2013 Research Publications

Browse the full list of research publications from the Rural Health Research Centers.

Products – Freely accessible products include policy briefs, fact sheets, full reports, chartbooks, and interactive data websites.

Journal Articles – Articles in peer-reviewed journals may require a subscription or affiliation with a subscribing library. For these publications, Gateway lists the article citation, a brief summary, a link to additional information and access to the full-text of the article, if available.

Assessing the Impact of Rural Provider Service Mix on the Primary Care Incentive Payment Program
RUPRI Center for Rural Health Policy Analysis
Date: 12/2013
Under the Primary Care Incentive Payment Program (PCIP), if certain evaluation and management services represented 60% or more of Medicare allowable charges, the provider qualified for a 10% bonus calculated on the primary care portion of allowable charges. This brief assesses the impact of the rural provider service mix on the PCIP.
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/Urban Differences in Inpatient Related Costs and Use Among Medicare Beneficiaries
Rapid Response to Requests for Rural Data Analysis
Date: 12/2013
Medicare beneficiaries who are admitted to rural hospitals tend to have lower outpatient costs than their counterparts at urban hospitals. The differences are due to multiple factors. The analysis suggests that consideration of the total cost of an acute episode of care might be considered, not just the cost of the acute inpatient stay.
Change in Profitability and Financial Distress of Critical Access Hospitals From Loss of Cost-Based Reimbursement
Rapid Response to Requests for Rural Data Analysis
Date: 12/2013
Changes to Critical Access Hospitals' reimbursement, such as a reversion to prospective payment, would have marked negative effects on CAHs. About three quarters of CAHs would operate at a loss. The number of CAHs at high risk for financial distress would nearly triple, and nearly half would be at medium-high to high risk of financial distress.
Implications for Beneficiary Travel Time if Financially-Vulnerable Critical Access Hospitals Close
Rapid Response to Requests for Rural Data Analysis
Date: 12/2013
Changes to Critical Access Hospitals' reimbursement may spur some to close. This analysis considers the communities served by the 93 CAHs with the lowest profitability and therefore most likely to close due to a change in Medicare reimbursement.
Hospice Workforce: An Annotated Review of the Literature
North Dakota and NORC Rural Health Reform Policy Research Center
Date: 11/2013
This report contains an annotated review of hospice workforce literature published between 2000 and 2013. The review was completed to help identify hospice provider types for a hospice workforce study to be completed by the Rural Health Reform Policy Research Center.
Case Studies of Regional Extension Centers Serving Rural Practices: North Carolina
University of Minnesota Rural Health Research Center
Date: 11/2013
This case study focuses on the North Carolina HIT Regional Extension Center and its experience working with rural physician practices in the state.
Case Studies of Regional Extension Centers Serving Rural Practices: Minnesota and North Dakota
University of Minnesota Rural Health Research Center
Date: 11/2013
This case study focuses on the HIT Regional Extension Center serving Minnesota and North Dakota and its experiences working with rural physician practices in the two states.
Demographic and Economic Characteristics Associated With Sole County Pharmacy Closures, 2006-2010
RUPRI Center for Rural Health Policy Analysis
Date: 11/2013
This policy brief describes demographic and economic characteristics associated with counties experiencing closure of their sole pharmacy.
Inadequate Prenatal Care Among Racial and Ethnic Groups in the Rural United States, 2005
WWAMI Rural Health Research Center
Date: 10/2013
This brief reports that in most states, rural minority racial/ethnic groups had levels of inadequate prenatal care (less than 50% of expected visits) in the "worst" or "worse than mid-range" categories.
Inadequate Prenatal Care in the Rural United States, 2005
WWAMI Rural Health Research Center
Date: 10/2013
This policy brief finds that the states with levels of rural inadequate prenatal care (less than 50% of expected visits) in the "worst" or "worse than mid-range" categories were largely in southern and southwestern areas of the United States.
Low Birth Weight Rates Among Racial and Ethnic Groups in the Rural United States, 2005
WWAMI Rural Health Research Center
Date: 10/2013
Reports that non-hispanic blacks generally had the highest rural low birth weight rates of all races/ethnicities, regardless of geographic location.
Rural Hospice in the United States: A Review of the Literature
North Dakota and NORC Rural Health Reform Policy Research Center
Date: 10/2013
This review explores the current environment of rural hospice care in the United States. It provides a discussion of the current structure of hospice services as well as a formal review of current (2000-2013) rural research on the topic.
Rural Hospice in the United States: An Annotated Review of the Literature
North Dakota and NORC Rural Health Reform Policy Research Center
Date: 10/2013
This report provides an annotated review of hospice literature published between 2000 and 2013, including resources that have addressed rural hospice care, access, and utilization. The information begins with an overview of hospice organizations and agencies cited most frequently, along with a discussion of their most recent research.
Low Birth Weight Rates in the Rural United States, 2005
WWAMI Rural Health Research Center
Date: 10/2013
This brief shares that the rural U.S. low birth weight rate in 2005 was significantly higher than the urban U.S. low birth weight rate.
Geographic Variation in the Profitability of Critical Access Hospitals
Policy Brief
North Carolina Rural Health Research and Policy Analysis Center
Date: 09/2013
This study describes geographic variation in the profitability of Critical Access Hospitals (CAHs) in 2012 to understand some of the regional differences in the potential effects of implementing policy proposals impacting CAHs.
The Aging of the Rural Primary Care Physician Workforce: Will Some Locations Be More Affected than Others?
WWAMI Rural Health Research Center
Date: 09/2013
This report shows that as the aging primary care physician population retires, rural provider shortages will be further exacerbated.
The Current State of Agricultural Health Research and Practice: Critical Review (Final Report)
West Virginia Rural Health Research Center
Date: 09/2013
The report provides an overview of the present state of agricultural health research for healthcare policy makers and providers.
March 2013: Medicare Advantage Update
Rapid Response to Requests for Rural Data Analysis
Date: 09/2013
This policy brief discusses current rural Medicare Advantage enrollment data.
Provision of Uncompensated Care by Rural Hospitals: A Preliminary Look at Medicare Cost Report Worksheet S-10
Policy Brief
North Carolina Rural Health Research and Policy Analysis Center
Date: 08/2013
This brief is a preliminary assessment of uncompensated care data quality included in Medicare Cost Report Worksheet S-10 for critical access hospitals and other rural hospitals to identify data quality issue implications for research and policy decisions. Worksheet S-10 data were collected from the Healthcare Cost Reporting Information System.
Profitability of Rural Hospitals
Policy Brief
North Carolina Rural Health Research and Policy Analysis Center
Date: 08/2013
This study compares the profitability between 2010 and 2012 of urban and rural hospitals paid under the Medicare Prospective Payment System (U-PPS and R-PPS, respectively) to rural hospitals with special Medicare payment provisions.
Rates of Black Lung Disease in Relationship to Black Lung Treatment Centers (Full Report)
West Virginia Rural Health Research Center
Date: 08/2013
This report investigates the rates of black lung disease among active miners in relationship to the location of Black Lung Clinics.
Causes and Consequences of Rural Pharmacy Closures: A Multi-Case Study
RUPRI Center for Rural Health Policy Analysis
Date: 08/2013
This policy brief identifies factors that contributed to the closing of six rural pharmacies in various states and describes how the affected communities adapted to losing locally based services.
The Frontier Extended Stay Clinic Model: A Potential Health Care Delivery Alternative for Small Rural Communities
RUPRI Center for Rural Health Policy Analysis
Date: 08/2013
This policy brief describes how the Frontier Extended Stay Clinic model may be appropriate in rural communities beyond the five original demonstration sites.
Accountable Care Organizations in Rural America
RUPRI Center for Rural Health Policy Analysis
Date: 07/2013
This policy brief reports that Medicare Accountable Care Organizations currently operate in 16.7% of all U.S. non-metropolitan counties.
The Uninsured: An Analysis by Income and Geography
RUPRI Center for Rural Health Policy Analysis
Date: 06/2013
This brief reports that a larger proportion of the rural versus urban population is uninsured and low income and will be eligible for subsidized Health Insurance Marketplace coverage due to income levels and current lack of insurance.
Promotion and Protection of Rural Miner Health: Are the Resources in Place? (Final Report)
West Virginia Rural Health Research Center
Date: 06/2013
This report shows that mining areas in the United States, compared to non-mining areas, have on average better supplies of safety net providers, hospitals, and practicing primary care physicians. However, the study results support the need to examine the availability of safety net provider types in selected geographic areas where mining is done.
Rural Implications of the Primary Care Incentive Payment Program
RUPRI Center for Rural Health Policy Analysis
Date: 06/2013
This policy brief reports on eligibility among rural primary care providers for the Primary Care Incentive Payments established in the Patient Protection and Affordable Care Act.
Challenges and Opportunities for Improving Mental Health Services in Rural Long-Term Care
Maine Rural Health Research Center
Date: 06/2013
This study explores practices for increasing the quality, quantity, and accessibility of mental health services in rural long-term care.
Patterns of Care for Rural and Urban Children With Mental Health Problems
Maine Rural Health Research Center
Date: 06/2013
This study reports that rural children are significantly less likely to be diagnosed and treated for non-ADHD mental health problems than urban children and are less likely to receive mental health counseling.
The Rural H1N1 Experience: Lessons Learned for Future Pandemics
West Virginia Rural Health Research Center
Date: 06/2013
This report describes the rural H1N1 experience, including comparisons of rural versus urban H1N1 vaccination rates, and describes rural H1N1 incidence, care patterns, and mortality.
Obstetric Services and Quality Among Critical Access, Rural, and Urban Hospitals in Nine States
University of Minnesota Rural Health Research Center
Date: 06/2013
This policy brief compares the characteristics and quality of obstetric care in critical access hospitals, other rural hospitals, and their urban counterparts.
Rural Vets: Their Barriers, Problems, Needs
Journal Article
Maine Rural Health Research Center
Date: 05/2013
Evolving population trends--the aging of rural veterans, the growing number of female veterans and rates of homelessness among veterans--place significant demands on VA and rural delivery systems. Coordination among healthcare providers is essential to increasing the availability of services and expanding veteran outreach programs.
Comparing Rural and Urban Medicare Part D Enrollment Patterns and Prescription Drug Coverage Rates
University of Minnesota Rural Health Research Center
Date: 05/2013
This study examines Medicare Part D enrollment rates in rural and urban areas and the resulting impact on rural beneficiaries' overall prescription drug coverage rates.
Diffusion of Preventive Innovation: Racial and Rural Differences in Cervical Cancer Prevention and Control Practices
Rural and Minority Health Research Center
Date: 05/2013
This report examines differences associated with residence and race/ethnicity in receipt of cervical cancer screening and HPV vaccination.
September 2012: Medicare Advantage Enrollment Update
Rapid Response to Requests for Rural Data Analysis
Date: 04/2013
This policy brief discusses current rural Medicare Advantage enrollment data.
Profile of Rural Health Clinics: Clinic & Medicare Patient Characteristics
North Carolina Rural Health Research and Policy Analysis Center
Date: 03/2013
This brief presents a summary of the geographic distribution and clinic-level characteristics of rural health clinics, as well as an overview of the Medicare beneficiaries they served.
Dental Sealant Utilization Among Rural and Urban Children
Rural and Minority Health Research Center
Date: 03/2013
This report examines the proportion of rural children who have received dental sealants applied to the surface of their teeth to prevent or delay the development of dental decay.
State Health Insurance Exchanges: Assessing Rural Implications of Statutes
RUPRI Center for Rural Health Policy Analysis
Date: 02/2013
This report analyzes how five characteristics of health insurance exchanges might address particular rural concerns.
Agricultural Health Training for Rural America
West Virginia Rural Health Research Center
Date: 02/2013
This report locates agricultural health programs and courses and describes collaborations that exist between clinicians and agriculture-related agencies.
June 2012: Rural MA Enrollment and Premium Update
RUPRI Center for Rural Health Policy Analysis
Date: 02/2013
Though 2012 Medicare Advantage enrollment grew and premiums declined, rural enrollees faced higher premiums than urban enrollees. Analysis of the zero premiums by plan in relationship to plans charging premiums gives insights into the MA marketplace.
Rural Residency Training for Family Medicine Physicians: Graduate Early-Career Outcomes, 2008-2012
WWAMI Rural Health Research Center
Date: 01/2013
This policy brief provides an update on the rural and shortage area practice outcomes of family physicians who have completed graduate medical education in Rural Training Track (RTT) residency programs.
Dialysis Availability in Rural America
Rural and Minority Health Research Center
Date: 01/2013
This study explores the availability of dialysis services in rural America, including the prevalence of dialysis use across urban and rural counties, travel distance for services, and dialysis quality outcomes.
Rural Pharmacy Closures: Implications for Rural Communities
RUPRI Center for Rural Health Policy Analysis
Date: 01/2013
This study documents the closure of local retail pharmacies in which the pharmacist was the only clinical provider available in the community at the time the pharmacy closed. This brief describes the characteristics of the communities and retail pharmacies in question.
HIV/AIDS in Rural America (Key Facts)
Rural and Minority Health Research Center
Date: 01/2013
This report describes the proportion of the population affected by HIV/AIDS.
HIV/AIDS in Rural America: Prevalence and Service Availability
Rural and Minority Health Research Center
Date: 01/2013
This report examines the prevalence of HIV/AIDS in rural counties across 28 states in 2008 and the rural-versus-urban distribution of Ryan White providers.
Rural Border Health Chartbook (Key Facts)
Rural and Minority Health Research Center
Date: 01/2013
This report examines potential geographic and ethnic disparities among U.S. border residents and describes select indicators related to access to care, women's preventive services, oral health, infectious and communicable diseases, and mental health that have been identified as disparities.
Rural Border Health Chartbook
Rural and Minority Health Research Center
Date: 01/2013
The chartbook examines potential geographic and ethnic disparities among U.S. border residents and describes select indicators related to access to care, women's preventive services, oral health, infectious and communicable diseases, and mental health that have been identified as disparities.
Are Primary Care Practices Ready to Become Patient-Centered Medical Homes?
Journal Article
RUPRI Center for Rural Health Policy Analysis
Date: 2013
Measures the readiness of rural primary care practices to be eligible as patient-centered medical homes (PCMHs) by comparing PCMH readiness scores with metropolitan and nonmetropolitan primary care practices.
Rural Population Estimates: An Analysis of a Large Secondary Data Set
Journal Article
Rural and Minority Health Research Center
Date: 2013
Examines in the underrepresentation of rural counties in large secondary data sources, specifically the Behavioral Risk Factor Surveillance System (BRFSS).