Post-acute care
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
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Estimated Impacts of Multiple Payment Policies on Rural-Serving Home Health Agencies
Policy Brief
WWAMI Rural Health Research Center
Date: 07/2024
This brief examines the estimated impact of three Medicare payment policy changes on home health agency (HHA) reimbursement by rural-serving status, geographic location, and select HHA characteristics. -
Nursing Home Closures and Access to Post-Acute Care and Long-Term Care Services in Rural Areas
Journal Article
RUPRI Center for Rural Health Policy Analysis
Date: 01/2024
Nursing home closures have raised concerns about access to post-acute care (PAC) and long-term care (LTC) services. In this study, researchers estimate the additional distance rural residents had to travel to access PAC and LTC services because of nursing home closures.
2022
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Quality of Home Health Agencies Serving Rural Medicare Beneficiaries
Policy Brief
WWAMI Rural Health Research Center
Date: 02/2022
This policy brief describes the quality of home health agencies (HHAs) by rural-serving status. While quality of patient care star ratings were not associated with rural-serving status, rural HHAs and urban HHAs that serve rural patients had higher patient experience star ratings than urban HHAs that do not serve rural patients. -
Quality of Skilled Nursing Facilities Serving Rural Medicare Beneficiaries
Policy Brief
WWAMI Rural Health Research Center
Date: 02/2022
This policy brief describes the quality of skilled nursing facilities (SNFs) by rural-serving status. While overall star ratings and staffing star ratings were not associated with rural-serving status, rural SNFs and urban SNFs that serve rural patients had lower quality star ratings compared to urban SNFs that do not serve rural patients.
2021
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Post-acute Care Trajectories for Rural Medicare Beneficiaries: Planned Versus Actual Hospital Discharges to Skilled Nursing Facilities and Home Health Agencies
Policy Brief
WWAMI Rural Health Research Center
Date: 03/2021
This policy brief describes trajectories for rural Medicare beneficiaries following hospital discharge, including differences between planned and actual discharge to skilled nursing facilities and home health agencies. More than 40% of beneficiaries for whom home health care was indicated did not receive care from a home health agency.
2020
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Variation in Use of Home Health Care Among Fee-for-Service Medicare Beneficiaries by Rural-Urban Status and Geographic Region: Assessing the Potential for Unmet Need
Policy Brief
WWAMI Rural Health Research Center
Date: 02/2020
This study describes use of home healthcare by rural-urban status and geographic region. Findings suggest geographic region drives variation more than rural-urban status. Unmet need may be highest in the most remote rural counties and rural counties within the West North Central, East North Central, Mountain, and Pacific Census Divisions.
2019
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Differences in Care Processes Between Community-Entry Versus Post-Acute Home Health for Rural Medicare Beneficiaries
Policy Brief
WWAMI Rural Health Research Center
Date: 04/2019
This study describes home healthcare processes for rural Medicare beneficiaries who are admitted from the community (community-entry) versus those who are admitted following an inpatient stay (post-acute). Care processes include timely initiation of care, length of stay, and services provided (e.g., physical therapy, medical social work).
2018
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Service Provision and Quality Outcomes in Home Health for Rural Medicare Beneficiaries at High Risk for Unplanned Care
Journal Article
WWAMI Rural Health Research Center
Date: 06/2018
This study examined service provision and quality outcomes among rural Medicare beneficiaries who used home health from 2011-2013 and were at high risk for unplanned care. More skilled nursing visits and visits by more types of providers were associated with higher hospital readmission and emergency department use and lower community discharge.
2017
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Rural Long-Term Services and Supports: A Primer
RUPRI Health Panel: Rural Policy Analysis and Applications
Date: 11/2017
This paper provides policymakers and other interested stakeholders a primer on the fundamentals of the rural LTSS system, rural access to and use of LTSS, and the opportunities and limitations of current federal and state LTSS policy for advancing rural health system transformation toward a high-performing rural health delivery system.
2015
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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.
2012
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Effect of Outpatient Visits and Discharge Destination on Potentially Preventable Readmissions for Congestive Heart Failure and Bacterial Pneumonia
Policy Brief
Upper Midwest Rural Health Research Center
Date: 03/2012
This brief explores the relationship between potentially preventable readmissions and use of outpatient follow-up care, discharge destination, rural versus urban patients, and time to follow-up care. These factors were examined in a large population of Medicare patients with hospital stays for congestive heart failure or bacterial pneumonia. -
Effect of Outpatient Visits and Discharge Destination on Potentially Preventable Readmissions for Congestive Heart Failure and Bacterial Pneumonia (Final Report)
Upper Midwest Rural Health Research Center
Date: 03/2012
This study explored the relationship between potentially preventable readmissions and use of outpatient follow-up care, discharge destination, rural versus urban residence of the patient, and time to follow-up care.
2011
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Will Bundling Work in Rural America? Analysis of the Feasibility and Consequences of Bundled Payments for Rural Health Providers and Patients
Policy Brief
Upper Midwest Rural Health Research Center
Date: 09/2011
This report assesses the challenges and consequences for rural providers and patients of implementing bundled payments for acute and post-acute care episodes; explores impacts on care quality under a facility-physician bundled payment system; and describes potential modifications to bundling proposals and steps that could address rural issues.
2010
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Alternatives to the Outpatient Prospective Payment System: Assessing the Impact on Rural Hospitals
NORC Walsh Center for Rural Health Analysis
Date: 04/2010
The purpose of this policy brief is to explore alternatives to the outpatient prospective system and how these options would affect rural hospitals.
2009
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Rural Issues Related to Bundled Payments for Acute Care Episodes
Policy Brief
Upper Midwest Rural Health Research Center
Date: 06/2009
Bundling Medicare payments has been proposed as a way of encouraging providers to find innovative, cost-reducing strategies to provide better coordinated care. This brief describes challenges to implementing bundled payments in rural settings and discusses potential contracting and reimbursement strategies to address the challenges.
2005
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Patterns of Post-Acute Utilization in Rural and Urban Communities: Home Health, Skilled Nursing, and Inpatient Medical Rehabilitation
NORC Walsh Center for Rural Health Analysis
Date: 03/2005
This report describes rural Medicare beneficiaries' patterns of post-acute utilization of home health services, skilled nursing facilities, and inpatient rehabilitation facilities. -
Rural Implications of Medicare's Post-Acute-Care Transfer Payment Policy
Journal Article
NORC Walsh Center for Rural Health Analysis
Date: 2005
Examines how the initial policy change affected rural and urban hospitals and investigates the likely impact of the FY2004 expansion and other possible future expansions. The authors conclude that rural hospitals are not disproportionately harmed by the post-acute-care transfer policy.
2004
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Exploring the Impact of Medicare's Post-Acute Care Transfer Payment Policy on Rural Hospitals
NORC Walsh Center for Rural Health Analysis
Date: 07/2004
This policy analysis brief describes a change in Medicare post-acute transfer payment policy and its impact on rural and urban hospitals. It includes data on the financial impact and hospital discharge behavior before and after the change. -
Rural Implications of Medicare's Post-Acute Care Transfer Payment Policy
NORC Walsh Center for Rural Health Analysis
Date: 06/2004
This study examines the behavioral and financial impacts of the initial 10-DRG policy and projects the likely financial impact of extending the policy to cover additional DRGs or discharges to swing beds.
2002
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Rural Dimensions of Medicare Reimbursement for Inpatient and Outpatient Institutional and Physician Services
NORC Walsh Center for Rural Health Analysis
Date: 12/2002
This report examines major Medicare payment policies from the rural perspective and summarizes major payment policies with explicit rural dimensions that directly affect physicians and hospitals. It looks at whether direct rural impacts are consistent with legislative and regulatory intentions.
2001
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Quality of Medicare Outpatient Claims Data and Its Implications for Rural Outpatient Payment Policy
NORC Walsh Center for Rural Health Analysis
Date: 12/2001
This study analyzes Medicare outpatient claims to see if the relatively poor quality of small rural hospitals' claims data have amplified the negative effects of the new payment system on small hospitals. -
Improving the Quality of Outpatient Care for Older Patients With Diabetes: Lessons From a Comparison of Rural and Urban Communities
Journal Article
WWAMI Rural Health Research Center
Date: 08/2001
Compares the quality of diabetic care received by patients in rural and urban communities in Washington State. Concludes that large rural towns may provide the best conditions for high-quality care-growing communities that serve as regional referral centers and have an adequate, but not excessive, supply of generalist and specialist physicians.