Rural Health
Research Gateway

Legislation and regulation

Completed Projects

Listed by project completion date. You can also view these projects alphabetically.

2023

  • Evaluating the Federal Office of Rural Health Policy's Community-Based Division Funding Programs: Does the Performance Improvement and Measurement Systems (PIMS) Database Adequately Capture Impact
    This project examined three types of Federal Office of Rural Health Policy Community-Based Division programs to determine whether the Performance Improvement and Measurement Systems captures the programs' impact and goals as set forth in their respective notices of funding opportunities.
    Research center: Southwest Rural Health Research Center
    Topic: Legislation and regulation
  • Rural/Urban Differences in Postpartum Health Insurance, Healthcare Use, and Health Outcomes
    The purpose of this project was to identify rural/urban differences in health insurance, healthcare use, and health outcomes among postpartum individuals, and to describe policy-relevant implications or strategies to improve insurance coverage, receipt of recommended healthcare, and, ultimately, health outcomes among rural residents who give birth. With a lens towards health equity, all analyses were stratified by race/ethnicity and income.
    Research center: University of Minnesota Rural Health Research Center
    Topics: American Indians and Alaska Natives, Health disparities and health equity, Healthcare access, Healthcare financing, Hispanics, Hospitals and clinics, Legislation and regulation, Maternal health, Medicaid and CHIP, Minority health, Private health insurance, Women

2022

  • Estimation of the Fixed and Variable Costs of a Rural Emergency Hospital
    This project: 1) informed the design of CMS Rural Emergency Hospital (REH) payment methods, particularly the Medicare monthly additional facility payment; 2) estimated patient break-even volumes for the long-run financial sustainability of REHs; and; 3) provided a tool that rural hospitals can use to estimate the cost of operating a REH.
    Research center: North Carolina Rural Health Research and Policy Analysis Center
    Topics: Hospitals and clinics, Legislation and regulation, Medicare
  • Three Models of a Rural Emergency Hospital
    This project used secondary data about small rural emergency departments and expert opinion to develop three clinical and operational models of a Rural Emergency Hospital (REH). The REH models were based on case mix, service mix, patient volume, clinical staffing, and technology.
    Research center: North Carolina Rural Health Research and Policy Analysis Center
    Topics: Hospitals and clinics, Legislation and regulation, Medicare

2020

  • Malpractice Claims Among Rural and Urban Providers: Do State Telehealth Laws Make a Difference?
    This project examines trends in state telehealth laws and whether they have affected the rural and urban malpractice environments differentially. Data from the National Practitioner Data Bank are used to determine whether changes in telehealth laws are associated with increased malpractice claims and other adverse actions against providers.
    Research center: Southwest Rural Health Research Center
    Topics: Allied health professionals, Legislation and regulation, Nurses and nurse practitioners, Telehealth, Workforce

2019

  • Developing Rural-Relevant Strategies to Reduce Maternal Morbidity
    The purpose of this project was to distinguish and analyze predictors of maternal morbidity during childbirth hospitalization by geography and to develop recommendations to improve the safety of childbirth for rural residents. It also assessed the degree of rural focus and representation in current policy efforts to address this crisis.
    Research center: University of Minnesota Rural Health Research Center
    Topics: Health disparities and health equity, Health services, Healthcare access, Hospitals and clinics, Legislation and regulation, Maternal health, Quality, Women
  • Examining the Legal Landscape in Rural America: Implications for the Healthcare Workforce, Access to Care, and Population Health
    This project explores potential rural/urban differences in the prevalence of malpractice claims, clinical privilege actions, and state licensure actions among health care providers. We will also examine whether variations in nurse practitioner scope of practice laws affect rural residents differentially, especially with respect to preventive care.
    Research center: Southwest Rural Health Research Center
    Topics: Allied health professionals, Health services, Legislation and regulation, Nurses and nurse practitioners, Workforce

2018

2017

  • State Policy Issues That May Impact HIMs' Success in Rural Places: A Regional Analysis
    Goals of this project include gathering detailed data and providing analysis and policy recommendations on issues relating to network adequacy and service areas for HIMs, with additional investigation of other state-level policy variables (such as the Medicaid expansion decision) which may have a confounding or moderating effect on the relationship between network adequacy and enrollees' choices and premiums.
    Research center: RUPRI Center for Rural Health Policy Analysis
    Topics: Health information technology, Legislation and regulation, Medicaid and CHIP, Private health insurance, Telehealth

2016

  • Analyzing the Variation in the Performance of Accountable Care Organizations Serving Rural Medicare Beneficiaries
    The goals of this project are to characterize ACOs that operate in rural areas, describe the models being used to organize those ACOs, and to test relationships of those characteristics to performance measures related to financial success and quality. The study will identify potential changes in legislative and regulatory policies that could strengthen the utility of the ACO model to achieve high performing rural healthcare delivery organizations.
    Research center: RUPRI Center for Rural Health Policy Analysis
    Topics: Healthcare financing, Legislation and regulation, Medicare, Quality

2012

  • Assessing the Community Impact of the MMA
    This project will measure the community-level impacts of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) and will provide feedback to policymakers regarding the impact of the MMA on its policy targets (providers and beneficiaries), in the context of rural places.
    Research center: RUPRI Center for Rural Health Policy Analysis
    Topics: Legislation and regulation, Medicare, Medicare Part D

2006

  • Declining Access to Hospital-based Obstetric Services in Rural Areas: Causes and Impact
    This study examines the declining availability of hospital-based obstetric services in rural areas from the mid-1980s to the early 2000s. It examines potential causes for this trend and explores the effects of medical malpractice reforms.
    Research center: NORC Walsh Center for Rural Health Analysis
    Topics: Hospitals and clinics, Legislation and regulation, Maternal health, Women
  • Implementation of the Medicare Prescription Drug Benefit: What is Available to Rural Beneficiaries?
    This study will focus on the impact of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 on rural beneficiaries, based on actual prescription drug plan contracts, comparing the impact of the legislation on rural beneficiaries to their urban counterparts.
    Research center: RUPRI Center for Rural Health Policy Analysis
    Topics: Legislation and regulation, Medicare Part D

2005

  • How Rural Hospitals Are Meeting the Needs of Low-English Proficiency Patients
    This study will determine the extent to which rural hospitals have implemented plans for compliance with the DHHS Low-English Proficiency regulations, describe the difficulties rural hospitals must overcome in order to provide health care to Hispanic clients, ascertain the translation techniques most commonly used by rural hospitals, and describe the most effective approaches in the provision of culturally competent health care to Hispanic clients.
    Research center: Rural and Minority Health Research Center
    Topics: Hispanics, Legislation and regulation, Minority health

2004

2003

2002

2001