Kevin Bennett, PhD

South Carolina Rural Health Research Center

Phone: 803.251.6317
Email: kevin.bennett@uscmed.sc.edu


Current Projects - (1)

  • Characteristics and Utilization Patterns of Rural Medicaid Recipients
    This study will use the Medicaid Analytic Extract file to examine the characteristics of persons enrolled in Medicaid by type of eligibility. The study will also examine overall utilization and total payments for this utilization. All estimates will be subset by rurality and region.
    Research center: South Carolina Rural Health Research Center
    Topics: Medicaid and S-CHIP, Rural statistics and demographics

Completed Projects - (6)

  • Identification of Highly Vulnerable Counties: The Intersection of Race, Poverty, and Health Care Resources
    The United States rural population has changed since the 2000 Census; minority populations have increased while overall population growth has slowed. This analysis will identify places of high vulnerability, defined as counties with high proportions of poor and/or minority populations with low or reduced healthcare resources.
    Research center: South Carolina Rural Health Research Center
    Topics: Health insurance and the uninsured, Minority health
  • Intensity of Service Provision for Medicare Beneficiaries Utilizing Home Health Services
    This study will assess whether Medicare beneficiaries in rural areas receive a lower intensity of home health (HH) services compared to their urban counterparts. Specifically, the study will examine (1) the distribution of levels of HH services for four conditions: joint (hip and knee) replacement, stroke, end-stage renal disease (ESRD), and diabetes; (2) the distribution of type of provider for each condition across the levels of rurality; and (3) the median charge and payment per beneficiary for these services across the levels of rurality.
    Research center: South Carolina Rural Health Research Center
    Topics: Chronic diseases and conditions, Home health, Medicare
  • Post-Hospital Transitions in Care Among Dually-Eligible Medicare Beneficiaries
    This project will examine the hospitalization rates, post-discharge physician follow-up, and subsequent readmission rates among Medicare beneficiaries who are also enrolled in Medicaid. We will examine these dual-eligible beneficiaries by level of rurality to determine if residence is a significant factor in these rates. We will also control for co-morbidities, county characteristics, and other factors related to readmission rates.
    Research center: South Carolina Rural Health Research Center
    Topics: Health policy, Hospitals and clinics, Medicare
  • Rural and Urban Differences in Case-Mix Among Recipients of Home Health Care
    We will examine current patient case-mix for the Medicare population receiving skilled health care from a home health agency to determine if there are rural or race/ethnicity-based disparities with regards to receipt of services and clinical acuity indicators.
    Research center: South Carolina Rural Health Research Center
    Topics: Health disparities, Home health, Medicare
  • Rural-Urban Differences in Medicare Service Use and Expenditures in the Last Six Months of Life
    Patterns of end-of-life care are known to vary by rurality and by minority status, and the availability of facilities such as hospice also vary with rurality. This study will examine the relationship between level of service use during the last six months of life and facility availability in county of residence (hospital, SNF, IRF, home health, hospice), as well as minority status of the beneficiary and whether the beneficiary is also eligible for Medicaid (“dual eligible”).
    Research center: South Carolina Rural Health Research Center
    Topics: Aging, Medicaid and S-CHIP, Medicare, Minority health
  • Transitions in Care for Rural Medicare Beneficiaries with Diabetes
    Hospital readmission rates among persons with diabetes, as well as absolute admission rates, may be used to study health disparities among rural and minority populations. This project will use data from the Medicare Chronic Conditions Data Warehouse to explore residence- and race-based disparities in diabetes admission rates, effective transitions to outpatient care, and re-admission rates, to help guide rural policy-makers and health care providers.
    Research center: South Carolina Rural Health Research Center
    Topics: Chronic diseases and conditions, Health disparities, Medicare, Minority health

Publications - (17)

  • Characteristics, Utilization Patterns, and Expenditures of Rural Dual Eligible Medicare Beneficiaries
    Policy Brief
    South Carolina Rural Health Research Center
    Date: 11/2014

    Study analyzes the rural-urban differences regarding dual eligible beneficiaries and their race, region of residence, patterns of utilizing health services and Medicare expenditures.

  • Dialysis Availability in Rural America
    South Carolina Rural Health Research Center
    Date: 01/2013

    Explores the availability of dialysis services in rural America including the prevalence of dialysis use across urban and rural counties, travel distance for services, and dialysis quality outcomes.

    Include the following:

    • The prevalence of dialysis use did not differ across urban versus rural counties.
    • Rural residents travel further for dialysis services.
    • Fewer expanded dialysis services (peritoneal dialysis, home hemodialysis training, and after-hours availability) were offered in rural areas.
    • Dialysis quality outcomes were similar across rural and urban end stage renal disease facilities.
  • Differences in Medicare Service Use in the Last Six Months of Life among Rural and Urban Dual – Eligible Beneficiaries
    Report
    South Carolina Rural Health Research Center
    Date: 08/2017
    In this brief, we compare rural and urban dual-eligible beneficiaries to Medicare-only beneficiaries in their service utilization in the last six months of life. Within rural beneficiaries, we further explore differences associated with race/ethnicity.
  • Disparities in Home Health Service Providers Among Medicare Beneficiaries with Stroke
    South Carolina Rural Health Research Center
    Date: 01/2016
    Examines the intensity of home health services, by the number of visits and service delivery by rehabilitation specialists, among Medicare beneficiates with stroke. There were no significant rural-urban differences in the number of home health visits, but rural residents were less likely to receive services from rehabilitation specialists.
  • Geographic Disparities in Mortality Among the End Stage Renal Disease Patients: An Analysis of the United States Renal Data System, 2007-08.
    South Carolina Rural Health Research Center
    Date: 06/2016
    Explores the association between morality, rurality, and distance from the treatment facility of patients with end-stage renal disease (ESRD). Rural patients were found to have a mortality advantage.
  • Handling the Handoff: Rural and Race-Based Disparities in Post Hospitalization Follow-up Care Among Medicare Beneficiaries with Diabetes
    South Carolina Rural Health Research Center
    Date: 09/2011
    Diabetes is one of the most common chronic diseases, affecting an estimated 23.6 million people in the United States (7.8% of the total population). Rural African American and Hispanic residents with diabetes are less likely to exhibit good control of their condition, putting them at greater risk for the consequences of this disease, such as kidney failure, blindness and amputation. Effective outpatient care is key to diabetes management. Absence of such care, conversely, may play a role in poorer diabetes control in rural areas. The present report uses information regarding Medicare beneficiaries with diabetes to examine the provision of care in rural America. It provides estimates of hospital admission rates for rural Medicare beneficiaries with diabetes, tracks the proportion of patients who receive adequate outpatient care post discharge, and assesses subsequent readmissions to the hospital. It also explores the potential for race-based disparities in care for diabetes.
  • Health Disparities: A Rural-Urban Chartbook (Full Report)
    South Carolina Rural Health Research Center
    Date: 06/2008
    Rural minorities experience disparities in health and health care delivery. Previous studies have illustrated many of the health disparities experienced by rural residents, such as poorer health status, higher obesity prevalence, more with activity limitations, and higher mortality rates. The Chartbook seeks to expand the work of the National Healthcare Disparities Reports, issued annually by the Agency for Healthcare Research and Quality. These Reports are limited in their discussion of disparities experienced by rural residents and present little data regarding disparities among rural minority populations. The present Chartbook expands upon prior work by examining potential disparities among rural populations in health, health behaviors, preventive services and diabetes care.
  • Home Health Care Agency Availability in Rural Counties
    Report
    South Carolina Rural Health Research Center
    Date: 06/2014

    Examines home healthcare across the United States and in rural counties including home healthcare agency availability and quality of services provided. Reports that counties at risk for limited service availability were almost entirely rural. Of the 34 counties lacking a home health agency, 30 were rural. Of the 120 counties served by a single agency, 118 were rural.

  • Intensity of Service Provision for Medicare Beneficiaries Utilizing Home Health Services: A Closer Look at Cerebrovascular Disease, Diabetes, and Joint Replacement
    Report
    South Carolina Rural Health Research Center
    Date: 11/2014

    Reports on the impact of home health services provided to the rural elderly receiving Medicare by the number of visits, the use of rehabilitation specialists, and the median payment per each claim.

  • Lower Rehospitalization Rates among Rural Medicare Beneficiaries with Diabetes
    South Carolina Rural Health Research Center
    Date: 2012
    Evaluates 30-day readmission rates of Medicare beneficiaries with diabetes in rural areas.
  • Missing the Handoff: Post-Hospitalization Follow-up Care Among Rural Medicare Beneficiaries with Diabetes
    South Carolina Rural Health Research Center
    Date: 2012
    Analyzes urban and rural differences in post-discharge physician follow-up care using data from 2005 Medicare claims files.
  • Post-discharge Rehabilitation Care Delivery for Rural Medicare Beneficiaries with Stroke
    Policy Brief
    South Carolina Rural Health Research Center
    Date: 09/2015

    Stroke is the fourth leading cause of death and the leading cause of long-term disability in the United States (U.S.). Post-discharge care has been shown to be vital in preventing long-term morbidity and improving functionality and quality of life for stroke patients. The most appropriate post-discharge rehabilitation care (PDRC) setting for stroke patients depends on several factors including the patient’s clinical profile, patient preferences, provider recommendations, and proximity to available resources. Limited evidence suggests geographic as well as racial and ethnic disparities in receipt of PDRC. We sought to examine the following research questions:

    1. Are there differences in the provision and type of PDRC received post-discharge by rurality and race/ethnicity among stroke survivors?
    2. Is distance between the patient’s home and the discharge hospital related to the type of PDRC recommended?
    3. Are factors such as initial hospital admission (transfer from other hospital vs. referral from primary care vs. direct admission from emergency departments) related to PDRC provision and type?
  • Rural Population Estimates: An Analysis of a Large Secondary Data Set
    South Carolina Rural Health Research Center
    Date: 2013
    Examines in the underrepresentation of rural counties in large secondary data sources, specifically the Behavioral Risk Factor Surveillance System (BRFSS).
  • Rural-Urban Differences in Medicare Service Use in the Last Six Months of Life
    Report
    South Carolina Rural Health Research Center
    Date: 08/2017
    This brief focuses on the current status of healthcare use during the last six months of life among Medicare beneficiaries. We used data from a sample of Medicare beneficiary claims to assess whether service utilization differed between rural and urban decedents and across decedents of different race/ethnicity categories.
  • Thirty-Day Readmission Rates Among Dual-Eligible Beneficiaries
    South Carolina Rural Health Research Center
    Date: 08/2015
    Examines readmission rates and factors affecting readmission of patients eligible for both Medicare and Medicaid (dual-eligibility).
  • Transitions in Care Among Rural Residents with Congestive Heart Failure, Acute Myocardial Infarction, and Pneumonia
    Report
    South Carolina Rural Health Research Center
    Date: 08/2017
    Rural and urban hospitals vary with regard to the levels of care they are able to provide, requiring that a subset of patients be transferred from the first point of encounter to a second facility. The degree to which inter-hospital transfers occur, and the outcomes for transfer patients, have not been studied across rural and urban institutions.
  • Vulnerable Rural Counties: The Changing Landscape, 2000-2010
    Policy Brief
    South Carolina Rural Health Research Center
    Date: 07/2016
    This brief illustrates the distribution of rural vulnerable populations and the challenges they face. Understanding the demography of rural America is vital to understanding what programs, interventions and policy initiatives are needed to improve health care access, delivery and outcomes.