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George H. Pink, PhD

Deputy Director, North Carolina Rural Health Research and Policy Analysis Center

Phone: 919.966.5011
Email: gpink@email.unc.edu

University of North Carolina - Chapel Hill


Current Projects - (5)

  • Did Hospitals That Converted to Rural Emergency Hospital (REH) Avoid Closure?
    The goal of the Rural Emergency Hospital (REH) is to preserve access to essential services for rural residents, and to decrease the likelihood of hospital closures; some worry that the REH offers an option for otherwise financially strong hospitals to shed services. This study will investigate whether hospitals that converted to an REH in 2023 and 2024 would have likely closed in the absence of the REH designation.
    Research center: North Carolina Rural Health Research and Policy Analysis Center
    Topics: Healthcare access, Healthcare financing, Hospitals and clinics, Medicare, Rural Emergency Hospitals (REHs)
  • Evaluating the Variation in Rural and Urban Hospital Wages and Wage Index Pre- and Post-COVID-19 Pandemic
    The primary purpose of the wage index is to address the differences in labor costs that hospitals experience based on their geographical location.
    Research center: North Carolina Rural Health Research and Policy Analysis Center
    Topics: Healthcare financing, Hospitals and clinics, Medicare, Workforce
  • Financial Consequences of Growth in the Number of Rural Referral Centers
    Since Centers for Medicare & Medicaid Services amended its regulations to allow hospitals in urban areas to reclassify as rural, over 400 hospitals have obtained status as a Rural Referral Center. This project will estimate the costs to hospital Medicare payment and profitability.
    Research center: North Carolina Rural Health Research and Policy Analysis Center
    Topics: Healthcare financing, Hospitals and clinics, Medicare
  • Medicare Advantage and Financial, Hospital, and Community Characteristics of Rural Hospitals
    This project will compare financial, hospital, and community differences among rural hospitals located in areas with lower versus higher rates of Medicare Advantage penetration.
    Research center: North Carolina Rural Health Research and Policy Analysis Center
    Topics: Hospitals and clinics, Medicare, Medicare Advantage (MA)
  • Usual Source of Primary Care for Rural Medicare Beneficiaries Before and During COVID-19
    The global pandemic was highly disruptive to existing health care use patterns, potentially affecting rural America more than urban communities. This study will describe the usual sources of primary care (USC) for rural Medicare beneficiaries before and during COVID-19 to provide insight into how COVID-19 affected USC of Medicare beneficiaries.
    Research center: North Carolina Rural Health Research and Policy Analysis Center
    Topics: Federally Qualified Health Centers (FQHCs), Healthcare access, Hospitals and clinics, Medicare, Rural Health Clinics (RHCs)

Completed Projects - (22)

  • A Comparison of 2017-2019 Uncompensated Care of Rural and Urban Hospitals and a First Look at Uncompensated Care in 2020 and 2021
    This project compared 2017-2019 uncompensated care as a percent of operating expense for rural and urban hospitals and investigated uncompensated care data for 2020 and 2021.
    Research center: North Carolina Rural Health Research and Policy Analysis Center
    Topics: Hospitals and clinics, Medicare
  • Ambulatory Care Provided to Rural Medicare Beneficiaries by Rural and Urban FQHCs, RHCs, and Acute Hospitals
    This project characterized the volume, cost, and case mix of ambulatory care provided to rural Medicare beneficiaries by rural and urban federally qualified health centers (FQHCs), rural health clinics (RHCs), and acute hospitals. The study included urban-rural and geographic comparisons of volume, cost, and case mix by provider type.
    Research center: North Carolina Rural Health Research and Policy Analysis Center
    Topics: Health services, Hospitals and clinics, Medicare
  • Can a Model Predict Financial Distress Among Rural Hospitals?
    This project will extend an existing model of CAH financial distress to other types of rural hospitals. A valid model would be helpful to ORHP and state Offices of rural Health interested in predicting financial distress or closure of rural hospitals.
    Research center: North Carolina Rural Health Research and Policy Analysis Center
    Topics: Critical Access Hospitals (CAHs), Hospitals and clinics
  • Changes in Care-Seeking After Rural Hospitals Merge
    This project seeks to understand how mergers affect the inpatient care-seeking of markets served by merging hospitals.
    Research center: North Carolina Rural Health Research and Policy Analysis Center
    Topics: Healthcare access, Hospitals and clinics
  • Characteristics of Rural Hospitals at High Risk of Financial Distress
    Updates the Financial Distress Index Model with current hospital and market data. Evaluates changes in risk status and geographic distribution over time. Conducts an in-depth analysis of high risk hospitals.
    Research center: North Carolina Rural Health Research and Policy Analysis Center
    Topics: Healthcare financing, Hospitals and clinics
  • Community and Financial Experience of Medicare Dependent Hospitals in Comparison to Other Rural Hospitals
    This research will investigate the community and financial experience of Medicare Dependent Hospitals (MDHs) in comparison with other rural hospitals. Analysis of the financial experience will include comparison of the long-term profitability of MDHs to other rural hospitals, estimation of the potential profitability consequences of eliminating the payment classification, and estimation of the potential consequences of maintaining the payment classification but failing to update the base year from which costs are trended forward.
    Research center: North Carolina Rural Health Research and Policy Analysis Center
    Topics: Hospitals and clinics, Medicare, Medicare Prospective Payment System (PPS)
  • Current and Longer Term Challenges of Rural Hospitals: A Survey of Rural Hospital Executives
    This project involved surveying rural hospital executives about how they will respond to current and long-term challenges related to financial and regulatory burdens.
    Research center: North Carolina Rural Health Research and Policy Analysis Center
    Topics: Health reform, Healthcare financing, Hospitals and clinics, Medicare
  • Decline in Inpatient Volume at Rural Hospitals
    The purpose of this study was to compare the decline in inpatient volume of rural hospitals to urban hospitals and among rural hospitals of different size, region, rurality, and payment type.
    Research center: North Carolina Rural Health Research and Policy Analysis Center
    Topics: Healthcare access, Hospitals and clinics
  • Developing a Financial Performance Measurement System for Critical Access Hospitals
    This project uses research and expert opinion to select dimensions and indicators of financial performance, develop appropriate bases or methods of peer comparison, investigate the relationship between quality of care and financial performance, and identify characteristics of high performing CAHs.
    Research center: North Carolina Rural Health Research and Policy Analysis Center
    Topics: Critical Access Hospitals (CAHs), Healthcare financing
  • Developing a Post-COVID Financial Distress Index
    This project updated and improved the North Carolina Rural Health Research Program's Financial Distress Index, which uses historical data about hospital financial performance, government reimbursement, organizational characteristics, and market characteristics to predict the current risk of financial distress.
    Research center: North Carolina Rural Health Research and Policy Analysis Center
    Topics: Hospitals and clinics, Medicare
  • Estimating the Number of Hospitals that Might Convert to Rural Emergency Hospitals
    This project reviewed the literature to establish what is known about freestanding emergency centers (FECs) and implications for a rural community. The number and types of rural hospitals that would be eligible to convert to an FEC as an alternative to closure of acute inpatient care was estimated.
    Research center: North Carolina Rural Health Research and Policy Analysis Center
    Topics: Health reform, Healthcare access, Healthcare financing, Hospitals and clinics, Medicare
  • 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
  • How Have the Sources of Revenue for Rural Hospitals Changed Since 2005?
    Rural hospitals have seen a steadily decreasing average acute daily census. If outpatient revenue is not expanding to fill that decrease, the decrease in patient revenue could further threaten hospital viability.
    Research center: North Carolina Rural Health Research and Policy Analysis Center
    Topics: Healthcare financing, Hospitals and clinics, Medicare
  • Importance of Surgery to Rural Hospital Financial Condition and Market Share
    This study explores the provision of surgical services in rural hospitals and its relationship to financial performance. The percentage of rural hospitals that offer surgical services and the number that have discontinued surgical services over the last decade will be described, and, for those that have discontinued services, the impact on financial condition will be explored.
    Research center: North Carolina Rural Health Research and Policy Analysis Center
    Topic: Hospitals and clinics
  • Low Volume Hospitals
    This analysis compared rural low-volume hospitals (LVHs) to non-LVH characteristics and estimate the financial impact of eliminating the LVH program and reverting to the original (2005) LVH classification and payment adjustment.
    Research center: North Carolina Rural Health Research and Policy Analysis Center
    Topics: Hospitals and clinics, Medicare
  • Rural Hospital Mergers and Acquisitions - Who is Being Acquired and What Happens Afterwards?
    This study compares the financial and market characteristics of recently acquired rural hospitals to other rural hospitals and investigates the post-acquisition change in services and financial performance of these hospitals. This study will inform rural advocates, federal and state agencies, and regulators as to how mergers and acquisitions (M&As) of small rural hospitals affect access to care for Medicare beneficiaries, and the potential financial consequences of M&As to small rural hospitals.
    Research center: North Carolina Rural Health Research and Policy Analysis Center
    Topics: Healthcare financing, Hospitals and clinics, Medicare
  • Rural-urban Comparison of Hospital Financial Performance by Medicare Payment Classification
    This project will compare the financial performance of rural and urban short term general hospitals by Medicare payment classifications (PPS only, Medicare dependent hospitals, sole community hospitals, rural referral centers, and critical access hospitals).
    Research center: North Carolina Rural Health Research and Policy Analysis Center
    Topics: Hospitals and clinics, Medicare
  • The Financial and Community Experience of Sole Community Hospitals in Comparison to Other Rural Hospitals
    This research will investigate the financial and community experience of Sole Community Hospitals (SCHs) in comparison with other rural hospitals. The availability of alternative facilities, and the socioeconomic and demographic characteristics of SCH service areas will be compared to other rural hospital service areas.
    Research center: North Carolina Rural Health Research and Policy Analysis Center
    Topics: Hospitals and clinics, Medicare, Medicare Prospective Payment System (PPS), Rural statistics and demographics
  • 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
  • What Does it Cost to Operate a Rural Free-Standing Emergency Department (RFED)?
    In recent months, there have been numerous media reports of rural hospital closures and the adverse effect on communities. In the face of hospital closure, one alternative for maintaining access to healthcare is a rural free-standing emergency department (RFED).
    Research center: North Carolina Rural Health Research and Policy Analysis Center
    Topics: Critical Access Hospitals (CAHs), Healthcare financing, Medicare
  • What Happens after Acute Inpatient Care is No Longer Provided by a Rural Hospital?
    This project will investigate the precursors to closure of acute inpatient care by rural hospitals and the post-closure configuration of health care services in the community.
    Research center: North Carolina Rural Health Research and Policy Analysis Center
    Topic: Hospitals and clinics
  • What Would be the Financial Consequence of Eliminating Low Volume Hospital Payments?
    Analysis will include comparison of the long-term profitability of low-volume hospitals to other rural hospitals and estimation of the potential profitability consequences of eliminating the payment classification altogether.
    Research center: North Carolina Rural Health Research and Policy Analysis Center
    Topics: Hospitals and clinics, Medicare, Medicare Prospective Payment System (PPS)

Publications - (60)

2024

  • News Media Coverage of Rural Hospital Closures and the Causes
    Policy Brief
    North Carolina Rural Health Research and Policy Analysis Center, Rapid Response to Requests for Rural Data Analysis
    Date: 10/2024
    This study augments previous research with findings from a structured framework of attributed causes of rural hospital closures through the analysis of news media reports.
  • An Updated Model of Rural Hospital Financial Distress
    Journal Article
    North Carolina Rural Health Research and Policy Analysis Center
    Date: 10/2024
    In fall 2024, the North Carolina Rural Health Research Program completed a study modeling financial distress among rural hospitals, "An Updated Model of Rural Hospital Financial Distress." The model updates a 2016 version, by adding recent changes in the operating environment.
  • The Low-Volume Hospital Adjustment Before and During COVID-19
    Policy Brief
    North Carolina Rural Health Research and Policy Analysis Center
    Date: 07/2024
    This brief uses current low-volume hospital adjustment qualifying criteria to compare low-volume hospitals to other rural hospitals and explores the effect of removing the adjustment before COVID-19 and during COVID.
  • 2018-23 Profitability of Rural and Urban Hospitals by Medicare Payment Designation
    Policy Brief
    North Carolina Rural Health Research and Policy Analysis Center, Rapid Response to Requests for Rural Data Analysis
    Date: 06/2024
    This study compares profitability of three types of hospitals in both urban and rural locations: Critical Access Hospitals, Prospective Payment System-only (PPS) hospitals by number of acute beds, and PPS hospitals with special payment designations hospitals over a five-year period.
  • 2018-23 Profitability of Rural Hospitals by Ownership and System Affiliation
    Policy Brief
    North Carolina Rural Health Research and Policy Analysis Center, Rapid Response to Requests for Rural Data Analysis
    Date: 06/2024
    This study compares the 2018-23 profitability of rural hospitals based on ownership and system affiliation status. The purpose of this brief is to describe the profitability of rural hospitals over a five-year period consisting of two years before and three years after COVID-19.
  • 2018-23 Profitability of Rural Hospitals by With and Without Rural Health Clinics and Long-Term Care
    Policy Brief
    North Carolina Rural Health Research and Policy Analysis Center, Rapid Response to Requests for Rural Data Analysis
    Date: 06/2024
    This study compares the 2018-23 profitability of rural hospitals for hospitals that provide and do not provide long-term care, and that operate and do not operate rural health clinics.
  • Differences in Measurement of Operating Margin: An Update
    Policy Brief
    North Carolina Rural Health Research and Policy Analysis Center, Rapid Response to Requests for Rural Data Analysis
    Date: 05/2024
    This study uses recent Medicare Cost Report data to compare rural and urban hospitals using the three definitions for operating margin. Researchers assess the distribution and extent of extreme values of operating margin.
  • Using the Updated Financial Distress Index to Describe Relative Risk of Hospital Financial Distress
    Policy Brief
    North Carolina Rural Health Research and Policy Analysis Center
    Date: 04/2024
    Using a recent revision of the Financial Distress Index (FDI) model, this study aimed to describe the relative risk of experiencing financial distress for rural hospitals and selected urban hospitals.
  • COVID-19 Affected Rural and Urban Hospital Uncompensated Care
    Fact Sheet
    North Carolina Rural Health Research and Policy Analysis Center
    Date: 03/2024
    The purpose of this infographic is to illustrate the impact COVID-19 had on uncompensated care and operating margin among rural and urban hospitals.
  • A Comparison of 2017-19 Uncompensated Care of Rural and Urban Hospitals by Net Patient Revenue, System Affiliation, and Ownership
    Policy Brief
    North Carolina Rural Health Research and Policy Analysis Center
    Date: 01/2024
    The purpose of this study is to better understand patterns of uncompensated care. It extends a 2018 study of geographic variation in uncompensated care between rural and urban hospitals. Specifically, researchers investigate the association of uncompensated care with net patient revenue, system affiliation, and ownership.

2023

  • Rural Emergency Hospital Map and Data
    North Carolina Rural Health Research and Policy Analysis Center, Rapid Response to Requests for Rural Data Analysis
    Date: 10/2023
    This interactive map tracks hospitals that have converted to Rural Emergency Hospitals since January 2023.
  • Suitability of Low-Volume Rural Emergency Departments to New Rural Emergency Hospital Designation
    Journal Article
    North Carolina Rural Health Research and Policy Analysis Center, Rapid Response to Requests for Rural Data Analysis
    Date: 09/2023
    The Rural Emergency Hospital is a new Medicare payment model that requires hospitals to focus on emergency, observation, and outpatient services in lieu of inpatient care. This study's exploratory objective was to examine care delivery from eligible hospitals to assess their fit with the new payment model.

2022

2021

  • Medicare Covers a Lower Percentage of Outpatient Costs in Hospitals Located in Rural Areas
    Policy Brief
    North Carolina Rural Health Research and Policy Analysis Center, Rapid Response to Requests for Rural Data Analysis
    Date: 09/2021
    The purpose of this brief is to describe differences in Medicare Outpatient Prospective Payment System (OPPS) payments between rural and urban hospitals by Medicare payment classification and by number of acute beds.
  • How Many Hospitals Might Convert to a Rural Emergency Hospital?
    North Carolina Rural Health Research and Policy Analysis Center
    Date: 07/2021
    In this study, three measures were used to predict the number of rural hospitals with 50 beds or less that are likely to consider conversion to a Rural Emergency Hospital: 1) three years negative total margin; 2) average daily census (acute + swing) less than three; and 3) net patient revenue less than $20 million.
  • Changes in Provision of Selected Services by Rural and Urban Hospitals Between 2009 and 2017
    Policy Brief
    North Carolina Rural Health Research and Policy Analysis Center
    Date: 04/2021
    The purpose of this study is to gain a better understanding of recent trends in hospital service provision and whether there were disparities between rural and urban hospitals. This brief describes and compares the changes in service provision for rural and urban hospitals between 2009 and 2017.
  • 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.

2020

  • Decline in Inpatient Volume at Rural Hospitals
    Journal Article
    North Carolina Rural Health Research and Policy Analysis Center
    Date: 12/2020
    This study examined inpatient volume in rural hospitals between 2011 and 2017. Patient population and the organizational and geographic characteristics of hospitals that were significant predictors of inpatient volume included census region, Medicare payment type, ownership type, total margin, and percent of the population in poverty.
  • A Comparison of Rural and Urban Specialty Hospitals
    Policy Brief
    Rapid Response to Requests for Rural Data Analysis
    Date: 09/2020
    This brief describes key differences between specialty hospitals located in rural versus urban areas.
  • Urban Hospitals With a High Percentage of Inpatient Days for Rural Patients
    Policy Brief
    North Carolina Rural Health Research and Policy Analysis Center, Rapid Response to Requests for Rural Data Analysis
    Date: 09/2020
    The purpose of this brief is to describe characteristics of urban hospitals with a high percentage of inpatient days for rural patients and to compare how they differ from urban hospitals with lower percentages of rural inpatient days.
  • Changes in Care-Seeking After Rural Hospitals Merge
    Policy Brief
    North Carolina Rural Health Research and Policy Analysis Center
    Date: 07/2020
    Rural hospital mergers have increased significantly since 2010. Enhanced financial performance and improved quality are often cited as benefits, but hospital mergers can also lead to changes in the services provided by acquired hospitals. This brief estimates the use of inpatient services delivered by acquired rural hospitals following a merger.
  • 2016-18 Profitability of Urban and Rural Hospitals by Medicare Payment Classification
    Policy Brief
    North Carolina Rural Health Research and Policy Analysis Center
    Date: 04/2020
    This study compares the 2016-18 profitability of urban Prospective Payment System (PPS) hospitals to that of rural hospitals. Rural hospitals are further divided by size of rural PPS hospitals and by the rural Medicare payment classifications.
  • Rural Hospitals With Long-Term Unprofitability
    Policy Brief
    North Carolina Rural Health Research and Policy Analysis Center, Rapid Response to Requests for Rural Data Analysis
    Date: 04/2020
    The purpose of this study is to examine the characteristics of rural hospitals that had negative total margins in 2016, 2017, and 2018. We examined net patient revenue, Medicare payment classification, region, and state for 311 rural hospitals.
  • Understanding the Broader Context of Rural Hospitals and Profitability
    North Carolina Rural Health Research and Policy Analysis Center, Rapid Response to Requests for Rural Data Analysis
    Date: 04/2020
    The intent of this infographic is to quantify rural hospital profitability in the broader context of all hospitals. This infographic compares the number of rural and urban hospitals and rural and urban operating revenue and operating income.

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.
  • Geographic Variation in Uncompensated Care Between Rural and Urban Hospitals
    Policy Brief
    North Carolina Rural Health Research and Policy Analysis Center
    Date: 06/2018
    The purpose of this brief is to compare uncompensated care in rural and urban hospitals and to describe how it varies across regions of the country.
  • Market Characteristics Associated With Rural Hospitals' Provision of Post-Acute Care
    Policy Brief
    North Carolina Rural Health Research and Policy Analysis Center
    Date: 04/2018
    This brief uses data from Medicare cost reports, the Provider of Services File, and the U.S. Department of Agriculture to provide a window into current hospital-based post-acute care offerings by summarizing both hospital- and market-level factors that are associated with rural hospitals that provided post-acute care between 2012 and 2015.
  • Rural and Urban Provider Market Share of Inpatient Post-Acute Care Services Provided to Rural Medicare Beneficiaries
    Policy Brief
    North Carolina Rural Health Research and Policy Analysis Center
    Date: 04/2018
    The purpose of this brief is to characterize rural providers' market share of inpatient post-acute care services provided to rural Medicare beneficiaries.
  • Geographic Variation in the 2016 Profitability of Urban and Rural Hospitals
    Policy Brief
    North Carolina Rural Health Research and Policy Analysis Center
    Date: 03/2018
    This study describes the geographic variation in 2016 profitability of critical access hospitals (CAHs), other rural hospitals (Medicare Dependent Hospitals, Sole Community Hospitals, and rural Prospective Payment System (PPS) hospitals denoted as "ORH"), and urban PPS hospitals by census region, census division, and state.
  • Access to Care: Populations in Counties With No FQHC, RHC, or Acute Care Hospital
    Policy Brief
    North Carolina Rural Health Research and Policy Analysis Center
    Date: 01/2018
    To help provide a quick understanding of how many people may have more limited access to primary care and where they live, this brief focuses on three main primary care providers in rural areas (Federally Qualified Health Centers, Rural Health Centers, and acute care hospitals).
  • Range Matters: Rural Averages Can Conceal Important Information
    Policy Brief
    North Carolina Rural Health Research and Policy Analysis Center
    Date: 01/2018
    This short brief uses three examples to demonstrate how focusing on averages without also considering the data range can conceal important information: 1) average rural hospital profitability, 2) distance from closed rural hospitals to the next closest hospital, and 3) HIV prevalence by county.

2017

  • The Financial Importance of Medicare Post-Acute and Hospice Care to Rural Hospitals
    Policy Brief
    North Carolina Rural Health Research and Policy Analysis Center
    Date: 07/2017
    This brief describes Medicare post-acute and hospice care provided by hospitals in rural areas by characterizing the variation in the number of rural hospitals that provide PAC and hospice care, the average amount of Medicare revenue rural hospitals receive for these services, and the financial importance of PAC and hospice care to rural hospitals.
  • CMS Hospital Quality Star Rating: For 762 Rural Hospitals, No Stars Is the Problem
    Policy Brief
    Rapid Response to Requests for Rural Data Analysis
    Date: 06/2017
    The purpose of this brief is to look more closely at the characteristics of rural hospitals with and without CMS Hospital Quality Star Ratings to help inform ongoing discussions about the usefulness of the quality star rating for comparing hospital quality and possible ways to improve the star rating initiative.
  • Predicting Financial Distress and Closure in Rural Hospitals
    Journal Article
    North Carolina Rural Health Research and Policy Analysis Center
    Date: 06/2017
    Examines the financial distress of rural hospitals to better predict closures within two years.

2016

2015

2013

2007

2004

  • Comparative Performance Data for Critical Access Hospitals
    Journal Article
    Maine Rural Health Research Center, North Carolina Rural Health Research and Policy Analysis Center
    Date: 2004
    Discusses the potential use of comparative performance data for critical access hospitals (CPD-CAH) to facilitate performance and quality improvement. Covers potential benefits and drawbacks of CPD-CH and identifies issues in the development and implementation of CPD-CAH.