Rural Health
Research Gateway

Healthcare financing

Research Products & Journal Articles

Browse the full list of research publications on this topic completed by the Rural Health Research Centers.

Products – Freely accessible products include policy briefs, fact sheets, full reports, chartbooks, and interactive data websites.

Journal Articles – Articles in peer-reviewed journals may require a subscription or affiliation with a subscribing library. For these publications, Gateway lists the article citation, a brief summary, a link to additional information and access to the full-text of the article, if available.

2024

  • Understanding the Impact of Medical Debt in Rural Communities: Perspectives From Rural Hospital Administrators
    Policy Brief
    University of Minnesota Rural Health Research Center
    Date: 11/2024
    This policy brief presents findings from key informant interviews with nine administrators representing rural hospitals in seven states. Using content analysis of interview data, researchers share findings around hospital and community-level implications of medical debt, and policies that may help or hinder this issue.
  • News Media Coverage of Rural Hospital Closures and the Causes
    Policy Brief
    North Carolina Rural Health Research and Policy Analysis Center, Rapid Response to Requests for Rural Data Analysis
    Date: 10/2024
    This study augments previous research with findings from a structured framework of attributed causes of rural hospital closures through the analysis of news media reports.
  • An Updated Model of Rural Hospital Financial Distress
    Journal Article
    North Carolina Rural Health Research and Policy Analysis Center
    Date: 10/2024
    In fall 2024, the North Carolina Rural Health Research Program completed a study modeling financial distress among rural hospitals, "An Updated Model of Rural Hospital Financial Distress." The model updates a 2016 version, by adding recent changes in the operating environment.
  • Financial Performance of Rural and Urban Hospitals in the Medicare Shared Savings Program
    Policy Brief
    RUPRI Center for Rural Health Policy Analysis
    Date: 09/2024
    This brief presents financial performance trends of hospitals who participated in Medicare's Shared Savings Program (SSP) from 2011 to 2018. Trends in six financial outcomes are compared between SSP and non-SSP hospitals over time and between rural and urban hospitals.
  • Profiling Social Needs Activities in Publicly Traded Medicare Advantage Organizations
    Journal Article
    RUPRI Center for Rural Health Policy Analysis
    Date: 08/2024
    This article reviews how six major Medicare Advantage (MA) companies address social determinants of health (SDOH) through supplemental benefits. It analyzes public reports, highlighting MA growth, SDOH activities, and plan initiatives.
  • The Low-Volume Hospital Adjustment Before and During COVID-19
    Policy Brief
    North Carolina Rural Health Research and Policy Analysis Center
    Date: 07/2024
    This brief uses current low-volume hospital adjustment qualifying criteria to compare low-volume hospitals to other rural hospitals and explores the effect of removing the adjustment before COVID-19 and during COVID.
  • 2018-23 Profitability of Rural Hospitals by Ownership and System Affiliation
    Policy Brief
    North Carolina Rural Health Research and Policy Analysis Center, Rapid Response to Requests for Rural Data Analysis
    Date: 06/2024
    This study compares the 2018-23 profitability of rural hospitals based on ownership and system affiliation status. The purpose of this brief is to describe the profitability of rural hospitals over a five-year period consisting of two years before and three years after COVID-19.
  • 2018-23 Profitability of Rural Hospitals by With and Without Rural Health Clinics and Long-Term Care
    Policy Brief
    North Carolina Rural Health Research and Policy Analysis Center, Rapid Response to Requests for Rural Data Analysis
    Date: 06/2024
    This study compares the 2018-23 profitability of rural hospitals for hospitals that provide and do not provide long-term care, and that operate and do not operate rural health clinics.
  • 2018‐23 Profitability of Rural and Urban Hospitals by Medicare Payment Designation
    Policy Brief
    North Carolina Rural Health Research and Policy Analysis Center, Rapid Response to Requests for Rural Data Analysis
    Date: 06/2024
    This study compares profitability of three types of hospitals in both urban and rural locations: Critical Access Hospitals, Prospective Payment System-only (PPS) hospitals by number of acute beds, and PPS hospitals with special payment designations hospitals over a five-year period.
  • Using the Updated Financial Distress Index to Describe Relative Risk of Hospital Financial Distress
    Policy Brief
    North Carolina Rural Health Research and Policy Analysis Center
    Date: 04/2024
    Using a recent revision of the Financial Distress Index (FDI) model, this study aimed to describe the relative risk of experiencing financial distress for rural hospitals and selected urban hospitals.
  • COVID-19 Affected Rural and Urban Hospital Uncompensated Care
    Fact Sheet
    North Carolina Rural Health Research and Policy Analysis Center
    Date: 03/2024
    The purpose of this infographic is to illustrate the impact COVID-19 had on uncompensated care and operating margin among rural and urban hospitals.
  • A Comparison of 2017-19 Uncompensated Care of Rural and Urban Hospitals by Net Patient Revenue, System Affiliation, and Ownership
    Policy Brief
    North Carolina Rural Health Research and Policy Analysis Center
    Date: 01/2024
    The purpose of this study is to better understand patterns of uncompensated care. It extends a 2018 study of geographic variation in uncompensated care between rural and urban hospitals. Specifically, researchers investigate the association of uncompensated care with net patient revenue, system affiliation, and ownership.

2023

2022

  • Community Sociodemographics and Rural Hospital Survival
    Journal Article
    Center for Economic Analysis of Rural Health
    Date: 12/2022
    This study examines whether community sociodemographic factors are associated with the survival or closure of rural hospitals at risk of financial distress between 2010 and 2019.
  • Factors Predicting Swing Bed Versus Skilled Nursing Facility Use
    Policy Brief
    North Carolina Rural Health Research and Policy Analysis Center
    Date: 10/2022
    This study examines differences between patients discharged to swing beds versus skilled nursing facilities, stratifying by admitting hospital type (i.e., rural Critical Access Hospital versus rural Prospective Payment System hospital).
  • The Impact of Medicare Shared Savings Program Participation on Hospital Financial Performance: An Event-Study Analysis
    Journal Article
    RUPRI Center for Rural Health Policy Analysis
    Date: 10/2022
    This study evaluated the extent to which Medicare Shared Savings Program participation affected hospital financial outcomes, including patient revenue, operating margin, different revenue source shares, and allowance and discount rate.
  • Higher Electronic Health Record Functionality Is Associated With Lower Operating Costs in Urban—but Not Rural—Hospitals
    Journal Article
    Center for Economic Analysis of Rural Health
    Date: 07/2022
    This study examines the relationship between electronic health record use/functionality and hospital operating costs and compares the results across rural and urban facilities.
  • Nursing Homes in Rural America: A Chartbook
    Chartbook
    RUPRI Center for Rural Health Policy Analysis
    Date: 07/2022
    Closure of nursing homes and hospitals with swing beds in recent years has changed the availability of post-acute and long-term care services in rural areas. This study examines the availability of post-acute and long-term care services as well as characteristics of residents and nursing homes in noncore, micropolitan, and metropolitan counties.
  • Types of Rural and Urban Hospitals and Counties Where They Are Located
    Policy Brief
    North Carolina Rural Health Research and Policy Analysis Center, Rapid Response to Requests for Rural Data Analysis
    Date: 07/2022
    The purpose of this brief is to provide a snapshot of the types of rural and urban hospitals and the counties where they are located.
  • Trends in Revenue Sources Among Rural Hospitals
    Policy Brief
    North Carolina Rural Health Research and Policy Analysis Center
    Date: 05/2022
    Possible issues with existing rural hospital financing models suggest that outpatient-centric payment methods may be more effective in providing financial relief to rural hospitals. Given this, we explored the financial importance of outpatient care to rural hospitals by estimating changes in outpatient care as a source of revenue.
  • Predictors of Hospital Choice Among Rural Patients Seeking Elective Surgery: A Scoping Review
    Policy Brief
    North Carolina Rural Health Research and Policy Analysis Center, Rapid Response to Requests for Rural Data Analysis
    Date: 04/2022
    The purpose of this scoping review was to identify literature describing determinants of hospital choice among rural patients seeking elective surgery.
  • The Economic Effects of Rural Hospital Closures
    Journal Article
    North Carolina Rural Health Research and Policy Analysis Center
    Date: 03/2022
    This study updates previous research (Holmes, et al. 2006) on the economic effects of rural hospital closures by measuring the economic changes over time among U.S. rural counties that had a hospital closure from 2001-2018.
  • Rural Hospital Administrators' Beliefs About Safety, Financial Viability, and Community Need for Offering Obstetric Care
    Journal Article
    University of Minnesota Rural Health Research Center
    Date: 03/2022
    This study offers results from a national survey of a sample of 292 rural hospitals that provided obstetric services in 2021. Obstetric unit administrators shared about their experiences, the challenges they face, and the decisions that factor into providing labor and birth care for their rural communities.
  • Rural Hospital Profitability During the Global COVID-19 Pandemic Requires Careful Interpretation
    Policy Brief
    North Carolina Rural Health Research and Policy Analysis Center, Rapid Response to Requests for Rural Data Analysis
    Date: 03/2022
    Many small rural hospitals struggle with profitability compared to their urban counterparts. The findings brief describes the pre-pandemic (2011-19) trend of rural hospital profitability and explains why possible increases in reported profitability during the pandemic (2020-21) may mask the long-term financial challenges of rural hospitals.

2021

2020

2019

  • 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.
  • Rural Health Clinic Costs and Medicare Reimbursement
    Policy Brief
    Maine Rural Health Research Center
    Date: 11/2019
    We used cost report data to examine Rural Health Clinic (RHC) services costs. The findings support the National Advisory Committee on Rural Health & Human Service's conclusion that the cost-based methodology used to determine Medicare reimbursement for RHCs is outdated and RHCs subject to the reimbursement cap are paid less than their costs.
  • 2019 Wage Index Differences and Selected Characteristics of Rural and Urban Hospitals
    Policy Brief
    Rapid Response to Requests for Rural Data Analysis
    Date: 05/2019
    This brief characterizes rural/urban disparities in the 2019 Centers for Medicare & Medicaid Services hospital wage index by describing and comparing the wage indices of rural and urban hospitals by the number of beds, the amount of net patient revenue, and Medicare payment classification.
  • Rural/Urban and Regional Variation in the 2019 CMS Hospital Wage Index
    Policy Brief
    Rapid Response to Requests for Rural Data Analysis
    Date: 05/2019
    This brief describes the geographic variation of the 2019 Centers for Medicare & Medicaid Services hospital wage index by rural/urban definition, census region, Frontier and Remote Area codes and state.
  • Characteristics of Communities Served by Rural Hospitals Predicted to Be at High Risk of Financial Distress in 2019
    Policy Brief
    Rapid Response to Requests for Rural Data Analysis
    Date: 04/2019
    This brief compares characteristics of communities served by rural hospitals predicted to be at high risk of financial distress to those served by rural hospitals predicted to not be at high risk of financial distress in 2019.
  • Geographic Variation in the 2019 Risk of Financial Distress Among Rural Hospitals
    Policy Brief
    Rapid Response to Requests for Rural Data Analysis
    Date: 04/2019
    This brief investigates 2019 geographic variation in risk of financial distress among rural hospitals.
  • Primary Care Clinician Participation in the CMS Quality Payment
    Policy Brief
    RUPRI Center for Rural Health Policy Analysis
    Date: 04/2019
    Approximately 10% of primary care clinicians participate in Advanced Alternative Payment Models (A-APMs) and less than 30% of primary care clinicians participate in the Merit-Based Incentive Payment System. Metropolitan primary care clinicians are more likely to participate in A-APMs than nonmetropolitan primary care clinicians.
  • Trends in Risk of Financial Distress Among Rural Hospitals, 2015 to 2019
    Policy Brief
    Rapid Response to Requests for Rural Data Analysis
    Date: 04/2019
    This brief investigates 2015 to 2019 trends in risk of financial distress among rural hospitals by census region and Medicare payment classification.
  • Do Hospital Closures Affect Patient Time in an Ambulance?
    Policy Brief
    Rural and Underserved Health Research Center
    Date: 02/2019
    Our study explores how a local hospital closure changes patient time in an ambulance for 9-1-1 calls. Access to emergency department services in communities, especially rural communities, persists as a priority for the Medicare program. We found when hospitals close, rural patients requiring ambulance services are disproportionately affected.

2018

  • Changes to the Merit-Based Incentive Payment System Pertinent to Small and Rural Practices, 2018
    Policy Brief
    RUPRI Center for Rural Health Policy Analysis
    Date: 11/2018
    This policy brief highlights key regulatory changes to the Merit-based Incentive Payment System that occurred in 2018. It discusses the implications of these changes with an emphasis on how these changes may affect small and rural practices.
  • Spread of Medicare Accountable Care Organizations in Rural America
    Policy Brief
    RUPRI Center for Rural Health Policy Analysis
    Date: 08/2018
    This policy brief describes Medicare accountable care organization (ACO) growth in non-metropolitan U.S. counties from 2016 to 2017. This brief, which includes data through December 2017, follows a similar analysis released in October 2016 that described ACO trends from 2013 to 2015.
  • Average Beneficiary CMS Hierarchical Condition Category (HCC) Risk Scores for Rural and Urban Providers
    Policy Brief
    North Carolina Rural Health Research and Policy Analysis Center
    Date: 07/2018
    This brief investigates potential differences in urban and rural Centers for Medicare & Medicaid Services (CMS) hierarchical condition category (HCC) risk scores at the provider's patient panel level.
  • Geographic Variation in Uncompensated Care Between Rural and Urban Hospitals
    Policy Brief
    North Carolina Rural Health Research and Policy Analysis Center
    Date: 06/2018
    The purpose of this brief is to compare uncompensated care in rural and urban hospitals and to describe how it varies across regions of the country.
  • Geographic Variation in the 2016 Profitability of Urban and Rural Hospitals
    Policy Brief
    North Carolina Rural Health Research and Policy Analysis Center
    Date: 03/2018
    This study describes the geographic variation in 2016 profitability of critical access hospitals (CAHs), other rural hospitals (Medicare Dependent Hospitals, Sole Community Hospitals, and rural Prospective Payment System (PPS) hospitals denoted as "ORH"), and urban PPS hospitals by census region, census division, and state.
  • Medicare Accountable Care Organization Growth in Rural America, 2014-2016
    Policy Brief
    RUPRI Center for Rural Health Policy Analysis
    Date: 03/2018
    This RUPRI Center data report describes Medicare accountable care organization (ACO) growth in non-metropolitan U.S. counties from 2014 to 2016. ACOs are the most widespread of the Centers for Medicare & Medicaid Services (CMS) value-based payment programs and demonstrations.
  • Rural Family Physicians Have a Broader Scope of Practice Than Urban Family Physicians
    Policy Brief
    Rural and Underserved Health Research Center
    Date: 02/2018
    While the scope of practice of family physicians has been shrinking, they still practice broadly, often due to fewer health care resources in rural areas. Using data from family physicians seeking continued board certification in 2014 and 2015, we found that a high percentage of rural family physicians provide nearly every clinical service queried.
  • Rural Family Physicians in Patient Centered Medical Homes Have a Broader Scope of Practice
    Policy Brief
    Rural and Underserved Health Research Center
    Date: 02/2018
    The Patient Centered Medical Home (PCMH) is supposed to provide accessible and comprehensive care. Using data from family physicians seeking to continue their American Board of Family Medicine certification in 2014 and 2015, we found that rural family physicians in PCMH practices generally provide more services than those in non-PCMH practices.

2017

  • Distribution of Disproportionate Share Hospital Payments to Rural and Critical Access Hospitals
    Policy Brief
    RUPRI Center for Rural Health Policy Analysis
    Date: 11/2017
    This policy brief provides information about the potential impact of scheduled changes in Medicaid Disproportionate Share Hospital (DSH) payment on hospitals in 47 states. We expect variation across states, because of differences in state policies allocating DSH payments, as well as geographic variation by census region.
  • Ambulance Services for Medicare Beneficiaries: State Differences in Usage, 2012-2014
    Policy Brief
    Rural and Underserved Health Research Center
    Date: 10/2017
    Ambulance services are at risk of scaling back or dissolving in some places. We analyzed Medicare beneficiaries' use of ambulance services across the U.S. Improved understanding of how beneficiaries, most of whom are elderly, use these services provides vital information for policymakers who set rules and regulations about access to the services.
  • Predicting Financial Distress and Closure in Rural Hospitals
    Journal Article
    North Carolina Rural Health Research and Policy Analysis Center
    Date: 06/2017
    Examines the financial distress of rural hospitals to better predict closures within two years.

2016

  • How Would Rural Hospitals Be Affected by Loss of the Affordable Care Act's Medicare Low-Volume Hospital Adjustment?
    Journal Article
    North Carolina Rural Health Research and Policy Analysis Center
    Date: 11/2016
    Using data from the Hospital Market Service Area File, the Hospital Cost Report Information System, and Nielsen-Claritas Pop-Facts, this study examined the effect the low-volume hospital payment adjustment has on a hospital's finances. It also looked at the effects of losing the payment adjustment.
  • The Financial Importance of the Sole Community Hospital Payment Designation
    Policy Brief
    North Carolina Rural Health Research and Policy Analysis Center
    Date: 11/2016
    Assesses the financial importance of the Sole Community Hospital (SCH) program by: the proportion of SCHs that was reimbursed at the hospital specific rate between 2006 and 2015; the profitability of providing services to Medicare patients in SCHs between 2006 and 2015, and; the financial consequences if the SCH program had not existed in 2015.
  • To What Extent Do Community Characteristics Explain Differences in Closure Among Financially Distressed Rural Hospitals?
    Journal Article
    North Carolina Rural Health Research and Policy Analysis Center
    Date: 11/2016
    This study examined the differences between rural hospitals at high risk of financial distress that stayed open and those that closed.
  • Spread of Accountable Care Organizations in Rural America
    Policy Brief
    RUPRI Center for Rural Health Policy Analysis
    Date: 10/2016
    This brief updates a RUPRI Center analysis of the presence of Medicare Accountable Care Organizations (ACOs) in rural areas of the US in 2013. Using participation data through 2015, the current brief finds that there has been broad growth in the number of places where ACO participating providers can be found, including rural locations.
  • The Impact of the Low Volume Hospital (LVH) Program on the Viability of Small, Rural Hospitals
    Policy Brief
    North Carolina Rural Health Research and Policy Analysis Center
    Date: 10/2016
    This brief compares rural Low Volume Hospital (LVH) to non-LVH characteristics and estimates the financial impact of eliminating the LVH program and reverting to the original (2005) LVH classification and payment adjustment.
  • Trends in Risk of Financial Distress Among Rural Hospitals
    Policy Brief
    North Carolina Rural Health Research and Policy Analysis Center
    Date: 10/2016
    From January 2005 to July 2016, 118 rural hospitals have closed permanently, and the rate of rural hospital closures is increasing. Hospital closures impact millions of rural residents. Identifying hospitals at high risk of closure and assessing the trends over time may inform strategies to prevent or mitigate the effects of closures.
  • Financial Performance of Rural Medicare ACOs
    Journal Article
    RUPRI Center for Rural Health Policy Analysis
    Date: 08/2016
    Assesses the financial performances of rural accountable care organizations (ACOs) based on different levels of rural presence.
  • Does ACA Insurance Coverage Expansion Improve the Financial Performance of Rural Hospitals?
    Policy Brief
    North Carolina Rural Health Research and Policy Analysis Center
    Date: 04/2016
    Views on how the implementation of the Affordable Care Act's (ACA) expanded insurance coverage is affecting the financial performance of rural hospitals. The study found that while respondents believe the expanded insurance coverage was the right thing to do for patients, they worried coverage may not be adequate to ensure access to care.
  • 2012-14 Profitability of Urban and Rural Hospitals by Medicare Payment Classification
    Policy Brief
    North Carolina Rural Health Research and Policy Analysis Center
    Date: 03/2016
    The profitability of urban hospitals to that of rural hospitals are compared for fiscal years 2012-2014 based on size and rural Medicare payment classifications.
  • Geographic Variation in the Profitability of Urban and Rural Hospitals
    Policy Brief
    North Carolina Rural Health Research and Policy Analysis Center
    Date: 03/2016
    Historic and recent evidence suggest that unprofitability can reduce hospital services and quality, or worse, lead to closure. This study describes the current geographic variability of hospital profitability by comparing the 2014 profitability of CAHs, other rural hospitals, and urban hospitals by census region, census division, and state.
  • Access to Rural Home Health Services: Views From the Field
    Report
    WWAMI Rural Health Research Center
    Date: 02/2016
    Access to home health care can be challenging for rural Medicare clients. Key informants for this study detailed obstacles, including financial, regulatory, workforce, and geographic issues. Rural communities will likely benefit from payment reforms that reward quality services while providing incentives to use best practices in home health care.
  • Geographic Variation in Risk of Financial Distress Among Rural Hospitals
    Policy Brief
    North Carolina Rural Health Research and Policy Analysis Center
    Date: 01/2016
    From 2005 to 2015, 112 rural hospital closures have been identified. The closures impact millions of rural residents. This brief describes the geographic variation in the proportion of rural hospitals forecasted to be at high risk of distress in 2015.
  • Prediction of Financial Distress Among Rural Hospitals
    Policy Brief
    North Carolina Rural Health Research and Policy Analysis Center
    Date: 01/2016
    From 2005 to 2015, more than 100 rural hospitals have closed their doors to patients in need of inpatient services. To understand factors affecting rural hospital financial distress and to develop an early warning system to identify hospitals at risk, the North Carolina Rural Health Research Program developed the Financial Distress Index.

2015

  • Estimated Costs of Rural Freestanding Emergency Departments
    Policy Brief
    North Carolina Rural Health Research and Policy Analysis Center
    Date: 11/2015
    A rural freestanding emergency department (RFED) is one potential model for providing emergency services in areas where hospitals have closed. The North Carolina Rural Health Research Program's Findings Brief, Estimated Costs of Rural Freestanding Emergency Departments explains the RFED concept and estimates RFED costs in three scenarios.
  • Medicare Value-Based Payment Reform: Priorities for Transforming Rural Health Systems
    Report
    RUPRI Health Panel: Rural Policy Analysis and Applications
    Date: 11/2015
    As Medicare moves to value-based payment, healthcare groups are made more accountable for patient health. But the changes have been concentrated in urban areas. Policies meant to strengthen rural health systems are complicating payment and delivery system reform in rural areas. This study examines ways to include rural areas in the changes.
  • Rural Enrollment in Health Insurance Marketplaces, by State
    Policy Brief
    RUPRI Center for Rural Health Policy Analysis
    Date: 10/2015
    This brief compares cumulative enrollment totals in Health Insurance Marketplaces in metropolitan and non-metropolitan areas by state and the percentages of potential market participants enrolled. Non-metropolitan enrollment rates were higher in several states. The analysis shows how well outreach/enrollment efforts targeting rural areas work.
  • 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.
  • Health Insurance Marketplaces: Early Findings on Changes in Plan Availability and Premiums in Rural Places, 2014-2015
    Policy Brief
    RUPRI Center for Rural Health Policy Analysis
    Date: 05/2015
    Analysis of national county-level Health Insurance Marketplace (HIM) plan data for 2014 and 2015 shows there is no systematic pattern to rural experiences of HIMs, although some isolated places may be at risk for weak outcomes.
  • Developmental Strategies and Challenges for Rural Accountable Care Organizations
    Policy Brief
    RUPRI Center for Rural Health Policy Analysis
    Date: 02/2015
    This brief offers insights into the initial strategic decisions and challenges of four accountable care organizations (ACOs) with rural presences. These ACOs were formed as a step toward a value-driven rural delivery system. While several challenges need to be addressed, these insights can inform development of other rural ACOs.

2013

  • Assessing the Impact of Rural Provider Service Mix on the Primary Care Incentive Payment Program
    RUPRI Center for Rural Health Policy Analysis
    Date: 12/2013
    Under the Primary Care Incentive Payment Program (PCIP), if certain evaluation and management services represented 60% or more of Medicare allowable charges, the provider qualified for a 10% bonus calculated on the primary care portion of allowable charges. This brief assesses the impact of the rural provider service mix on the PCIP.
  • Provision of Uncompensated Care by Rural Hospitals: A Preliminary Look at Medicare Cost Report Worksheet S-10
    Policy Brief
    North Carolina Rural Health Research and Policy Analysis Center
    Date: 08/2013
    This brief is a preliminary assessment of uncompensated care data quality included in Medicare Cost Report Worksheet S-10 for critical access hospitals and other rural hospitals to identify data quality issue implications for research and policy decisions. Worksheet S-10 data were collected from the Healthcare Cost Reporting Information System.
  • Are Primary Care Practices Ready to Become Patient-Centered Medical Homes?
    Journal Article
    RUPRI Center for Rural Health Policy Analysis
    Date: 2013
    Measures the readiness of rural primary care practices to be eligible as patient-centered medical homes (PCMHs) by comparing PCMH readiness scores with metropolitan and nonmetropolitan primary care practices.

2011

  • The High Performance Rural Health Care System of the Future
    RUPRI Health Panel: Rural Policy Analysis and Applications
    Date: 09/2011
    This project describes a future rural system that would be built on foundations of affordability, accessibility, community focus, high quality, and patient centeredness.

2009

  • A Case Study of Rural Health Care in the Economic Downturn
    North Carolina Rural Health Research and Policy Analysis Center
    Date: 07/2009
    This report describes the economic and healthcare environment in Ashe County, a rural community in the mountains of western North Carolina. The experience in Ashe County exemplifies the healthcare challenges faced in many rural areas across the country.

2008

2007

2006

2005

2004

2003

  • A Primer on Interpreting Hospital Margins
    North Carolina Rural Health Research and Policy Analysis Center
    Date: 07/2003
    This document explains the most commonly used measures of hospital profitability and how they are used to inform policy changes.
  • The Financial Effects of Critical Access Hospital Conversion
    University of Minnesota Rural Health Research Center
    Date: 01/2003
    This paper describes how the first wave of conversions to critical access hospital status affected rural hospitals' financial performances and organizational structures.

2002

2001

2000