Rural Health
Research Gateway

Home health

Completed Projects

Listed by project completion date. You can also view these projects alphabetically.

2024

  • Examining the Potential Impact of Multiple Payment Policies on Rural Versus Urban Home Health Agencies
    This study estimated the impact of three recent and upcoming Medicare home health payment policies (revised rural add-on payments, new prospective payment system, and value-based purchasing demonstration) on reimbursement for home health agencies based on rural-urban status, community factors, and home health agency characteristics.
    Research center: WWAMI Rural Health Research Center
    Topics: Health services, Healthcare access, Healthcare financing, Home health, Medicare, Post-acute care

2023

  • Availability of Healthcare Infrastructure in Minoritized Racial/Ethnic Groups
    This analysis compared the likelihood that selected healthcare infrastructure elements are available within rural and urban ZIP Code Tabulation Areas that contain versus do not contain a high proportion of historically disadvantaged minority residents.
    Research center: Rural and Minority Health Research Center
    Topics: American Indians and Alaska Natives, Health disparities and health equity, Healthcare access, Hispanics, Home health, Long-term care, Minority health
  • The Direct Care Workforce in Rural Areas
    In this study, we measured the supply of long-term care services and supports (LTSS) direct care workers relative to older adult populations in rural and urban areas and measure employer and industry turnover among LTSS direct care workers. We also explored how compensation levels – including wages and employer-based health insurance – are related to and predict worker turnover in the LTSS direct care workforce in rural and urban areas.
    Research center: University of Minnesota Rural Health Research Center
    Topics: Aging, Allied health professionals, Health services, Home health, Long-term care, Post-acute care, Poverty, Rural statistics and demographics, Social determinants of health, Workforce

2022

  • Aging in Place in Rural America: What Does It Look Like and How Can It Be Supported?
    In general, people want to age in place. This project looked at the structures in place to help them do so and how those structures vary by rurality. Federal, state, and local policy implications for improving health outcomes and quality of life for rural older adults aging in place were also be identified.
    Research center: University of Minnesota Rural Health Research Center
    Topics: Aging, Disabilities, Health disparities and health equity, Healthcare access, Home health, Long-term care, Social determinants of health
  • Post-acute Care Quality for Rural Medicare Beneficiaries
    This study examined rural post-acute care quality for rural Medicare beneficiaries and potential disparities in post-acute care between urban and rural providers. Publicly reported quality measures for rural skilled nursing facilities and home health agencies were compared with state and national averages as well as urban providers.
    Research center: WWAMI Rural Health Research Center
    Topics: Home health, Post-acute care

2021

  • Post-acute Care Trajectories for Rural Medicare Beneficiaries
    Utilization and costs of post-acute care for Medicare fee-for-service beneficiaries have grown rapidly during the last decade. This study examined post-acute care utilization for rural Medicare beneficiaries following acute hospitalization, describing use of home health and skilled nursing care and trajectories of care across settings.
    Research center: WWAMI Rural Health Research Center
    Topics: Aging, Allied health professionals, Health services, Home health, Hospitals and clinics, Medicare, Nurses and nurse practitioners, Post-acute care

2020

  • Assessing Potential Unmet Need for Home Healthcare in Rural Areas
    This study estimated potential unmet need for home healthcare in rural areas for fee-for-service Medicare beneficiaries. We compared rates of home healthcare utilization in rural areas with urban areas, accounting for acute hospital discharges and utilization of inpatient rehabilitation facilities and skilled nursing facilities.
    Research center: WWAMI Rural Health Research Center
    Topics: Health services, Home health, Hospitals and clinics, Medicare, Post-acute care

2019

2018

2017

  • Examination of Rural and Frontier Home Health Services
    This mixed-method study is an in-depth examination of access to and utilization of home health services provided in rural and frontier areas. The study begins to explore how influential patient-centered decision-making is in determining the type of post-acute care services used by rural and frontier Medicare beneficiaries.
    Research center: North Dakota and NORC Rural Health Reform Policy Research Center
    Topics: Frontier health, Home health, Post-acute care

2016

  • Access To and Use of Home and Community-Based Services in Rural Areas
    This study will use data from the 2010 Medicaid Analytic eXtract (MAX) file and in-depth policy reviews and interviews in four states to examine differences in the use of institutional and home and community-based service (HCBS) use by older adults across urban and rural areas, and the policy and community factors that contribute to differences or comparability in use.
    Research center: Maine Rural Health Research Center
    Topics: Aging, Home health, Long-term care
  • Access to Home Care Services in the Rural United States
    This study will identify and describe the scope of home health services required to meet current and future needs in rural areas of the U.S., identify current and anticipated barriers to accessing those needs, and describe ways that may help overcome these barriers.
    Research center: WWAMI Rural Health Research Center
    Topics: Aging, Home health
  • Use of Home Health Services Among High Risk Rural Medicare Patients: Patient, Service, and Community Factors Associated with Hospital Readmission
    This study will examine the 60-day post-acute care outcomes of rural Medicare patients who were discharged from hospitals and admitted to home healthcare services. Key predictors include home health services provided, type of Medicare home health reimbursement, and available community healthcare resources.
    Research center: WWAMI Rural Health Research Center
    Topics: Home health, Hospitals and clinics, Medicare, Post-acute care

2014

  • Adequacy of Home Health Care Availability in Rural Counties
    This project will describe current distribution of HHC agencies, by ZIP Code and county of facility location and of service provision, across levels of rurality. Second, the project will estimate whether rural populations at risk for inadequate access to HHC, based on projected population need population / provider ratios.
    Research center: Rural and Minority Health Research Center
    Topics: Aging, Home health
  • Intensity of Service Provision for Medicare Beneficiaries Utilizing Home Health Services
    This study will assess whether Medicare beneficiaries in rural areas receive a lower intensity of home health (HH) services compared to their urban counterparts. Specifically, the study will examine (1) the distribution of levels of HH services for four conditions: joint (hip and knee) replacement, stroke, end-stage renal disease (ESRD), and diabetes; (2) the distribution of type of provider for each condition across the levels of rurality; and (3) the median charge and payment per beneficiary for these services across the levels of rurality.
    Research center: Rural and Minority Health Research Center
    Topics: Chronic diseases and conditions, Diabetes, Home health, Medicare
  • Rural and Urban Differences in Case-Mix Among Recipients of Home Health Care
    We will examine current patient case-mix for the Medicare population receiving skilled health care from a home health agency to determine if there are rural or race/ethnicity-based disparities with regards to receipt of services and clinical acuity indicators.
    Research center: Rural and Minority Health Research Center
    Topics: Health disparities and health equity, Home health, Medicare

2005

  • Impact of the Home Health PPS on Access in Rural America
    This study is designed to help policymakers understand whether patterns of home care use in rural communities have been affected by the PPS. Analyses will provide information on the characteristics of the patients served, the number and mix of services rendered, and quality of care.
    Research center: NORC Walsh Center for Rural Health Analysis
    Topics: Home health, Medicare Prospective Payment System (PPS)
  • Medicare Beneficiary Outcomes in Rural and Urban Home Health Agencies
    This study will compare the performance of rural and urban home care agencies, and identify agency characteristics that contribute to better patient care outcomes.
    Research center: NORC Walsh Center for Rural Health Analysis
    Topics: Home health, Medicare Prospective Payment System (PPS), Quality
  • National Study of Home Health Access in Rural America
    This project will develop home health care service areas that will allow for the measurement of access to home health care for rural Medicare beneficiaries who die of cancer, and recommend options for increasing access to home health care in underserved rural areas.
    Research center: FORHP-funded Individual Grantees
    Topics: Cancer, Health services, Home health, Hospice and palliative care, Medicare
  • Post-Acute Care: A Rural and Urban Comparison
    This multi-phase analysis examines whether discharge patterns for and use of post-acute care services by rural and urban hospitalized Medicare beneficiaries differ and, if they do, what are the sources of these different patterns.
    Research center: NORC Walsh Center for Rural Health Analysis
    Topics: Home health, Long-term care, Medicare, Post-acute care
  • Rural and Urban Differences in Utilization of Formal Home Care
    This project uses the Medical Expenditure Panel Survey and other data sources to examine rural and urban differences in the utilization and costs of formal home care, including changes in utilization patterns and costs across residence types over time.
    Research center: FORHP-funded Individual Grantees
    Topics: Home health, Long-term care

2004

  • State of Rural Health Provider Organizations and Health Professional Shortages
    This study addresses the convergence of health professions shortages and financial limitations among rural hospitals and rural home health providers. Successful strategies or best practices implemented in rural areas to address the shortages will be identified.
    Research center: Southwest Rural Health Research Center
    Topics: Allied health professionals, Home health, Nurses and nurse practitioners, Workforce

2002

2001

2000