beneficiaries
    The purpose of this project is to: 1) determine how location of hospitals used for initial admissions by rural patients affects readmission rates; 2) assess how the use of swing beds affects rural patients' readmissions; and 3) examine the impact of the type and timeliness of post-acute care, including home health care, skilled nursing, and physician visits, on readmissions for rural patients.
    Research center: Upper Midwest Rural Health Research Center
    Topics: Hospitals and clinics, Medicare
  • Federal Rural Health Outreach Grant Program: The Impact and Sustainability of Grantees
    Research center: University of Minnesota Rural Health Research Center
    Topics: Health services, Networking and collaboration
  • Has the Medicare Part D Program Improved Medication Access and the Health Status of Rural Beneficiaries?
    This project will use Medicare Current Beneficiary Survey data to assess the impact of the Medicare Part D Program on medication access and the health status of rural Medicare beneficiaries.
    Research center: University of Minnesota Rural Health Research Center
    Topics: Medicare Advantage (MA), Medicare Part D, Pharmacy and prescription drugs
  • Health Information Technology and Quality in Rural Hospitals
    The purpose of this project is to: 1) examine the adoption of health information technology (HIT) among rural hospitals and identify hospital and market characteristics that facilitate or impede HIT diffusion; 2) measure the effect of HIT on clinical quality in rural hospitals; and 3) identify technologies that may be promoted to improve quality of care in rural areas.
    Research center: Upper Midwest Rural Health Research Center
    Topics: Health information technology, Hospitals and clinics, Quality
  • High Quality Rural Hospitals and Post-Acute Care Providers
    This project will use several large longitudinal national databases to model alternative ways of identifying high quality rural hospitals, analyze factors related to quality in rural hospitals, and examine the relationship between the quality of care provided by rural hospitals and the quality of care provided by nursing homes and home health agencies within rural communities.
    Research center: University of Minnesota Rural Health Research Center
    Topics: Hospitals and clinics, Quality
  • Hospitalizations of Rural Children for Ambulatory Care Sensitive Conditions
    This project uses state inpatient discharge data from six states, data from the Area Resource File and the AHRQ Pediatric Quality Indicators to examine Ambulatory Care Sensitive Condition admission rates for rural children.
    Research center: Upper Midwest Rural Health Research Center
    Topics: Children, Chronic diseases and conditions
  • Identifying Adverse Drug Events and Improving Patient Safety in Rural Hospitals
    This study identifies rates of adverse drug events (ADEs) and opportunities to improve patient safety in Critical Access Hospitals (CAHs) and non‐CAH rural hospitals.
    Research center: University of Minnesota Rural Health Research Center
    Topics: Critical Access Hospitals and Rural Hospital Flexibility Program, Hospitals and clinics, Pharmacy and prescription drugs, Quality
  • Impact of Expansion of Ambulatory Surgery Centers on Rural Hospitals and Communities
    This project will examine the extent of freestanding ambulatory surgery center (ASC) expansion into rural communities between 1998 and 2005, the market factors driving that expansion, and the impact of ASCs on the operational and financial viability of rural hospitals located in the same communities.
    Research center: Upper Midwest Rural Health Research Center
    Topics: Health services, Healthcare financing
  • Impact of Health Insurance Coverage on Native Elder Health: Implications for Addressing the Health Care Needs of Rural American Indian Elders
    This project examined the types of health insurance coverage of rural Native American elders ages 55 and older, and examine how different types of health insurance coverage and lack of health insurance coverage impact access to health care services among Native American elders by geographic location (rural frontier, rural non-frontier and urban).
    Research center: Upper Midwest Rural Health Research Center
    Topics: Aging, American Indians and Alaska Natives, Frontier health, Health insurance and the uninsured, Minority health, Rural statistics and demographics
  • Impact of Hospitalists on Inpatient and Primary Care in Rural Communities
    This project will analyze primary data from a survey of rural hospitals about their use of hospitalists along with several sources of secondary data to examine why and how hospitalists are being used in rural hospitals and the impact of their use.
    Research center: Upper Midwest Rural Health Research Center
    Topic: Hospitals and clinics
  • Impact of Private Sector Quality Initiatives on Rural Providers and Patients
    The purpose of this project is to assess the impact of private sector quality reporting and quality improvement initiatives on rural providers and on the quality of care provided to rural patients.
    Research center: University of Minnesota Rural Health Research Center
    Topic: Quality
  • Impact of the CMS Value-Based Purchasing and Readmission Reduction Programs on Rural Hospitals
    The purpose of this project is to assess the initial impacts of the Value-Based Purchasing (VBP) and Readmission Reduction Programs on rural Prospective Payment System (PPS) hospitals.
    Research center: University of Minnesota Rural Health Research Center
    Topic: Hospitals and clinics
  • Implementation of Telepharmacy in Rural Hospitals: Potential for Improving Medication Safety
    The purpose of this project is to describe successful telepharmacy activities and to analyze policy issues related to the implementation of telepharmacy projects in rural hospitals. These policy issues include the potential impact of telepharmacy use on the quality of pharmaceutical services and medication safety for rural patients.
    Research center: Upper Midwest Rural Health Research Center
    Topics: Hospitals and clinics, Pharmacy and prescription drugs, Quality, Telehealth
  • Measuring Quality Performance in CAHs
    The purpose of the project is to update our previous analyses of CAH participation in Hospital Compare, analyze trends over time, and explore additional sources of quality data for CAHs.
    Research center: University of Minnesota Rural Health Research Center
    Topics: Critical Access Hospitals and Rural Hospital Flexibility Program, Quality
  • National Rural Hospital Flexibility Program Tracking Project: Analysis of CAH Quality Improvement (QI) Strategies
    Research center: University of Minnesota Rural Health Research Center
    Topics: Critical Access Hospitals and Rural Hospital Flexibility Program, Quality
  • National Rural Hospital Flexibility Program Tracking Project: Analysis of the Financial Impact of Conversion on Critical Access Hospitals (CAHs) and the Medicare Program
    Research center: University of Minnesota Rural Health Research Center
    Topics: Critical Access Hospitals and Rural Hospital Flexibility Program, Healthcare financing
  • Nursing Workforce Impact on Rural Hospital Performance Improvement in the Hospital Quality Incentive Demonstration Project
    The purpose of this project is to examine the impact of nurse staffing on hospital performance improvement in the CMS/premier Inc. Hospital Quality Incentive Demonstration project with specific interest in whether and how this relationship differs in rural hospitals as compared to urban hospitals.
    Research center: Upper Midwest Rural Health Research Center
    Topics: Hospitals and clinics, Quality, Workforce
  • Obstetric Care Practice Models and Quality in Rural Hospitals
    The project will examine current obstetric practice models in rural hospitals and assess the prospects for implementation of new policy recommendations for reducing primary cesarean rates and non-medically indicated inductions of labor in rural hospitals.
    Research center: University of Minnesota Rural Health Research Center
    Topics: Maternal and child health, Quality
  • Patient Assessments and Quality of Care in Rural Hospitals
    This study will 1)analyze the relationships between rural patients' perspectives of hospital quality of care and key hospital characteristics that may influence patients' experiences of hospital care; and 2) assess whether rural patients' perspectives of hospital quality of care are related to quality measures focused on the provision of recommended care for medical conditions.
    Research center: Upper Midwest Rural Health Research Center
    Topics: Health services, Quality
  • Pay-for-Performance and Quality Improvement in Rural Hospitals
    This project will estimate the impact on rural hospitals in the U.S. of a pay-for-performance (PFP) program similar to the CMS-sponsored Premier, Inc. Hospital Quality Incentive Demonstration; synthesize the major factors that will influence the inclusion of rural hospitals in PFP programs; and make recommendations for the design of PFP programs that will appropriately reward rural hospitals for improving quality.
    Research center: Upper Midwest Rural Health Research Center
    Topics: Healthcare financing, Hospitals and clinics, Quality
  • Preventing Errors in Rural Hospitals
    Research center: University of Minnesota Rural Health Research Center
    Topics: Hospitals and clinics, Quality
  • Progress Toward Meaningful Use of Health Information Technology Among Rural Physician Practices
    This project will assess progress toward the meaningful use of health information technology among rural physician practices, using several sources of data. This empirical analysis will be supplemented by a qualitative assessment of rural physician practices' experiences with the meaningful use of health IT, working with two quality improvement organizations (QIOs)/Regional Extension Centers (RECs).
    Research center: University of Minnesota Rural Health Research Center
    Topics: Health information technology, Physicians
  • Quality and Financial Status of Critical Access Hospitals: A Preliminary Analysis
    The purpose of this project is to continue to investigate the relationship between CAH financial performance and quality of care. UMN and UNC will jointly develop hypotheses related to the finance-quality link and statistical models suitable for testing hypotheses.
    Research centers: North Carolina Rural Health Research and Policy Analysis Center, University of Minnesota Rural Health Research Center
    Topics: Critical Access Hospitals and Rural Hospital Flexibility Program, Healthcare financing, Quality
  • Quality Measures and Sociodemographic Risk Factors: The Rural Environmental Context
    For three acute care conditions/diagnoses (potential examples include diabetes, congestive heart failure, COPD), this study will (1) identify the key socio-demographic variables that may affect quality adjustment for rural populations/providers; (2) identify data sources/strategies available for the above variables; and (3) identify the quality measures (e.g. readmission rates) that should be adjusted for socio-demographic variables for rural populations/providers and estimate the potential impact of those adjustments on quality measurement.
    Research center: University of Minnesota Rural Health Research Center
    Topics: Quality, Rural statistics and demographics
  • Role of Rural Hospitals in Community-Centered Systems of Care: Supporting Population Health Improvement for Rural Communities
    This project will assess the degree to which rural hospitals engage in activities that facilitate community responsiveness and the provision of community-oriented services, using 1996 to 2004 data from the American Hospital Association Annual Survey and the Area Resource File.
    Research center: Upper Midwest Rural Health Research Center
    Topics: Health services, Hospitals and clinics
  • Rural Emergency Department Staffing: Implications for the Quality of Emergency Care Provided in Rural Areas
    This project will describe emergency department (ED) staffing patterns in rural hospitals; determine how the certification, training, and experience of ED physicians and other providers in different ED staffing models vary; and assess the implications of rural ED staffing for the quality of emergency care in rural areas, continuity of care, and rural EDs' role as safety net providers.
    Research center: Upper Midwest Rural Health Research Center
    Topics: Emergency medical services (EMS), Hospitals and clinics, Quality, Workforce
  • Rural Hospital Flexibility Performance Monitoring Project- Grant Years 2003-2008
    Under contract with the federal Office of Rural Health Policy, the Rural Health Research Centers at the Universities of Minnesota, North Carolina, and Southern Maine are cooperatively conducting a performance monitoring project for the Medicare Rural Hospital Flexibility Program (Flex Program). The monitoring project will assess the impact of the Flex Program on rural hospitals and communities and the role of states in achieving overall program objectives, including improving access to and the quality of health care services; improving the financial performance of Critical Access Hospitals; and engaging rural communities in health care system development.
    Research centers: Maine Rural Health Research Center, North Carolina Rural Health Research and Policy Analysis Center, University of Minnesota Rural Health Research Center
    Topic: Critical Access Hospitals and Rural Hospital Flexibility Program
  • Rural Hospital Obstetric Workforce, Procedure Utilization, and Quality of Care
    This study examines the relationships between key aspects of the obstetric workforce in rural hospitals and procedure intensity and quality of maternity care in those hospitals.
    Research center: University of Minnesota Rural Health Research Center
    Topics: Maternal and child health, Quality, Women, Workforce
  • Rural Implications of Health Care Reform: Issues Related to Quality of Care, Health Information Technology and Care Coordination
    The purpose of this project is to provide support to the Office of Rural Health Policy on rural health care reform issues.
    Research center: Upper Midwest Rural Health Research Center
    Topics: Health policy, Health services
  • Rural Women Giving Birth in Non-Local Hospitals: Implications for Obstetric Access and Quality
    The purpose of this project is to: 1) analyze recent data from nine geographically diverse states on delivery by rural women at non-local hospitals; 2) characterize the roles of medical vs. non-medical factors in delivery at a non-local hospital by identifying lower-risk and higher-risk women using established criteria; and 3) analyze the relationship between delivery at a non-local hospital and obstetric quality.
    Research center: University of Minnesota Rural Health Research Center
    Topics: Hospitals and clinics, Quality, Women
  • Rural-Urban Differences in Insurer Participation, Premiums, Health Plan Provider Networks in Federal and State Marketplaces
    This two-year project will: 1) measure rural-urban differences in the size, scope, and composition of provider networks affiliated with Marketplace plans; 2) analyze the relationships between provider network size and composition, other benefit design attributes, geographic rating area designations, and premiums; and 3) examine how rural and urban Marketplace-based plan enrollment is affected by plan availability and provider network size and scope.
    Research center: University of Minnesota Rural Health Research Center
    Topic: Health insurance and the uninsured
  • Successful Implementation of Medication Safety Initiatives in Rural Hospitals: The Role of Pharmacists and Technology
    This project will assess the capacity of rural hospitals to implement medication safety practices that reduce the likelihood of serious adverse drug events, and will identify factors that facilitate successful implementation of medication safety practices in rural hospitals.
    Research center: Upper Midwest Rural Health Research Center
    Topics: Hospitals and clinics, Pharmacy and prescription drugs, Quality, Technology
  • What Constitutes An Adequate Provider Network For Rural Health Populations?
    The purpose of this study is to develop norms/standards for provider network adequacy for rural populations (which may vary across different rural environments) that will be useful to consumers, providers, and policymakers in the decisions they face with respect to health plan choices, participation, and policies.
    Research center: University of Minnesota Rural Health Research Center
    Topic: Health insurance and the uninsured

Publications - (76)