Research
Completed Projects
2019
Analysis of Trends in Characteristics of Rural Beneficiaries Enrolling in Medicare Advantage Plans
This work compared characteristics of rural and urban beneficiaries enrolling in Medicare Advantage (MA) plans, including their age, health status, income, and race/ethnicity. Analyses included the consequences of increasing use, promoted by policy choices, of a market-based approach in the Medicare program.
Funder: Office of Rural Health Policy
Lead researcher: Tim McBride, PhD
Publications:
Comparing Rural and Urban Medicare Advantage Beneficiary Characteristics. Date: 3/2019
The Rural MACRA Experience
This project studied primary care clinician participation in the Medicare Quality Payment Program (QPP). Low participation rates could identify opportunities to extend the QPP to more clinicians serving non-metropolitan populations.
Funder: Office of Rural Health Policy
Lead researcher: A. Clinton MacKinney, MD, MS
Publications:
Primary Care Clinician Participation in the CMS Quality Payment Program. Date: 4/2019
Changes to the Merit-based Incentive Payment System Pertinent to Small and Rural Practices, 2018. Date: 11/2018
2018
Health Insurance Marketplaces, Medicaid, and Uncompensated Care: The Rural Impact
This project provided an in-depth analysis of Health Insurance Marketplace (HIM) plan design, specifically measuring the availability and prevalence of high-deductible plans in rural as compared to urban areas.
Funder: Office of Rural Health Policy
Lead researcher: Tim McBride, PhD
Publications:
The Market Mechanism & Health Insurance in Rural Places: Lessons Learned from an Economics & Policy Perspective. Date: 2/2019
Distance and Networks: A Regional Analysis of Health Insurance Marketplaces. Date: 1/2018
Rural/Urban Analysis on Individual Insurance Market Topics - A RUPRI Special Data Release. Date: 8/2017
What Does Healthcare Delivery System Reconfiguration Portend for Rural Health?
This project worked to understand the dynamic relationships between healthcare system changes and healthcare network configurations that involve rural providers.
Funder: Office of Rural Health Policy
Lead researcher: Keith Mueller, PhD
Publications:
The Rural Hospital and Health System Affiliation Landscape – A Brief Review. Date: 11/2018
Trends in Hospital System Affiliation, 2007-2016. Date: 10/2018
2017
After Hospital Closure: Pursuing High Performance Rural Health Systems without Inpatient Care
Opportunities for rural communities to develop a high performance rural health system after hospital closure, including three case studies that describe real-world transitions from hospital-based locus of care to new models of care delivery in rural places.
Funder: Office of Rural Health Policy
Lead researcher: Keith Mueller, PhD
Publications:
After Hospital Closure: Pursuing High Performance Rural Health Systems without Inpatient Care. Date: 6/2017
Assessing the Impact of Medicaid Policy Changes
This project was designed to: 1) clearly articulating the rural considerations in Medicare reform by synthesizing information on the impact of Medicare on rural people, places, and providers; 2) assessing the impact of specific proposals to reform Medicare; and 3) analyzing the effects of market-based reform on rural populations, focusing on specific provisions of Medicare reform proposals.
Funder: Office of Rural Health Policy
Lead researcher: Keith Mueller, PhD
Publications:
Distribution of Disproportionate Share Hospital Payments to Rural and Critical Access Hospitals. Date: 11/2017
Changing Rural and Urban Enrollment in State Medicaid Programs. Date: 5/2017
Assessing the Stability of Rural Pharmacy Services
This project's goals included deepening our understanding of economic forces beyond the immediate control of local pharmacies that are affecting their ability to remain in business, assessing the future of sole community retail pharmacies in rural places, and exploring alternative modalities for delivering pharmacy services in the absence of retail pharmacy businesses.
Funder: Office of Rural Health Policy
Lead researcher: Fred Ullrich, BA
Publications:
Telepharmacy Rules and Statutes: A 50-State Survey. Date: 5/2018
Financial Issues Challenging Sustainability of Rural Pharmacies. Date: 8/2017
Issues Confronting Rural Pharmacies after a Decade of Medicare Part D. Date: 4/2017
Telepharmacy Rules and Statutes: A 50-State Survey
- Supplemental Table. Date: 4/2017
Do Rural Health Clinics (RHCs) Provide Services that Lower Rates of Preventable Hospitalizations?
This project used 3 years of individual-level Medicare claims data to analyze the relationship between receiving care at a Rural Health Clinic (RHC) and the likelihood of potentially preventable hospitalization and/or potentially preventable emergency department (ED) visits. Further, it explored this relationship among both fee-for-service Medicare enrollees and Medicare-Medicaid dual eligibles.
Funder: Office of Rural Health Policy
Lead researcher: Brad Wright, PhD
Publications:
The Relationship Between Rural Health Clinic Use and Potentially Preventable Hospitalizations and Emergency Department Visits Among Medicare Beneficiaries. Date: 7/2017
State Policy Issues That May Impact HIMs’ Success in Rural Places: A Regional Analysis
Goals of this project included gathering detailed data and providing analysis and policy recommendations on issues relating to network adequacy and service areas for HIMs, with additional investigation of other state-level policy variables (such as the Medicaid expansion decision) which may have a confounding or moderating effect on the relationship between network adequacy and enrollees’ choices and premiums.
Funder: Office of Rural Health Policy
Lead researcher: Tim McBride, PhD
Publications:
Rural Enrollment in Health Insurance Marketplaces, by State. Date: 1/2017
Health Insurance Marketplaces: Premium Trends in Rural Areas. Date: 1/2016
Rural Enrollment in Health Insurance Marketplaces, by State. Date: 10/2015