Michael Meit, MA, MPH
Deputy Director, Rural Health Equity Research Center
Phone: 240.273.2751
Email: meitmb@etsu.edu
East Tennessee State University
- Current Projects - (2)
- Completed Projects - (32)
- Publications - (15)
Current Projects - (2)
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Building the Rural Evidence Base: Examining the Feasibility of Implementing Pilot Programs and Demonstrations in Rural Communities
Evidence-based interventions are commonly developed in populated, urban centers and then adapted for rural communities. This project will investigate the benefits of piloting and evaluating interventions in rural areas to build the rural evidence base as a step in addressing health disparities and improving health conditions in rural communities.
Research center: Rural Health Equity Research Center
Topics: Health disparities and health equity, Health promotion and disease prevention, Health services
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Understanding Rural Health Data Challenges through Analysis of Peer-Reviewed Publication Limitations
This project will quantify and characterize health data-related limitations commonly identified in published studies on rural health and ways in which researchers overcome these challenges. Findings will provide a rigorous description of rural health data challenges, which may be used by researchers, policymakers, and rural health data collectors to improve rural data and research using rural data.
Research center: Rural Health Equity Research Center
Topic: Rural statistics and demographics
Completed Projects - (32)
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Achieving Equity in Disproportionate Share Payments to Rural Hospitals: An Examination of MedPAC's Revised Disproportionate Share Formula
Research center: NORC Walsh Center for Rural Health Analysis
Topics: Healthcare financing, Hospitals and clinics, Legislation and regulation
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Advantages and Disadvantages of Hospital-Based Emergency Medical Services in Rural Areas
This project sought to clarify issues surrounding hospital decisions to acquire and maintain ownership of community ambulance services.
Research center: NORC Walsh Center for Rural Health Analysis
Topics: Emergency medical services (EMS) and trauma, Hospitals and clinics
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Assessment of the Area Deprivation Index in Rural Areas
The Area Deprivation Index (ADI) was created by University of Wisconsin researchers to provide a score for neighborhoods based on their level of disadvantage. This study characterized differences in ADI in rural vs urban areas, summarized the existing literature on ADI, and described expert considerations for utilizing the ADI for future policy.
Research center: Rural Health Equity Research Center
Topics: Frontier health, Health disparities and health equity, Poverty, Rural statistics and demographics, Social determinants of health
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Augmenting Efforts for a Tool to Predict Post-Event Rural Population Surge
The Walsh Center is developing a tool to predict post-event rural population surge following public health emergencies, with funding originating from CDC. To enhance predictive accuracy of this tool and to more generally inform rural preparedness efforts, this project will gather information using key informant and survey methodologies.
Research center: NORC Walsh Center for Rural Health Analysis
Topic: Emergency preparedness and response
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Burdens of HIPAA on Rural Hospitals
Research center: NORC Walsh Center for Rural Health Analysis
Topics: Hospitals and clinics, Legislation and regulation
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Declining Access to Hospital-based Obstetric Services in Rural Areas: Causes and Impact
This study examines the declining availability of hospital-based obstetric services in rural areas from the mid-1980s to the early 2000s. It examines potential causes for this trend and explores the effects of medical malpractice reforms.
Research center: NORC Walsh Center for Rural Health Analysis
Topics: Hospitals and clinics, Legislation and regulation, Maternal health, Women
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Determinants of Quality of Care in Rural Communities: How Does The Health Care Infrastructure Affect Quality of Care in Rural America?
Research center: NORC Walsh Center for Rural Health Analysis
Topics: Health services, Quality, Workforce
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Effective Strategies for Achieving HIPAA Compliance Among Rural Hospitals
Research center: NORC Walsh Center for Rural Health Analysis
Topics: Hospitals and clinics, Legislation and regulation
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Examining the Burden of Public Stigma Associated with Mental Illness in the Rural U.S.
This project quantitatively examined the burden of public stigma associated with mental illness in rural versus nonrural communities using a nationally representative panel-based survey. Findings inform strategies aimed at reducing stigma and improving the lives of those experiencing mental illness in rural communities.
Research center: Rural Health Equity Research Center
Topics: Health services, Mental and behavioral health
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Exploring the Black Box: Design and Implementation Issues of P4P for Rural Physicians
Information about how pay-for-performance (P4P) payment systems work in ambulatory care settings, and in particular, how rural physicians might be affected, is scarce. This study employs qualitative research methods to explore the design and implementation of P4P systems and to investigate effects of P4P on rural physicians in a variety of settings.
Research center: NORC Walsh Center for Rural Health Analysis
Topics: Emergency medical services (EMS) and trauma, Healthcare financing, Physicians
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Financing Rural Public Health Activities in Chronic Disease Prevention and Health Promotion
This project describes the federal-state funding streams for selected local public health activities in the area of chronic disease prevention and health promotion, and assesses potential barriers to program implementation in less populated, local areas of a state.
Research center: NORC Walsh Center for Rural Health Analysis
Topics: Chronic diseases and conditions, Health promotion and disease prevention, Healthcare financing, Public health
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Following the Money: Do Block Grant Resources Reach Rural Communities?
This project applied a mixed methods design to describe the distribution of block grant resources from federal agencies through states to the local level in rural and non-rural communities in the United States. Findings could guide federal agencies and policy makers to develop strategies to more effectively target block grant resources to ensure that the needs of vulnerable rural populations are addressed.
Research center: Rural Health Equity Research Center
Topics: Health services, Healthcare financing, Public health, Rural statistics and demographics
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Impact of CAH Conversion on Hospital Costs and Mix of Services
This study examined Medicare Cost Report and claims data for hospitals before and after CAH conversion in order to better understand changes in hospital costs associated with CAH conversion, factors associated with any cost growth, and changes in the mix of services provided by the facility.
Research center: NORC Walsh Center for Rural Health Analysis
Topics: Critical Access Hospitals (CAHs), Health services, Healthcare financing
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Impact of the Home Health PPS on Access in Rural America
This study is designed to help policymakers understand whether patterns of home care use in rural communities have been affected by the PPS. Analyses will provide information on the characteristics of the patients served, the number and mix of services rendered, and quality of care.
Research center: NORC Walsh Center for Rural Health Analysis
Topics: Home health, Medicare Prospective Payment System (PPS)
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Investments in Health Information Technology by Rural Hospitals
This study involved a national survey of rural hospitals conducted in late spring 2006 to gather data about readiness to adopt health IT, current use of different technologies, perceptions about the benefits and barriers to health IT adoption, future implementation plans, use of Federal programs designed to facilitate IT adoption, and interest in various health IT policy options.
Research center: NORC Walsh Center for Rural Health Analysis
Topics: Health information technology, Hospitals and clinics
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Involvement of State Offices of Rural Health in Emergency Preparedness Activities
This project will follow-up with the state offices of rural health (SORH) to identify their current involvement with preparedness in rural areas, particularly in the use of funds earmarked to bioterrorism preparedness.
Research center: NORC Walsh Center for Rural Health Analysis
Topic: Emergency preparedness and response
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Medicare Beneficiary Outcomes in Rural and Urban Home Health Agencies
This study will compare the performance of rural and urban home care agencies, and identify agency characteristics that contribute to better patient care outcomes.
Research center: NORC Walsh Center for Rural Health Analysis
Topics: Home health, Medicare Prospective Payment System (PPS), Quality
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Medicare Payment for Post-Acute Care Transfers
Research center: NORC Walsh Center for Rural Health Analysis
Topics: Healthcare financing, Hospitals and clinics, Post-acute care
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National Rural Hospital Flexibility Program Tracking Project: Emergency Medical Services
Research center: NORC Walsh Center for Rural Health Analysis
Topics: Critical Access Hospitals (CAHs), Emergency medical services (EMS) and trauma, Networking and collaboration, Rural Hospital Flexibility Program
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National Rural Hospital Flexibility Program Tracking Project: Perceptions of Community Physicians
Research center: NORC Walsh Center for Rural Health Analysis
Topics: Critical Access Hospitals (CAHs), Physicians, Rural Hospital Flexibility Program
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Options for Structuring Disproportionate Share (DSH) Payments to Account for Uncompensated Care: Impact on Rural Hospitals
This study will identify options for development of an equitable DSH payment adjustment that accounts for hospital uncompensated care costs and determine the financial impact of each of these proposals on rural hospitals, using simulations with data from Washington, West Virginia, Texas, and Iowa.
Research center: NORC Walsh Center for Rural Health Analysis
Topics: Healthcare financing, Hospitals and clinics
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Outpatient Payment Policy Under Medicare: Recent Policy Developments from the Rural Perspective
This study was designed to examine outpatient payment options for rural hospitals, the advantages and disadvantages of each, and their potential impact on hospital revenue and rural access to health services.
Research center: NORC Walsh Center for Rural Health Analysis
Topics: Healthcare financing, Hospitals and clinics
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Post-Acute Care: A Rural and Urban Comparison
This multi-phase analysis examines whether discharge patterns for and use of post-acute care services by rural and urban hospitalized Medicare beneficiaries differ and, if they do, what are the sources of these different patterns.
Research center: NORC Walsh Center for Rural Health Analysis
Topics: Home health, Long-term care, Medicare, Post-acute care
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Public Health System Performance Measurement: Are Standards Applicable to Rural Communities?
This project aims to increase understanding of how public health governance affects the structure of public health services, and how this in turn influences the strategies adopted for meeting community public health needs in rural areas.
Research center: NORC Walsh Center for Rural Health Analysis
Topics: Legislation and regulation, Public health
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Quality Improvement Organizations' Contributions to Rural Hospital Performance
This qualitative study is designed to gather information on best-practices in Quality Improvement Organization (QIO)-rural hospital partnerships. Specifically, this study will identify successful and replicable examples in which QIOs have worked with rural and critical access hospitals to improve processes of care, implement health information technology and promote organizational safety culture.
Research center: NORC Walsh Center for Rural Health Analysis
Topics: Critical Access Hospitals (CAHs), Health information technology, Hospitals and clinics, Quality
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Rapid Response: Elimination of Bad Debt Payments to Rural PPS Hospitals
The purpose of this project is to examine: (1) the extent to which elimination of Medicare Bad Debt payments will reduce reimbursement to rural prospective payment system (PPS) hospitals and (2) how rural hospitals would respond to this reduction in reimbursement.
Research center: NORC Walsh Center for Rural Health Analysis
Topics: Healthcare financing, Hospitals and clinics, Medicare Prospective Payment System (PPS)
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Roadmap for the Adoption of Health Information Technology in Rural Communities
This project developed a resource document intended to help rural health care providers of all types as they think about whether an investment in health information technology makes sense for them and work through various implementation issues. The document was distributed at the September 2006 conference entitled "Health Information Technology: A Rural Provider's Roadmap to Quality," sponsored by ORHP.
Research center: NORC Walsh Center for Rural Health Analysis
Topics: Health information technology, Health services
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Rural Dimensions of Medicare Payment Policies
This project examines major Medicare fee-for-service payment policies from the rural perspective.
Research center: NORC Walsh Center for Rural Health Analysis
Topics: Medicare, Post-acute care
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Rural Perspective on Restructuring Medicare
Research center: NORC Walsh Center for Rural Health Analysis
Topics: Medicare, Pharmacy and prescription drugs
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Stay or Leave: Evidence from a Cohort of Young Rural Physicians
This project aims to improve understanding of the dynamics of physician practice location decision making by examining and analyzing changes in practice locations for a sample of rural physicians.
Research center: NORC Walsh Center for Rural Health Analysis
Topics: Physicians, Workforce
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Understanding the Roles of the Rural Hospital in Responding to Bioterrorist Attacks and Other Emergencies
Research center: NORC Walsh Center for Rural Health Analysis
Topics: Emergency preparedness and response, Hospitals and clinics
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Volunteer Labor and the Organizational Structure of Rural Emergency Medical Services (EMS) Providers
Research center: NORC Walsh Center for Rural Health Analysis
Topics: Emergency medical services (EMS) and trauma, Workforce
Publications - (15)
2024
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Use of the Area Deprivation Index and Rural Applications in the Peer-Reviewed Literature
Policy Brief
Rural Health Equity Research Center
Date: 03/2024
The Area Deprivation Index (ADI) was developed to capture area-level social deprivation for use in policy and research. In this literature review, researchers find that the use of the ADI in research is common.
2023
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State Priorities and Needs: The Role of Block Grants
Journal Article
Rural Health Equity Research Center
Date: 11/2023
This study looks at state-level funding allocations for 5 federal block grant programs from 2015-2019, and associations with state-level measures of need that align with the purposes of each block grant program. -
The Relationship Between Experience With Mental Illness and Stigmatizing Attitudes and Beliefs
Policy Brief
Rural Health Equity Research Center
Date: 08/2023
This policy brief documents the relationship between self-reported experience with any mental illness (whether first-hand or second-hand) and public stigma associated with mental illness. Differences in the prevalence of experience with mental illness by geography are also explored.
2022
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Examining the Burden of Public Stigma Associated With Mental Illness in the Rural United States
Policy Brief
Rural Health Equity Research Center
Date: 09/2022
Stigma is a widely recognized barrier to receipt of health and mental health services. This policy brief documents the burden of public stigma associated with any mental illness in rural versus non-rural communities in the United States. Differences in stigmatizing attitudes and beliefs by rurality, gender, race and ethnicity, and age are examined.
2016
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Exploring Rural and Urban Mortality Differences
North Dakota and NORC Rural Health Reform Policy Research Center
Date: 03/2016
Contains visual aids which display indicators of mortality rates by cause of death, age group, rural-urban status, region, and sex for populations 15 years of age and older cross-referenced to tables and statistical results.
2014
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The 2014 Update of the Rural-Urban Chartbook
Chartbook
North Dakota and NORC Rural Health Reform Policy Research Center
Date: 10/2014
This chartbook includes trends and disparities in urban/rural health. Reports on population characteristics include age, race and ethnicity, and poverty; risk factors such as smoking, alcohol use, and obesity; mortality data; health status measures such as adolescent births and total tooth loss; healthcare access/use; and mental health measures. -
Rural-Urban Disparities in Heart Disease
Policy Brief
North Dakota and NORC Rural Health Reform Policy Research Center
Date: 10/2014
The Department of Health and Human Services' report Health, United States, 2001: With Urban and Rural Health Chartbook illustrated trends and highlighted priorities in urban/rural health. The Rural Health Reform Policy Research Center replicated the analyses using the most recent data available. This brief highlights key heart disease findings.
2010
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The Medicare Physician Quality Reporting Initiative: Implications for Rural Physicians (Final Report)
NORC Walsh Center for Rural Health Analysis
Date: 08/2010
This report discusses the impact of rurality on office-based physicians' participation in the 2007 Physician Quality Reporting Initiative (PQRI). PQRI offers a financial incentive to physicians and other eligible professionals who successfully report quality measures related to services provided under the Medicare Physician Fee Schedule. -
The Medicare Physician Quality Reporting Initiative: Implications for Rural Physicians (Policy Brief)
Policy Brief
NORC Walsh Center for Rural Health Analysis
Date: 08/2010
Rural practices may be at a disadvantage with respect to participating in the Physician Quality Reporting Initiative, not necessarily because of their geographic location, but because they tend to be smaller and have fewer resources and a less developed quality measurement infrastructure.
2008
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Urban-to-Rural Evacuation: Planning for Rural Population Surge (Final Report)
NORC Walsh Center for Rural Health Analysis
Date: 08/2008
This study assessed the likelihood of urban evacuation to rural areas and provides recommendations for rural planning and response. -
Financing Rural Public Health Activities in Prevention and Health Promotion (Final Report)
NORC Walsh Center for Rural Health Analysis
Date: 06/2008
This is the final report of a study to determine whether the flow of federal resources, from federal agencies, through states, and to communities, is influenced by state- and local-level public health infrastructure. -
Rural Public Health Financing: The Relationship Between Infrastructure and Local Program Funding
Policy Brief
NORC Walsh Center for Rural Health Analysis
Date: 06/2008
This study's purpose was to describe how federal funds for selected chronic disease prevention and health promotion activities are distributed to local health departments and non-governmental organizations at the local level and to identify infrastructure-related barriers that rural agencies may face in securing and using funds for such purposes. -
Critical Access Hospitals' Experience With Medicare Advantage Plans
NORC Walsh Center for Rural Health Analysis, RUPRI Center for Rural Health Policy Analysis
Date: 03/2008
This report details findings from a survey of 60 critical access hospital (CAH) administrators regarding their experiences with Medicare Advantage plans.
2007
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Spontaneous Evacuation Following a Dirty Bomb or Pandemic Influenza: Highlights From a National Survey of Urban Residents' Intended Behavior
NORC Walsh Center for Rural Health Analysis
Date: 11/2007
This policy analysis brief reports the results of a national survey to assess the evacuation intentions of urban citizens following emergency scenarios. It includes information on how likely it would be for evacuees to go to rural or urban areas and discusses the potential impact of an urban evacuation on rural areas. -
Urban-to-Rural Evacuation: Planning for Population Surge
Policy Brief
NORC Walsh Center for Rural Health Analysis
Date: 04/2007
This policy brief discusses disaster planning and how rural preparedness officials face significant informational, organizational, and infrastructural constraints in their abilities to prepare for a potential population surge from urban areas.