Rural Health
Research Gateway

Sharita Thomas, MPP

North Carolina Rural Health Research and Policy Analysis Center

Phone: 757.705.3800
Email: srthomas@email.unc.edu
X: @rural_rita

Department of Health Policy and Management
University of North Carolina - Chapel Hill
135 Dauer Drive
1101 McGavran-Greenberg Hall, CB #7411
Chapel Hill, North Carolina 27599

Publications - (18)

2023

  • Rural Population Health in the United States: A Chartbook
    Chartbook
    North Carolina Rural Health Research and Policy Analysis Center
    Date: 02/2023
    This chartbook uses a range of indicators to describe population health in rural America and document health disparities between rural and urban areas. This report includes 33 measures of population health, organized into five domains: Access to Care, Health Outcomes and Risks, Mortality, Social Determinants of Health, and Socioeconomics.

2022

2021

  • Alternatives to Hospital Closure: Findings From a National Survey of CAH Executives
    North Carolina Rural Health Research and Policy Analysis Center
    Date: 02/2021
    Despite the many challenges of operating a Critical Access Hospital (CAH), little research examines the perspectives of CAH executives on potential community healthcare options if the CAH closed. This brief provides policymakers with a better understanding of what CAH executives think about the viability of various alternatives to closure.
  • Health System Challenges for Critical Access Hospitals: Findings From a National Survey of CAH Executives
    Policy Brief
    North Carolina Rural Health Research and Policy Analysis Center
    Date: 02/2021
    Despite the numerous challenges of operating a Critical Access Hospital (CAH), there is little research examining the perspectives of CAH executives on potential community healthcare options if the CAH closed. This brief presents a subset of results from a national survey of CAH executive perspectives on pressing challenges.

2019

2018

  • Rural Hospital Mergers From 2005 Through 2016
    Policy Brief
    North Carolina Rural Health Research and Policy Analysis Center
    Date: 08/2018
    This brief describes the number and geographic distribution of rural hospital mergers from 2005-2016.

2017

  • Differences in Community Characteristics of Sole Community Hospitals
    Policy Brief
    North Carolina Rural Health Research and Policy Analysis Center
    Date: 11/2017
    The purpose of this brief is to present a snapshot of Sole Community Hospitals (SCHs) and the communities served by them in 2015 (cross-sectional analysis), and identify some trends in selected SCH and community characteristics between 2006 and 2015 (longitudinal analysis).

2016

  • 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.
  • To What Extent Do Community Characteristics Explain Differences in Closure Among Financially Distressed Rural Hospitals?
    Journal Article
    North Carolina Rural Health Research and Policy Analysis Center
    Date: 11/2016
    This study examined the differences between rural hospitals at high risk of financial distress that stayed open and those that closed.
  • 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 Affordable Care Act's (ACA) 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.
  • 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.
  • 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.

2015

  • The Rising Rate of Rural Hospital Closures
    Journal Article
    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.
  • A Comparison of Closed Rural Hospitals and Perceived Impact
    Policy Brief
    North Carolina Rural Health Research and Policy Analysis Center
    Date: 04/2015
    This policy brief compares selected characteristics of abandoned rural hospitals and their markets to those of converted rural hospitals.

2014

  • 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.