Sharita Thomas, MMP

North Carolina Rural Health Research and Policy Analysis Center

Email: sharita.thomas@unc.edu

University of North Carolina - Chapel Hill


Publications - (7)

  • 2012-14 Profitability of Urban and Rural Hospitals by Medicare Payment Classification
    Policy Brief
    North Carolina Rural Health Research and Policy Analysis Center
    Date: 03/2016
    The profitability of urban hospitals to that of rural hospitals are compared for fiscal years 2012-2014 based on size and rural Medicare payment classifications.
  • 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

    The Affordable Care Act provided coverage through the Health Insurance Marketplace to nearly seven million people during the first open enrollment period. Yet, research suggests that the enrollment rates for eligible individuals living in rural areas was less than enrollment rates for those living in urban areas. That may be due, in part, to specific challenges in rural communities, including lack of internet access, low population density, travel barriers to obtaining help, or strong political opposition to “Obamacare.”

    Among rural communities, there was considerable variation in the enrollment rate. The North Carolina Rural Health Research Program conducted key informant interviews of navigators, health centers, Certified Application Counselors (CACs), and other partner organizations in nine rural counties with high enrollment rates in seven states to try to identify best practices for marketing, outreach and education, in-reach (identifying eligible current clients), and enrollment in rural communities.

  • A Comparison of Closed Rural Hospitals and Perceived Impact
    Policy Brief
    North Carolina Rural Health Research and Policy Analysis Center
    Date: 04/2015

    From 2010 through 2014, 47 rural hospitals ceased providing inpatient services in 23 states across the country (“closed”). Among the 47 closed hospitals, 26 hospitals no longer provide any healthcare services (“abandoned”), and 21 continue to provide a mix of health services but no inpatient care (“converted”).

    These closures have affected approximately 800,000 people in the markets with abandoned hospitals and 700,000 people in the markets with converted hospitals. Loss of a rural hospital could impact access to certain necessary health services and is concerning as residents of rural communities are typically older and poorer, more dependent on public insurance programs, and have poorer health status than urban residents.

    Policy-makers, researchers, and rural residents are concerned and interested in determining why these hospitals are closing, whether the rate will continue to climb, and what effects there could be on local health care providers and the communities they serve.

    This policy brief compares selected characteristics of abandoned rural hospitals and their markets to those of converted rural hospitals.

    More specifically:
    • How do abandoned rural hospitals compare to converted rural hospitals?
    • What has been the perceived impact of rural hospital closures?
  • Does ACA Insurance Coverage Expansion Improve the Financial Performance of Rural Hospitals?
    Policy Brief
    North Carolina Rural Health Research and Policy Analysis Center
    Date: 04/2016
    Views on how the implementation of the ACA’s expanded insurance coverage is affecting the financial performance of rural hospitals. The study found that while respondents believe the expanded insurance coverage was the right thing to do for patients, they worried coverage may not be adequate to ensure access to care.
  • Geographic Variation in the Profitability of Urban and Rural Hospitals
    Policy Brief
    North Carolina Rural Health Research and Policy Analysis Center
    Date: 03/2016
    Historic and recent evidence suggest that unprofitability can reduce hospital services and quality, or worse, lead to closure. This study describes the current geographic variability of hospital profitability by comparing the 2014 profitability of CAHs, other rural hospitals, and urban hospitals by census region, census division, and state.
  • The Financial Importance of the Sole Community Hospital Payment Designation
    Policy Brief
    North Carolina Rural Health Research and Policy Analysis Center
    Date: 11/2016
    Assesses the financial importance of the Sole Community Hospital (SCH) program by: the proportion of SCHs that was reimbursed at the hospital specific rate between 2006 and 2015; the profitability of providing services to Medicare patients in SCHs between 2006 and 2015, and; the financial consequences if the SCH program had not existed in 2015.
  • The Rising Rate of Rural Hospital Closures
    North Carolina Rural Health Research and Policy Analysis Center
    Date: 07/2015
    Discusses the increase in rural hospital closure rates, including the causes of closures and its impact on rural communities.