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Rural Health
Research Gateway

Ira Moscovice, PhD

University of Minnesota Rural Health Research Center

Phone: 612.624.8618
Email: mosco001@umn.edu

University of Minnesota
Division of Health Policy and Management
2221 University Ave. SE, Suite 350
Minneapolis, MN 55414

Completed Projects - (18)

  • Assessing the Rural Relevance of Hospital Outpatient Quality Measures
    The purpose of this project is to: 1) determine the diagnoses that are most commonly treated and the procedures most commonly performed in rural hospital outpatient settings; and 2) to evaluate the rural relevance of the proposed new CMS outpatient quality measures and other potential outpatient quality measures.
    Research center: Upper Midwest Rural Health Research Center
    Topics: Hospitals and clinics, Quality
  • Beyond Simple Ranking: Identifying and Empirically Testing Alternative Approaches for Recognizing Quality in Rural Hospitals
    The purpose of this project is to explore several alternative methods for assessing the relative quality of hospitals using data from the Hospital Quality Incentive Demonstration Project and Hospital Compare.
    Research center: Upper Midwest Rural Health Research Center
    Topics: Hospitals and clinics, Quality
  • Critical Access Hospital Readiness for CMS Value-Based Purchasing
    The purpose of this project will be to assess Critical Access Hospital readiness for participation in a Value-based Purchasing program similar to that proposed by CMS for Prospective Payment System hospitals.
    Research center: Upper Midwest Rural Health Research Center
    Topics: Critical Access Hospitals (CAHs), Healthcare financing, Quality
  • Developing Quality Measures and Communication Strategies for Rural Patient Transfers
    The purpose of this project is to quantify the complexity of the coordination of patient care in rural health care systems and to expand our work on developing quality measures for rural patients whose care is transferred between providers.
    Research center: Upper Midwest Rural Health Research Center
    Topic: Quality
  • Effect of Type and Timeliness of Post-Acute Care on Preventable Hospital Readmissions for Rural Medicare Beneficiaries
    The purpose of this project is to: 1) determine how location of hospitals used for initial admissions by rural patients affects readmission rates; 2) assess how the use of swing beds affects rural patients' readmissions; and 3) examine the impact of the type and timeliness of post-acute care, including home health care, skilled nursing, and physician visits, on readmissions for rural patients.
    Research center: Upper Midwest Rural Health Research Center
    Topics: Hospitals and clinics, Medicare, Post-acute care
  • Health Information Technology and Quality in Rural Hospitals
    The purpose of this project is to: 1) examine the adoption of health information technology (HIT) among rural hospitals and identify hospital and market characteristics that facilitate or impede HIT diffusion; 2) measure the effect of HIT on clinical quality in rural hospitals; and 3) identify technologies that may be promoted to improve quality of care in rural areas.
    Research center: Upper Midwest Rural Health Research Center
    Topics: Health information technology, Hospitals and clinics, Quality
  • Hospitalizations of Rural Children for Ambulatory Care Sensitive Conditions
    This project uses state inpatient discharge data from six states, data from the Area Resource File and the AHRQ Pediatric Quality Indicators to examine Ambulatory Care Sensitive Condition admission rates for rural children.
    Research center: Upper Midwest Rural Health Research Center
    Topics: Children and adolescents, Chronic diseases and conditions
  • Impact of Expansion of Ambulatory Surgery Centers on Rural Hospitals and Communities
    This project will examine the extent of freestanding ambulatory surgery center (ASC) expansion into rural communities between 1998 and 2005, the market factors driving that expansion, and the impact of ASCs on the operational and financial viability of rural hospitals located in the same communities.
    Research center: Upper Midwest Rural Health Research Center
    Topics: Health services, Healthcare financing
  • Impact of Health Insurance Coverage on Native Elder Health: Implications for Addressing the Health Care Needs of Rural American Indian Elders
    This project examined the types of health insurance coverage of rural Native American elders ages 55 and older, and examine how different types of health insurance coverage and lack of health insurance coverage impact access to health care services among Native American elders by geographic location (rural frontier, rural non-frontier and urban).
    Research center: Upper Midwest Rural Health Research Center
    Topics: Aging, Frontier health, Healthcare access, Private health insurance, Rural statistics and demographics, Uninsured and underinsured
  • Impact of Hospitalists on Inpatient and Primary Care in Rural Communities
    This project will analyze primary data from a survey of rural hospitals about their use of hospitalists along with several sources of secondary data to examine why and how hospitalists are being used in rural hospitals and the impact of their use.
    Research center: Upper Midwest Rural Health Research Center
    Topic: Hospitals and clinics
  • Implementation of Telepharmacy in Rural Hospitals: Potential for Improving Medication Safety
    The purpose of this project is to describe successful telepharmacy activities and to analyze policy issues related to the implementation of telepharmacy projects in rural hospitals. These policy issues include the potential impact of telepharmacy use on the quality of pharmaceutical services and medication safety for rural patients.
    Research center: Upper Midwest Rural Health Research Center
    Topics: Hospitals and clinics, Pharmacy and prescription drugs, Quality, Telehealth
  • Nursing Workforce Impact on Rural Hospital Performance Improvement in the Hospital Quality Incentive Demonstration Project
    The purpose of this project is to examine the impact of nurse staffing on hospital performance improvement in the CMS/premier Inc. Hospital Quality Incentive Demonstration project with specific interest in whether and how this relationship differs in rural hospitals as compared to urban hospitals.
    Research center: Upper Midwest Rural Health Research Center
    Topics: Hospitals and clinics, Quality, Workforce
  • Patient Assessments and Quality of Care in Rural Hospitals
    This study will 1)analyze the relationships between rural patients' perspectives of hospital quality of care and key hospital characteristics that may influence patients' experiences of hospital care; and 2) assess whether rural patients' perspectives of hospital quality of care are related to quality measures focused on the provision of recommended care for medical conditions.
    Research center: Upper Midwest Rural Health Research Center
    Topics: Health services, Quality
  • Pay-for-Performance and Quality Improvement in Rural Hospitals
    This project will estimate the impact on rural hospitals in the U.S. of a pay-for-performance (PFP) program similar to the CMS-sponsored Premier, Inc. Hospital Quality Incentive Demonstration; synthesize the major factors that will influence the inclusion of rural hospitals in PFP programs; and make recommendations for the design of PFP programs that will appropriately reward rural hospitals for improving quality.
    Research center: Upper Midwest Rural Health Research Center
    Topics: Healthcare financing, Hospitals and clinics, Quality
  • Role of Rural Hospitals in Community-Centered Systems of Care: Supporting Population Health Improvement for Rural Communities
    This project will assess the degree to which rural hospitals engage in activities that facilitate community responsiveness and the provision of community-oriented services, using 1996 to 2004 data from the American Hospital Association Annual Survey and the Area Resource File.
    Research center: Upper Midwest Rural Health Research Center
    Topics: Health services, Hospitals and clinics
  • Rural Emergency Department Staffing: Implications for the Quality of Emergency Care Provided in Rural Areas
    This project will describe emergency department (ED) staffing patterns in rural hospitals; determine how the certification, training, and experience of ED physicians and other providers in different ED staffing models vary; and assess the implications of rural ED staffing for the quality of emergency care in rural areas, continuity of care, and rural EDs' role as safety net providers.
    Research center: Upper Midwest Rural Health Research Center
    Topics: Emergency medical services (EMS) and trauma, Hospitals and clinics, Quality, Workforce
  • Rural Implications of Health Care Reform: Issues Related to Quality of Care, Health Information Technology and Care Coordination
    The purpose of this project is to provide support to the Office of Rural Health Policy on rural health care reform issues.
    Research center: Upper Midwest Rural Health Research Center
    Topic: Health services
  • Successful Implementation of Medication Safety Initiatives in Rural Hospitals: The Role of Pharmacists and Technology
    This project will assess the capacity of rural hospitals to implement medication safety practices that reduce the likelihood of serious adverse drug events, and will identify factors that facilitate successful implementation of medication safety practices in rural hospitals.
    Research center: Upper Midwest Rural Health Research Center
    Topics: Hospitals and clinics, Pharmacy and prescription drugs, Quality

Publications - (20)

2012

  • Quality Reporting for CAHs and Rural PPS Hospitals: The Potential Impact of Composite Measures
    Policy Brief
    Upper Midwest Rural Health Research Center
    Date: 07/2012
    As a part of a larger project that examined alternative ways of identifying high quality rural hospitals, this report assesses the use of composite scores for public reporting of quality measures as one way of addressing the low volume issue for small rural hospitals.
  • The Use of Hospitalists in Small Rural Hospitals
    Upper Midwest Rural Health Research Center
    Date: 04/2012
    This policy brief describes the results of a survey of small rural hospitals that use hospitalists, who are physicians, physician assistants, or nurse practitioners who assume responsibility for patient care during inpatient hospital stays.

2011

  • Will Bundling Work in Rural America? Analysis of the Feasibility and Consequences of Bundled Payments for Rural Health Providers and Patients
    Policy Brief
    Upper Midwest Rural Health Research Center
    Date: 09/2011
    This report assesses the challenges and consequences for rural providers and patients of implementing bundled payments for acute and post-acute care episodes; explores impacts on care quality under a facility-physician bundled payment system; and describes potential modifications to bundling proposals and steps that could address rural issues.
  • Care Transitions: "Time to Come Home"
    Policy Brief
    Upper Midwest Rural Health Research Center
    Date: 03/2011
    This policy brief examines care coordination, with a focus on the transitions from inpatient care back to the rural community, and suggests ways of measuring the quality of care coordination on discharge from the hospital.
  • Care Transitions: "Time to Come Home" (Full Report)
    Upper Midwest Rural Health Research Center
    Date: 03/2011
    This report looks at care coordination for rural patients, with a focus on transitions from inpatient care back to the rural community, and suggests ways of measuring the quality of care coordination on discharge from the hospital.

2010

2009

  • Potentially Preventable Readmissions in Rural Hospitals
    Policy Brief
    Upper Midwest Rural Health Research Center
    Date: 08/2009
    Using 3-M algorithm software and Medicare inpatient claims data from five states, this brief examines potentially preventable readmission rates for rural and urban hospitals and discusses the rural implications of policy initiatives to reduce readmission rates.
  • Health Information Technology Policy and Rural Hospitals
    Policy Brief
    Upper Midwest Rural Health Research Center
    Date: 06/2009
    This brief summarizes the implementation status of key health information technology (HIT) applications in critical access hospitals and other rural hospitals and discusses policies for encouraging HIT adoption in rural hospitals.
  • Rural Issues Related to Bundled Payments for Acute Care Episodes
    Policy Brief
    Upper Midwest Rural Health Research Center
    Date: 06/2009
    Bundling Medicare payments has been proposed as a way of encouraging providers to find innovative, cost-reducing strategies to provide better coordinated care. This brief describes challenges to implementing bundled payments in rural settings and discusses potential contracting and reimbursement strategies to address the challenges.
  • Rural Issues Related to Comparative Effectiveness Research and Dissemination
    Policy Brief
    Upper Midwest Rural Health Research Center
    Date: 06/2009
    This brief describes strategies for expanding clinical research in rural environments; implementing practice guidelines in rural settings; and improving access to current evidence-based information for rural health professionals and patients.

2007

2006

2005