Rural Health
Research Gateway

Post-acute care

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
  • Rural and Urban Cancer Survivors' Follow-Up Care Experiences
    This project examined rural vs. urban differences in cancer survivors' follow-up care experiences using the 2017 Medical Expenditure Panel Survey.
    Research center: Rural and Underserved Health Research Center
    Topics: Cancer, Care management, Health disparities and health equity, Health services, Healthcare access, Physicians, Post-acute care, Quality

2023

  • 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

  • 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

  • Hospital Readmission Following Care in a Swing Bed
    This study built on our portfolio of swing bed work by examining the rate of hospital readmission for patients who receive post-acute care in swing beds compared to skilled nursing facilities and informed the discussion on use, cost, and benefit of swing bed care.
    Research center: North Carolina Rural Health Research and Policy Analysis Center
    Topics: Hospitals and clinics, Medicare, Medicare Prospective Payment System (PPS), Post-acute care, Quality
  • How Do Costs for Rural Medicare Beneficiaries Using Swing Beds Compare to Those Using Skilled Nursing Facilities?
    This study estimated and compared total Medicare expenditures for episodes of care that include post-acute stays in either swing beds or skilled nursing facilities (SNFs). Results informed federal and state agencies, rural providers and communities as to how post-acute care in swing bed versus a SNF affects the trajectory of costs and utilization for rural Medicare beneficiaries.
    Research center: North Carolina Rural Health Research and Policy Analysis Center
    Topics: Long-term care, Medicare, Post-acute care
  • How Medicare Payment Standardization Affects the Perceived "Cost" of Post-Acute Care Provided in Critical Access Hospital Swing Beds
    Medicare-allowed charges are adjusted for geographic cost differences and payments that support larger Medicare program goals. This study aimed to identify the effects of the payment standardization method on the perceived "cost" of post-acute care provided in Critical Access Hospital swing beds.
    Research center: North Carolina Rural Health Research and Policy Analysis Center
    Topics: Critical Access Hospitals (CAHs), Hospitals and clinics, Medicare, Post-acute care
  • 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

  • Diverging Populations Served by the Medicare Home Health Benefit: Comparison of Post-acute vs. Community-entry Home Health in Rural Areas
    This study examined differences between rural, fee-for-service Medicare beneficiaries who were admitted to home health from the community (community-entry) and those who were admitted to home health following an inpatient stay (post-acute) in terms of their clinical and non-clinical characteristics as well as the communities in which they live.
    Research center: WWAMI Rural Health Research Center
    Topics: Health services, Home health, Medicare, Post-acute care
  • Financial Impact of Reimbursing CAH Swing Bed Days at the SNF PPS Rate
    This study assessed the financial impact of changing Critical Access Hospital (CAH) swing bed reimbursement from the cost-based system to the skilled nursing facility (SNF) prospective payment system (PPS).
    Research center: North Carolina Rural Health Research and Policy Analysis Center
    Topics: Critical Access Hospitals (CAHs), Healthcare financing, Long-term care, Medicare, Post-acute care

2018

  • Measuring the Quality of Swing Bed Care in Critical Access Hospitals
    This project identified quality measures to be used by Critical Access Hospitals to assess the quality of care provided to their swing bed patients, and recommend appropriate uses of the measures.
    Research center: University of Minnesota Rural Health Research Center
    Topics: Hospitals and clinics, Post-acute care, Quality
  • Post-Acute Care for Rural Medicare Beneficiaries
    This project described the variation in the volume, mix and financial importance of post-acute services to rural hospitals; identified hospital and community characteristics associated with variation in post-acute services provided by rural hospitals; and determined where rural Medicare beneficiaries receive post-acute services.
    Research center: North Carolina Rural Health Research and Policy Analysis Center
    Topics: Hospitals and clinics, Long-term care, Post-acute care
  • Use of Home Health Services Among High Risk Rural Medicare Patients: Patient, Service, and Community Factors Associated with Outcomes of Care
    This study examined outcomes of care for rural Medicare patients who were discharged from hospitals and admitted to home healthcare for post-acute services. Outcomes included emergent care use and re-hospitalization during the home health admission and community discharge.
    Research center: WWAMI Rural Health Research Center
    Topics: Health services, Home health, Medicare, Post-acute care

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

2015

  • Post-Acute Stroke Care Delivery for Rural Medicare Beneficiaries
    Post-stroke rehabilitation has been shown to improve outcomes among patients, but the limited available evidence suggests that rural residents and African Americans are less likely to receive this care. Our analysis will determine whether residence or race-based disparities exist in post-stroke care, after taking into consideration differences in patient status.
    Research center: Rural and Minority Health Research Center
    Topics: Medicare, Minority health, Post-acute care

2014

  • High Quality Rural Hospitals and Post-Acute Care Providers
    This project will use several large longitudinal national databases to model alternative ways of identifying high quality rural hospitals, analyze factors related to quality in rural hospitals, and examine the relationship between the quality of care provided by rural hospitals and the quality of care provided by nursing homes and home health agencies within rural communities.
    Research center: University of Minnesota Rural Health Research Center
    Topics: Hospitals and clinics, Post-acute care, Quality

2012

  • Effect of Type and Timeliness of Post-Acute Care on Preventable Hospital Readmissions for Rural Medicare Beneficiaries
    The purpose of this project is to: 1) determine how location of hospitals used for initial admissions by rural patients affects readmission rates; 2) assess how the use of swing beds affects rural patients' readmissions; and 3) examine the impact of the type and timeliness of post-acute care, including home health care, skilled nursing, and physician visits, on readmissions for rural patients.
    Research center: Upper Midwest Rural Health Research Center
    Topics: Hospitals and clinics, Medicare, Post-acute care

2008

  • Rural Dimensions of Medicare Payment Policies
    This project examines major Medicare fee-for-service payment policies from the rural perspective.
    Research center: NORC Walsh Center for Rural Health Analysis
    Topics: Medicare, Post-acute care

2006

2005

  • 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

2003

Unknown

  • Acute and Post-Acute Care Bundled Payments and Care Coordination in Rural Environments
    The purpose of this project is to: 1) Identify opportunities and potential unintended consequences for rural providers of current proposals for implementing bundled payments for acute and post-acute care episodes; 2) Describe modifications to current bundling proposals that will address rural-specific issues; and 3) Identify quality measures related to care coordination that are relevant for rural patients whose services are reimbursed by a bundled payment.
    Research center: Upper Midwest Rural Health Research Center
    Topics: Health services, Post-acute care, Quality