Craig Holden
ETSU/NORC Rural Health Research Center
Phone: 301.634.9387
Email: holden-craig@norc.org
NORC Walsh Center for Rural Health Analysis
4350 East West Highway, Suite 700
Bethesda, MD 20814
- Current Projects - (5)
- Completed Projects - (4)
- Publications - (1)
Current Projects - (5)
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A Closer Examination of Rural Hospital Bypass
This project will estimate the rural hospital bypass rate using all-payer claims data for a set of states and compare patients based on the inpatient treatments and procedures received relative to those routinely provided by rural facilities.
Research center: ETSU/NORC Rural Health Research Center
Topics: Critical Access Hospitals (CAHs), Health reform, Health services, Healthcare access, Hospitals and clinics, Medicaid and CHIP, Medicare, Medicare Advantage (MA), Private health insurance, Uninsured and underinsured
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Examining Post-Acute Care Utilization and Outcomes for Rural Medicare FFS and Medicare Advantage Beneficiaries
This study will describe differences in post-acute care utilization and post-discharge outcomes between rural Medicare Fee-for-Service beneficiaries and rural Medicare Advantage beneficiaries overall, by region of the country, and levels of rurality.
Research center: ETSU/NORC Rural Health Research Center
Topics: Care management, Critical Access Hospitals (CAHs), Healthcare access, Home health, Medicare, Medicare Advantage (MA), Post-acute care
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Examining Rural Population Characteristics and Access to Care: A Study of Health Professional Shortage Areas (HPSAs) and Medically Underserved Areas (MUAs)
This project examined Health Professional Shortage Areas (HPSAs) and Medically Underserved Areas (MUAs), analyzing geographic disparities in provider shortages across rural and urban settings. Findings highlight variations in access to primary care, mental health, and dental services, informing federal programs that allocate resources to improve health care access.
Research center: ETSU/NORC Rural Health Research Center
Topics: Healthcare access, Mental and behavioral health, Oral health, Workforce
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Rural and Urban Sepsis Outcomes as a Measure of Health Care Quality: A Nationwide Comparative Analysis Using HCUP Data
This study examines differences in sepsis prevalence, outcomes, costs, and treatment between rural and urban hospitals using the HCUP Nationwide Readmissions Database. It aims to inform policies related to access to timely, high-quality sepsis care and identify strategies to enhance healthcare outcomes across diverse hospital settings.
Research center: ETSU/NORC Rural Health Research Center
Topics: Care management, Critical Access Hospitals (CAHs), Emergency medical services (EMS) and trauma, Healthcare access, Hospitals and clinics, Medicaid and CHIP, Medicare, Medicare Advantage (MA), Private health insurance, Quality, Social determinants of health
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Rural/Urban Differences in Forgoing Health Care during the COVID-19 Pandemic
Several surveys conducted during the COVID-19 pandemic showed that adults delayed or skipped healthcare services during the initial months of the COVID-19 pandemic. This study examines changes in healthcare utilization for primary and preventative care among rural and urban Medicare fee-for-service enrollees since the COVID-19 pandemic.
Research center: ETSU/NORC Rural Health Research Center
Topics: Aging, Care management, Chronic diseases and conditions, Coronavirus Disease 2019 (COVID-19), Diabetes, Health promotion and disease prevention, Health services, Medicare, Mental and behavioral health, Telehealth
Completed Projects - (4)
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Examining Differences in Rural and Urban Medicare FFS Beneficiaries' Emergency Department Use Pre-COVID-19 and During COVID-19
This study described and compared the differences in the utilization of emergency department (ED) services among rural and urban Medicare Fee-For-Service enrollees during 2018-2021. Researchers identified factors associated with differences in ED use, including shifts in volume, primary diagnoses, and admission source, before and since the COVID-19 public health emergency in rural and urban areas.
Research center: ETSU/NORC Rural Health Research Center
Topics: Coronavirus Disease 2019 (COVID-19), Critical Access Hospitals (CAHs), Emergency medical services (EMS) and trauma, Healthcare access, Hospitals and clinics, Medicare, Social determinants of health
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Hierarchical Condition Category (HCC) Risk Scores: Designed to Predict Future Cost and Health Care Resource Use – Do They Also Accurately Reflect Differences in Health Status between Rural and Urban Beneficiaries?
This CMS Hierarchical Condition Category (CMS-HCC) risk score study investigated differences in underlying health between rural and urban populations using recent data and analyze which factors drive observed differences.
Research center: ETSU/NORC Rural Health Research Center
Topics: Health services, Healthcare access, Hospitals and clinics, Medicaid and CHIP, Medicare, Medicare Advantage (MA)
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Inpatient Treatment Costs Associated with Substance Use Disorders
The purposes of this project were to examine the costs and characteristics of inpatient stays associated with substance use disorders and to examine whether there are systematic differences in these stays and costs for persons residing in rural areas compared to urban areas.
Research center: ETSU/NORC Rural Health Research Center
Topics: Healthcare access, Healthcare financing, Mental and behavioral health, Substance use and treatment
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Rural-Urban Analysis of Persistent Health Professional Shortage Areas
The study described rural-urban differences in persistent Health Professional Shortage Area designations for primary care, mental health, and dental care between 2010 and 2020.
Research center: ETSU/NORC Rural Health Research Center
Topics: Healthcare access, Mental and behavioral health, Oral health, Workforce
Publications - (1)
2025
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Are HCC Risk Scores a Reliable Health Status Indicator Across Rural and Urban Areas?
Policy Brief
ETSU/NORC Rural Health Research Center
Date: 04/2025
This brief explores differences in CMS Hierarchical Condition Category (HCC) risk scores between rural and urban Medicare beneficiaries, revealing lower scores for rural populations despite higher chronic disease prevalence. The brief highlights HCC score limitations and suggests improvements and alternatives for accurate health representation.