Rural Health
Research Gateway

Michelle Casey, MS

Contact information for this researcher is no longer available, but you can still access their previous work.

Completed Projects - (17)

  • Analysis of Critical Access Hospital Inpatient Hospitalizations and Transfers from CAHs to Other Acute and Post-Acute Care Settings Using State Inpatient Databases
    The purpose of this project is to analyze Critical Access Hospital (CAH) inpatient hospitalizations and transfers from CAHs in order to help inform the development of quality indicators for CAHs, especially quality indicators focused on the transfer process.
    Research center: University of Minnesota Rural Health Research Center
    Topics: Critical Access Hospitals (CAHs), Post-acute care, Quality
  • Analyzing the Relationship Among Critical Access Hospital Financial Status, Organizational Linkages, and Scope of Services
    This project will systematically analyze the relationships among pre- and post-conversion Critical Access Hospital (CAH) financial performance, the organizational linkages in which the hospital participates (e.g., health care systems and/or networks), and the scope of services (i.e., the number and type of services) provided.
    Research center: University of Minnesota Rural Health Research Center
    Topics: Critical Access Hospitals (CAHs), Health services, Healthcare financing, Networking and collaboration
  • 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
  • Critical Access Hospital Participation in the Hospital Quality Alliance and Initial Quality Measure Results
    This project examined the participation of Critical Access Hospitals (CAHs) in public reporting of quality measures in the Centers for Medicare and Medicaid Services Hospital Compare database. It presented the initial Hospital Compare results for CAHs and comparisons with other groups of hospitals on quality measures for three conditions: acute myocardial infarction (heart attack), heart failure and pneumonia.
    Research center: University of Minnesota Rural Health Research Center
    Topics: Critical Access Hospitals (CAHs), Quality
  • Dental Care For Rural Low Income And Minority Populations
    Research center: University of Minnesota Rural Health Research Center
    Topics: Minority health, Oral health, Poverty
  • Health Care System Response to a Growing Latino Population in Rural America
    Research center: University of Minnesota Rural Health Research Center
    Topics: Hispanics, Minority health, Rural statistics and demographics
  • 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 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
  • Impact of Private Sector Quality Initiatives on Rural Providers and Patients
    The purpose of this project is to assess the impact of private sector quality reporting and quality improvement initiatives on rural providers and on the quality of care provided to rural patients.
    Research center: University of Minnesota Rural Health Research Center
    Topic: Quality
  • 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
  • Measuring Quality in Rural Health Services: Are Hospital and Health Plan Accreditation Standards Appropriate for Rural Areas?
    Research center: University of Minnesota Rural Health Research Center
    Topic: Quality
  • Measuring Quality Performance in CAHs
    The purpose of the project is to update our previous analyses of Critical Access Hospital (CAH) participation in Hospital Compare, analyze trends over time, and explore additional sources of quality data for CAHs.
    Research center: University of Minnesota Rural Health Research Center
    Topics: Critical Access Hospitals (CAHs), Quality
  • 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
  • Quality Implications of Transferring Emergency Department Patients from Rural Hospitals
    This project will use Medicare inpatient and Emergency Department claims data to 1.) compare patients who are transferred directly from rural hospital Emergency Departments to larger hospitals with those who are admitted as inpatients to rural hospitals in terms of diagnoses, comorbidities, demographics, and the care received and 2.) analyze how the inclusion or exclusion of transferred emergency patients affects risk-adjusted mortality rates for transferring and receiving hospitals.
    Research center: University of Minnesota Rural Health Research Center
    Topics: Emergency medical services (EMS) and trauma, Quality
  • 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 Quality-Based Physician Payment Reform
    The purpose of this project is to assess existing national data about the quality of care provided by rural physicians, and to determine what additional information will be needed as CMS moves towards inclusion of all physicians in payment reforms based on quality.
    Research center: University of Minnesota Rural Health Research Center
    Topics: Physicians, Quality
  • 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 - (80)

2019

  • Quality Measures for Critical Access Hospital Swing Bed Patients
    Policy Brief
    University of Minnesota Rural Health Research Center
    Date: 10/2019
    This study identified measures to be used to assess the quality of care provided to Critical Access Hospital (CAH) swing bed patients with the goal of having these measures endorsed by the National Quality Forum and used by policymakers to help assess the value of CAH swing beds.

2018

2017

2016

  • Relationship Between Hospital Policies for Labor Induction and Cesarean Delivery and Perinatal Care Quality Among Rural U.S. Hospitals
    Journal Article
    University of Minnesota Rural Health Research Center
    Date: 11/2016
    This study focused on maternity care quality by taking a look at hospitals' policies regarding induced labor and Cesarean deliveries.
  • Why Are Obstetric Units in Rural Hospitals Closing Their Doors?
    Journal Article
    University of Minnesota Rural Health Research Center
    Date: 08/2016
    Analyzes the reasons behind hospital- and county-level factors for rural obstetric unit closures.
  • Factors Associated With High-Risk Rural Women Giving Birth in Non-NICU Hospital Settings
    Journal Article
    University of Minnesota Rural Health Research Center
    Date: 07/2016
    Identifies rick factors for childbirth in facilities without neonatal intensive care unit (NICU) capacities among high-risk rural women. The study found that rural women with preterm birthday and multiple gestation pregnancies were less likely to give birth in a hospital with NICU capacity if no local hospital had this capacity.
  • Ensuring Access to High-Quality Maternity Care in Rural America
    Journal Article
    University of Minnesota Rural Health Research Center
    Date: 05/2016
    Examines the access to high-quality for rural women care during pregnancy and childbirth. Policy interventions at the local, state, and federal levels could help to address maternity care workforce shortages and improve quality of care available to the one-half million rural U.S. women who give birth each year.
  • Location of Childbirth for Rural Women: Implications for Maternal Levels of Care
    Journal Article
    University of Minnesota Rural Health Research Center
    Date: 05/2016
    This study looks into the rate at which rural women give birth at nonlocal hospitals. Approximately 75% of rural women gave birth at local hospitals. However, after controlling for clinical complications, rural Medicaid beneficiaries were less likely to give birth at nonlocal hospitals, implying a potential access challenge for this population.
  • Quality Measures and Sociodemographic Risk Factors: The Rural Context
    Policy Brief
    University of Minnesota Rural Health Research Center
    Date: 05/2016
    This policy brief aims to inform discussions concerning whether or not to adjust provider quality measures for differences in patient characteristics by examining how rurality and key sociodemographic variables might affect quality-of-care outcomes.
  • State Variations in the Rural Obstetric Workforce
    Policy Brief
    University of Minnesota Rural Health Research Center
    Date: 05/2016
    Many types of staff are necessary to successfully run an obstetrics unit. Rural hospitals face unique staffing challenges. This policy brief describes the obstetric workforce in rural hospitals by state for nine states: Colorado, Iowa, Kentucky, New York, North Carolina, Oregon, Vermont, Washington, and Wisconsin.
  • Rural Implications of Expanded Birth Volume Threshold for Reporting Perinatal Care Measures
    Journal Article
    University of Minnesota Rural Health Research Center
    Date: 04/2016
    In 2016 the minimum annual birth volume threshold for required reporting of the Joint Commission Perinatal Care measures by accredited hospitals decreased from 1,100 to 300 births. This study used the publicly available Join Commission Quality Check data from April 2014 to March 2015.
  • Medicare Costs and Utilization Among Beneficiaries in Rural Areas
    Policy Brief
    University of Minnesota Rural Health Research Center
    Date: 03/2016
    This study assesses the relationship between service utilization patterns and costs for rural Medicare beneficiaries across the rural continuum. It also examines the relationships between rural beneficiaries' service utilization and healthcare delivery market structure and evaluates strategies and policies to address high costs in rural areas.
  • Does the Medicare Part D Decision-Making Experience Differ by Rural/Urban Location?
    Journal Article
    University of Minnesota Rural Health Research Center
    Date: 02/2016
    Evaluates the personal experiences with choosing a Part D plan among rural residents. This study examines the geographic differences in Part D enrollees' opinion of the plans decision-making process.
  • Rural-Urban Differences in Satisfaction With Medicare Part D: Implications for Policy
    Journal Article
    University of Minnesota Rural Health Research Center
    Date: 01/2016
    Examines the difference in rural and urban satisfaction with Medicare Part D coverage by using data from the 2012 Medicare Current Beneficiary Survey. The research found that rural residents have lower satisfaction with their coverage.

2015

  • Rural Hospital and Physician Participation in Private Sector Quality Initiatives
    Policy Brief
    University of Minnesota Rural Health Research Center
    Date: 10/2015
    This project examined private sector quality reporting and quality improvement initiatives being implemented by dominant insurers in states with significant rural populations. The policy brief profiles 12 initiatives, half focused on physician quality improvement and half focused on hospital quality improvement.
  • Which Rural and Urban Hospitals Have Received Readmission Penalties Over Time?
    Policy Brief
    University of Minnesota Rural Health Research Center
    Date: 10/2015
    The Hospital Readmissions Reduction Program reduces Medicare payments for hospitals with excess rates of patient readmissions for certain conditions. It assesses rural/urban differences in the proportion of hospitals penalized under the program over time and whether condition-specific hospital readmission rates differ for rural/urban hospitals.
  • Differences in Part D Plans Offered to Rural and Urban Medicare Beneficiaries
    Policy Brief
    University of Minnesota Rural Health Research Center
    Date: 07/2015
    This brief analyzes how the plan options available to rural and urban beneficiaries differ in terms of premiums, deductibles, and copayments, as well as differences in plan options within rural areas.
  • Rural and Urban Differences in Choice of and Satisfaction With Medicare Part D Plans
    Policy Brief
    University of Minnesota Rural Health Research Center
    Date: 07/2015
    This brief examines whether rural Medicare beneficiaries are satisfied with their Medicare Part D drug plans and whether there is a difference in beneficiary satisfaction and plan selection experience by rurality.
  • Rural Women Delivering Babies in Non-Local Hospitals: Differences by Rurality and Insurance Status
    Policy Brief
    University of Minnesota Rural Health Research Center
    Date: 06/2015
    This policy brief describes the extent to which rural pregnant women give birth in non-local hospitals and analyzes current patterns of non-local delivery by rural women's health insurance status and residential rurality.
  • Minimum Distance Requirements Could Harm High-Performing CAHs and Rural Communities
    Journal Article
    North Carolina Rural Health Research and Policy Analysis Center, University of Minnesota Rural Health Research Center
    Date: 04/2015
    Compares the effect of location on critical access hospitals' size, quality of care, and financial strength. Discusses implications of minimum distance requirements on critical access hospitals.
  • The Rural Obstetric Workforce in U.S. Hospitals: Challenges and Opportunities
    Journal Article
    University of Minnesota Rural Health Research Center
    Date: 03/2015
    Describes the healthcare and clinician types who are delivering babies in rural hospitals, such as family physicians, general surgeons, obstetricians, and midwives. Discusses the relationship between hospital birth volume and staffing models.
  • Nurse Staffing Levels and Quality of Care in Rural Nursing Homes
    Policy Brief
    University of Minnesota Rural Health Research Center
    Date: 01/2015
    This study's purpose was to examine the relationship between nurse staffing levels and care quality in rural nursing homes and to assess potential differences between hospital-based and freestanding rural nursing homes.

2014

2013

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

  • Meaningful Use of Health Information Technology by Rural Hospitals
    Journal Article
    University of Minnesota Rural Health Research Center
    Date: 01/2011
    This study examines the current status of meaningful use of health information technology in Critical Access Hospitals (CAHs) and other rural and urban U.S. hospitals, and it discusses the potential role of Medicare payment incentives and disincentives in encouraging CAHs and other rural hospitals to achieve meaningful use.

2010

  • Current Practices and State Regulations Regarding Telepharmacy in Rural Hospitals
    Journal Article
    University of Minnesota Rural Health Research Center
    Date: 07/2010
    Telepharmacy practices in rural hospitals in several states were examined, and relevant policies and state laws and regulations were analyzed, along with issues to be addressed as the use of telepharmacy expands.
  • Patient Assessments and Quality of Care in Rural Hospitals
    Policy Brief
    Upper Midwest Rural Health Research Center
    Date: 06/2010
    This policy brief analyzes the relationships between rural patients' perspectives of hospital quality of care and key hospital characteristics that may influence patients' experiences of hospital care.
  • Patient Assessments and Quality of Care in Rural Hospitals (Final Report)
    Upper Midwest Rural Health Research Center
    Date: 06/2010
    This report analyzes the relationships between rural patients' perspectives of hospital quality of care and key hospital characteristics that may influence patients' experiences. It assesses whether rural patients' perspectives of quality of care are related to quality measures focused on the provision of recommended care for medical conditions.
  • The Effect of Health Information Technology on Quality in U.S. Hospitals
    Journal Article
    University of Minnesota Rural Health Research Center
    Date: 04/2010
    This study examines changes in quality of care following adoption of electronic health records among a national sample of U.S. hospitals from 2004 to 2007. The use of computerized physician order entry and electronic health records resulted in significant improvements in two quality measures; larger effects in academic than nonacademic hospitals.

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 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.
  • Implementation of Telepharmacy in Rural Hospitals: Potential for Improving Medication Safety
    Policy Brief
    Upper Midwest Rural Health Research Center
    Date: 03/2009
    This policy brief describes successful telepharmacy activities being implemented in rural hospitals and analyzes policy issues related to the implementation of telepharmacy projects in rural hospitals.

2008

2007

2006

2005

  • Pharmacist Staffing and the Use of Technology in Small Rural Hospitals: Implications for Medication Safety (Full Report)
    Upper Midwest Rural Health Research Center
    Date: 12/2005
    This study's results show that many small rural hospitals have limited hours of onsite pharmacist coverage and a significant number don't have a pharmacy computer or don't use one for clinical purposes. Implementation of protocols related to medication use and key medication safety practices are areas where small rural hospitals could improve.
  • Providing Hospice Care in Rural Areas: Challenges and Strategies to Address Them
    Journal Article
    University of Minnesota Rural Health Research Center
    Date: 2005

    Hospices in rural settings face challenges in the provision of hospice care as a result of their location and the size of their service area population. To ascertain the challenges that hospices face in serving rural communities, researchers conducted in-depth case studies of four different models of hospice care in rural areas. The authors describe strategies used by the case study hospices and recommend policies that could increase access to hospice care for rural Medicare beneficiaries and other rural residents. National initiatives to improve end-of-life care need to consider the special challenges faced by rural hospices.

2004

  • Access to Dental Care for Rural Low Income and Minority Populations
    University of Minnesota Rural Health Research Center
    Date: 09/2004
    Using data from the 1999 National Health Interview Survey, this study examines the relationships between rural residence, income, race/ethnicity, and access to dental care.
  • Critical Access Hospital Patient Safety Priorities and Initiatives: Results of the 2004 National CAH Survey
    University of Minnesota Rural Health Research Center
    Date: 09/2004
    This paper describes the patient safety results from a 2004 survey of critical access hospital administrators.
  • Quality Improvement Activities in Critical Access Hospitals: Results of the 2004 National CAH Survey
    University of Minnesota Rural Health Research Center
    Date: 09/2004
    This paper describes quality improvement efforts in critical access hospitals (CAHs) based on a 2004 survey of 474 CAH administrators. It includes data on the use of clinical guidelines and quality measures in CAHs and the role of Medicare Quality Improvement Organizations.
  • 2004 CAH Survey National Data
    University of Minnesota Rural Health Research Center
    Date: 08/2004
    The Flex Monitoring Team conducted a national survey of critical access hospital (CAH) administrators between January and April 2004. The survey's purpose was to document program-related experiences of CAHs during the last two years to help shape public policy to improve the effectiveness of the Flex Program and CAHs.
  • Do Rural Elders Have Limited Access to Medicare Hospice Services?
    Journal Article
    University of Minnesota Rural Health Research Center, Upper Midwest Rural Health Research Center
    Date: 05/2004
    Examines whether there are urban-rural differences in use of the Medicare hospice benefit before death and whether those differences suggest that there is a problem with access to hospice care for rural Medicare beneficiaries.
  • Quality Improvement Strategies and Best Practices in Critical Access Hospitals
    University of Minnesota Rural Health Research Center
    Date: 01/2004
    This paper describes critical access hospital (CAH) quality improvement (QI) initiatives, with examples of best practices from two CAHs that have innovative QI programs. It includes lists of changes made to staffing, training, equipment, and other issues related to QI.

2003

2002

2001

  • Access to Rural Pharmacy Services in Minnesota, North Dakota, and South Dakota
    University of Minnesota Rural Health Research Center
    Date: 07/2001
    This paper describes the status of rural retail pharmacies in the three states; examines the availability of pharmacy services in rural areas of the states; and analyzes regulatory and policy issues that affect the delivery of pharmacy services in rural areas.

2000

  • Influence of Rural Residence on the Use of Preventative Health Care Services
    University of Minnesota Rural Health Research Center
    Date: 11/2000
    This paper details a study of the utilization of specific preventive healthcare services by rural women and men to assess the impact of rural residence, the availability of healthcare providers and technology, demographic factors, and health insurance status on the likelihood of obtaining several preventive healthcare services.