Rebecca T. Slifkin, PhD
- Completed Projects - (26)
- Publications - (19)
Completed Projects - (26)
-
Analysis of the Cesarean Section Rates in Rural Hospitals
This project will describe the practice patterns for deliveries in rural hospitals. Cesarean section rates in rural hospitals will be compared to urban hospitals and the national rate.
Research center: North Carolina Rural Health Research and Policy Analysis Center
Topics: Hospitals and clinics, Maternal health
-
Analytic Capacity to Respond to Changes in Medicare and Medicaid, Data Assistance to Policy Staff at the Federal Office of Rural Health Policy, and Production of Short Policy Briefs
This project will produce short policy briefs on a variety of topics related to proposed and enacted changes in Medicare and Medicaid, as requested by policy staff at the federal Office of Rural Health Policy.
Research center: North Carolina Rural Health Research and Policy Analysis Center
Topics: Legislation and regulation, Medicaid and CHIP, Medicare
-
Assessing the Impact of Transfer of Pharmacy Services for Dual Eligible Beneficiaries to Medicare Part D
This project will focus on the implementation of the new Part D benefit for those dually eligible for Medicare and Medicaid. The study will examine the impact on rural dual eligibles and their local pharmacies of the transfer to Part D coverage. The project is a joint undertaking with the RUPRI Center, taking advantage of unique data sets held at each center, the analytical and programming resources of both centers, and the ability to conduct qualitative analysis in multiple states efficiently.
Research center: North Carolina Rural Health Research and Policy Analysis Center
Topics: Medicaid and CHIP, Medicare Part D, Pharmacy and prescription drugs
-
Background Paper on Skilled Nursing Facilities in Rural Areas
Research center: North Carolina Rural Health Research and Policy Analysis Center
Topic: Long-term care
-
Community Impact Assessment
This project will evaluate the impact of the Flex program on local communities. Activities will focus on identifying the ways in which the program could have a measurable effect, as well as the ways in which Flex program coordinators intended to affect community health. A briefing paper that integrates information on scope of services, networking, and quality will be produced. Additionally, case studies will be conducted in six CAH communities.
Research centers: Maine Rural Health Research Center, North Carolina Rural Health Research and Policy Analysis Center
Topics: Critical Access Hospitals (CAHs), Networking and collaboration, Rural Hospital Flexibility Program
-
Critical Access Hospital Conversion Tracking
Information regarding new CAH conversions will be gathered from Flex coordinators and CMS, and added to the CAH management information dataset that is housed at UNC. Flex coordinators will also be queried regarding topics of interest to the coordinators, the monitoring team, and the federal Office of Rural Health Policy.
Research center: North Carolina Rural Health Research and Policy Analysis Center
Topic: Critical Access Hospitals (CAHs)
-
Describing Geographic Access to Physicians in Rural America Using Statistical Applications in GIS
This study will use a geographically weighted regression to assess the influence of distance and travel time on the distribution of physicians in rural America. The ultimate goal of the study will be to improve our measures of access by identifying the extent to which border resources can be considered in indices of access.
Research center: North Carolina Rural Health Research and Policy Analysis Center
Topics: Health services, Physicians
-
Describing the Health Care Infrastructure in Rural Towns
Research center: North Carolina Rural Health Research and Policy Analysis Center
Topics: Federally Qualified Health Centers (FQHCs), Hospitals and clinics, Physician assistants, Physicians, Rural Health Clinics (RHCs), Rural statistics and demographics
-
Developing a Financial Performance Measurement System for Critical Access Hospitals
This project uses research and expert opinion to select dimensions and indicators of financial performance, develop appropriate bases or methods of peer comparison, investigate the relationship between quality of care and financial performance, and identify characteristics of high performing CAHs.
Research center: North Carolina Rural Health Research and Policy Analysis Center
Topics: Critical Access Hospitals (CAHs), Healthcare financing
-
Financial Performance of Critical Access Hospitals, Pre- and Post-Conversion
Making use of the financial indicators developed by project staff, the focus of this project is a longitudinal analysis of the dimensions and indicators of financial performance. Descriptive analyses are used to capture changes in all dimensions of financial performance pre- and post-conversion.
Research center: North Carolina Rural Health Research and Policy Analysis Center
Topics: Critical Access Hospitals (CAHs), Healthcare financing, Medicare Prospective Payment System (PPS), Rural Hospital Flexibility Program
-
Impact of The Medicaid Budget Crisis on Rural Communities: A 50-State Survey
The impact of the Medicaid budgetary crisis on rural communities across the US will be assessed through a 50-state survey of state Medicaid agencies, state Offices of Rural Health and state rural health associations.
Research center: North Carolina Rural Health Research and Policy Analysis Center
Topic: Medicaid and CHIP
-
Medicaid and SCHIP Participation in Rural and Urban Areas
This project examines state-level Medicaid and SCHIP participation rates for children in rural and urban areas. It also updates the State Profiles of Medicaid and SCHIP in Rural and Urban Areas web site and documents changes in program characteristics relevant to rural areas over the past few years.
Research center: North Carolina Rural Health Research and Policy Analysis Center
Topic: Medicaid and CHIP
-
Occupational Mix Differences Across PPS Hospitals: Analysis of Hospital Occupation Mix Survey Data and Implications for Rural Hospital Payments
This study addresses the occupation-mix adjustment that has recently been added to the computation of the area wage index used to adjust Medicare prospective rates for all institutional healthcare providers. The study will review the policy objectives as well as the mechanics of the adjustment, and then analyze the data from the most recent occupation-mix survey to obtain a better understanding of occupation mix differences across labor markets and hospital types.
Research center: North Carolina Rural Health Research and Policy Analysis Center
Topics: Hospitals and clinics, Medicare Prospective Payment System (PPS), Workforce
-
Office of Rural Health Policy: Cooperative Agreement for Rapid Response to Issue-Specific Rural Research
Office of Rural Health Policy: Cooperative Agreement for Rapid Response to Issue-Specific Rural Research
Research centers: North Carolina Rural Health Research and Policy Analysis Center, RUPRI Center for Rural Health Policy Analysis
Topic: Pharmacy and prescription drugs
-
Premium Assistance Programs: Exploring Public-Private Partnerships as a Vehicle for Expanding Health Insurance to Rural Uninsured
This project examines the experience of states that have implemented premium assistance programs in rural areas to determine whether there are certain design features or certain types of rural communities where these programs may be more feasible.
Research center: North Carolina Rural Health Research and Policy Analysis Center
Topics: Private health insurance, Uninsured and underinsured
-
Rapid and Flexible Analysis of Data from Centers for Medicare and Medicaid Services
Project staff will provide rapid and flexible analysis of Centers for Medicare and Medicaid Services (CMS) data in response to requests from Office of Rural Health Policy (ORHP) staff. Work will be ongoing throughout the contract year, with the design of individual products determined in response to ORHP staff needs.
Research center: North Carolina Rural Health Research and Policy Analysis Center
Topics: Medicare, Rural statistics and demographics
-
Role of Intensive Care Units in Critical Access Hospitals
This project will examine the role that intensive care units (ICUs) play in Critical Access Hospitals (CAHs). The number and geographic distribution of CAH with ICUs will be described, and types of services provided in these units discussed.
Research center: North Carolina Rural Health Research and Policy Analysis Center
Topics: Critical Access Hospitals (CAHs), Health services
-
Rural Emergency Medical Services: Workforce and Medical Direction
This two year study will examine the status of medical direction for rural EMS systems and the nature of the challenges and impediments to obtaining adequate medical direction in rural areas across the country. In addition, the study will address issues surrounding the recruitment and retention of paid and volunteer staff for rural EMS systems.
Research center: North Carolina Rural Health Research and Policy Analysis Center
Topics: Emergency medical services (EMS) and trauma, Workforce
-
Rural Hospital Closures, 1990-2000: Community Profiles and Economic Indicators Before and After the Event
This study investigated the economic impact of hospital closures in non- metropolitan counties, taking into account the economic characteristics and employment trends that may have preceded the event.
Research center: North Carolina Rural Health Research and Policy Analysis Center
Topic: Hospitals and clinics
-
Rural Hospital Participation in the 340B Drug Discount Program
The 340B drug discount program enables certain types of safety net organizations to obtain deeply discounted medications, at prices below the 'best price' typically offered to Medicaid agencies. This study used telephone interviews and mail surveys to explore the experiences that rural hospitals have had in seeking 340B eligibility status.
Research centers: NORC Walsh Center for Rural Health Analysis, North Carolina Rural Health Research and Policy Analysis Center
Topics: Hospitals and clinics, Pharmacy and prescription drugs
-
Rural Medicaid and CHIP Mini-Studies
Medicaid and the Children's Health Insurance Program (CHIP) are important sources of health insurance coverage in rural communities and it is likely that the importance of Medicaid/CHIP will grow as job-based health insurance coverage continues to erode and policymakers pursue the goal of expanding coverage. This project is composed of three mini-studies that: 1) Update our State Profiles of Medicaid and CHIP in Rural and Urban Areas website, adding information on Medicaid Disproportionate Share Hospital (DSH) payments to rural hospitals; 2) Analyze trends in Medicaid/CHIP enrollment in rural and urban areas over the past two to three years; and 3) Explore the future role of CHIP given increasing levels of childhood poverty.
Research center: North Carolina Rural Health Research and Policy Analysis Center
Topics: Children and adolescents, Medicaid and CHIP
-
Rural Population and Providers: Mapping the 2000 Census
Research center: North Carolina Rural Health Research and Policy Analysis Center
Topics: Rural statistics and demographics, Workforce
-
State Facts about Medicaid: Rural Specific Data
This project will develop state-specific fact sheets which will include information on the groups covered (and income eligibility), structure of the state's SCHIP program, services covered, delivery system, some provider payment information for certain safety net providers, and percentage of the state's rural and urban population that are enrolled in Medicaid. Additional information comparing urban and rural areas of the state will be provided, when available. The rural and urban comparisons will include total numbers of Medicaid recipients, Medicaid expenditures, and enrollment in different types of managed care plans.
Research center: North Carolina Rural Health Research and Policy Analysis Center
Topics: Medicaid and CHIP, Rural statistics and demographics
-
Tracking the Implementation of Medicaid Managed Care in Rural Areas
Research center: North Carolina Rural Health Research and Policy Analysis Center
Topic: Medicaid and CHIP
-
Trends in Swing Bed and Skilled Nursing Facility Use in Rural Hospitals, 1996-2003
This study will examine trends in the distribution of skilled nursing facility (SNF) services in rural hospitals during a period of dramatic change in Medicare reimbursement, most notably the transition from cost-based reimbursement to SNF prospective payment system (PPS).
Research center: North Carolina Rural Health Research and Policy Analysis Center
Topics: Aging, Hospitals and clinics, Long-term care, Medicare Prospective Payment System (PPS)
-
Unmet Needs for Health Care Services: An Analysis of Children with Special Health Care Needs in Rural Areas
This project will study whether parents of children with special healthcare needs (CSHCNs) who live in rural areas are less likely to perceive the need for routine and specialty medical care than their metropolitan counterparts, and whether CSHCNs that live in rural areas face a greater risk of having unmet needs for healthcare services than their metropolitan counterparts.
Research center: North Carolina Rural Health Research and Policy Analysis Center
Topics: Children and adolescents, Disabilities, Health services, Oral health
Publications - (19)
2007
-
The Experience of Rural Independent Pharmacies With Medicare Part D: Reports From the Field
Journal Article
North Carolina Rural Health Research and Policy Analysis Center, RUPRI Center for Rural Health Policy Analysis
Date: 2007
Describes first-hand reports from rural pharmacist-owners about their experiences with Medicare Part D plans in the first 7 months of 2006 in order to gain a more thorough understanding of the challenges faced by rural independent pharmacies as a result of program implementation. -
Intensive Care in Critical Access Hospitals
Journal Article
North Carolina Rural Health Research and Policy Analysis Center
Date: 2007
Describes the facilities, equipment, and staffing used by Critical Access Hospitals (CAHs) for intensive care, the types of patients receiving ICU care, and the perceived impact of closing the ICU on CAH staff and the local community. -
Rural/Urban Differences in Barriers to and Burden of Care for Children With Special Health Care Needs
Journal Article
North Carolina Rural Health Research and Policy Analysis Center
Date: 2007
Examines the barriers and difficulties experienced by rural families of children with special healthcare needs in caring for their children. Covers rural-urban differences in types of providers used, reasons for unmet healthcare needs, insurance and financial difficulties encountered, and the family burden of providing the child's medical care. -
Variations in Financial Performance Among Peer Groups of Critical Access Hospitals
Journal Article
North Carolina Rural Health Research and Policy Analysis Center
Date: 2007
Reports findings from a study that investigated whether indicators of financial performance and condition systematically vary among peer groups of Critical Access Hospitals (CAHs).
2006
-
The Effect of Rural Hospital Closures on Community Economic Health
Journal Article
North Carolina Rural Health Research and Policy Analysis Center
Date: 04/2006
This article describes the effect of hospital closures on the local economies based on a study of county-level economic data for 1990-2000 in rural counties experiencing hospital closures. -
The Effect of Rural Residence On Dental Unmet Need for Children With Special Health Care Needs
Journal Article
North Carolina Rural Health Research and Policy Analysis Center
Date: 2006
Unmet need for dental care is the most prevalent unmet healthcare need among children with special healthcare needs (CSHCN). The combination of rural residence and special healthcare needs may leave rural CSHCN particularly vulnerable to high levels of unmet dental needs.
2005
-
The Effects of Rural Residence and Other Social Vulnerabilities on Subjective Measures of Unmet Need
Journal Article
North Carolina Rural Health Research and Policy Analysis Center
Date: 2005
Are self-reports of unmet need a biased measure of access to healthcare? We examined the relationship between rural residence and perceived need for physician services and the likelihood of reporting a need for routine preventive care and/or specialty care using data from the National Survey of Children with Special Health Care Needs. -
How Might the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 Affect the Financial Viability of Rural Pharmacies? An Analysis of Preimplementation Prescription Volume and Payment Sources in Rural and Urban Areas
Journal Article
North Carolina Rural Health Research and Policy Analysis Center
Date: 2005
Presents descriptive information on mail-order prescriptions, volume, and payer type of retail prescriptions in rural vs. urban areas. Together, these data provide a baseline for evaluating how implementation of the Medicare Prescription Drug, Improvement, and Modernization Act may affect the financial viability of rural independent pharmacies. -
Understanding the Impacts of the Medicare Modernization Act: Concerns of Congressional Staff
Journal Article
Maine Rural Health Research Center, RUPRI Center for Rural Health Policy Analysis, Upper Midwest Rural Health Research Center
Date: 2005
The most efficient mechanism for research to affect policy is to provide policy makers with information on issues about which they have voiced concern. The Rural Policy Research Institute's Health Panel conducted 2 focus groups with 16 congressional staff in 2004 to identify a set of researchable questions concerning rural healthcare.
2004
-
Comparative Performance Data for Critical Access Hospitals
Journal Article
Maine Rural Health Research Center, North Carolina Rural Health Research and Policy Analysis Center
Date: 2004
Discusses the potential use of comparative performance data for critical access hospitals (CPD-CAH) to facilitate performance and quality improvement. Covers potential benefits and drawbacks of CPD-CH and identifies issues in the development and implementation of CPD-CAH.
2003
-
An Assessment of Proposals for a Medicare Outpatient Prescription Drug Benefit: The Rural Perspective
RUPRI Center for Rural Health Policy Analysis
Date: 01/2003
This policy paper assesses legislative proposals to add an outpatient prescription drug benefit to the Medicare program and their implications for the delivery of services and the welfare of beneficiaries in rural areas.
2002
-
Tracking Medicaid Managed Care in Rural Communities: A Fifty-State Follow-Up
Journal Article
North Carolina Rural Health Research and Policy Analysis Center
Date: 08/2002
This article updates a 1997 study examining implementation of rural Medicaid-managed care programs.
2001
-
Comments on the June 2001 Report of the Medicare Payment Advisory Commission: Medicare in Rural America
RUPRI Center for Rural Health Policy Analysis
Date: 09/2001
This paper comments on and critiques the findings in MedPAC's Medicare in Rural America. -
Redesigning Medicare: Considerations for Rural Beneficiaries and Health Systems
RUPRI Center for Rural Health Policy Analysis
Date: 02/2001
This book provides a framework to help shape proposals to redesign Medicare to the benefit of rural beneficiaries and providers. Chapters focus on quality, choice, access, and cost.
2000
-
The Area Wage Index of the Medicare Inpatient Hospital Prospective Payment System: Perspectives, Policies, and Choices
RUPRI Center for Rural Health Policy Analysis
Date: 08/2000
This policy paper summarizes the positions of various rural health advocates and records the actions taken by Congress and the Health Care Financing Administration to improve the wage index. Finally, it outlines the research needed to energize the policy discussion of the uses and methods of calculating the hospital wage index. -
Designing a Prescription Drug Benefit for Rural Medicare Beneficiaries: Principles, Criteria, and Assessment
Maine Rural Health Research Center, RUPRI Center for Rural Health Policy Analysis
Date: 08/2000
This paper offers a rural perspective on the debate about the design/implementation of a Medicare prescription drug benefit. Background information on rural Medicare beneficiaries' need for, and access to, prescription drugs is provided, along with a set of rural-oriented principles for use in evaluating how various proposals may meet rural needs. -
Redesigning the Medicare Program: An Opportunity to Improve Rural Health Care Systems?
RUPRI Center for Rural Health Policy Analysis
Date: 08/2000
With this paper, the RUPRI Rural Health Panel is presenting a well-defined framework for what should be included in any discussion of Medicare policies. -
Improving Prescription Drug Coverage for Rural Medicare Beneficiaries: Key Rural Considerations and Objectives for Legislative Proposals
Maine Rural Health Research Center, RUPRI Center for Rural Health Policy Analysis
Date: 06/2000
This policy paper combines the work from current projects of the Maine Rural Health Research Center and the Rural Health Panel of the Rural Policy Research Institute to provide a statement of specific rural considerations and objectives for any proposal that would add a prescription drug benefit to the Medicare program. -
A Rural Assessment of Leading Proposals to Redesign the Medicare Program
RUPRI Center for Rural Health Policy Analysis
Date: 05/2000
This paper provides a critique of two proposals to redesign the Medicare program: the "Medicare Preservation and Improvement Act of 1999" and "The President's Plan to Modernize and Strengthen Medicare for the 21st Century." Rural implications of the proposals are discussed.