Rural Health
Research Gateway

Uninsured and underinsured

Current Projects

  • A Closer Examination of Rural Hospital Bypass
    This project will estimate the rural hospital bypass rate using all-payer claims data for a set of states and compare patients based on the inpatient treatments and procedures received relative to those routinely provided by rural facilities.
    Research center: Rural Health Equity Research Center
    Topics: Critical Access Hospitals (CAHs), Health reform, Health services, Healthcare access, Hospitals and clinics, Medicaid and CHIP, Medicare, Medicare Advantage (MA), Minority health, Private health insurance, Uninsured and underinsured
  • Changes in Access to Care During the Public Health Emergency: Examining Rural-Urban Disparities by Insurance Type
    Using the Behavioral Risk Factor Surveillance System data, this study will compare key access to care indicators among adult beneficiaries residing in rural and urban areas before and after the Public Health Emergency by types of health insurance. Researchers will explore state-level policy variations, such as the Affordable Care Act Medicaid expansion and COVID-19-related Medicaid coverage for uninsured adults.
    Research center: Rural and Underserved Health Research Center
    Topics: Health disparities and health equity, Healthcare access, Healthcare financing, Medicaid and CHIP, Uninsured and underinsured
  • Changes in Rural Health Insurance Coverage, 2020-2023
    This project uses secondary data sources to characterize changes in health insurance coverage during the public health emergency (2020-2023) for rural and urban people according to demographic, employment, and geographic characteristics, and to describe how changes in federal policies impacted coverage. Researchers also assess the potential impact of maintaining more robust marketplace subsidies on rural and urban coverage rates once the "unwinding" of continuous Medicaid enrollment is complete.
    Research center: RUPRI Center for Rural Health Policy Analysis
    Topics: Health reform, Healthcare financing, Medicaid and CHIP, Medicare, Medicare Advantage (MA), Private health insurance, Rural statistics and demographics, Uninsured and underinsured
  • Comparing Across Health Indices: Differences by Rurality, Missingness, and Associations With Health Outcomes
    The purpose of this study is to describe and compare existing area-level indices of vulnerability by rurality and to examine associations between indices and health outcomes of interest by area-level measures of rurality.
    Research center: Rural Health Equity Research Center
    Topics: Health disparities and health equity, Healthcare access, Poverty, Rural statistics and demographics, Social determinants of health, Uninsured and underinsured
  • Identifying High-Need Counties for Resource Planning
    The primary aim of this project is to use data examining health care infrastructure, chronic disease prevalence, and the socioeconomic environment to create a metric for classifying rural counties based on needs and resources.
    Research center: Rural and Minority Health Research Center
    Topics: Chronic diseases and conditions, Diabetes, Health disparities and health equity, Healthcare access, Maternal health, Obesity, Oral health, Physicians, Poverty, Public health, Rural statistics and demographics, Social determinants of health, Uninsured and underinsured, Workforce
  • Out-of-Pocket Spending Among Privately Insured Rural and Urban Residents
    Out-of-pocket spending for healthcare services has been on the rise as deductibles and other cost-sharing requirements among the privately insured increase. This study compares rural and urban out-of-pocket healthcare spending to identify whether rural residents have been disproportionately affected by this trend.
    Research center: Maine Rural Health Research Center
    Topics: Healthcare access, Healthcare financing, Private health insurance, Public health, Uninsured and underinsured
  • Postpartum Morbidity and Mortality and Health Care Utilization in Rural vs. Urban Communities
    Using 2006-2018 data from the National Health Interview Survey linked to the National Death Index through 2019, this project will examine postpartum mortality among rural and urban residents. We will also evaluate differences in health, health care utilization, and barriers to care across rural and urban communities.
    Research center: University of Minnesota Rural Health Research Center
    Topics: Health disparities and health equity, Healthcare access, Maternal health, Medicaid and CHIP, Mental and behavioral health, Private health insurance, Social determinants of health, Uninsured and underinsured, Women
  • Review of Current Research on Rural/Urban Differences in Social Determinants of Health
    Social determinants of health are social, economic, and community variables that influence health outcomes. This project will synthesize the extant literature on rural/urban differences in the social determinants of health, culminating in a comprehensive report that includes a summary of information gaps and further research needs.
    Research center: Rural and Underserved Health Research Center
    Topics: Health disparities and health equity, Healthcare access, Poverty, Quality, Social determinants of health, Uninsured and underinsured
  • Rural-Urban Differences in Out-of-Pocket Prescription Drug Spending
    Using data from the 2014-17 Medical Expenditure Panel Survey, this study will examine rural-urban differences in out-of-pocket costs for prescription drugs. Additional analyses will examine rural-urban differences in out-of-pocket costs by type of medication and third party payer.
    Research center: Maine Rural Health Research Center
    Topics: Pharmacy and prescription drugs, Uninsured and underinsured
  • Suicide Mortality: A Comparison of Urban and Rural Rates
    Suicide contributes to significant mortality in the United States. This project will examine the variation in suicide rates by geography and explore its driving factors among urban and rural areas in the United States from 2018 to 2021. The research design of this study will adopt a cross-sectional, retrospective approach, using secondary data.
    Research center: Rural Health Equity Research Center
    Topics: Health disparities and health equity, Healthcare access, Mental and behavioral health, Public health, Rural statistics and demographics, Social determinants of health, Uninsured and underinsured
  • Updating and Exploring the Burden of Potentially Avoidable Emergency Department Visits in Rural U.S. Communities
    This project will update the Federal Office of Rural Health Policy's research portfolio on potentially avoidable emergency department (ED) visits among rural residents across the U.S., particularly as they relate to ambulatory care sensitive conditions (ACSCs). Data on ACSC-related ED visits will be drawn from the State Emergency Department Databases, and findings will be stratified by census region, patient's place along the urban-rural continuum, and by race/ethnicity.
    Research center: Southwest Rural Health Research Center
    Topics: Emergency medical services (EMS) and trauma, Healthcare access, Medicaid and CHIP, Uninsured and underinsured