Research

Current Projects

An Insurance Profile of Rural America: A Chartbook

This chartbook will describe current conditions and recent trends in rural health insurance by drawing from census data and other sources. Tables and maps, accompanied by bulleted policy takeaways, will compare rural and urban coverage sources, the degree of competition among issuers, and the share of the population who are underinsured.
Funder: Office of Rural Health Policy
Lead Researcher: Tim McBride, PhD

Changes in Hospital Services Offered After Mergers, Acquisition and Affiliations

Hospitals have affiliated with systems in increasing numbers since 2007, as of 2016 reaching 56.1 percent of nonmetropolitan prospective payment system hospitals and 42.8 percent of critical access hospitals. This project will examine resulting changes in services offered by rural hospitals, hypothesizing shifts of some services to regional hospitals and growth in some service lines.
Funder: Office of Rural Health Policy
Lead Researcher: Keith Mueller, PhD

Continuous Services in the Absence of Retail Pharmacies in Rural Communities

This project will identify communities with and without pharmacies by rurality and describe the differences in population and market characteristics of communities with and without any pharmacies. Research findings regarding "pharmacy deserts" will inform alternative methods of securing services based on community characteristics.
Funder: Office of Rural Health Policy
Lead Researcher: Keith Mueller, PhD

Differences in Rural and Urban Hospital Cost Structures: Evidence and Implications

The project will compare fixed-to-variable cost ratios in U.S. rural and urban hospitals. We hypothesize that rural hospitals will realize proportionally greater fixed costs than urban hospitals, suggesting important hospital payment system implications.
Funder: Office of Rural Health Policy
Lead Researcher: Tim McBride, PhD

Financial Risk Assumption Among Rural Healthcare Providers

This project will assess rural/urban providers' participation in different payment models and assumption of financial risk in the Medicare Quality Payment Program. We will conduct qualitative interviews to examine rural providers' motivations and preparedness for participating in different risk-bearing payment models.
Funder: Office of Rural Health Policy
Lead Researcher: Xi Zhu, PhD

How Does Participation in Medicare Accountable Care Organizations Affect Rural Hospital Financial Outcomes?

This project will examine the impact of Medicare Accountable Care Organizations' (ACOs') participation on rural hospitals' financial outcomes. Findings from this project will provide policy-relevant information on how ACO participation affects rural hospitals' financial bottom lines, contributing to further program design.
Funder: Office of Rural Health Policy
Lead Researcher: Xi Zhu, PhD

Medicare Beneficiary Access to Prescription Drugs Under Part D

This study will build on RUPRI Center work describing patterns of enrollment into Medicare Part D plans (including access to zero deductible plans) by using transaction files to analyze how medications are actually acquired and implications for access to local pharmacy services.
Funder: Office of Rural Health Policy
Lead Researcher: Keith Mueller, PhD

Rural and Racial/Ethnic Disparities in COVID-19 Mortality Rates and Associations with Community Characteristics

This project examines rural and racial/ethnic disparities in COVID-19 mortality rates during the peak of COVID-19 deaths (December 2020-January 2021). We will examine mortality rates across non-metropolitan and metropolitan counties overall and stratified by racial/ethnic composition and U.S. census region, and spatial regression methods will be used to identify community characteristics (e.g., rurality, sociodemographic, health conditions, and health care access) associated with mortality rates at the county level.
Funder: Office of Rural Health Policy
Lead Researcher: Whitney Zahnd, PhD

Rural-Urban Differences in Performance of Clinicians Participating in MIPS

This project will use quantitative methods to compare MIPS performance and reported measures for clinicians working in rural and urban areas, overall, and by practice size; evaluate differences in spending per beneficiary, overall, and stratified by drugs and medical services for rural and urban clinicians participating in MIPS; and compare MIPS performance and spending for clinicians serving a large proportion of racial/ethnic minorities in rural and urban areas.
Funder: Office of Rural Health Policy
Lead Researcher: Hari Sharma, PhD

Medicare Beneficiary Access to Prescription Drugs Under Part D

For more information on current projects funded under cooperative agreement with the Federal Office of Rural Health Policy (ORHP), see the Rural Health Research Gateway