Rural Health Research: Zachariah T. Croll, MPH

Identifying Rural Health Clinics Within the Transformed Medicaid Statistical Information System (T-MSIS) Analytic Files
Policy Brief
Maine Rural Health Research Center
Date: 03/2024
This brief describes a methodology for identifying Rural Health Clinic encounters within the Medicaid claims data using Transformed Medicaid Statistical Information System (T-MSIS) Analytic Files.

Ambulance Deserts: Geographic Disparities in the Provision of Ambulance Services
Chartbook
Maine Rural Health Research Center
Date: 05/2023
Access to timely ambulance service is an essential part of the emergency medical system. Yet ambulance access varies widely with significant gaps across the country. This research identifies places and people that are more than 25 minutes from an ambulance station, also called an ambulance desert.
Rural-Urban Differences in Workers' Access to Paid Sick Leave
Journal Article
Maine Rural Health Research Center
Date: 02/2023
The authors analyzed the prevalence of paid sick leave (PSL) among rural versus urban workers and found that rural workers had lower access to PSL than urban workers, even after adjusting for worker and employment characteristics, especially those who were Hispanic, lacked employer-sponsored insurance, and reported poorer health status.

Community Characteristics and Financial and Operational Performance of Rural Health Clinics in the United States: A Chartbook
Chartbook
Maine Rural Health Research Center
Date: 05/2022
This chartbook provides an overview of Rural Health Clinic (RHC) characteristics and issues and will be useful to policymakers and others interested in the performance of RHCs nationally. It provides a discussion of the challenges related to collection and reporting of RHC quality data.

Acuity Differences Among Newly Admitted Older Residents in Rural and Urban Nursing Homes
Journal Article
Maine Rural Health Research Center
Date: 11/2020
This study found newly admitted residents of rural nursing homes were more likely to have cognitive issues/problem behaviors than those in urban facilities. Yet rural facilities admitted less complex older (age 75+) residents than urban, raising questions about the rural long-term services and supports system and capacity of rural nursing homes.

Rural Health Clinic Costs and Medicare Reimbursement
Policy Brief
Maine Rural Health Research Center
Date: 11/2019
We used cost report data to examine Rural Health Clinic (RHC) services costs. The findings support the National Advisory Committee on Rural Health & Human Service's conclusion that the cost-based methodology used to determine Medicare reimbursement for RHCs is outdated and RHCs subject to the reimbursement cap are paid less than their costs.

Rural Health Clinic Participation in the Merit-Based Incentive System and Other Quality Reporting Initiatives: Challenges and Opportunities
Policy Brief
Maine Rural Health Research Center
Date: 07/2018
This brief discusses the Merit-Based Incentive Payment System (MIPS) within the context of past and current Rural Health Clinic (RHC) quality reporting initiatives and assesses options for encouraging RHCs to voluntarily participate in MIPS.
Residential Settings and Healthcare Use of the Rural "Oldest-Old" Medicare Population
Policy Brief
Maine Rural Health Research Center
Date: 03/2018
This study used Medicare Current Beneficiary Survey data to profile rural/urban Medicare beneficiaries ages 85 & older. Rural adults in this age group are more likely to be disabled and live alone in the community or in nursing homes and less likely to live in assisted living facilities. Findings highlight rural needs for community-based services.

Health Insurance CO-OPs: Product Availability and Premiums in Rural Counties
Policy Brief
Maine Rural Health Research Center
Date: 10/2016
We describe regional distribution and market prevalence of Consumer Operated and Oriented Plan (CO-OP) products in rural and urban counties, and compare the number of products available in counties with and without CO-OP plans in 2014 and 2015.
Understanding the Business Case for Telemental Health in Rural Communities
Journal Article
Maine Rural Health Research Center
Date: 07/2016
This article describes the current landscape and characteristics of rural telemental health programs and then examines their business case.
Are Rural Older Adults Benefiting From Increased State Spending on Medicaid Home and Community-Based Services?
Policy Brief
Maine Rural Health Research Center
Date: 06/2016
Little is known about variations in the availability or use of Medicaid Home and Community-Based Services (HCBS) within states, across rural and urban areas. This study used national claims data to examine differences in HCBS use and expenditures among rural and urban older adult Medicaid beneficiaries receiving LTSS.

Adoption and Use of Electronic Health Records by Rural Health Clinics: Results of a National Survey
Policy Brief
Maine Rural Health Research Center
Date: 09/2015
This study reports the extent of electronic health record implementation and use in a randomly selected sample of 1,497 rural health clinics surveyed in 2013.
Rural Health Clinic Readiness for Patient-Centered Medical Home Recognition: Preparing for the Evolving Healthcare Marketplace
Policy Brief
Maine Rural Health Research Center
Date: 02/2015
This policy brief reports findings from a survey of rural health clinics (RHC) that examined their capacity to meet the National Council for Quality Assurance patient-centered medical home requirements and discusses the implications of the findings for efforts to support RHC capacity development.

Profile of Rural Residential Care Facilities: A Chartbook
Chartbook
Maine Rural Health Research Center
Date: 05/2014
This chartbook offers information on part of the rural long-term services and supports (LTSS) continuum—the residential care facility (RCF). Survey results identify national/regional differences between rural and urban RCFs, focusing on facilities, resident and service characteristics of RCFs, and the ability to meet the LTSS needs of residents.
Meaningful Use of the Electronic Health Records by Rural Health Clinics
Maine Rural Health Research Center
Date: 02/2014
This paper identifies the rates of electronic health record adoption among a random national sample of rural health clinics (RHCs) and the extent to which RHCs that have adopted an EHR are likely to achieve Stage 1 meaningful use.

Telemental Health in Today's Rural Health System
Maine Rural Health Research Center
Date: 12/2013
This policy brief describes the organizational setting, services provided, and staff used in 53 telemental rural health programs. It also outlines the opportunities and challenges for telemental health in the rural health system.

Rural Health
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