Health services

Current Projects

• Access to and Provision of Child and Youth Behavioral Health Services in the Rural and Urban U.S.
  The need for behavioral health treatment for youth has been exacerbated by the COVID-19 pandemic. Little is known about the availability of youth behavioral health providers in rural areas. This study will investigate who provides behavioral health services to youth, how the workforce is distributed, and gaps in service availability.
  Research center: WWAMI Rural Health Research Center
  Topics: Allied health professionals, Children and adolescents, Health services, Healthcare access, Mental and behavioral health, Nurses and nurse practitioners, Pharmacy and prescription drugs, Physician assistants, Physicians, Substance use and treatment, Workforce
  
• Assessing Access to Medication Treatment for Opioid Use Disorder in Rural Communities Influenced by the Rural Communities Opioid Response Program (RCORP)
  This project will use national prescription claims data to compare access to buprenorphine treatment for opioid use disorder in rural counties with and without Rural Communities Opioid Response Program (RCORP) funding and urban counties. An accurate understanding of access to buprenorphine treatment is essential for determining the influence of RCORP funding on a critical strategy for curbing the opioid epidemic.
  Research center: WWAMI Rural Health Research Center
  Topics: Health services, Healthcare access, Mental and behavioral health, Pharmacy and prescription drugs, Substance use and treatment, Workforce
  
• Availability, Care Practices, and Quality of Hospice Providers Serving Rural versus Urban Communities
  This project will examine differences in availability of hospice care in rural versus urban communities as well as provider-level quality and care practices by rural-urban status of hospices. Findings will highlight potential rural-urban disparities in hospice care that can be used to inform future Medicare policy.
  Research center: WWAMI Rural Health Research Center
  Topics: Aging, Coronavirus Disease 2019 (COVID-19), Health services, Healthcare access, Hospice and palliative care, Medicare, Quality
  
• Causal Effect of Nursing Home Closure on Resident Outcomes in Rural Areas
  We will evaluate the causal impact of nursing home closure on two key outcomes: distance to the transitioned nursing home, and resident physical and mental health outcomes. We will compare the effect of closures on outcomes for rural and urban areas using resident-level data from 2010-2019 and advanced difference-in-differences regression methods.
  Research center: RUPRI Center for Rural Health Policy Analysis
  Topics: Aging, Health services, Healthcare access, Long-term care, Post-acute care, Quality
  
• 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 services, Healthcare access, Healthcare financing, Home health, Medicare, Medicare Advantage (MA), Post-acute care, Quality
  
• Dentist Supply, Dental Care Utilization, and Oral Health Among Rural and Urban U.S. Residents: Exploring Changes in the Past 15 Years
  This project will describe the national supply of the rural and urban dental workforce and investigate whether rural adults, compared to urban adults, report lower dental care utilization, higher prevalence of dental disease or both. This study will also look at whether disparities in oral health care and supply have changed over the past 15 years.
  Research center: WWAMI Rural Health Research Center
  Topics: Allied health professionals, Health services, Healthcare access, Oral health, Workforce
  
• Hierarchical Condition Category (HCC) Risk Scores: Designed to Predict Future Cost and Health Care Resource Use – Do They Also Accurately Reflect Differences in Health Status between Rural and Urban Beneficiaries?
  This CMS Hierarchical Condition Category (CMS-HCC) risk score study will investigate differences in underlying health between rural and urban populations using recent data and analyze which factors drive observed differences.
  Research center: ETSU/NORC Rural Health Research Center
  Topics: Health services, Healthcare access, Hospitals and clinics, Medicaid and CHIP, Medicare, Medicare Advantage (MA)
  
• Medical and Mental Health Service Provision Amongst Rural Health Clinics
  This study will provide a descriptive analysis of differences in Rural Health Clinic (RHC) type, clinic size, and geographic location of RHCs providing same day medical and mental health visits, compared to RHCs that are only providing one or the other type of visits on the same day.
  Research center: Maine Rural Health Research Center
  Topics: Health services, Mental and behavioral health, Rural Health Clinics (RHCs)
  
• Non-Metropolitan/Metropolitan Differences in Barriers to Care and Utilization of Preventive Care and Wellness Visits Among Traditional Medicare and Medicare Advantage
  This project proposes to use the Medicare Current Beneficiaries Survey to examine differences across geography and plan type (Medicare Advantage vs. traditional) with regards to barriers to care (e.g., costs) and use of preventive services (e.g., flu shot).
  Research center: RUPRI Center for Rural Health Policy Analysis
  Topics: Health services, Healthcare access, Medicare Advantage (MA)
  
• Retention and Expansion of Hospital Services Offered by Rural Hospitals After Enrollment in 340B
  The 340B Federal program is designed to provide hospitals with financial stability through provision of drug discounts which may, in turn, allow hospitals to maintain or expand their service line offerings. Using a series of event study analyses over an 11-year period, this study will examine the impact of enrollment in the 340B program on discontinuing services, maintaining services, and adding new services in eligible rural hospitals.
  Research center: RUPRI Center for Rural Health Policy Analysis
  Topics: Critical Access Hospitals (CAHs), Health services, Hospitals and clinics, Pharmacy and prescription drugs
  
• Rural and Urban Medical School Programs that Demonstrate a Commitment to Producing Rural Physicians
  Studies of individual medical schools have identified characteristics associated with working in rural areas, but little is known about which organizational factors are the most significant predictors of rural practice. This project will examine characteristics of medical schools' missions and organizational commitments to promote physician practice in rural communities.
  Research center: WWAMI Rural Health Research Center
  Topics: Health services, Healthcare access, Physicians, Workforce
  
• Rural-Urban Differences in Medicare Advantage Plan Quality Scores
  This project updates previous RUPRI Center publications focused on rural-urban differences in access to, and enrollment in, Medicare Advantage plans with four- and five-star quality ratings.
  Research center: RUPRI Center for Rural Health Policy Analysis
  Topics: Health services, Healthcare financing, Medicare, Medicare Advantage (MA)
  
• Specialist Physicians in the Rural and Urban U.S.: Supply, Distribution, and Access
  This project will describe the geographic distribution (rural/urban, regional, and intra-rural) of specialist physicians who care for patients experiencing conditions that account for the top four leading causes of rural mortality. It will also explore how patients in rural communities that lack these specialists obtain needed care.
  Research center: WWAMI Rural Health Research Center
  Topics: Cancer, Care management, Chronic diseases and conditions, Frontier health, Health services, Healthcare access, Physicians, Social determinants of health, Telehealth, Workforce
  
• The Emerging Landscape of Rural Family Medicine Residency Training: Defining Models and Assessing Their Value
  Rural residency training options for family physicians are growing, as is the evidence for rural training in promoting rural practice choice. This study aims to use a new classification of six residency program types to describe and quantify programs and positions by type and compare relative effectiveness in producing rural physicians.
  Research center: WWAMI Rural Health Research Center
  Topics: Health services, Healthcare access, Physicians, Workforce
  
• The Impact of Rural Surgery Training on General Surgeon Supply in Rural Communities
  A growing number of general surgery programs offer rural training that aims to address the dwindling supply of rural surgeons. This study aims to describe program models for providing rural general surgery training; quantify the availability of programs; and compare the models' effectiveness in producing rural surgeons.
  Research center: WWAMI Rural Health Research Center
  Topics: Health services, Healthcare access, Physicians, Workforce
  
• Treatment, Provider, and Cost Differences for Rural and Urban Patients with Opioid Use Disorder Across the U.S.
  This study describes and compares the treatment that rural and urban patients with opioid use disorder (OUD) receive, documenting the workforce providing care, distance that patients travel to receive care, and cost of care. Findings will inform policies to ensure that rural patients with OUD have access to care from local healthcare providers.
  Research center: WWAMI Rural Health Research Center
  Topics: Health services, Healthcare access, Healthcare financing, Mental and behavioral health, Nurses and nurse practitioners, Pharmacy and prescription drugs, Physician assistants, Physicians, Substance use and treatment, Telehealth
  
• Treatment, Provider, and Cost Differences for Rural and Urban Patients with Opioid Use Disorder and Medicaid Insurance Across the U.S.
  This project will analyze Medicaid claims data to compare the treatment that rural and urban patients with opioid use disorder receive, documenting the workforce providing care, the distance that patients travel to receive care, and the cost of care. Findings from this study can be used to improve policies regarding opioid use disorder treatment.
  Research center: WWAMI Rural Health Research Center
  Topics: Health services, Healthcare access, Healthcare financing, Legislation and regulation, Medicaid and CHIP, Mental and behavioral health, Nurses and nurse practitioners, Pharmacy and prescription drugs, Physician assistants, Physicians, Substance use and treatment, Telehealth, Workforce
  
• Understanding Rural Health Clinic Services, Use, and Reimbursement
  This study describes the scope and intensity of services provided to Medicare beneficiaries by independent and provider-based Rural Health Clinics. It will also assess the adequacy of the Centers for Medicare & Medicaid Services' changes to the outpatient evaluation and management codes in 2021 compared to the 2021 per-visit reimbursement cap.
  Research center: Maine Rural Health Research Center
  Topics: Health services, Healthcare financing, Hospitals and clinics, Medicare, Rural Health Clinics (RHCs)
  
• Use of Home and Community Based Services by Medicare Beneficiaries
  Using the Medicare Current Beneficiary Survey, we will examine rural-urban differences in the need for long term services and supports, rates of home and community-based services (HCBS) use, the use of different types of HCBS, and the impact of HCBS on subsequent use of emergent services such as hospitalizations and emergency department visits.
  Research center: Maine Rural Health Research Center
  Topics: Aging, Health services, Home health, Long-term care, Medicare