Rural Health Research: Paula Weigel, PhD

Averted Transfers in Rural Emergency Departments Using Telemedicine: Rates and Costs Across Six Networks
Journal Article
Rural Telehealth Research Center
Date: 08/2020
In a cohort of 4,324 tele-ED cases across 26 months in 65 hospitals in 6 tele-ED networks, 20% were averted transfers, and 43% of those were then routinely discharged rather than being transferred. Averted transfers saved on average $2,673 in avoidable transport costs per patient, with 63.6% of these cost savings accruing to public insurance.
Identifying Measures and Data Elements for the HRSA Evidence-Based Tele-Emergency Network Grant Program
Policy Brief
Rural Telehealth Research Center
Date: 03/2020
This brief details multi-project work to identify measures and develop data elements appropriate to emergency department-based telehealth, create an Excel-based tool, and systematically collect data from grantees in the Health Resources and Services Administration Evidence-Based Tele-Emergency Network Grant Program.

Impact of the Medicare Disproportionate Share Hospital Payment Cap on Urban and Rural Hospitals
Policy Brief
RUPRI Center for Rural Health Policy Analysis
Date: 12/2019
The Medicare Disproportionate Share Hospital payment adjustment is intended to compensate hospitals serving a disproportionate number of low-income patients. This policy brief describes the number and location of urban and rural hospitals affected by a 12% payment cap established by the Medicare Modernization Act of 2003.
Tele-Emergency Behavioral Health in Rural and Underserved Areas
Journal Article
Rural Telehealth Research Center
Date: 11/2019
This paper describes how two distinct tele-emergency department (ED) behavioral health models address challenges in access and placement for patients in rural and underserved areas presenting to EDs. The notable difference in disposition rates between cases and controls shows the impact each model is having on care practices and processes.
Pediatric Tele-Emergency Care: A Study of Two Delivery Models
Journal Article
Rural Telehealth Research Center
Date: 04/2019
This study describes two tele-emergency programs that provide care to pediatric populations. Qualitative descriptions of the two tele-emergency department (ED) models and key characteristics of the patient populations served by tele-ED are presented. The study informs others about evaluative measures and how tele-ED works in practice.

Assessing the Unintended Consequences of Health Policy on Rural Populations and Places
Report
RUPRI Health Panel: Rural Policy Analysis and Applications
Date: 12/2018
This paper explores the unintended consequences of health policy through an analysis of policy actions that have affected, or had the potential to affect, rural people, places, and/or providers in ways counteractive to policy intent.

Rural-Urban Enrollment in Part D Prescription Drug Plans: June 2017 Update
Policy Brief
RUPRI Center for Rural Health Policy Analysis
Date: 12/2017
As of June 2017, the percentage of rural enrollment in Part D plans, which include stand-alone prescription drug plans (PDPs) and Medicare Advantage with Prescription Drug (MA-PD) plans, lags urban enrollment despite significant growth overall in the number of Medicare beneficiaries with prescription drug coverage through Medicare Part D plans.
Rural Long-Term Services and Supports: A Primer
RUPRI Health Panel: Rural Policy Analysis and Applications
Date: 11/2017
This paper provides policymakers and other interested stakeholders a primer on the fundamentals of the rural LTSS system, rural access to and use of LTSS, and the opportunities and limitations of current federal and state LTSS policy for advancing rural health system transformation toward a high-performing rural health delivery system.
After Hospital Closure: Pursuing High Performance Rural Health Systems Without Inpatient Care
RUPRI Health Panel: Rural Policy Analysis and Applications
Date: 06/2017
A new paper describing opportunities for rural communities to develop a high performance rural health system after hospital closure, including three case studies that describe real-world transitions from hospital-based locus of care to new models of care delivery in rural places.

Variation in Primary Care Service Patterns by Rural-Urban Location
Journal Article
RUPRI Center for Rural Health Policy Analysis
Date: 03/2016
Examines primary care physician service patterns by rural-urban location and discusses effect on recruitment strategies for primary care providers in rural communities.
Surgical Patient Safety Outcomes in Critical Access Hospitals: How Do They Compare?
Journal Article
RUPRI Center for Rural Health Policy Analysis
Date: 02/2016
Examines how Critical Access Hospitals perform compared to Prospective Payment System hospitals on measures of quality.

Rural Bypass for Elective Surgeries
Journal Article
RUPRI Center for Rural Health Policy Analysis
Date: 11/2015
Describes the elective surgical bypass rate, the procedures most commonly bypassed by rural residents, the distribution of volume among Critical Access Hospitals (CAHs) that offer elective surgical services, and factors predictive of bypass.
Care Coordination in Rural Communities Supporting the High Performance Rural Health System
Report
RUPRI Health Panel: Rural Policy Analysis and Applications
Date: 06/2015
This paper examines care coordination programs and processes that affect rural areas to discover what is happening in rural communities, how various programs and approaches are working, who benefits, and to make policy recommendations that will facilitate care coordination efforts in support of high performance rural health system development.
Surgical Services in Critical Access Hospitals, 2011
Policy Brief
RUPRI Center for Rural Health Policy Analysis
Date: 02/2015
This brief describes the types and volume of major surgical services provided in critical access hospitals across four regionally representative states in 2011.

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