Jeffery Talbert, PhD

Deputy Director, Rural and Underserved Health Research Center

Phone: 859.323.7141
Email: jeff.talbert@uky.edu

Institute for Biomedical Informatics, College of Medicine
University of Kentucky
Healthy Kentucky Research Building
760 Press Avenue, Suite 360
Lexington, KY 40536

Current Projects - (4)
Completed Projects - (5)
Publications - (9)

Current Projects - (4)

Evaluating the Impact of Inflation Reduction Act Provisions on Medicare Advantage Prescription Drug Costs
Using Merative MarketScan data, this study will evaluate changes in the affordability of prescription drugs for urban and rural Medicare beneficiaries before and after the recent Inflation Reduction Act (IRA). The primary outcome will be an assessment of whether the IRA succeeded in reducing costs and identifying any remaining health disparities.
Research center: Rural and Underserved Health Research Center
Topics: Health disparities and health equity, Healthcare financing, Medicare Advantage (MA), Pharmacy and prescription drugs
Impact of High Deductible Health Plans on Rural Populations
Using data from Merative MarketScan insurance claims, this study will investigate utilization, spending, and care patterns of rural members enrolled in high deductible health plans (HDHP) compared to traditional plans. Trends in health outcomes before and after HDHP growth will be assessed to inform policy design tailored to rural residents.
Research center: Rural and Underserved Health Research Center
Topics: Health disparities and health equity, Healthcare access, Healthcare financing, Private health insurance, Rural statistics and demographics
Rural Access to Opioid Treatment Program Clinics and Certified Community Behavioral Health Clinics
This project will identify all Certified Community Behavioral Health Clinics and Opioid Treatment Program Clinics in the U.S. and then present the number of rural and urban clinics in each state as frequency tables and map visualizations.
Research center: Rural and Underserved Health Research Center
Topics: Health services, Healthcare access, Mental and behavioral health, Substance use and treatment
Third Party Negotiated Pricing in Rural and Urban Hospitals
We will use third party negotiated pricing information to compare prices in urban and rural hospitals, across a variety of common services. Because there has been poor compliance with the Centers for Medicare & Medicaid Services (CMS) requirement to publish third party negotiated pricing, we will also examine if the availability of this information differs for rural and urban hospitals.
Research center: Rural and Underserved Health Research Center
Topics: Critical Access Hospitals (CAHs), Federally Qualified Health Centers (FQHCs), Healthcare financing, Hospitals and clinics, Medicare, Medicare Prospective Payment System (PPS), Private health insurance

Completed Projects - (5)

Barriers and Disparities Associated with Pneumococcal Immunization Among Rural Elderly Adults
Our Center conducted analyses of national survey data and unique insurance claims data sets to identify how rurality of residence and key demographic, social, and economic characteristics serve as barriers or facilitators to vaccination against pneumococcal disease, which is relatively common although largely preventable among older Americans.
Research center: Rural and Underserved Health Research Center
Topics: Health disparities and health equity, Health promotion and disease prevention
Diabetes Management in Urban and Rural Areas of the U.S.
This project used the IBM MarketScan database to examine differences in type 2 diabetes prevalence and monitoring for a commercially insured sample. It also employed definitions from the Health Effectiveness Data and Information Set guidelines for comprehensive diabetes care to determine if rural residents are more or less likely to meet recommended standards for type 2 diabetes monitoring and control.
Research center: Rural and Underserved Health Research Center
Topics: Care management, Chronic diseases and conditions, Diabetes, Health disparities and health equity, Health promotion and disease prevention, Health services, Healthcare access, Private health insurance, Quality
Lung Diseases Among Coal Miners
Coal miners are at increased risk of lung diseases. Using secondary datasets, we will assess the distribution of lung diseases across regions, identify patterns of healthcare utilization among miners relative to HRSA-funded Black Lung Clinics, and compare healthcare utilization patterns, behaviors, and comorbidities among miners and non-miners.
Research center: Rural and Underserved Health Research Center
Topics: Chronic diseases and conditions, Environmental and agricultural health, Health disparities and health equity, Health services
Medicare Beneficiaries' Access to Preventive Services: Diabetes Self-Management Training, Medical Nutrition Therapy, and Health and Behavior Assessment and Intervention
Medicare offers preventive services focused on self-management through several programs: Diabetes Self-Management Training, Medical Nutrition Therapy, and Health and Behavior Assessment and Intervention.
Research center: Rural and Underserved Health Research Center
Topics: Diabetes, Health promotion and disease prevention, Medicare, Obesity
Unintentional Injury in Metropolitan and Nonmetropolitan Settings by Race or Ethnicity
This study described the rates of fatal and nonfatal unintentional injury comparing metropolitan and nonmetropolitan areas, stratified by race or ethnicity. This study used Centers for Disease Control WONDER data (2014-2018) and the 2018 National Hospital Ambulatory Medical Care Survey.
Research center: Rural and Underserved Health Research Center
Topics: Emergency medical services (EMS) and trauma, Health disparities and health equity

Publications - (9)

2023

Diabetes Prevalence and Monitoring in Nonmetropolitan and Metropolitan Areas Within a Commercially Insured U.S. Population
Policy Brief
Rural and Underserved Health Research Center
Date: 06/2023
This study used recent claims data, from services received between 2018 and 2020, to examine the prevalence of diabetes and to determine if patients with diabetes are more or less likely to receive annual hemoglobin A1c screening.

2022

Medicaid Expansion and Access to Naloxone in Metropolitan and Nonmetropolitan Areas
Journal Article
Rural and Underserved Health Research Center
Date: 11/2022
This study evaluated the association of Medicaid expansion at the state level on the number of naloxone prescriptions dispensed and the percentage paid by Medicaid. Increasing the percentage of Medicaid-paid naloxone prescriptions improved access in metro areas.
Increased Rates of Death From Unintentional Injury Among Non-Hispanic White, American Indian/Alaska Native, and Nonmetropolitan Communities
Policy Brief
Rural and Underserved Health Research Center
Date: 07/2022
This brief examines the rate of fatal and nonfatal unintentional injuries in nonmetropolitan and metropolitan areas, with a focus on the effects of race/ethnicity.

2021

Medicare-Paid Naloxone: Trends in Nonmetropolitan and Metropolitan Areas
Policy Brief
Rural and Underserved Health Research Center
Date: 05/2021
Naloxone is an opioid overdose reversal medication. Medicare beneficiaries benefit from access to naloxone because they have high rates of high-dose prescription opioids. This brief examines trends in Medicare-paid naloxone dispensing rates in nonmetropolitan versus metropolitan areas from 2014 to 2018.

2020

Rural/Urban Disparities in the Utilization of Health and Behavioral Assessments/Interventions in the Fee-for-Service Medicare Population
Policy Brief
Rural and Underserved Health Research Center
Date: 06/2020
Identifying behaviors that contribute to disease and modifying them can be an important step in treatment. This study investigated geographic disparities and the availability of Health and Behavioral Assessments and Interventions services in rural and urban areas by examining fee-for-service Medicare beneficiaries in 2012-2016.
Rural/Urban Disparities in Utilization of Diabetes Self-Management Training to the Fee-for-Service Medicare Population
Policy Brief
Rural and Underserved Health Research Center
Date: 06/2020
Diabetes self-management training (DSMT) is recommended for all newly diagnosed patients with diabetes. However, the utilization rate of DSMT is low, and geographic disparities in availability exist. This study sought to identify the extent of the rural/urban disparity in the provision of DSMT to fee-for-service Medicare beneficiaries in 2012-2016.
Rural/Urban Disparities in Utilization of Medical Nutrition Therapy to the Fee-for-Service Medicare Population
Policy Brief
Rural and Underserved Health Research Center
Date: 06/2020
Medical Nutrition Therapy (MNT) is important in the treatment of many chronic conditions, but the availability of MNT in rural versus urban communities has not been examined. This study sought to identify the availability of MNT in rural and urban communities by examining Medicare fee-for-service beneficiaries in 2012-2016.

2018

Update: Rural/Urban Disparities in Pneumococcal Vaccine Service Delivery Among the Fee-for-Service Medicare Population, 2012-2015
Policy Brief
Rural and Underserved Health Research Center
Date: 11/2018
Delivery of pneumococcal vaccines to fee-for-service Medicare beneficiaries increased 380% from 2014-2015 as a result of uptake of pneumococcal conjugate vaccine (PCV13). However, a significant rural-urban disparity remains. Pharmacy providers delivered a significantly greater proportion of vaccines in rural versus urban counties.
Rural/Urban Disparities in Pneumococcal Vaccine Service Delivery Among the Fee-for-Service Medicare Population
Policy Brief
Rural and Underserved Health Research Center
Date: 02/2018
Using 2014 Medicare data, we found a significant disparity in pneumococcal vaccine service delivery to fee-for-service Medicare beneficiaries. Although primary care providers delivered the majority of pneumococcal vaccines to this population, pharmacy providers delivered a significantly greater proportion of vaccines in rural versus urban counties.