Lisa Garberson, PhD

WWAMI Rural Health Research Center

Phone: 206.685.3108
Email: lgarbers@uw.edu

University of Washington
4311 11th Ave NE, Suite 210
Seattle, WA 98105

Current Projects - (1)
Publications - (30)

Current Projects - (1)

Comparing Utilization and Quality of Home Health Care Between Medicare Fee-for-Service and Medicare Advantage Beneficiaries by Rural-Urban Status
This project examines differences in home health use and quality by enrollment in Medicare Fee-for-Service (FFS) versus Medicare Advantage (MA) plans. Findings will include information on rural-urban and intra-rural variation in home health care to inform policies on access, payment, and quality for Medicare FFS and MA plans.
Research center: WWAMI Rural Health Research Center
Topics: Aging, Allied health professionals, Health disparities and health equity, Health services, Healthcare access, Healthcare financing, Home health, Medicare, Medicare Advantage (MA), Post-acute care, Quality

Publications - (30)

2024

Trends in the Health Workforce Supply in the Rural U.S.
Report
WWAMI Rural Health Research Center
Date: 10/2024
This report examines the availability of current and historical workforce data for a variety of health care professionals and provides estimates of the trends in the supply and distribution in the rural vs. urban U.S. workforce.
Estimated Impacts of Multiple Payment Policies on Rural-Serving Home Health Agencies
Policy Brief
WWAMI Rural Health Research Center
Date: 07/2024
This brief examines the estimated impact of three Medicare payment policy changes on home health agency (HHA) reimbursement by rural-serving status, geographic location, and select HHA characteristics.

2023

Understanding and Overcoming Barriers to Rural Training in Family Medicine Obstetrics Fellowships
Policy Brief
WWAMI Rural Health Research Center
Date: 06/2023
This policy brief describes the results of a survey on the characteristics and challenges faced by rurally oriented family medicine obstetrics fellowship programs. All survey respondents reported their programs had a mission to train family physicians for rural practice, yet less than one-third of programs reported they required rural training.
Understanding and Overcoming Barriers to Rural Obstetric Training for Family Physicians
Journal Article
WWAMI Rural Health Research Center
Date: 03/2023
Family physicians are the most common health professional providing rural obstetric (OB) care, but the number of family physicians practicing OB is declining. This mixed-methods study aimed to inform policy and practice solutions to address the training landscape and inform sustainable initiatives for rural family medicine obstetrical training.

2022

Changes in the Supply and Rural-Urban Distribution of Counselors in the U.S., 2014-2021
Fact Sheet
WWAMI Rural Health Research Center
Date: 10/2022
There are rural vs. urban disparities and unequal distribution of behavioral health providers across U.S. Census Divisions. This study examined the trends in the supply of counselors by rural-urban status and Census Division.
Changes in the Supply and Rural-Urban Distribution of Psychiatric Nurse Practitioners in the U.S., 2014-2021
Fact Sheet
WWAMI Rural Health Research Center
Date: 10/2022
There are rural vs. urban disparities and unequal distribution of behavioral health providers across U.S. Census Divisions. This study examined the trends in the supply of psychiatric nurse practitioners by rural-urban status and Census Division.
Changes in the Supply and Rural-Urban Distribution of Psychiatrists in the U.S., 1995-2019
Fact Sheet
WWAMI Rural Health Research Center
Date: 10/2022
There are rural vs. urban disparities and unequal distribution of behavioral health providers across U.S. Census Divisions. This study examined the trends in the supply of psychiatrists by rural-urban status and Census Division.
Changes in the Supply and Rural-Urban Distribution of Psychologists in the U.S., 2014-2021
Fact Sheet
WWAMI Rural Health Research Center
Date: 10/2022
There are rural vs. urban disparities and unequal distribution of behavioral health providers across U.S. Census Divisions. This study examined the trends in the supply of psychologists by rural-urban status and Census Division.
Changes in the Supply and Rural-Urban Distribution of Social Workers in the U.S., 2014-2021
Fact Sheet
WWAMI Rural Health Research Center
Date: 10/2022
There are rural vs. urban disparities and unequal distribution of behavioral health providers across U.S. Census Divisions. This study examined the trends in the supply of social workers by rural-urban status and Census Division.
Prehospital Emergency Medical Services Personnel: Comparing Rural and Urban Professional Experience and Provision of Evidence-Based Care
Policy Brief
WWAMI Rural Health Research Center
Date: 05/2022
This policy brief examines the effects of emergency medical services (EMS) personnel level of experience and agency rurality on the provision of evidenced-based care. Compared with urban-serving EMS agencies, rural-serving agencies provided evidence-based care less often for stroke, hypoglycemia, and trauma but more often for seizures.
Quality of Home Health Agencies Serving Rural Medicare Beneficiaries
Policy Brief
WWAMI Rural Health Research Center
Date: 02/2022
This policy brief describes the quality of home health agencies (HHAs) by rural-serving status. While quality of patient care star ratings were not associated with rural-serving status, rural HHAs and urban HHAs that serve rural patients had higher patient experience star ratings than urban HHAs that do not serve rural patients.
Quality of Skilled Nursing Facilities Serving Rural Medicare Beneficiaries
Policy Brief
WWAMI Rural Health Research Center
Date: 02/2022
This policy brief describes the quality of skilled nursing facilities (SNFs) by rural-serving status. While overall star ratings and staffing star ratings were not associated with rural-serving status, rural SNFs and urban SNFs that serve rural patients had lower quality star ratings compared to urban SNFs that do not serve rural patients.

2021

Geographic Access to Health Care for Rural Medicare Beneficiaries: A National Study
Policy Brief
WWAMI Rural Health Research Center
Date: 09/2021
Using national data from 2014, this policy brief describes geographic variation in the mix of providers caring for rural versus urban Medicare beneficiaries, the quantity of visits received by beneficiaries across Census Divisions and types of rural areas, and the distance traveled for care for several serious conditions.
Geographic Access to Health Care for Rural Beneficiaries in Five States: An Update
Policy Brief
WWAMI Rural Health Research Center
Date: 04/2021
Using data from five states, this study describes the mix of providers caring for rural Medicare beneficiaries, the quantity of care received, and how far rural beneficiaries traveled for care for several selected conditions in 2014. Results are also compared with a similar study of the same states that used data from 1998.
The Distribution of the General Surgery Workforce in Rural and Urban America in 2019
Policy Brief
WWAMI Rural Health Research Center
Date: 03/2021
Researchers examined the 2019 per capita supply of general surgeons in rural and urban areas of the U.S. and compared those results to a similar study of general surgeon supply conducted in 2001. Researchers also examined change in the regional distribution and age and gender characteristics of general surgeons since 2001.
Post-acute Care Trajectories for Rural Medicare Beneficiaries: Planned Versus Actual Hospital Discharges to Skilled Nursing Facilities and Home Health Agencies
Policy Brief
WWAMI Rural Health Research Center
Date: 03/2021
This policy brief describes trajectories for rural Medicare beneficiaries following hospital discharge, including differences between planned and actual discharge to skilled nursing facilities and home health agencies. More than 40% of beneficiaries for whom home health care was indicated did not receive care from a home health agency.

2020

Comparing the Health Workforce Provider Mix and the Distance Travelled for Mental Health Services by Rural and Urban Medicare Beneficiaries
Journal Article
WWAMI Rural Health Research Center
Date: 08/2020
This study used 2014 administrative Medicare claims data to describe the mix of health professionals who care for rural and urban patients with mood and/or anxiety disorders. It further describes where these beneficiaries received care and the one-way distance (miles) and time (minutes) they travelled to receive it.
Supply and Distribution of the Primary Care Workforce in Rural America: 2019
Policy Brief
WWAMI Rural Health Research Center
Date: 06/2020
Maintaining an adequate supply of primary care providers in the U.S. is one of the key challenges in rural healthcare. This study examines the 2019 supply and geographic distribution of primary care physicians, nurse practitioners, and physician assistants across rural areas of the U.S.
Supply and Distribution of the Primary Care Workforce in Rural America: A State-Level Analysis
Report
WWAMI Rural Health Research Center
Date: 06/2020
Maintaining an adequate supply of primary care providers in the U.S. is one of the key challenges in rural health care. This study examines the 2019 supply and geographic distribution of primary care physicians, nurse practitioners, and physician assistants across rural areas of the U.S., providing state-level data briefs.
The Supply and Rural-Urban Distribution of the Obstetrical Care Workforce in the U.S.
Policy Brief
WWAMI Rural Health Research Center
Date: 06/2020
Monitoring the supply of the obstetrical (OB) care workforce is important for identifying areas that may lack OB care access. This brief describes the supply and geographic distribution of obstetricians, advanced practice midwives, midwives (not advanced practice), and family physicians in rural versus urban counties.
The Supply and Rural-Urban Distribution of the Obstetrical Care Workforce in the U.S. - A State-Level Analysis
Report
WWAMI Rural Health Research Center
Date: 06/2020
Monitoring the supply of the obstetrical (OB) care workforce is important for identifying areas that may lack OB care access. This set of data briefs describes the supply and geographic distribution of obstetricians, advanced practice midwives, midwives (not advanced practice), and family physicians in rural versus urban counties for every state.
Variation in Use of Home Health Care Among Fee-for-Service Medicare Beneficiaries by Rural-Urban Status and Geographic Region: Assessing the Potential for Unmet Need
Policy Brief
WWAMI Rural Health Research Center
Date: 02/2020
This study describes use of home healthcare by rural-urban status and geographic region. Findings suggest geographic region drives variation more than rural-urban status. Unmet need may be highest in the most remote rural counties and rural counties within the West North Central, East North Central, Mountain, and Pacific Census Divisions.

2019

Preparing Physicians for Rural Practice: Availability of Rural Training in Rural-Centric Residency Programs
Journal Article
WWAMI Rural Health Research Center
Date: 10/2019
This study surveyed physician residency programs in anesthesiology, emergency medicine, general surgery, internal medicine, obstetrics and gynecology, pediatrics, and psychiatry to describe training locations and rural-specific content of rural-centric residency programs (those requiring at least eight weeks of rurally located training).
Differences in Care Processes Between Community-Entry Versus Post-Acute Home Health for Rural Medicare Beneficiaries
Policy Brief
WWAMI Rural Health Research Center
Date: 04/2019
This study describes home healthcare processes for rural Medicare beneficiaries who are admitted from the community (community-entry) versus those who are admitted following an inpatient stay (post-acute). Care processes include timely initiation of care, length of stay, and services provided (e.g., physical therapy, medical social work).

2018

Different Populations Served by the Medicare Home Health Benefit: Comparison of Post-Acute Versus Community-Entry Home Health in Rural Areas
Policy Brief
WWAMI Rural Health Research Center
Date: 07/2018
This study describes differences between rural, fee-for-service Medicare beneficiaries who are admitted to home health from the community (community-entry) and those who are admitted to home health following an inpatient stay (post-acute) in terms of their clinical and non-clinical characteristics as well as the communities in which they live.
Geographic Variation in the Supply of Selected Behavioral Health Providers
Journal Article
WWAMI Rural Health Research Center
Date: 06/2018
This study examined the supply of select behavioral health providers by metropolitan, micropolitan, and non-core county and Census Division. Psychiatrists, psychologists, and psychiatric nurse practitioners are unequally distributed throughout the U.S., with disparities between Census Divisions and rural vs. urban areas.
Service Provision and Quality Outcomes in Home Health for Rural Medicare Beneficiaries at High Risk for Unplanned Care
Journal Article
WWAMI Rural Health Research Center
Date: 06/2018
This study examined service provision and quality outcomes among rural Medicare beneficiaries who used home health from 2011-2013 and were at high risk for unplanned care. More skilled nursing visits and visits by more types of providers were associated with higher hospital readmission and emergency department use and lower community discharge.

2016

What Is the Potential of Community Paramedicine to Fill Rural Healthcare Gaps?
Journal Article
WWAMI Rural Health Research Center
Date: 11/2016
This study collected information on rural community paramedicine in the U.S. programs to describe their goals, target populations, services offered, connections with local community providers and resources, outcomes measured, and results, where available.
Community Factors and Outcomes of Home Health Care for High-Risk Rural Medicare Beneficiaries
Policy Brief
WWAMI Rural Health Research Center
Date: 10/2016
Outcomes of care vary by region of the country for rural Medicare beneficiaries receiving home health services for high-risk conditions such as heart failure. Those in the East South Central and West South Central Census Divisions had lower rates of community discharge and higher rates of hospital readmission and emergency department use.
Supply and Distribution of the Behavioral Health Workforce in Rural America
Policy Brief
WWAMI Rural Health Research Center
Date: 09/2016
This brief uses National Provider Identifier (NPI) data to report on the variability of the supply and provider to population ratios of five types of behavioral health workforce providers (psychiatrists, psychologists, social workers, psychiatric nurse practitioners, counselors) in Metropolitan, Micropolitan and Non-core rural areas across the U.S.