Pam Silberman, JD, DrPH

North Carolina Rural Health Research and Policy Analysis Center

Phone: 919.966.4525
Email: pam_silberman@unc.edu


Completed Projects - (6)

  • Early Rural Experiences of Changes to Medicaid
    This project will 1) develop baseline state-level snapshots of rural enrollment in Medicaid and 2) estimate and model enrollment expansion in each state. We will also conduct a baseline provider key informant interviews in late 2013 to gauge expected effects, with follow up interviews in Summer 2014 as a sentinel warning system of early effects of changes to Medicaid in order to inform timely policy development.
    Research center: North Carolina Rural Health Research and Policy Analysis Center
    Topics: Federally Qualified Health Centers (FQHCs), Health insurance and the uninsured, Health policy, Hospitals and clinics, Medicaid and S-CHIP
  • Impact of The Medicaid Budget Crisis on Rural Communities: A 50-State Survey
    The impact of the Medicaid budgetary crisis on rural communities across the US will be assessed through a 50-state survey of state Medicaid agencies, state Offices of Rural Health and state rural health associations.
    Research center: North Carolina Rural Health Research and Policy Analysis Center
    Topics: Health policy, Medicaid and S-CHIP
  • Medicaid Managed Care in Rural Areas: Innovative Case Management Strategies
    Research center: North Carolina Rural Health Research and Policy Analysis Center
    Topic: Medicaid and S-CHIP
  • Premium Assistance Programs: Exploring Public-Private Partnerships as a Vehicle for Expanding Health Insurance to Rural Uninsured
    This project examines the experience of states that have implemented premium assistance programs in rural areas to determine whether there are certain design features or certain types of rural communities where these programs may be more feasible.
    Research center: North Carolina Rural Health Research and Policy Analysis Center
    Topic: Health insurance and the uninsured
  • State Facts about Medicaid: Rural Specific Data
    This project will develop state-specific fact sheets which will include information on the groups covered (and income eligibility), structure of the state's SCHIP program, services covered, delivery system, some provider payment information for certain safety net providers, and percentage of the state's rural and urban population that are enrolled in Medicaid. Additional information comparing urban and rural areas of the state will be provided, when available. The rural and urban comparisons will include total numbers of Medicaid recipients, Medicaid expenditures, and enrollment in different types of managed care plans.
    Research center: North Carolina Rural Health Research and Policy Analysis Center
    Topics: Medicaid and S-CHIP, Rural statistics and demographics
  • Tracking the Implementation of Medicaid Managed Care in Rural Areas
    Research center: North Carolina Rural Health Research and Policy Analysis Center
    Topic: Medicaid and S-CHIP

Publications - (12)

  • Best Practices for Health Insurance Marketplace Outreach and Enrollment in Rural Areas
    Fact Sheet
    North Carolina Rural Health Research and Policy Analysis Center
    Date: 12/2014
    Research suggests enrollment rates for those in rural areas was less than urban areas during the first Health Insurance Marketplace enrollment period. Interviews of navigators, health centers, and others in rural counties with high enrollment rates were conducted to uncover best practices for marketing, outreach/education, in-reach, and enrollment.
  • Design of Enhanced Primary Care Case Management Programs Operating in Rural Communities: Lessons Learned from Three States
    North Carolina Rural Health Research and Policy Analysis Center
    Date: 03/2003
    This findings brief discusses state programs that provide enhanced benefits to Medicaid beneficiaries, such as enhanced primary care case management.
  • Effect of Market Reform on Rural Public Health Departments
    North Carolina Rural Health Research and Policy Analysis Center
    Date: 01/2000
    This study seeks to determine how rural health departments and populations they serve have been affected by recent health system changes, especially Medicaid managed care.
  • Geographic Variation in Plan Uptake in the Federally Facilitated Marketplace
    Policy Brief
    North Carolina Rural Health Research and Policy Analysis Center
    Date: 10/2014
    This brief combines the data on plan selection in the federally facilitated marketplaces with estimates of those likely to qualify for the marketplace to calculate the percentage of potential eligible individuals who chose a health insurance plan (the uptake rate). It contains a heat map showing the variation in uptake rates across the country.
  • The Impact of Medicaid Cuts on Rural Communities
    North Carolina Rural Health Research and Policy Analysis Center
    Date: 08/2005
    This study assesses the perception of state Medicaid staff and individuals from State Offices of Rural Health (SORH) and Rural Health Associations (RHA) regarding the impact on rural areas of state Medicaid policy changes that occurred between 2002 and 2004.
  • Impact Of The Medicaid Budgetary Crisis On Rural Communities
    North Carolina Rural Health Research and Policy Analysis Center
    Date: 08/2003
    This paper provides an overview of the Medicaid program and options states have to reduce program costs. Steps states have proposed or taken to reduce Medicaid costs and the potential impact of these changes on rural areas are discussed. The potential impact on rural communities of federal proposals to redesign Medicaid is assessed.
  • Innovative Primary Care Case Management Programs Operating in Rural Communities: Case Studies of Three States
    North Carolina Rural Health Research and Policy Analysis Center
    Date: 01/2003
    This study examines three states that have implemented primary care case management and provides an overview of each program, including their strengths and weaknesses.
  • Premium Assistance Programs for Low Income Families: How Well Does it Work in Rural Areas?
    North Carolina Rural Health Research and Policy Analysis Center
    Date: 01/2006
    This paper reports the results of a study on the viability in rural areas of premium assistance programs use Medicaid or State Children's Health Insurance funding to subsidize the premium costs of employer-sponsored insurance or private non-group policies for eligible individuals.
  • Rural Medicare Beneficiaries Have Fewer Follow-up Visits and Greater Emergency Department Use Post-discharge
    North Carolina Rural Health Research and Policy Analysis Center
    Date: 09/2015
    Compares rates of post hospital discharge care among Medicare beneficiaries in rural and urban settings. Discusses the effect on policies for follow-up care and readmission penalties.
  • Rural Provider Perceptions of the ACA: Case Studies in Four States
    Policy Brief
    North Carolina Rural Health Research and Policy Analysis Center
    Date: 02/2015
    This brief summarizes the perceptions from rural providers in four states regarding the early effects of the Affordable Care Act, including changes to patient populations, financial health, and capacity for rural hospitals and rural federally qualified health centers.
  • State Profiles of Medicaid and SCHIP in Rural and Urban Areas
    North Carolina Rural Health Research and Policy Analysis Center
    Date: 08/2007
    This final report is one component of a larger project that includes the development of web-based State Profiles of Medicaid and SCHIP in Rural and Urban Areas. The report provides national data comparing Medicaid enrollment and expenditures in rural and urban counties.
  • Tracking Medicaid Managed Care in Rural Communities: A Fifty-State Follow-Up
    North Carolina Rural Health Research and Policy Analysis Center
    Date: 08/2002
    This article updates a 1997 study examining implementation of rural Medicaid-managed care programs.