H. Ann Howard, BS

University of North Carolina - Chapel Hill
Cecil G. Sheps Center for Health Services Research
CB# 7590
Chapel Hill, NC 27599

Publications - (10)

Types of Rural and Urban Hospitals and Counties Where They Are Located
Policy Brief
North Carolina Rural Health Research and Policy Analysis Center, Rapid Response to Requests for Rural Data Analysis
Date: 07/2022
The purpose of this brief is to provide a snapshot of the types of rural and urban hospitals and the counties where they are located.

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.

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.

Rural/Urban and Regional Variation in the 2019 CMS Hospital Wage Index
Policy Brief
Rapid Response to Requests for Rural Data Analysis
Date: 05/2019
This brief describes the geographic variation of the 2019 Centers for Medicare & Medicaid Services hospital wage index by rural/urban definition, census region, Frontier and Remote Area codes and state.

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.
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.

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.